No appetite? How to get nutrition during cancer treatment

Sometimes cancer or cancer treatment can affect your appetite.

Though you might not feel like eating, it's important to do what you can to maintain your calorie, protein and fluid intake during cancer treatment. Use this information to help plan meals and snacks that will be more appealing and provide the nutrition you need to get better.

Keep in mind that in some cases, such as advanced cancer, eating may not affect the outcome of your illness or treatment. In these situations, trying to follow specific dietary guidelines, such as adhering to a low-sodium or low-fat diet, may not be practical.

Sometimes caregivers or family members can unintentionally add stress by pushing or trying to force you to eat certain foods. Ask your doctor how carefully you need to follow specific dietary guidelines.

Mealtime

• Eat small amounts more frequently. If you feel full after eating only a small amount, try eating small amounts throughout the day when you get the urge to eat. You may find it easier to eat small amounts several times each day rather than at mealtimes.
• Schedule mealtimes. If you never seem to feel hungry, it's often helpful to eat according to a schedule rather than to rely on appetite.
• Eat more when you're hungry. Take advantage of the times when you feel your best to eat more. Many people have their best appetite in the morning, when they're rested.
• Limit fluids during meals. Liquids can fill you up and limit your intake of higher calorie foods. It may help to drink most of your liquids at least a half-hour before or after meals.
• Create a pleasant mealtime atmosphere. For example, use soft music, candles or nice place settings.
• Make meals more appealing. Select foods with a variety of colors and textures to make your meals more appealing.
• Avoid smells that make you sick. Pay attention to smells, as certain scents may decrease your appetite or bring on nausea. Avoid smells that have this effect on you.

Snack time

• Keep snacks handy. Have snacks readily available so that you can eat when you're up to it.

  Cheese, ice cream, canned fruit in heavy syrup, dried fruit, nuts, peanut butter with crackers, cheese with crackers, muffins, cottage cheese and chocolate milk are examples of high-calorie snacks requiring little or no preparation.

  Don't be too concerned that some of these options are high in cholesterol or fat. Once you regain your appetite, you can focus on lower calorie snacking options.

• Have a bedtime snack. Bedtime may be a good time to snack because your appetite for the next meal won't be affected.

Anytime

• Try cold foods. Foods that are cold or at room temperature may be more appealing, particularly if strong smells bother you. Cold sandwiches or main-dish salads, such as pasta salad or tuna, chicken, egg and ham salads, are good choices.
• Experiment with foods. Once-favorite foods may no longer appeal to you, while foods you were never fond of may become appealing.
• Exercise to increase your appetite. Regular exercise may help stimulate your appetite. Ask your doctor whether exercise is safe for you.
• Try shakes and instant drink mixes. Nutritional supplement drinks, such as instant breakfast mixes and canned or powdered shakes, can provide a significant amount of calories and require little or no preparation. It may be easier for you to drink rather than to eat something.
• Make your own smoothies. Combine fruits and vegetables with yogurt, ice cream or milk to make your own smoothies. Choose the ingredients that are most appealing to you. This option takes more effort than pre-made smoothies, but it allows you to customize the recipe to your tastes and nutritional needs.

Increasing calories

During illness, treatment or recovery, your need for calories and protein may be greater than usual. The following suggestions can help increase the number of calories you consume:

• Add butter or oils to foods. Use butter or margarine generously on potatoes, bread, toast, hot cereal, rice, noodles and vegetables and in soups. Put olive oil or another oil on bread, rice, pasta and vegetables.
• Spread peanut butter or other nut butters — which contain protein and healthy fats — on toast, bread, apple or banana slices, crackers, or celery. Dip pretzels in peanut butter.
• Use croissants or biscuits to make sandwiches.
• Add powdered creamer or dry milk powder to hot cocoa, milkshakes, hot cereal, gravy, sauces, meatloaf, cream soups or puddings.
• Add sliced avocado or guacamole to salads and sandwiches.
• Add seeds, such as sunflower and pumpkin seeds, to salads, stir-fries and casseroles.
• Add ground flaxseeds to yogurt, smoothies, hot cereals and casseroles.
• Top hot cereal with brown sugar, honey, dried fruit, cream or nut butter.
• Top pie, cake, gelatin or pudding with ice cream, whipped cream or cream.
• Use fruit canned in heavy syrup. It has more calories than does fresh or juice-packed fruit. If you prefer fresh fruit, add sugar and cream.
• Drink beverages that contain calories, such as fruit juice, lemonade, fruit-flavored drinks, malts, floats, soda pop, cocoa, milkshakes, smoothies and eggnog. Nutritional supplement drinks are convenient options.

Though some of these suggestions add more fat and sugar to your diet, this shouldn't be a concern since you're only adding the extra calories until you can get your appetite back on track. Check with your doctor or a dietitian if you have concerns about changing the way you eat.

Increasing protein

Protein is important for growth, health and repair of your body. If you've been ill, you may need extra protein. Some suggestions include:

• Add extra meat, poultry, fish, cheese or beans (pinto, navy, black, kidney) to casseroles, soups or stews.
• Choose meat salads, such as chicken, ham, turkey or tuna.
• Make your own high-protein milk: Add 1/4 cup powdered milk to 1 cup whole milk, or add 1 cup powdered milk to 1 quart whole milk. Use it as a beverage, add it to malts or shakes, or use it in cooking.
• Try a commercially prepared protein supplement.

If illness has made red meat — beef, pork or lamb — less appealing to you, try the following foods, which also are good sources of protein:

• Cheese
• Cottage cheese
• Beans
• Lentils
• Eggs
• Fish
• Poultry
• Nuts and nut butters
• Peanut butter
• Milk
• Milkshakes
• Custard
• Pudding
• Vegetarian burgers
• Yogurt
• Quinoa

Fluids

Drinking plenty of fluids also is key to helping your body during treatment. Try to drink at least 64 ounces (2 liters) of fluid a day, unless your doctor has directed you to limit your fluid intake.

Try to choose drinks that contain calories. If sweetened beverages are too sweet, try flavored water or fruit juices diluted with water.

Consider a multivitamin

If your loss of appetite is keeping you from eating well for more than a few days, you might consider asking your doctor about taking a multivitamin. Cancer treatments and other medications can interact with nutritional supplements, so discuss it with your doctor first.

Check the label and look for a multivitamin that doesn't give you more than 100% of the Daily Value of all the vitamins and minerals.

Keep in mind, though, that if you're eating or drinking nutritional supplements, such as bars, cookies, smoothies and other products that are fortified with additional vitamins and minerals, you may not need a multivitamin or additional supplements.