Nourishing Your Body and Staying Active During Chemotherapy: A Comprehensive Guide

Dear Patient,

During your chemotherapy treatment, prioritizing your well-being through proper nutrition and appropriate physical activity is crucial. This guide provides detailed information and practical tips to support you, focusing on managing potential side effects, maintaining your strength, and supporting your immune system.

The Vital Role of Nutrition During Chemotherapy

Chemotherapy can significantly impact your body. Good nutrition can help you to:

• Maintain Energy and Strength: Adequate nutrient intake provides the necessary fuel to combat fatigue and maintain your overall strength.
• Manage Side Effects: Nutrition plays a key role in alleviating common side effects, such as nausea, taste alterations, and mucositis.
• Support Immune Function: Proper nutrition is essential for a robust immune system, which is critical during chemotherapy.
• Preserve Muscle Mass: Chemotherapy can contribute to muscle loss (sarcopenia). Sufficient protein intake and exercise can help mitigate this.
• Enhance Quality of Life: Feeling well-nourished can significantly improve your overall sense of well-being and ability to engage in daily activities.

Detailed Nutritional Guidelines and Side Effect Management

• Protein Powerhouse: Protein is fundamental for tissue repair, muscle maintenance, and immune support. Prioritize these protein sources:
• Lean meats (poultry, fish)
• Eggs
• Dairy products (yogurt, milk, cheese – choose low-fat options if needed)
• Legumes (beans, lentils)
• Nuts and seeds
• Soy products (tofu)
  • Tip: Incorporate protein into every meal and snack. Animal-based proteins have a composition that offers superior anabolic potential, compared to plant-derived proteins. Thus, animal-based foods should represent the majority (i.e., ≥65%) of protein intake during active cancer treatment.
• Fruits and Vegetables: A colourful array of fruits and vegetables provides essential vitamins, minerals, and antioxidants, which support your overall health and immune function.
  • Tip: If mucositis (mouth sores) is a concern, choose soft, cooked fruits and vegetables. Avoid acidic options like citrus fruits if they irritate your mouth.

• Whole Grains: Opt for whole grains for sustained energy and fiber.
  • Examples: whole-wheat bread, brown rice, quinoa, oats
  • Tip: If you experience diarrhea, choose refined grains temporarily until your digestive system settles.
• Hydration is Key: Adequate fluid intake is essential.
  • Recommended fluids: water, diluted juices, herbal teas, broths
  • Tip: Sip fluids throughout the day, especially if you experience nausea.

Managing Specific Side Effects:

• Nausea and Vomiting:
  • Eat small, frequent meals instead of large ones.
  • Choose bland foods (toast, crackers, plain rice).
  • Avoid greasy, fried, or overly sweet foods.
  • Ginger (ginger ale, ginger tea, ginger candies) may help.
  • Take anti-nausea medication as prescribed by your doctor.

• Taste Changes (Dysgeusia):
  • Experiment with different flavors and textures.
  • Tart or spicy foods may be more appealing for some.
  • If red meat tastes unpleasant, try poultry, fish, or plant-based protein sources.
  • Maintain good oral hygiene.
  • Zinc supplements may be helpful in some cases, but consult your doctor first.
• Mucositis (Mouth Sores):
  • Choose soft, non-irritating foods.
  • Avoid hot, spicy, acidic, or rough foods.
  • Rinse your mouth frequently with a salt-soda solution.
• Diarrhea:
  • Drink plenty of fluids to prevent dehydration.
  • Eat low-fiber foods (bananas, rice, applesauce, toast).
  • Avoid fatty, greasy, or very sweet foods.
• Constipation:
  • Increase fiber intake gradually if tolerated (whole grains, fruits, vegetables).
  • Drink plenty of fluids.
  • Engage in gentle physical activity.
• Nutritional Supplements:
  • Discuss the use of any supplements with your healthcare team.
  • They can advise on the safety and appropriateness of supplements in your specific situation.
  • Protein supplements or oral nutritional supplements (ONS) may be recommended to help meet nutritional needs, especially if you’re struggling to eat enough.

The Importance of Physical Activity

Gentle physical activity can provide numerous benefits during chemotherapy:

• Combating Fatigue: Exercise can increase energy levels and reduce fatigue.
• Maintaining Muscle Mass: Physical activity helps preserve muscle strength and function.
• Improving Mood: Exercise can reduce stress and improve mental well-being.
• Enhancing Circulation: Movement promotes healthy blood flow.

Safe Exercise Guidelines

• Consult Your Doctor: Always talk to your healthcare team before starting any new exercise program.
• Listen to Your Body: Rest when needed and avoid overexertion.
• Start Slowly: Begin with short periods of activity and gradually increase the duration and intensity as tolerated.
• Recommended Activities:
  • Walking
  • Light stretching
  • Chair exercises
  • Yoga or Tai Chi (with modifications as needed)
• Findings from Studies:
  • Studies like the BENITA study and the one by Sanft et al. highlight the feasibility and potential benefits of exercise interventions during chemotherapy, showing that they can be safe and well-tolerated.

Working Together for Your Optimal Health

Your healthcare team is here to support you throughout your chemotherapy journey. Please do not hesitate to reach out with any questions or concerns regarding your nutrition or physical activity. We are committed to helping you maintain your strength, manage side effects, support your immune system, and improve your overall quality of life.

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