Getting the most from food

Sunday 30 June, 2013

Download PDF Order FREE booklet

On this page: How to gain and maintain weight ι Food-type nutritional supplements ι Vitamin and mineral supplements ι Unproven dietary treatments ι   Reviewers


There are many treatment side effects that can affect your food intake and your appetite. A lot of time can be spent travelling to the hospital, waiting around for appointments and staying in temporary accommodation with limited cooking facilities. Having a range of quick and easy snacks that are suitable to eat when you're away from home, or when you don't feel like preparing a meal is important to prevent weight loss and malnutrition.

If you're not able to eat your usual amount of food, or you need to gain or maintain your weight, it's helpful to take in more energy (kilojoules) without having to eat more. Try adding extras to your basic foods at mealtimes, such as protein, fats and sugar.

How to gain and maintain weight

Increasing the amount of energy or kilojoules (e.g. protein, fat and sugar) in your diet is usually a temporary measure to keep you eating well during and after treatment. It's important to understand that eating extra fat and sugar while you're underweight, or struggling to maintain your weight because of treatment side effects won't hurt you and is often only needed for a small period of time.

Speak with your doctor and dietitian about relaxing low-cholesterol or diabetes dietary restrictions that may prevent you from eating extra fat and sugar.

Tips:

  • Treat food like medicine: something you have to have. Set times for meals and snacks.
  • Make sure your meal or drink is nourishing, for example drink milk rather than water and choose cheese and biscuits over lollies.
  • Aim to have a small snack and/or nourishing drink, such as a milkshake or smoothie, if you can't manage larger quantities.
  • Use full cream milk and dairy products, or enrich milk with milk powder.
  • Add milk, cream, butter, margarine or yoghurt to porridge, sauces, desserts, mashed vegetables, egg dishes and soups.
  • Add cheese to sauces, soup, vegetables, casseroles, salads and sandwiches.
  • Fry or roast meat, chicken, seafood and vegetables in oil, butter or margarine.
  • Spread bread, toast, scones, muffins, biscuits or fruit buns with butter or margarine and add honey or jam for extra energy. You can also use avocado, hummus or lite cream cheese if you prefer a low fat option.
  • Use egg or mayonnaise, cheese, cold meats, canned salmon or tuna, peanut butter, banana, baked beans, avocado on bread, toast, crumpets or muffins.
  • Carry snacks such as hard boiled eggs, chocolate bars, muesli bars, sweet biscuits, cakes and slices. Look for those with fruits and nuts for added energy.
  • Ready-to-use drinks are handy for travel and are useful if preparation is difficult. Examples include Sustagen, Ensure and Resource Fruit Beverage.

Food-type nutritional supplements

If you can't manage to eat a balanced and varied diet, or are experiencing unintentional weight loss, then it's recommended that you use nourishing fluids and/or nutritional supplements.

Nutritional supplements such as Sustagen Hospital Formula, Ensure and Resource contain energy, protein and other nutrients in a concentrated source. Glucose powder supplements can also provide energy, but they don't provide protein, vitamins or minerals, so they have a particular function and shouldn't be used as a meal replacement. You can sprinkle glucose powder on food or stir it through to give meals and snacks extra energy.

Nutritional supplements and/or nourishing fluids should be taken in addition to eating your usual meals, for example try them as between meal snacks. A dietitian can suggest the most appropriate supplement for you, and where it can be purchased. Your choice of supplement should be based on your nutritional needs, on availability and on the cost of the supplement.

If you've been assessed by a speech pathologist as having swallowing difficulties and need thickened fluids the nutritional supplements need to be thickened to the advised consistency. Discuss this with your speech pathologist.

The following tables provide some suggestions of nutritional supplements which you may be able to try (however it shouldn't be considered a complete list of those available). 

Powders

Product name Flavour Description
Boost Powder™ (500g or 1.5kg can) Vanilla, chocolate, banana, strawberry, coffee Gluten free, low GI, low fat, low salt, contains fibre
Enprocal Powder™ (540g can or 2.1kg can) Neutral Gluten free, low GI, contains fibre
Ensure Powder™ (900g can) Vanilla, chocolate Low lactose, gluten free, low GI, contains fibre
Fortisip Powder™ (900g can) Vanilla Low lactose, gluten free, low GI
Proform Powder™ (1kg can) Neutral, vanilla, white chocolate Gluten free, low GI
Sustagen Hospital Formula™ (900g can) Neutral, vanilla, chocolate Gluten free, low GI
Sustagen Hospital Formula™ (3kg bag) Neutral Gluten free, low GI
Sustagen Plus Fibre™ (900g can) Vanilla, chocolate Gluten free, low GI, contains fibre

NB: When using powders, prepare as per directions on the can.

Milk-based drinks

Product name Flavour Description
Enrich Plus™ (200ml tetrapak) Chocolate, raspberry, vanilla Ready–to–drink, Low lactose, gluten free, low GI, contains fibre
Ensure Ready–to–drink™ (237ml can) Vanilla, chocolate, banana, fruits of the forest Ready–to–drink, Low lactose, gluten free, low GI
Ensure Plus™ (200ml tetrapak) Vanilla Low lactose, gluten free, low GI
Ensure Plus™ (250ml can) Vanilla, chocolate Ready–to–drink, lactose free, gluten free, low GI
Fortisip™ (200ml bottle) Neutral, vanilla, white chocolate Gluten free, low GI
Fortisip Multifibre™ (200ml bottle) Vanilla, banana, chocolate, strawberry, orange Ready–to–drink, low lactose, gluten free, low GI, contains fibre
Resource Plus™ (237ml tetrapak) Vanilla, chocolate, strawberry Ready–to–drink, low lactose, gluten free, low GI
Resource Protein™ (200ml bottle) Vanilla, coffee, forest fruits, chocolate, apricot Gluten free, high protein
Resource 2.0™ (237mL tetrapak) Vanilla Ready–to–drink, lactose free, gluten free
Sustagen Ready–to–drink™ (250ml tetrapak) Chocolate, vanilla, mocha chocolate Ready–to–drink, gluten free, low GI, available from supermarkets

Specialised drinks

(with added fish oil - use as recommended by your dietitian)

Product name Flavour Description
Forticare™ (125ml tetrapak) Peach–ginger Ready–to–drink, lactose free, gluten free, high protein, contains fibre, enriched with fish oil (EPA)
Impact Advanced Recovery™ (237ml tetrapak) Vanilla, chocolate Low lactose, gluten free, contains fibre, enriched with fish oil (EPA/DHA)
Prosure™ (240ml tetrapak) Vanilla Ready–to–drink, low lactose, gluten free, low fat, high protein, high energy, contains fibre, enriched with fish oil (EPA)
Prosure™ (380g can – powder) Vanilla Low lactose, gluten free, contains fibre, low fat, high protein, high energy, enriched with fish oil (EPA)

There's also a range of capsules and liquids containing fish oil available from pharmacies that may be used on the recommendation of a dietitian or doctor.

Fruit-based drinks

Product name Flavour Description
Apple, strawberry, orange Enlive Plus™ (220ml tetrapak) Ready–to–drink, lactose free, gluten free
Fortijuice™ (200ml tetrapak) Forest fruits, apple, tropical Ready–to–drink, lactose free, gluten free, fat free
Resource Fruit Beverage™ (237ml tetrapak) Orange, peach, wild berry Ready–to–drink, lactose free, gluten free, low GI, fat free

Soups

Product name Flavour Description
Dr MacLeod’s Boost Soup Powder™ (400g or 1kg can) Beef & mushroom, chicken, pumpkin Low GI, contains fibre
Flavour Creations Not Just Soup™ (185ml cup) Beef & vegetable, chicken & vegetable, tomato, pumpkin Gluten free, high fibre

Desserts and snacks

Product name Flavour Description
Boost Dessert Powder™ (500g or 1.5kg can) Vanilla, mango Gluten free, low GI, low fat, contains fibre
Boost Jelly Powder™ (560g can) Lime, pineapple, raspberry Lactose free, low GI, low fat, low sodium, contains fibre
Ensure Pudding™ (113g tub) Vanilla, chocolate Ready–to–eat, gluten free, low GI, contains fibre
Flavour Creations Just Desserts Custard™ (110ml cup) Vanilla, banana, chocolate Ready–to–eat, gluten free, low fat
Forticreme Pudding™ (125g tub) Chocolate, vanilla, forest fruits, banana Ready–to–eat, gluten free, low GI
Resource Dessert Fruit™ (125g snackpack) Apple–prune, apple–strawberry Gluten free, contains fibre
Sustagen Instant Pudding Powder™ (450g can) Vanilla Gluten free, low GI

Vitamin and mineral supplements

Vitamins and minerals are an essential part of a healthy diet and play an important role in the body’s immune system. If you're managing to eat a balanced diet through eating a variety of foods then the use of vitamin and mineral supplements isn't usually necessary.

Some people believe that taking high–dose vitamin supplements will strengthen the body’s immune system, but there's little evidence to support this. In fact, many vitamins and herb compounds can be toxic at high levels, and may interfere with chemotherapy, radiotherapy and other medications. Therefore high doses of vitamin or mineral supplements are usually not recommended for use during treatment.

Dietary supplements can't replace whole foods, which are still the best source of vitamins and minerals. Many dietary supplements contain levels of antioxidants (such as vitamins C and E) that are much higher than the recommended Dietary Reference Intakes for optimal health.

Whether antioxidants or other vitamin supplements are helpful or harmful during chemotherapy or radiation treatment is a major question without a clear science–based answer right now. Until more evidence is available, it’s best for people having these treatments to avoid dietary supplements, except to treat a known deficiency of a certain nutrient, and to avoid supplements that exceed the recommended daily intake.

Talking to your doctor, dietitian or cancer pharmacist before taking vitamin and mineral supplements or before starting treatment is encouraged. For more information, call Cancer Council on 13 11 20.

Unproven dietary treatments

Complementary therapies are treatments that may help you cope better with side effects such as pain. They may also increase your sense of control over what's happening to you, decrease your stress and anxiety, and improve your mood. There are many types of complementary therapies, such as herbal medicine, acupuncture, massage, relaxation and meditation.

By contrast, alternative therapies, which include unproven diets, are often defined as those used instead of conventional medical treatments. These therapies may be harmful if people with cancer delay or stop using medical treatment in favour of them.

There are no special foods, diets or vitamin and mineral supplements that have been scientifically proven to cure cancer or to stop it from recurring. Unproven diets are often expensive, restrictive and repetitive. It's important to enjoy a wide variety of foods to keep you well nourished.

Many unproven dietary treatments, particularly those that cut out food groups such as meat or dairy products are likely to be low in energy (kilojoules), protein, fat, iron, calcium and zinc as well as vitamins. This can cause unwanted weight loss, tiredness and decrease your immune function. Your recovery and quality of life can improve if your diet includes adequate amounts from each food group.

Some alternative therapies can be harmful even when used in combination with conventional therapy. It's important that your doctor, dietitian, nurses and pharmacist are aware of all the treatments you're taking.

For more information, see our Understanding Complementary Therapies pages, or call Cancer Council on 13 11 20.

Juice Therapies

Juice therapies involve using fresh fruit and vegetable juices as the main source of food. Supporters of juice therapy believe it strengthens the immune system, reduces blood pressure and helps to clean out (detoxify) the body.

However, while the health benefits of fruit and vegetables are well documented, the benefits of juice therapy are not. Juice only contains a fraction of the fibre of whole fruit or vegetables. The protective effect of fruit and vegetables may be related to many factors in the whole fruit and vegetables, not just the juice. Use fresh fruit and vegetable juices as part of a varied eating plan.

The questions below will help you assess any diet therapy you're thinking of undertaking. Is the diet likely to:

  • Exclude one or more of the basic food groups?
  • Include large amounts of specific fruits, vegetables or their juices?
  • Exclude cooked foods or limit the cooking methods allowed?
  • Exclude or limit protein foods like meat, fish and chicken?
  • Completely change the way you choose, prepare and cook your foods?
  • Result in weight loss during your cancer therapy?
  • Prevent you enjoying social occasions with family and friends?
  • Include large amounts of special supplements?
  • Cost you a lot of money and time?

If you answer yes to any of these questions, the diet could affect your recovery and compromise your health. Some eating patterns and nutrition supplements or pills can be harmful and may interfere with the success of your medical treatment. Before radically changing the foods you eat, or taking vitamin/mineral pills or herbal remedies talk to your doctor or dietitian.


Reviewed by: Jenelle Loeliger, Head - Nutrition Department, Peter MacCallum Cancer Centre, VIC; Kate Aigner, Cancer Information Consultant, Cancer Council Helpline ACT; Ian Anderson, Consumer; Anna Boltong, PhD Candidate (Dietitian), Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, VIC; Clare Hughes, Nutrition Program Manager, Cancer Council NSW; Bridget Kehoe, Public Health Coordinator (Nutrition and Physical Activity), Cancer Council QLD; Steve Pratt, Nutrition and Physical Activity Manager, Cancer Council WA; and Roswitha Stegmann, Helpline Nurse, Cancer Council WA.
Updated: 30 Jun, 2013