Nutrition in Cancer

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Minors fighting life threatening diseases like cancer need special diets, writes Zeenat Farooq

Children need proper nutrition because they are in the growing age and their reserves of energy storage are meagre. But children combating any illness in general and cancer in particular, need special diet. Eating the right kind of food during cancer treatment is as important as the treatment itself so that the body’s reserves of energy are replenished which are likely to get depleted by the disease. It also increases the likelihood of child’s responsiveness to the treatment and keep the child strong enough to endure treatment and resist side effects.

Right kind and amount of nutrition should form a part of the cancer treatment for a child since some of the treatment options alter child’s ability to use certain foods, their tolerance towards foods or the way different foods are digested or used by the body.  American Cancer Society guidelines can help manage a child’s nutritional requirements during the treatment to maintain proper basal health and nutrition levels. The objectives of the guidelines include better tolerate treatment and treatment side effects, staying closer to the treatment plan schedule, having less risk of infection during treatment, better strength and energy, keeping up their weight and their body’s store of nutrients, doing better at keeping up normal growth and development and having a better perception and a better quality of life.

Required Nutrients

Nutritional requirements are slightly different than those from healthy children because of the altered state of health, metabolism and treatment. These requirements also vary with the age, weight, activity level, health status, type of cancer and the treatment plan. Some of the general nutritional requirements for such children would be:

Proteins: Proteins are required by the body to build muscle tissue, heal and repair wounds, strengthen immune system by renewing immune cells, proper blood formation, maintaining skin, digestive tract and all other vital organs. A child suffering from cancer can undergo muscle wasting due to extra need for fuel by body cells. Therefore, protein requirement almost always remain high. Also, the effects of treatment render body weak and additional proteins are required to recover from surgery trauma and to counteract the side effects of other forms of treatment. Poultry, eggs, lean red meat, milk, beans and nut butter are good sources of protein.

Carbohydrates:  These are body’s primary fuel to provide calories for proper basal metabolism, physical activities and organ functioning. The amount of calories required by children of growing age is always higher than adults due to the additional requirements of body growth and development. This, however, is further increased in children with cancer because of the excessive expenditure of calories spent by cancer cells for their growth. Infact, a child on cancer treatment might need as much as 20-80% more calories than a normal child of same age. This percentage varies with body weight, activity level, type and stage of cancer and also on the type of treatment option. Also, some children can experience increase in body weight due to some anti-cancer drugs. In this case, it is best to consult a registered dietician, in consultation with the cancer specialist, to plan a proper diet for the child. Fruits, vegetables and whole grains would be the best natural sources of carbohydrates for such children.

Fats: Required by the body to maintain cell structure, fats insulate vital organs and also to carry certain vitamins within the body. Fats are primarily required to supply Essential fatty acids (EFAs) to body which cannot be synthesized within the body. EFAs make cells and produce some hormones. In case of children with cancer, fat reserves of body are also utilized to meet energy demands of cancer cells. Soyabean, canola and walnut oils are good sources of Essential Fatty Acids.

Water: It is required by all body cells and for all cellular processes within the living system even in healthy individuals. Some forms of cancer and also some treatment options result in vomiting which deplete the fluid reserve triggering extra water requirement. As against this, some anti-cancer treatments promote fluid retention which might lead to oedema. In such cases, low sodium foods should be given to the child in order to promote loss of water through urine.

Vitamins and Minerals: These are required in small amounts for proper body functions and also to utilize the calories provided by fats and carbohydrates. Children eating balanced diet usually get enough vitamins and minerals but numerous studies have shown that even healthy children suffer from deficiencies of vitamin D and Calcium. Some of the drugs used for cancer treatment might lower the levels of Calcium and vitamin D.

In almost all the forms of cancer and also as a result of cancer treatment strategies and the psychological distress, it becomes very difficult to make a child eat who is suffering from cancer, sometimes as a result of nausea, vomiting, dizziness or changes in appetite. In such cases, one should follow these rules to make the child eat a well panned, balanced diet.

Cancer treatment changes a child’s sense of taste and smell. The changes may make food to taste bitter or metallic. Try foods which can be served cold in order to reduce the effect of smell. Make food more interesting by garnishing with fruits like berries. Keep liquid drinks covered and use a straw to feed the child, again to minimize the effect of smell. Cook foods at a place distant from the place where the child is kept. Try to use his favourite ingredients in almost everything cooked for the child. Prefer marinated meat to make it more palatable and soft so that the child can eat effortlessly. Try to feed fresh fruits and vegetables to the child in almost all the meals. If the child’s appetite cycle seems too altered as a result of the treatment, try feeding him small amounts of food at regular intervals rather than heavy meals. In any case, avoid forcing the child to eat against his will.

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