Decreased appetite and not feeling hunger cues as you normally would, is a common problem that occurs with many different therapies. The following suggestions may help you improve your intake:

• Eat smaller, more frequent meals. Eating 6-8 small meals or snacks throughout the day may be more easily tolerated than eating the same amount in 3, large meals.

• Choose foods that are high in calories and protein. Think full-fat dairy products (cream cheese, whole milk, cheese, and heavy cream), avocado, nuts and seeds, nut butter, dried fruits, butter, gravy, sour cream, and high-fat meats.

• Choose milkshakes, smoothies, or high-calorie, high-protein nutritional drinks if a meal sounds like too much. Drinks are often more appealing and can be easier to consume.

• Avoid having large amounts of liquids (water, juices, soda) with meals to prevent filling up on only fluids.

• Have snacks available at any time such as:

  • Crackers with peanut butter

  • Toast with butter

  • ½ a peanut butter and jelly sandwich

  • Yogurt with granola and fruit

  • Granola bars (Cliff bars, Perfect bars)

  • Cereal of choice

  • Dried fruit and nuts

  • Whole milk

  • Cottage cheese or yogurt

Nausea can be defined as the feeling of being queasy or sick to your stomach. It can occur with vomiting or without. Nausea can not only be uncomfortable, but can cause a decrease in appetite due having a consistent upset stomach. Nausea can be treated with anti-emetic medications, depending on the severity of the nausea. The following suggestions may help mitigate the nausea and improve your oral intake:

• Eat 6-8 small meals or snacks per day instead of 3 large meals. Having an empty stomach may worsen the nausea, and eating too much may upset your stomach. Eating at regular intervals can help you meet your calorie needs.

• Follow the BRAT diet! Bananas, rice, apple sauce, and toast are known for having a soothing effect on the stomach. They are simple, easy to digest carbohydrates that do not cause your digestive system to do much work.

• Try ginger chews or adding fresh ginger to your tea. Ginger has a soothing effect on the GI tract which allows the stomach to relax and reduces discomfort.

• Avoid strong smells such as garlic, onion, fish, perfume, and scented candles.

Specific chemotherapy medications and radiation therapy may cause taste changes. These taste changes may result in lack-of-taste or a metallic, acidic taste. Depending on the change in taste, there are specific tips that may help improve your symptoms including:

• For a dull taste, try adding

  • Citrus (lemon, orange, lime, grape-fruit juice)

  • Seasoning (rosemary, paprika, garlic, onion, red pepper flakes, oregano, cumin, cinnamon, etc)

• For acidic or metallic taste, try

  • Sprinkling sugar or drizzling honey to reduce harsh taste.

  • Using plastic or bamboo utensils instead of metal.

  • Drink a sweetened beverage with your meal.

  • Use sugar-free mints, candy, or gum to improve the taste in your mouth.

Constipation can not only be uncomfortable, but can sometimes be painful. Certain medications and treatment courses can cause constipation, a decreased movement in your bowels. When dealing with constipation, do not go longer than 2-3 days without a bowel movement without contacting your doctor.

• Drink 8-10 glasses of fluids daily – especially as you increase fiber in your diet and take medications.

• Increase fiber in your diet by adding fruits, vegetables, whole grains, legumes, beans, or a high-fiber cereal. Aim to have 2 servings of a high-fiber food per day.

• Sprinkle 1-2 tbsp of flaxseed or chia seed in your yogurt, smoothie, or cereal to help increase the fiber content.

• Movement! Go for a walk if you have the energy, or move around your house.

Diarrhea is described as soft, loose, watery stools. Diarrhea can not only be accompanied by abdominal cramps and pain, but can also potentially lead to dehydration due to a loss of fluids. It is important to prioritize your fluid intake during periods of increased stool output to prevent fluid losses. When having diarrhea, try

• Drinking room-temperature liquids throughout the day. Room-temperature beverages may be better tolerated by our GI system.

• To adequately replace fluids lost, drink 1 cup of fluids per loose bowel movement.

• Avoid high-fiber foods such as apples, berries, vegetables, whole grains, beans, and seeds that may increase GI motility.

• Aim to have bland, easy to digest carbohydrates such as the BRAT diet (bananas, rice, apple sauce, toast).

• Have foods higher in potassium and sodium such as bananas, avocado, broths, sports drinks, crackers, and pretzels.

Dry mouth can be caused by not only certain types of chemotherapy drugs, but also by radiation treatment. Treatment can decrease the amount of saliva made by the body and cause issues eating and talking. It is not only important to keep your mouth clean, but to combat dry mouth with increased hydration. When dealing with dry mouth, try

• Meet hydration requirements as directed by your dietitian

• Take a sip of water before each bite

• Suck on sugar-free hard candy to help moisten your mouth

• Moisten dry foods such as cereal with milk or avoid dry foods as a whole. Opt for soft items such as soups, smoothies, ice-cream, etc.

Mouth sores can develop from specific chemotherapy drugs in addition to radiation treatment, resulting in discomfort and pain with swallowing. If you are dealing with mouth sores, remember to put a heavy emphasis on oral hygiene, in addition to choosing the correct nutrition.

• Avoid spicy, herb-rich foods that may bother the sores

• Choose bland, room temperature foods (broth, ice-cream melted, yogurt, smoothies, nutrition shakes, fruit, etc)

• Avoid citrus foods such as lemon, lime, and grapefruit that may irritate the sores

• Moisten foods with broth, milk, cream, water, gravy, or butter to help with swallowing