Healing Nutrition

Poor appetite is one of the cancer treatments' most common side effects, which can increase the risk of malnutrition. This loss of appetite often means you do not eat enough calories and nutrients to repair damaged tissues during treatment. Consequently, poor appetite can lead to unintentional weight loss and fat and muscle wasting, thus causing poor tolerance to cancer treatment and poor quality of life (1). 
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Eating can be stimulated by improving the culinary preparation and presentation of the meals, frequently changing the type of foods and the way of preparation. It is also important to pay attention to the texture of foods to reduce the effort of eating if you feel debilitated (2). 

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Nutrition Strategies to Manage Poor Appetite

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• Eat smaller meals and snacks throughout the day (6 - 8 meals per day).

  • ​Small portions regularly are better tolerated and will give you more calories than trying to eat three large meals.  

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• Choose nutrient-dense, high-calorie, and high-protein foods and beverages.

  • Foods rich in protein, healthy fats, and complex carbohydrates will maximize your calorie and nutrient intake even if you eat a small portion.  ​

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• Choose beverages with calories, like fruit and vegetable juices, cow's milk, and soy milk, as these can boost your calorie intake.  

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• Limit drinking too much fluids during meals. Liquids can fill you up and limit your intake of high-calorie foods.
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• Do not wait until you feel hungry to eat. Eat by the clock and set the alarm to help yourself eat every 2 to 3 hours.   

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• Feel free to break up food. For example, divide a sandwich and eat half, then 2-3 hours later eat the rest. 

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• Eat a larger meal when you feel hungriest. For instance, if you are hungry in the morning, eat your larger meals and snacks in the morning and at lunch.   

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• Eat your favorite foods any time of the day. If you like scrambled eggs with potatoes and pancakes, you can eat them for dinner.  

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• Keep snacks handy. They should be ready to eat or easy to make. 

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• If you experience early satiety, which means getting full too soon and not finishing your meals, drink your beverage at the end or between meals. This way, you have more room for solid food. Choose liquids with extra calories. 

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• If you are able, try light exercise before meals. A 30–60-minute walk before meals can increase your appetite.  

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• Think of food as medicine for your body. 

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What to Eat with Poor Appetite

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Foods that are high in calories, especially those that come from whole foods. These foods will help you increase your nutrient intake even though you can eat only a small portion of them. Focus on foods high in protein, complex carbohydrates, and healthy fats (3).​

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High in Carbohydrates

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• Amaranth, buckwheat, teff, wild rice, quinoa, millet, oats, and sorghum

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• Potatoes, sweet potatoes, yams, corn, rice, noodles, pasta, quinoa, cassava, and yucca

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• Bread, cornbread, pita bread, injera, naan, corn tortillas, English muffin, and crackers

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• Warm cereals like oatmeal, cream of wheat, cream of rice, grits, porridge, and cornmeal

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• Cold cereals like buckwheat, soy flakes, barley, rice and corn cereals

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High in Protein

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• Eggs and egg substitutes 

• Dairy such as Greek yogurt, cheese, whole milk, evaporated milk, and dry milk

• Fish

• Chicken

• Turkey 

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High in Plant-Based Protein

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• Beans, peas, lentils

• Nuts and nut butters 

• Seeds and seed butters

• Nutritional yeast

• Soy-based products such as tofu, soy milk, and tempeh

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High in Healthy Fats

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• Avocado

• Olives

• Grass-fed butter

• Nuts and nut butters

• Seeds and seed butters

• Oils such as avocado, olive, and coconut oil

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What to Drink with Poor Appetite 

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Water should be the first beverage of choice. Yet, when it comes to getting more nutrients in your diet, choose drinks containing calories from healthy carbohydrates, protein, and fat. Beverages can add nutritional value to your diet regarding calories and nutrients.

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• Milk and plant-based milks

• Hot and cold cocoa drink

• Fortified milk

• Coconut water

• Fruit juices

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Shakes

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When eating is not appealing, shakes can give essential nutrients and enough calories and protein to replace a meal. Using a blender at home, consider preparing nutritious shakes with milk or plant-based milk alternatives, protein powder, fruits, nuts, and natural nut butter like peanut butter, cashew butter, and almond butter. You also can add yogurt, avocado oil, oats, flaxseeds, greens, hemp seeds, avocado, fruits, or fruit juices. 

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• Milkshakes

• Smoothies 

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Oral Nutrition Supplements (ONS)

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Oral nutritional supplements (ONS) can be part of the nutrition care plan and intervention to help reach dietary goals by adding calories, protein, vitamins, and minerals to a daily diet when people can get their nutrition goals with food alone.

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• Kate Farms 

• Orgain Organic

• Premier Protein 

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What Causes Poor Appetite in Cancer

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Chemotherapy and radiation therapy may decrease your desire to eat due to dry mouth, changes in taste or smell, mucositis, abdominal cramping, diarrhea or constipation, and severe nausea and vomiting (4).

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Depression, stress, anxiety, fear, and lack of activity in cancer patients also lead to loss of appetite (5, 6).

Cancer location - some cancers have a higher risk of decreased appetite and malnutrition. Tumors in the esophagus, stomach, pancreas, and head and neck cancers are among the highest risk since they can affect your ability to swallow, digest and tolerate your food (7).
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Cancer treatment - surgery, chemotherapy, and radiation can increase your body’s calorie and protein needs (8). 

Patients with more advanced cancer disease have greater poor appetite and malnutrition risk. 
 
Cytokines produced by the tumor and inflammation reduce appetite putting the person at risk of cancer cachexia (9). 
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Age is another factor that affects appetite. Elderly patients are also more prompt to feel full due to hormonal changes (10).

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It's essential to manage these side effects to help improve your appetite. Talk to your healthcare team if you have any of these.

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Foods and Drinks to Avoid with Poor Appetite

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​Avoid choosing ultra-processed foods and beverages.

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Even though they have high-calorie content, they have poor nutritional value, such as soft drinks, chips, cookies, sugary breakfast cereals, sausage, fast foods, instant noodles, candy, ice cream, fries, packaged pastries, and more. 

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