Vegetarian Nutrition soy beans

Vegetarian Diets During Cancer Treatment

by Donna Paglia, MS, RD

By now most of us have heard of the association between a vegetarian diet and cancer prevention. A multitude of antioxidants and phytochemicals in fruits, vegetables, and legumes are being studied intensely as a result of some promising studies showing these foods' anti-cancer properties. This research is leading us to believe that a vegetarian diet may be one of the best preventive measures against certain cancers. However, there is no clear consensus on the type of diet that is most beneficial after a diagnosis of cancer. There are those who advocate macrobiotic diets and various "nutritional therapies" as forms of cancer treatment, but there is not enough scientific evidence to back up these claims, and severe dietary restrictions can be detrimental to those already at risk for malnutrition. So, is vegetarianism a wise choice for someone with cancer? A vegetarian diet can be both safe and beneficial for people undergoing cancer treatment, provided they know how to make appropriate food choices. In fact, vegetarian foods may even help people get through difficult times during cancer treatment when their regular diets may falter. However, the guidance of a registered dietitian is recommended for any vegetarian undergoing cancer treatment, even if this diet is not new to them. This article provides information for planning a vegetarian diet that will satisfy the special nutritional needs of the cancer patient, whether that person is yourself, a friend or family member, or a client. Those who have been diagnosed with cancer and endured its treatment can attest to the nutritional deficiencies and weight loss which can be a difficult part of this experience. The foundation of this predicament is the increased calorie and protein requirements that often result from the presence of a tumor as well as from the need for repair of healthy tissues damaged by chemotherapy and radiation therapy. To complicate matters, these cancer treatments can challenge one's normal eating habits because of a variety of potential side effects. Chemotherapy, for example, works by attacking rapidly growing cells. This, unfortunately, targets not only the tumor, but some healthy tissues as well, including the lining of the gastrointestinal (GI) tract. While some of these drugs produce only mild side effects, others can severely impact quality of life. The effects of radiation therapy can be similar to those of chemotherapy, but are usually related to the part of the body that is being treated. Consequently, radiation to the head, neck, chest, and abdomen can induce significant GI distress and a decreased tolerance to many foods. Following is a list of some of the more common problems experienced during cancer treatment which can influence the ability to eat regularly:

During cancer treatment, you may be counseled on a diet that is high in both calories and protein in order to meet the body's increased demands, as well as to maximize the value of a reduced volume of food. Small, frequent, high calorie snacks may be helpful. The Table below compares a variety of foods which are relatively high in protein. If you are unable to eat large amounts of foods, choose those which have more calories per serving.

Food Item Calories
½ c. legumes 80-100
2 Tbsp peanut butter 180-200
1-2 oz. nuts/seeds 175-200
¼ c. cottage cheese 50
1 oz. cheese 100
7 oz. milk, yogurt 80-140
1 c. egg noodles 160
¼ c. tofu 75
1 ½ c. rice 300
1 c., ckd. broccoli 50
2 ½ oz. tempeh 120

Vegetarian Foods for the Non-Vegetarian

One of the treatment side effects mentioned can cause a change in food preferences. Your favorite foods may now be less appealing. You may develop an aversion to meat, poultry, fish, sweets, or coffee. Taste distortions often occur so that strongly flavored (or strong smelling), bitter, and sweet foods taste "off." From my experience counseling cancer patients, I have found that red meat is commonly among the first foods to be rejected, as well as coffee and highly acidic foods. This aversion to meat may be due to a heightened sense of bitterness or a metallic taste after the proteins are broken down in the mouth. Poultry may or may not have this effect. Dairy products and eggs are generally better tolerated. Smell sensitivity can also lead to a rejection of meat, fish, and poultry, as the odors produced while cooking can trigger nausea. In these situations, the adoption of vegetarian substitutes for these foods can help make up for potential calorie and protein deficiencies that could result from omission of these foods from your diet.

Lacto-Ovo Vegetarian Diet

For the lacto-ovo vegetarian, the choices of nourishing foods are many. Dairy products supply protein and are a good source of calories, as well as calcium, vitamin B12, riboflavin, and vitamin D. It is relatively easy to meet high calorie and protein needs with the use of foods such as milkshakes, cream soups, cheeses, and commercial nutritional supplements. Although these foods may be high in fat, the diet is often recommended only temporarily, and can also be adjusted according to individual fat tolerance. Eggs, egg substitutes, and legumes can be incorporated into the diet as additional protein and calorie sources.

Lactose intolerance is common in the general population, and even more prevalent in people receiving cancer treatment, even if only temporarily. This is especially true when diarrhea is a problem, as it can temporarily "wash" away the lactase enzyme, thus creating an inability to digest lactose. Fortunately, there are lactose-reduced and lactose-free dairy products available now, as well as lactase tablets and drops. These products may help some people digest milk products without developing abdominal discomfort, excess gas, or diarrhea. There are some people who cannot tolerate any dairy products, no matter what, and for those with chronic diarrhea, dairy products may only worsen the condition. In these cases, vegan foods can be extremely helpful in filling in dietary gaps.

Vegan Diet

Although it probably would be easiest for most non-vegetarians to make the transition to a lacto-ovo vegetarian diet, a vegan diet can be appropriate for the well-informed patient. A vegan diet should initially include as many familiar foods as possible, with "new" foods to fill in the gaps. The trick is to use products that are quick and simple to prepare, and can be easily exchanged for animal products in familiar dishes.

The vegan can substitute nutritious plant-based foods for most of the common dairy products. For example, the vegan can substitute fortified soy milk for cow's milk; vegetable oil or margarine for butter; soy/rice frozen desserts and sorbets for ice cream and frozen yogurts; soy alternatives for sour cream, cheese, yogurt, and cream cheese; and tofu or egg replacer for eggs.

Getting sufficient iron, calcium, and vitamin B12 is a particular concern with vegan diets. Vitamin B12 can be obtained from fortified cereals and fortified soy beverages, or a vitamin B12 supplement.

Macrobiotic diets are generally too restrictive for people with cancer, especially during treatment. The more limitations placed on the diet of a person who is experiencing eating difficulties or who may already be malnourished can set the stage for additional problems.

For those with an increased sense of strong or bitter tastes, the mild flavor of some soy products can be a welcome change. If taste blindness is a problem, using marinades and seasonings for tofu and tempeh can enhance the flavor.

Dry beans and peas, nuts, peanut butter, and seeds are examples of foods used sparingly or infrequently by non-vegetarians. These foods and snacks can be utilized frequently by vegans to supply a greater percentage of calorie and protein requirements. Shakes can be made with soy milk, tofu, and non-dairy frozen desserts and can be flavored with fruit or chocolate syrup to make a tasty, calorie-rich treat. Many varieties of trail mixes are readily available and great for high-energy snacks.

Quick and Easy High Calorie Snacks

For the lacto-ovo vegetarian these would include pizza, milk shakes, ice cream, yogurt, puddings and custards, cheese and crackers, fruit, and creamed vegetable soups. The vegan should select from the following foods: bean tacos/burritos, fruit shakes, non-dairy frozen desserts, soy yogurt and puddings, peanut butter on crackers, bean and chunky vegetable soups, fruit and dried fruit, nuts and seeds, and bagels.

A multivitamin/mineral supplement is often recommended for patients undergoing cancer treatment, as they may not be able to eat a variety of foods in sufficient amounts to meet their needs, whether following a vegetarian diet or not.

 

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