Optimizing Nutrition

During Treatment for

Brain Tumors

Nikki Spurgeon, MS, RDN, LMNT, CNSC

Objectives:

• Benefits of eating well throughout treatment

• Common nutritional side effects seen with tumors and with treatment

• Strategies to help manage side effects

• Answers to commonly asked questions

• Resources

Nutrition Services• Dietitian is available in the inpatient and

outpatient settings:

– Available during hospital stay or via phone,

email, face to face in clinic, radiation or during

infusions

– Am available upon patient request or when

consulted

Benefits of eating well

through treatment• Helps to maintain strength

• Decreases loss of muscle mass

• Helps to optimize immune system

• Promotes healing following treatment

• Helps to prevent treatment delays or dose-

reductions

Influences that may impact

nutritional intake:• Nutrition resources can be very

confusing!

• Nutrition in cancer prevention vstreatment

• Advice from loved ones, people you know

• Research on the internet

• Media

• Stress

• Energy levels

• Depression

Barriers to receiving adequate

nutritional intake

Tumor-related:

Neurological

Symptoms

Nausea/Vomiting

Fatigue

SIADH-?Fluid

restriction

Treatment-related:

Inflammation/steroid

use

Nausea/vomiting

Fatigue

Diarrhea/constipation

Mouth sores

Strategies to aid with nutritional

intakeDecreased Appetite

• Small and frequent meals,

regular meal/snack times

• Add a bedtime snack

• Calorie-containing fluids

• Nutrient-dense foods

• Fluids between meals

• ?Nutritional drink supplements

(ie Ensure, Boost, Carnation

Breakfast, etc) or make your

own (whey protein and milk or

juice, yogurt smoothie)

• Take medications with calorie-

containing fluids as able

Nausea and Vomiting

• Limit odors

• CHO-containing foods

• Small and frequent meals

• Bland foods (cereal, potatoes, cheese sticks, hard boiled eggs, yogurts, applesauce)

• Avoid overly spicy, greasy or sweetened foods and fluids

• Try ginger (ginger tea, ginger soda, crystalized ginger)

• Stay upright >30 mins after eating

*Avoid oral nutrition supplements if nausea is an issue

**Optimize nausea medications if needed

Strategies to aid with nutritional

intake

Diarrhea

• Small and frequent meals

often are easiest to

tolerate

• BRATY diet (Bananas,

Rice, Applesauce, Toast,

Yogurt)

• Bland foods – avoid

greasy, fatty or fried foods

• Drink plenty of fluids

(non-carbonated and

caffeine-free)

Constipation

• Drink plenty of fluids, try prune juice (non-carbonated); Try drinking a warm beverage

• Bowel regimen

• Activity

• Gradually adding fiber to diet as tolerated

• If bloated, avoid gas-forming foods (beans, broccoli, cauliflower, onions, garlic, etc.)

Strategies to aid with nutritional

intakeFatigue

• Make meal prep easier temporarily (convenience food items, frozen meals, prep extra meals when feeling well)

• Have ready-to-eat snacks available (trail mix, string cheese, dried fruits, pudding, peanut butter/crackers)

• Use of oral nutritional shakes may be of benefit

• Be physically active as appropriate

Sore mouth

• Cool or room-temperature foods often easier to tolerate than warm

• Soft, tender foods

• Use a straw

• Non-acidic foods and fluids

• Avoid alcohol-containing mouth rinses but practice good oral hygiene

• May consider use of mouth numbing rinses prior to eating

• Some things to try: applesauce, cottage cheese, mashed vegetables, nutritional or milk shakes, smoothies, cooked cereals

Recommendations

Nutritional recommendations which are

evidence-based

Maximize foods that you are able to eat to

maintain your strength

Goal is to maintain a healthy weight

Try to incorporate all food groups in your diet –

especially when feeling well

Commonly Asked Questions…

Sugar and Cancer:• All cells in your body require glucose as fuel

• Eating sugar has not been linked to cancer growing faster

• Avoiding dietary sugar will not prevent your body from making the glucose it needs

• Will break down protein and fats if needed to provide needed nutrients

• Can lead to unintended weight loss, fatigue, decreased immune function

• Unwarranted dietary restrictions can also lead to unnecessary anxiety and stress

Organic versus Non-organic

• A personal choice

• Conventional produce pesticide exposure

has been found to be at safe levels

• Eating fruits and vegetables is important

for health – reduces risk for heart disease,

cancer, obesity, diabetes

Vitamin/Mineral Supplements

• Goal of cancer treatment: Cancer cells to be destroyed

• Antioxidant supplement use has been found to protectcancer cells

• IT IS BEST TO OBTAIN NUTRIENTS FROM FOOD AND NOT PILLS

Synergistic affect of nutrients in

foods provides most benefit

• If take supplements, it is recommended to not take >100% Daily Value of the nutrient- discuss with doctor or dietitian

Resources:

• Oncologynutrition.org

• Cancerdietitian.com

• Cancer.org

• ABTA.org

• AICR.com

• Cancer.gov

• Quackwatch.com

• Nccih.nih.gov