Nutrition and cancer: eating a healthy and balanced diet

Monika Siemicka is a specialist dietitian who’s worked with teenagers and young adults with cancer for the past eight years. She kindly gave up her time to share her expert advice on nutrition for young people with cancer and her top tips to help you eat a healthy, varied diet.

Monika Siemicka

Thanks for your time, Monika! The coronavirus situation has made a lot of things uncertain for everyone, including young people with cancer – is there anything different about the nutrition advice you’re giving people right now?

Firstly, it’s still really important to follow a balanced diet. A balanced diet will ensure you’re getting all the nutrients you need to help support your body, including your immune system. It doesn’t need to be complicated or expensive though.

For all you aspiring chefs out there, now is the time to experiment in the kitchen! And for those of you who’ve always been a bit nervous about cooking, this could be a good time to start building on your skills – there are lots of online videos that can guide you through chopping an onion to cooking your own curry. 

What does a balanced diet look like?

Our diet is made up of different food groups that each provide different nutrients.  Within each group, there are lots of different options so you can choose what works for you whilst still providing your body with the fuel it needs. 

Fruit and veg

Try to still get your five a day. One portion is a handful (80g) and fresh, tinned and frozen all count. If you can, avoid tinned fruit in syrup as that’s just another word for sugar, or tinned veg in brine as that’s salt.  

Carbohydrate

Think things like potato, pasta, rice and bread. If possible, go for the wholegrain or brown options because they’re higher in fibre (they do take longer to cook though so check the packet for instructions!) Try to have some carbs with each meal.

Protein

Foods like eggs, meat, fish, soya, pulses (beans and lentils) and nuts are all great sources of protein. Try to have them 2-3 times a day either as part of your meals or as a snack.

Dairy and alternatives

Dairy or alternative milk, yoghurt and cheese contain a number of nutrients including protein and calcium. If you’re having alternatives such as almond milk or soya yoghurt then double check they have been enriched with calcium. Aim to have these 2-3 times a day e.g. 200ml glass of milk, 1 small pot of yoghurt, 30g cheese (about the size of a matchbox).

When you’re sitting down to your main meal, imagine your plate is split into thirds. Aim to have 1/3 plate protein (1 chicken breast/2-3 vegetarian sausages), 1/3 plate carbohydrate (about 2 hands cupped together of cooked rice or pasta) and 1/3 plate veg or salad.  

With people being advised to go to the shops as little as possible, what kind of foods can we think about having at home?

It’s good to have a variety of foods to stop you getting bored of having the same thing. Now might be the time to check what’s lurking in the back of your pantry (check the expiry date first!) It’s important to remember the different food groups so that you’re still eating a balanced diet. Here are some of my suggestions.

Store cupboard ideas:

  • Tinned fruit and veg e.g. mandarin segments in juice, sweetcorn
  • Tinned pulses e.g. kidney beans, baked beans, chickpeas
  • Dried lentils
  • Pasta, rice, couscous
  • Tinned tomatoes or passata (a useful substitute if you can’t get your hands on tinned tomatoes)
  • Tinned fish 
  • Tofu 
  • Oats 
  • Unsalted nuts 

Fridge ideas:

  • Eggs
  • Cheese
  • Milk
  • Fresh fruit + veg 
  • Potatoes

Freezer ideas:

  • Meat
  • Quorn mince 
  • Frozen fruit and veg
  • Sliced bread 
  • Vegetarian/vegan sausages 
  • Fish 
  • Herbs (useful for adding to dishes, especially if you’re experiencing taste changes).

What should I do if I’ve lost my appetite?

Sometimes it can help to have small, frequent meals and snacks rather than three meals a day. Things like baked beans on toast, tuna with sweetcorn and a jacket potato or a bowl of cereal with full-fat milk are a few ideas.

If you can, still think about having something from all the food groups but if there are only certain things you feel like eating then go for those – the most important thing is that you’re eating something.

What can I eat if I have a sore mouth from chemo?

Avoid rough foods like toast and crisps, anything acidic such as oranges, or spicy foods, as they might aggravate a sore or ulcerated mouth. Some people find cold food like ice-cream or yoghurt or drinking milkshakes and smoothies soothing. Using a straw can make things easier too.

It’s worth asking your medical team if they can prescribe regular painkillers and/or mouthwashes to help control the pain. As your mouth starts to feel better you can try reintroducing different foods. If you have a dry mouth, sucking on ice-lollies or ice-cubes, adding sauces to food and making sure you’re drinking enough can all help.

How much should I be drinking?

Aim to drink 1500-2000ml a day (6-8 250ml glasses), although the amount varies from person to person. The best way to tell is actually by the colour of your pee – it should be pale yellow.

Water, sugar-free squash, milk and hot drinks all contribute to your fluid intake. Try to limit sugary drinks like fizzy drinks, flavoured water and adding sugar to your tea!  It’s best to only have a 150ml glass of fruit juice/smoothie a day as they’re high in sugar too. 

What are some healthy snack ideas?

  • Veg sticks and hummus 
  • 1 apple sliced and dipped into a tablespoon of peanut butter
  • Small pack of raisins
  • Small handful unsalted nuts
  • 1 small pot yoghurt 
  • 2-3 handfuls plain popcorn

What if my immune system has been affected by cancer treatment?

If you are immunocompromised you’ll likely have received advice from your hospital team – it’s important you continue to follow this advice.  

In general, good food hygiene, hand washing and food safety are key.  Make sure that food is stored correctly and eaten within its use-by date.  Cook food thoroughly and if reheating food then eat it within 24 hours and don’t reheat more than once (with the exception of rice, which shouldn’t be reheated at all).

Nutrition for young people with cancer – top tips:

  • Keep up with eating 3 regular meals a day
  • Plan your meals for the week – look up recipes online for inspiration or fall back on your old favourites
  • Put together a shopping list with all the ingredients you’ll need based on your meal plan
  • Keep an eye on what needs to be eaten in your fridge first to make sure nothing goes to waste 
  • Don’t worry if you don’t have all the ingredients you need – get creative with what you do have!
  • If you have the storage space, then bulk cook and freeze.
  • If you’re feeling too tired to cook, then ready meals make for an easy, tasty option.

If you’ve got a question for Monika that isn’t answered here, let us know by emailing [email protected] and we’ll put together an FAQ with some answers!

Where can I go to find out more about nutrition and cancer?