Foods To Eat And Avoid During Chemotherapy

  • Aisha Din BSc (Hons) Biomedical Science at De Montfort University
  • Regina LopesJunior Editor, Centre of Excellence, Health and Social Care, The Open University

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Introduction 

What is chemotherapy?

Chemotherapy is the use of drugs/agents to slow the growth of cancer cells which rapidly divide uncontrollably to produce a tumour.1

Significance of diet during chemotherapy

A balanced diet consisting of healthy food sources containing micronutrients (vitamins and minerals) and macronutrients (carbohydrates, fats and proteins) supplemented by a recommended 6-8 glasses of water per day, lowers/eliminates the severity of side effects of chemotherapy.2,3 These include:4

  • Weight loss
  • Hair loss (alopecia)
  • Compromised immune system function
  • Fatigue
  • Bowel issues such as diarrhoea and constipation 

Foods and drinks to have during chemotherapy treatment

Carbohydrates

Carbohydrates have many roles in the body which include:3,5

  • Being a source of energy
  • Providing fibre, vitamins and minerals in fruits and vegetables

Healthy carbohydrate sources for chemotherapy patients are:3,5

  • Wholemeal breads 
  • Fresh and dried fruits and vegetables - The Eatwell Guide recommends 5 portions of fruit and vegetables per day
  • Oats 
  • Quinoa
  • Sweet potatoes
  • Brown pasta, rice, couscous and bulgur wheat 

Proteins

Proteins have many roles in the body such as:7

  • Being a source of energy
  • Aiding in the repair of cells which make up body tissues
  • Being important enzymes and hormones 

Healthy protein sources for chemotherapy patients include:3

  • Lean meats and poultry (chicken without skin, turkey, pork trimmed of fat, and beef loin)
  • Organic and free-range eggs 
  • Fish (haddock, cod, tilapia, grouper, seabass, and halibut)
  • Beans (kidney, chickpeas, edamame, soy, black beans, cannellini, and horse beans) and lentils 
  • Low/no salt peanuts 
  • Seeds (sunflower, linseed, pumpkin, sesame, and chia)
  • Reduced-fat dairy products with no added sugars (yoghurt, semi-skimmed/skimmed milk, and cheese)

Fats

Fats can be trans-saturated or saturated, which are both unhealthy in large amounts, and polyunsaturated/monounsaturated, which are healthy fats.3 Healthy fat sources for chemotherapy patients are:3

  • Nuts (walnuts, almonds, cashew nuts, macadamia, brazil, hazelnut, pecan, pine nuts, and pistachios) 
  • Fish
  • Avocados 
  • Olive oil

Recommended drinks 

The NHS recommend 6-8 glasses of water per day to prevent dehydration, reduce toxic chemotherapy by-product buildup by flushing toxins, and to retain normal body functions.2 

Other drinks include:

  • Low/no sugar black tea and coffee
  • Herbal tea (peppermint, ginger, flaxseed, chamomile, and nettle teas)8 
  • Fresh fruit and vegetable smoothies and juices 

Precautionary measures patients should take

It is not recommended to take certain herbal or other alternative therapies as it may cause negative interactions with chemotherapy treatment. Consult with a doctor, nurse and pharmacist for advice before using additional/alternative therapies and supplements.9

The following are herbs which have been shown to cause harmful chemotherapeutic drug toxicity:9

  • St John's wort
  • Ginkgo
  • Ginseng
  • Licorice
  • Kava
  • Garlic
  • Cranberry
  • Grape seed
  • Germander
  • Goldenseal
  • Valerian
  • Black cohosh
  • Grapefruit juice

Acidic (citrus fruit and tomatoes) and spicy foods and drinks may exacerbate side effects of chemotherapy such as mouth sores.3 Additionally, allergies and intolerance to nuts and seeds, fish and shellfish, wheat, eggs and dairy should be considered when consuming food and drink.

Foods which relieve side effects of chemotherapy

  • Ginger (taken in the form of teas, jams, and dishes has been used to reduce the symptoms of nausea)8 
  • Turmeric (relieves pain and inflammation)
  • Omega-3 fatty acids rich in fish oils (such as cod liver fish oil) prevent inflammation
  • Probiotics (in dairy products) for relieving bowel-related side effects such as diarrhoea10 

Foods to avoid during chemotherapy treatment

Processed foods

  • Red meat which can be high in salt (pork sausages and bacon, beef, veal, mutton, venison, goat, and lamb)3
  • Crisps
  • White bread products

Sugar-dense foods and drinks. These include:11

  • Condiments (sauces, dips and dressings)
  • Cakes, cookies, biscuits, pies and pastries 
  • Sweets and chocolates
  • Ice cream and ice lollies
  • Tinned food (such as fruit in juice and baked beans)
  • Cereals 
  • Carbonated beverages 
  • Fruit juices with added sugars
  • Alcohol 
  • Sports drinks 

Foods high in saturated fats and cholesterol

These include:

  • Deep fried foods 
  • Red meat3

Tips and recommendations for diet planning during chemotherapy 

During chemotherapy, a healthy and simplified diet plan, which does not exacerbate the side effects of chemotherapy and provides necessary nutrients, is optimal.12

  • Eat multiple smaller meals instead of larger meals
    • Chemotherapy can cause patients to not feel like eating
    • 5-6 smaller meals, eaten slowly, during the day can be consumed to prevent stomach fullness
  • Keep on-the-go healthy snacks close
    • Keep on-the-go foods, such as dried fruits, peanut butter on crackers, oatcakes with low-fat cheese, and healthy oat bars near you when required
  • Eat easy-to-consume foods
    • Whilst undergoing chemotherapy, patients may be unable to swallow or taste food 
    • Soft foods such as soups, fruit smoothies/juices, and mashed potatoes with peas are good options
  • Take frequent sips of water throughout the day
    • Drink 6-8 glasses of water per day to hydrate
  • Eat fruit, vegetables and whole grains
    • This helps relieve constipation caused by chemotherapy due to fibre content 
    • Be aware that too much fibre may exacerbate diarrhoea in patients
  • Consume sodium and potassium-rich products
    • Sodium and potassium minerals are lost in diarrhoea, a symptom of chemotherapy 
    • To replenish these minerals try consuming salty crackers or a soup broth containing high sodium, and eating tomatoes, bananas, and potatoes containing potassium
    • Salty crackers, bananas and applesauce also relieve nausea
  • Receiving help and advice from a dietician
    • Patients must consult with a dietician to get personalised diet adjustments and plans tailored to their side effect profile and other factors in chemotherapy treatment

FAQs

What foods are best to eat while on chemo?

Eat 5 portions of fruits and vegetables in a variety of colours, and consume healthy snacks such as dried fruits, nuts and seeds, oat bars with less added sugar, legumes, low-fat dairy products, fish, and lean meats low in saturated fat.

Summary

In summary, this article reiterates the importance of foods to eat and avoid during chemotherapy. This includes consuming fruits, vegetables, whole grains, seeds and pulses, and water to hydrate, as well as avoiding highly processed, high-fat, high-sugar, alcoholic, spicy, and acidic foods and beverages.

Furthermore, it is emphasised that food must be eaten according to the patient's side effect profile. Conclusively, diet planning tips are provided for patients of chemotherapy experiencing certain side effects and for maintaining good general health. It is vital patients consult with healthcare professionals regarding side effects, diet and taking alternative therapies alongside chemotherapy.

References

  1. Anand U, Dey A, Chandel AKS, Sanyal R, Mishra A, Pandey DK, et al. Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics. Genes Dis [Internet]. 2022 [cited 2024 Apr 24]; 10(4):1367–401. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310991/
  2. Buckley MC. Cancer treatment side effect: Dehydration. MD Anderson Cancer Center [Internet]. [cited 2024 Apr 24]. Available from: https://www.mdanderson.org/cancerwise/cancer-treatment-side-effect--dehydration.h00-159305412.html
  3. Barrera S, Demark-Wahnefried W. Nutrition During and After Cancer Therapy. Oncology (Williston Park) [Internet]. 2009 [cited 2024 Apr 24]; 23(2 Suppl):15–21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770876/
  4. Amjad MT, Chidharla A, Kasi A. Cancer Chemotherapy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Apr 24]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK564367/
  5. Slavin J, Carlson J. Carbohydrates1. Adv Nutr [Internet]. 2014 [cited 2024 Apr 24]; 5(6):760–1. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224210/
  6. Cobiac LJ, Scarborough P, Kaur A, Rayner M. The Eatwell Guide: Modelling the Health Implications of Incorporating New Sugar and Fibre Guidelines. PLoS One [Internet]. 2016 [cited 2024 Apr 24]; 11(12):e0167859. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5173361/
  7. LaPelusa A, Kaushik R. Physiology, Proteins. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Apr 24]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK555990/
  8. Koçaşlı S, Demircan Z. HERBAL PRODUCT USE BY THE CANCER PATIENTS IN BOTH THE PRE AND POST SURGERY PERIODS AND DURING CHEMOTHERAPY. Afr J Tradit Complement Altern Med [Internet]. 2017 [cited 2024 Apr 24]; 14(2):325–33. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446458/
  9. Fasinu PS, Rapp GK. Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings. Front Oncol [Internet]. 2019 [cited 2024 Apr 24]; 9:1356. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901834/
  10. Redman MG, Ward EJ, Phillips RS. The efficacy and safety of probiotics in people with cancer: a systematic review. Ann Oncol [Internet]. 2014 [cited 2024 Apr 24]; 25(10):1919–29. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0923753419365986
  11. Zupanič N, Miklavec K, Kušar A, Žmitek K, Fidler Mis N, Pravst I. Total and Free Sugar Content of Pre-Packaged Foods and Non-Alcoholic Beverages in Slovenia. Nutrients [Internet]. 2018 [cited 2024 Apr 24]; 10(2):151. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852727/
  12. National Cancer Institute, U.S. Department of Health & Human Services. Eating Hints: Before, during, and after Cancer Treatment [Internet]. [cited 2024 Apr 25]. Available from: https://www.cancer.gov/publications/patient-education/eatinghints.pdf

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Tamana Sisodiya

Bachelor of Science - BSc, University of Southampton, U.K

Tamana is a Biology graduate who is passionate about researching and writing about medical health topics in an easily accessible, evidence-based, understandable and useful manner to various audiences. She has utilised scientific communication skills throughout her degree (such as within presentations and critical scientific reviews) and in writing a question overview for aspiring medical students who will take medical exams in order to communicate science to different audiences. She aspires to learn more about medical writing and how to write effective articles for various audiences and is interested to enter the career path of scientific communication.

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