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No appetite? How to get nutrition during cancer treatment

By Mayo Clinic staff

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No appetite? How to get nutrition during cancer treatment

Eating well may help you feel better and make it easier to tolerate your cancer treatment. Use these tips to get the nutrition you need.

By Mayo Clinic staff

Sometimes cancer or cancer treatment can affect your appetite. Though you might not feel like eating, it's important to do what you can to maintain your calorie, protein and fluid intake during cancer treatment. Use this information to help plan meals and snacks that will be more appealing and provide the nutrition you need to get better.

Keep in mind that in some cases, such as advanced cancer, eating may not affect the outcome of your illness or treatment. In these situations, trying to follow specific dietary guidelines, such as adhering to a low-sodium or low-fat diet, may not be practical. Sometimes caregivers or family members can unintentionally add stress by pushing or trying to force you to eat certain foods. Ask your doctor how carefully you need to follow specific dietary guidelines.

Mealtime

  • If you feel full after eating only a small amount, try eating small amounts more frequently when you do get the urge to eat. You may find it easier to eat small amounts several times each day rather than at mealtimes.
  • If you never seem to feel hungry, it's often helpful to eat according to a schedule rather than to rely on appetite.
  • Take advantage of the times when you feel your best. Eat more when you're hungry. Many people have their best appetite in the morning, when they're rested.
  • Limit fluids during meals, as liquids can fill you up and limit your intake of higher calorie foods. It may help to drink most of your liquids 30 to 60 minutes before or after meals.
  • Create a pleasant mealtime atmosphere. For example, use soft music, candles or nice place settings.
  • Vary the color and texture of foods to make the meal more appealing.
  • For adults, a small amount of wine or beer before meals — if allowed by your doctor — may stimulate your appetite.
  • Pay attention to smells, as certain scents may decrease your appetite or bring on nausea. Avoid smells that have this effect on you.

Snack time

  • Keep snacks readily available so that you can eat when you're up to it. Cheese, ice cream, canned fruit in heavy syrup, nuts, peanut butter with crackers, cottage cheese and chocolate milk are examples of high-calorie snacks requiring little or no preparation. Don't be too concerned that some of these options are high in cholesterol or fat. Once you regain your appetite, you can focus on more healthy snacking options.
  • Bedtime may be a good time to snack because your appetite for the next meal won't be affected.

Anytime

  • Cold or room temperature foods may be more appealing, particularly if strong smells bother you. Cold sandwiches or main-dish salads, such as tuna, chicken, egg and ham salads, are good choices.
  • Experiment with foods. Once-favorite foods may no longer appeal to you, while foods you were never fond of may become appealing.
  • Regular moderate exercise may help stimulate your appetite. Check with your doctor for exercise limits.
  • Nutritional supplement drinks, such as canned or powdered shakes, can provide a significant amount of calories and require little or no preparation. It may be easier for you to drink rather than to eat something.

Increasing calories

During illness, treatment or recovery, your need for calories may be greater than usual. The following suggestions can help increase the number of calories you consume:

  • Use butter or margarine generously on potatoes, bread, toast, hot cereal, rice, noodles, vegetables and in soups.
  • Spread peanut butter — which is high in protein — on toast, bread, apple or banana slices, crackers or celery.
  • Add powdered creamer or dry milk powder to hot cocoa, milkshakes, hot cereal, gravy, sauces, meatloaf, cream soups or puddings.
  • Meat, chicken or fish that has been breaded or fried is higher in calories than meats that are baked, broiled or roasted.
  • Top hot cereal with brown sugar, honey, dried fruit or cream.
  • Top pie, cake, gelatin or pudding with ice cream, whipped cream or cream.
  • Use fruit canned in heavy syrup. It has more calories than does fresh or juice-packed fruit. If you prefer fresh fruit, add sugar and cream.
  • Drink beverages that contain calories. Good choices include fruit juice, lemonade, fruit-flavored drinks, malts, floats, soda pop, cocoa, milkshakes and eggnog. Nutritional supplement drinks are convenient options. Water, black coffee and tea have no calories, and bouillon and broth contain very few calories.

Though some of these suggestions add more fat and sugar to your diet, this shouldn't be a concern since you're only adding the extra calories until you can get your appetite back on track. Check with your doctor or a dietitian if you have concerns about changing the way you eat.

Increasing protein

Protein is important for growth, health and repair of your body. If you've been ill, you may need extra protein. Some suggestions include:

  • Add extra meat, poultry, fish or beans (pinto, navy, black, kidney) to casseroles, soups or stews.
  • Make your own high-protein milk: Add 1/4 cup (59 milliliters) powdered milk to 1 cup (237 milliliters) whole milk, or 1 cup (237 milliliters) powdered milk to 1 quart (about 1 liter) whole milk. Use it as a beverage, add it to malts or shakes, or use it in cooking.
  • Try a commercially prepared protein supplement.

If illness has made red meat — beef, pork or lamb — less appealing to you, try the following foods, which also are good sources of protein:

  • Cheese
  • Cottage cheese
  • Beans
  • Lentils
  • Eggs
  • Fish
  • Poultry
  • Nuts
  • Peanut butter
  • Milk
  • Milkshakes
  • Custard
  • Pudding
  • Yogurt

Fluids

Drinking plenty of fluids also is key to helping your body during treatment. Aim to get a minimum of about 64 ounces (2 liters) of fluid a day, unless your doctor has directed you to limit your fluid intake. Try to choose drinks that contain calories.

Consider a multivitamin

If your loss of appetite is keeping you from eating well for more than a few days, you might consider taking a multivitamin to help you get the vitamins and minerals you need. Check the label and look for a multivitamin that doesn't give you more than 100 percent of the Daily Value (DV) of all the vitamins and minerals. Keep in mind, though, that if you're drinking liquid nutritional supplements, those will give you some of the vitamins and minerals you need, so you may not need a multivitamin. A nutritional supplement drink usually contains the equivalent of about one-fourth of a multivitamin.

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June 14, 2008

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