MEDICAL NUTRITIONAL THERAPY

MEDICAL NUTRITIONAL THERAPY

Neutropenic diet: During chemotherapy neutrophil levels are suppressed, so a neutropenic diet is recommended. This diet consists of the low-microbial contamination.  The low-bacterial or low-microbial diet includes well-cooked foods and prohibits foods that are potentially harmful, such as raw fruits and vegetables and their juices, undercooked eggs, unpasteurized dairy products and undercooked meats. Such patients are advised to eat foods at right temperature, freshly cooked food. Stored foods /packaged foods should in aseptic condition. Good hygienic cooking and handling makes ensures food safe for consumption.  

Energy: Determining energy needs to maintain an energy balance and achieve a healthy weight, also to prevent unintentional weight gain or loss associated with cancer and cancer treatment. 

Energy requirements:  For nutritional repletion/ weight gain – 30-35kcal/kg/day; non-active cancer – 25-30kcal/kg/day; Hyper-metabolic cancer – 35kcal/kg/day; Sepsis – 25-30kcal/kg/day.

Protein:  Individual’s need for proteins is increased during times of illness and stress. Additional proteins are required to repair and rebuild tissues affected by cancer treatments and to maintain a healthy immune system. Inadequate protein intake, leads to breakdown muscle for bodily needs causing it delayed recovery and lower resistance to infection. Good sources of protein include fish, poultry, lean red meat, eggs, low-fat dairy products, nuts and nut butters, dried beans, peas and lentils, and soy foods.

Protein requirements: – ≥ 1.2g/kg actual body weight/day. 

Fluids: Fluid management in cancer care must ensure adequate hydration and electrolyte balance and prevent dehydration and hypovolemia.  Adults (without renal concerns) 20-40ml/kg OR 1ml fluid/ 1kg of calorie needs.

Fats: Monounsaturated fat, n-3 PUFA, and fat soluble vitamins helps in the prevention or suppression of cancer/tumour, whereas saturated fat and n-6 PUFA may increase the risk of carcinogenesis. Monounsaturated fat and n-3 fatty acids should be preferred over animal fats and other vegetable fats in the diet.

Anti-Oxidants: Antioxidants are chemicals that interact with and neutralize free radicals, thus preventing them from causing damage. Antioxidants are also known as “free radical scavengers.”

The body makes some of the antioxidants that it uses to neutralize free radicals.  Recommended a minimum of 400gm/day of fruits and vegetables containing antioxidants nutrients such as beta carotene, lutein, lycopene, selenium, vitamin C, vitamin E, etc.