Tracy Mangold (APD, MND) Dietitian, Royal North Shore Hospital

Notes accompanying presentation to the Sydney Neuro-Oncology Group (www.snog.org.au)
Brain Tumor Support Group
at the North Shore Private Hospital, Wednesday 16th May 2001

What Nutritional Problems are Common?

·        Loss of weight and appetite

·        Nausea

·        Vomiting

·        Constipation

·        Diarrhoea

·        Chewing or swallowing difficulties

·        Taste Changes

·        Loss of Appetite

Loss of Weight and Appetite

·        Many things may lead to weight loss

·        Eat more when you feel better

·        Small frequent meals

·        Use high energy/calorie snacks

·        Make every mouthful count

·        Enrich your food with high energy, high protein foods

·        Use nourishing drinks as a snack

·        Save energy e.g. special cutlery, convenience meals

·        Use of supplements

·        Make meal times enjoyable

·        Light exercise before meals

·        Small glass of alcohol before you eat

·        Accept help from family and friends

·        Try mints, chewing gum and brush teeth after meals

How to Enrich Foods

Supplements available

·        Commercial supplements – many different types and flavours, made by different companies.

·        Commercial supplements e.g. Sustagen, Resource, Ensure powder, Ensure Plus, Polyjoule, Nutridrink

·        Make your own high protein milk

Nausea and Vomiting

·        Ask your doctor about anti-nausea/anti vomiting medication

·        Avoid your favourite foods around treatment

·        Eat small amounts regularly

·        Avoid cooking smells

·        Use cold foods e.g sandwiches, puddings, yoghurt, fruit, fruit salad

·        Relax while eating!

·        Eat and drink slowly

·        Try a small snack such as dry toast or crackers

·        Try sour or salty foods

·        Drink plenty of fluids

·        Avoid lying flat after meals

Constipation

·        Drink plenty of fluids

·        Try to include more fibre in your diet

·        Include light, regular exercise

Diarrhoea

·        Avoid fatty foods

·        Avoid alcohol and limit caffeine and spicy foods

·        Drink plenty of fluids

·        Ask your doctor about anti-diarrhoea medication

·        Eat small, frequent meals

·        If persistent, limit high fibre foods

·        Reducing lactose may help

Chewing or Swallowing Difficulties, Sore Mouth

·        Seek advice from a Speech Pathologist

·        Modify textures e.g. avoid dry, hard, crunchy foods

·        Avoid foods that sting your mouth e.g. vinegar, spices, wine, spirits, orange and pineapple juice

·        Use soft foods e.g. eggs, creamy soups, milk puddings

·        Chop or blend foods e.g. meat, vegetables

·        Make foods moist by adding gravies, sauces, margarine

·        Use a straw

·        Use a mouthwash before and after meals

·        Avoid very hot or very cold foods

Changes in Taste or Smell

·        Marinate meat, chicken

·        Substitute different protein foods e.g. instead of red meat try chicken, fish, eggs, baked beans or kidney beans

·        Add salt, garlic, bacon, herbs, sugar for extra flavour

·        Use Salt, lemon juice, coffee powder if food is too sweet

·        Use sugar, honey, boiled lollies if food has a metallic taste