When you hear the phrase "healthy eating," what jumps to mind? Chances are, you think of a diet full of fruits, vegetables, and fiber and low in unhealthy fats and refined sugar. But for some, the phrase may mean something entirely different. Those who are literally fighting for their lives need to eat in a way that allows them to keep up their strength and manage the side effects of treatment, be it chemotherapy, radiation, or surgery. 

"Nutrition is a top priority, because patients who are about to start treatment can anticipate a lot of negative side effects," says Melissa Bailey, MS, RD, CNSC, clinical nutrition manager of Kate Farms. It’s common for some to become nauseous or lose their appetite, for example, and tastes or eating patterns may change altogether.  That’s why it’s helpful to have a pre-treatment nutrition plan in place—ideally one that’s designed in conjunction with your oncologist and dietitian. Here are some of the things you can do before that first treatment to kickstart a conversation with your health team.  

#1: Look into Medical Nutrition Therapy

Simply put, medical nutrition therapy (MNT) is the actual nutrition care process implemented by a dietitian during treatment, Bailey says.   If you’re already in the hospital and being seen by doctors, it’s common for dietitians to consult at that time to determine what your overall diet might look like, along with whether oral supplements or tube feeding might be necessary. Bailey says most facilities even offer a multidisciplinary approach where patients might see an oncologist, along with a dietitian and a social worker all in one visit, to receive a more comprehensive care plan. If you don’t see a dietitian during your oncology visit, Bailey suggests asking your doctor about it, as MNT may be more difficult to access if you’re not in the hospital.

#2: Rev up your calorie intake

For many people, one of the biggest battles is getting enough nutritious calories to combat the effects of treatment. 

"Even though you might be sitting on a couch or lying in bed, your body is fighting internally," Bailey explains. "It’s almost as if you’re constantly running a marathon." This constant battle can impact your metabolism, sending it into fight-or-flight mode so you’re burning a high number of calories, expending energy, and using muscle mass, Bailey says. All of this can take a toll on the body, and often it leads to significant weight loss. 

To give yourself a head start, Bailey recommends asking a dietitian or even your oncologist about potentially increasing total calorie intake before treatment even begins. While it’s not recommended you go to the store and stockpile nuts, oils, and other high-calorie foods as soon as you’re diagnosed, depending on your individual circumstance, an uptick in these foods might be helpful to help counteract potential weight loss or an upcoming struggle to consume calories.  

#3: Focus on whole foods

It’s no secret that cancer treatment is grueling on the body, so it’s common for patients to wonder what specific foods they should be eating to prepare themselves as best as possible. Unfortunately, there isn’t a clear answer.  "There’s a lot of controversy on what sort of foods you should eat, what you should avoid, and what you should add," Bailey says. "To say for one specific patient 'this is better than the other,' you can’t really do that." In general, the rule of thumb is to eat as many whole foods as possible—a variety of fruits and vegetables; beans, nuts, and seeds; healthy fats—and limit red meat consumption, Bailey says. As a starting point, the Mediterranean diet serves as a strong guideline for this.  "It really emphasizes those whole foods, limiting red meat, saturated fats, and unhealthy sort of processed stuff," she says. "All of these are going to give you a really good, nutrient-dense diet."

#4: Pump up the protein

"For chemo and radiation patients in particular, making sure to get enough calories and protein [is essential]," Bailey says. "That’s going to support their weight, their muscle mass, and their overall ability to tolerate treatment."

Your doctor and dietitian can help you determine exactly how much protein to aim for each day, and some foods win over others in the more-bang-for-your-buck department. There are many ways to add additional protein to your diet from both plant and animal sources¹.   

Regardless, Bailey says to keep an eye out for lean animal protein sources or plant-based options as much as possible, to give your body access to a variety of nutrients. It’s also smart to have liquid nutrition options on hand—not only to make it easier to hit your daily protein goals, but also to get in more calories when keeping down solid food may be a struggle. 

#5: Limit processed food and alcohol

Again, everyone’s diet is going to be different, but if you’re tinkering with yours, Bailey suggests looking for foods you currently eat that may be more irritating than helpful. Anything overly processed (meaning you struggle to recognize ingredients on the nutrition label) should be restricted, as should alcohol, high-fat dairy, fried foods, and saturated fats.

"They’re not necessarily hard NOs, but things in general to think about limiting in your diet," she says.