Special Diets for Special Needs

When you have special needs because of your illness or treatment, your doctor or registered dietitian may prescribe a special diet. They also may suggest a commercial product to help you meet your nutritional needs. In the following sections, you will find guidelines for several special diets used during cancer treatment. You also will learn about products that can boost nutrition and where you can buy them. Remember that special diets and products to improve nutrition should be used only as recommended by your doctor or registered dietitian.

Special diets are an important tool for correcting nutritional problems that occur during cancer treatment. For example, a soft diet may be best if your mouth, throat, esophagus, or stomach is sore. Or, if your treatment makes it difficult for you to digest dairy products, you may need to follow a low-lactose diet. Some diets are well balanced and can be followed for long periods of time. However, some special diets should be followed for only a few days because they may not provide enough nutrients for the long term.

Only your doctor or registered dietitian should decide whether you need a special diet and for how long. If you are already following a special diet for another health problem, such as diabetes or high cholesterol, you and your doctor and registered dietitian should work together to develop your new plan.

Guidelines for common special diets appear in this section, including:

• Clear-liquid diet.
• Full-liquid diet.
• Soft diet.
• Fiber-restricted diet.
• Low-lactose diet.

For each diet, you will find a brief explanation of when the diet usually is recommended, the major foods it includes, and a suggested meal pattern. This information will help you follow the diet recommended by your doctor or registered dietitian. If you think you need a special diet, talk with your doctor or registered dietitian.

Clear-Liquid Diet

Clear-liquid diets are useful if the body can't handle the softest foods or heavy or thick liquids. Patients usually follow this type of diet after surgery or before stomach or bowel surgery. Patients with severe nausea and vomiting may also have this diet. A clear-liquid diet of ten lasts 1 to 2 days or until you can drink or eat other beverages and foods. It cannot meet the daily servings suggested in Figure 1 (except for fruit juices), but it helps ensure that your body doesn't lose too much fluid as you recover and become ready for a regular diet.

Click Here to see the Clear Liquid Diet table and suggested menu.

Full-Liquid Diet

You may follow a full-liquid diet when your body can digest all liquids but can't handle solid food yet. Your doctor or registered dietitian may recommend this diet after surgery or when you can't chew and swallow food. All liquids served at room or body temperature are part of this diet. This diet can include most of the recommended food groups in Figure 1, except meat. Extra milk has been included to ensure adequate protein. When planned properly, this diet can be used for long periods. In these instances, your doctor may prescribe a commercial supplement and/or certain vitamins. However, you should only take these if your doctor or registered dietitian recommends them.

If you must follow a full-liquid diet over a long period, you can increase the protein and calorie content of the diet by:

• Adding nonfat dry milk to beverages and soups.
• Adding instant breakfast powder to milk, puddings, custards, and milkshakes.
• Adding strained meats (such as those in baby food) to broths.
• Adding butter to hot cereal and soups.
• Including sugar or syrup (glucose) in beverages.
• Using smooth ice cream in desserts and beverages.
• Using prepared breakfast mixes in milk or milkshakes.

Click Here to see the Full-Liquid Diet and sample menu.

Soft Diet

A soft diet is useful when your body is ready for more than liquids but still unable to handle a regular solid diet. Soft food is easier to eat than regular food when the mouth, throat, esophagus, and/or stomach are sore. This soreness can occur to these parts of the body during and after radiation therapy or during chemotherapy. A soft diet can be used for long periods because it contains all needed nutrients. The diet consists of bland, lower fat foods that you soften by cooking, mashing, pureeing, or blending.

The table lists foods included in a soft diet as well as foods you should try to avoid. Keep in mind, however, that you may be able to eat some of the "excluded" foods without any discomfort or problems. In general, though, it is probably best to avoid fried or greasy foods and foods that may cause gas.

Click Here for the Soft Diet and sample menu

Fiber Restricted

Your doctor or registered dietitian may recommend a fiber-restricted diet if your gastrointestinal (GI) tract cannot digest fiber in foods. This type of diet is often used after GI surgery before patients return to their regular diet. A fiber-restricted diet also may be needed when treatment, such as radiation, damages the bowel or when the GI tract becomes irritated.

A fiber-restricted diet limits the amount of vegetables, fruits, cereals, and grains that you can eat. It also limits to two cups per day the amount of milk and milk products, such as cream, yogurt, and cheese, that you can eat. Milk does not contain fiber, but it leaves a residue in the GI tract that can irritate the bowel and cause diarrhea and cramping. The diet also is helpful for the many cancer patients who have a hard time digesting the milk sugar, lactose. (See the section, "Low Lactose Diet".) A fiber-restricted diet can be changed easily, depending on how you feel after eating certain foods. Use the diet in this booklet as a guide and discuss any changes with your doctor or registered dietitian.

There may be times when a low-residue diet, which is more limited than a fiber-restricted diet, is needed. On the low-residue diet, you may be able to eat most strained vegetables and fruit juices, such as white potatoes without skin, and tomato juice. All other forms of vegetables and fruits may be excluded from the diet. The low-residue diet also limits the amount of fat and dairy products you can eat. Your doctor or registered dietitian will let you know if you need to follow a low residue diet.

Your registered dietitian may gradually increase fiber and milk products in your diet according to how well you handle them.

Click Here to see the Fiber Restricted Diet and menu.

Low-Lactose Diet

All milk products contain lactose (or milk sugar). The doctor or registered dietitian may recommend a low-lactose diet after radiation therapy to the intestines, which often makes lactose hard to digest for a time. Fermented milk products, such as buttermilk, acidophilus milk, sour cream, and yogurt, usually are easier to handle than whole milk. You also can buy low-lactose milk or use liquid drops or caplets that help break down the lactose in milk and other dairy products. Lactose is often used as a filler in many products such as instant coffee and some medicines. Carefully read labels on commercial foods to see if they contain lactose or any milk products or milk solids.

Lactose tolerance varies from person to person. Ask your doctor or registered dietitian about choosing allowed foods and about low-lactose dairy products that you can buy at the grocery store.

Click Here to see the Low-Lactose Diet and menu.

Commercial Products To Improve Nutrition

If you cannot get enough calories and protein from your diet, commercial nutrition supplements, such as formulas and instant breakfast powders, may be helpful. There also are products that can be added to any food or beverage to boost calorie content. These supplements are high in protein and calories and have extra vitamins and minerals. They come in liquid, pudding, and powder forms. Prepackaged blenderized diets made from whole foods also are available. These are a convenient and inexpensive alternative to homemade preparations. Most commercial nutrition supplements contain little or no lactose. However, it is important to check the label if you are sensitive to lactose. (See the section, "Low Lactose Diet.")

These products need no refrigeration until you open them. Thus, you can carry nutrition supplements with you and take them whenever you feel hungry or thirsty. They are good chilled as between-meal and bedtime snacks. You may want to take a can or two with you when you go for treatments or other times when long waits may tire you. Ask your registered dietitian which supplements would be best for you.

Many supermarkets and drugstores carry a variety of commercial nutrition supplements. If you don't see these products on the shelf, ask the store manager if they can be ordered. You also may want to ask your doctor or registered dietitian for information about products for special patients. Be sure to ask for manufacturers' names, and, as mentioned above, be sure to read the label to see if any of the products contains lactose.

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