Suggestions for appetite improvement include the following:[34,35,36]
- Plan a daily menu in advance.
- Eat small, frequent, high-calorie meals (every 2 hours).
- Arrange for help in preparing meals.
- Add extra protein and calories to food.
- Prepare and store small portions of favorite foods.
- Consume one third of daily protein and calorie requirements at breakfast.
- Snack between meals.
- Seek foods that appeal to the sense of smell.
- Be creative with desserts.
- Experiment with different foods.
- Perform frequent mouth care to relieve symptoms and decrease aftertastes.
What types of foods are usually recommended?
- Cheese and crackers.
- Nutritional supplements.
- Ice cream.
- Powdered milk added to foods such as pudding, milkshakes, or any recipe using milk.
- Finger foods (handy for snacking) such as deviled eggs, cream cheese or peanut butter on crackers or celery, or deviled ham on crackers.
See the NCI Web site'sEating Hints: Before, During, and After Cancer Treatment for recipes such as Lactose-Free Double Chocolate Pudding Recipe to Help with Lactose Intolerance, Banana Milkshake Recipe to Help with Appetite Loss, and Fruit and Cream Recipe to Help with a Sore Mouth. For a free copy of this booklet, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
Alterations of taste and smell
Alterations in taste can be related to unknown effects of cancer, radiation treatment, dental problems, mucositis and infection (thrush), or medications. Cancer patients undergoing chemotherapy frequently report changes in their sense of taste, specifically a bitter taste sensation during administration of the cytotoxic drugs. One study measured the taste thresholds among cancer patients under chemotherapy compared with controls. In this study, 62% of patients complained of taste disorders associated with the chemotherapy medications. Taste dysfunction can result in food avoidance, inducing weight loss and anorexia, all of which can have significant consequences on patients' quality of life. Simply changing the types of foods eaten as well as adding additional spices or flavorings to foods may help. Citrus may be tolerated well if no mouth sores or mucositis is present. Rinsing the mouth before eating may help improve the taste of food.
While undergoing cancer therapy, patients may experience taste changes or develop sudden dislikes for certain foods. Their sense of taste may return partially or completely, but it may be a year after therapy ends before their sense of taste is normal again. A randomized clinical trial found that zinc sulfate during treatment may be helpful in expediting the return of taste after head and neck irradiation.[Level of evidence: I]
Suggestions for helping cancer patients manage taste changes include the following:
- Eat small, frequent meals and healthy snacks.
- Be flexible. Eat meals when hungry rather than at set mealtimes.
- Use plastic utensils if foods taste metallic.
- Try favorite foods.
- Plan to eat with family and friends.
- Have others prepare the meal.
- Try new foods when feeling best.
- Substitute poultry, fish, eggs, and cheese for red meat.
- A vegetarian or Chinese cookbook can provide useful nonmeat, high-protein recipes.
- Use sugar-free lemon drops, gum, or mints when experiencing a metallic or bitter taste in the mouth.
- Add spices and sauces to foods.
- Eat meat with something sweet, such as cranberry sauce, jelly, or applesauce.