Question

Ruth from New York asks: My father is borderline diabetic, advised to limit intake of sugar, and is also concerned about cholesterol. How can we help him GAIN weight? His cancer treatment makes him sick so he isn't eating much. He's too thin already and has at least another year of treatment. What about supplemental drinks like Ensure?

Answer

While I cannot give advice specific to an individual, I can provide a general response. As you read in the question above, “limiting intake of sugar” does not mean totally excluding it from the diet. When someone is eating poorly during cancer treatment, the priority is “getting IN nutrition”, not “restrictions”. Your father may be concerned about his cholesterol, but often even dietary management of high cholesterol is put on the back burner when someone is fighting a cancer battle. Your father might need reassurance from his doctor to liberalize his diet during this battle if he is over restricting because of fear of cholesterol. While it would be nice to gain weight, a more realistic goal to start is to prevent further weight loss. This often requires 6-8 mini-meals, emphasizing foods high in caloric density. For example, if someone would normally start a meal with a broth soup (low in calories) but then is too full to eat, the main meal is offered first to squeeze in the most calories before the person is full. When an individual is eating poorly during cancer treatment it is very important to work with a nutrition professional if the treatment will have more than a 3-5 day impact on nutrition. In your father’s case, he has a long road ahead of him and will need all the help he can get to maintain his nutrition. Supplemental drinks are often well tolerated, particularly if someone’s mouth has become sore from chemo and they don’t enjoy chewing textures. To combat weight loss but prevent the supplement from interfering with meals, sometimes similar supplements are even tube fed during the night. If the cancer treatment is long term, sometimes a small feeding tube is even placed through the abdomen, into the stomach to make it easier to provide these supplements. One of my favorite books on this subject is “What To Eat When You Don’t Feel Like Eating” by James Haller. It is designed for cancer patients and those facing life threatening diseases. Good luck and thank you for your interest in nutrition. Dr. Irene