Indian diet for cancer patient after chemotherapy

 Indian diet for cancer patient after chemotherapy

You are a warrior and you are not alone. There are more than a million people in India who are struggling just like you.

Malnutrition is very common during this period for many obvious reasons. The treatment and it’s other complications probably led to the loss of appetite or has affected the usual way of digestion, absorption, or metabolism. However, it’s time to heal and nourish. You need nutrition to –

  • block further growth of new cancer cells
  • promote effective immune response to decrease the risk of infection
  • repair the wound
  • accelerate growth and development of normal cells and tissues
  • maintain normal body weight
  • maintain lean body mass
  • increase energy and strength
  • improve the quality of life
Indian diet for cancer patient after chemotherapy

Now the question is what to eat and how to eat?

Being an Indian, what are the regular foods you can consume without fear and at the same time what you must keep distance with.  Okay, let’s get started.

Indian diet guide for cancer patients after chemotherapy/ radiation / surgery

You must have read how avocado, blueberry, olive oil, etc are extremely beneficial for cancer patients. But in India, how feasible are they? Considering Indian climate and food tradition what would be the smarter Indian food choices that are more acceptable, available, and affordable?

If I am not wrong, cancer is not the only medical problem that you are dealing with. It must be associated with diabetes, hypertension, heart diseases, uric acid or thyroid issues etc.

Therefore you must follow a diet which should consider your entire existing problem and guide you to pick the right food.

Keep it simple using the regular Indian foods

No you don’t actually need any special food but what you must have special care for your daily diet. Confused? Okay, I am breaking it down.

There are basic 9 groups of foods and you must make sure you have some foods from at least 7- 8 groups every day.  Each group of foods has many unavoidable reasons to be a part of your daily diet. The food groups are –

  1. Cereal and cereal products
  2. Pulses and pulse products
  3. Vegetables
  4. Fruits
  5. Milk and milk products
  6. Nuts and seeds
  7. Egg/ fish/ chicken/meat
  8. Oils and fats
  9. Sugar and jaggery

All you need to be careful of striking a balance in these food groups.

Cereal and cereal products

Indian diet for cancer patient after chemotherapy 1

Your diet should have more food from this category.  Cereals provide a great amount of carbohydrate, a good amount of protein, and minute fat. These foods are rich in vitamin B complex and minerals. Therefore you can’t ignore these foods. What exactly do we mean by cereals? Check the table.

Know your cereals:

CerealsCereal ProductsCereal based items
RiceMurmura, Chirwa, KhoiDosa, Idli, Poha, Upma
WheatWheat flour, refined flour, semolina(sooji), dalia, Wheat puffsBiscuits,  noodles, pasta
Barley Barley water
CornCorn flour, corn flakesPopcorn, boiled corn
Millets –  Jowar, Bajra, RagiMillet flour, Millet puffsDosa, Idli, Poha, Upma
BuckwheatBuckwheat flour 
Quinoa  

How much cereal in a day?

Try to take cereals/ cereal products 3 times a day as a part of your major meals – breakfast, lunch, dinner. If you have got back your normal appetite it’s probably already there. Take any cereal product (Chirwa/ sooji/ Dalia etc) for breakfast and any cereal ( rice/ roti/ millets) of your choice for lunch and dinner. Don’t forget to try a variety of cereals.

Pick the right cereals –

Good cereal and productsBad Cereal and products
Semi polished rice, whole wheat flour, Murmura, Chirwa, Khoi, Sooji, Dalia, Roasted/ boiled  corn,Refined flour, instant noodles, instant pasta, instant popcorn, packaged breakfast cereal, commercial biscuits, cookies

How about brown rice and millets for cancer patients instead of white rice or roti?

Indian diet for cancer patient after chemotherapy 3

You are already struggling with treatment side effects and complications. If I am not wrong, you are probably facing a lack of appetite, acidity, constipation, dry mouth, mouth soreness, occasional diarrhea, low energy, etc on a regular basis.

Fiber is a form of carbohydrate which your body can not digest. Excess fiber also prevents the absorption of vitamins and minerals. Therefore, a sudden switch to a high fiber diet may aggravate digestive problems, flatulence, abdominal pain, etc.

Therefore it’s better to be slow but steady.  Avoid all kind of products containing refined flour as well as high fiber. Instead of brown rice, pick single polished rice, hand pound rice, boiled rice. Try millets as per the season once or twice a week. If you are not sensitive to gluten, enjoy atta instead of maida.

Remember you need a steady glucose response and can’t afford to have too many blood glucose spikes. So whole grain cereals are undoubtedly a better choice rather than its refined versions. (1) (2) (3) (4)

Rice and wheat products (murmura, chirwa, khoi, sooji, dalia, etc) contain a tolerable amount of fiber.

Pulse and pulse products

Indian diet for cancer patient after chemotherapy 4

Pulse includes all types of dal, beans, legumes, etc. This group of food essentially provides a large amount of protein, a good amount of fiber, vitamins – folate, and minerals. Each pulse has some special health benefits, so consider bringing variety in pulses for daily diet.

Know your pulses –

PulsesPulse productsPulse dishes
Green gram dal (whole, split, yellow),
Black gram dal, red gram dal, Lentil,
Bengal gram dal, Cow pea, Soybean, Peas, Rajma, Lobia, etc
Sattu, Besan, Roasted chana, Roasted peasDhokla, besan chilla

How much pulse in a day?

Try having a pulse twice a day as a part of your lunch and dinner. Two small bowls of dal are good for a day. You may also consider having a handful of roasted chana, dhokla, or besan chilla as a snack. If you are blessed with good digestion capacity, you may also think of trying overnight soaked chana to start the day.

Vegetables

Indian diet for cancer patient after chemotherapy5

Vegetables are the source of fiber, vitamins –  folate, and minerals in your diet. Apart from these, it also contains antioxidants and phytonutrients, essential to achieve good health and improve immune response. (12) (13) (14)

Know your vegetables –

CategoryType of vegetables
Green leafy vegetablesLeaves of  Amaranth, spinach, mustard, moringa, turmeric, fenugreek, colocasia, water spinach, lettuce etc
Roots & tubersPotato, yam, colocasia, tapioca, sweet potato, turnip  etc
Cruciferous vegetablesCabbage, cauliflower, Brussels sprout, broccoli, radish, Kohlrabi etc
Other vegetablesPumpkin, carrot, beetroot, tomato, various gourds, ladies finger etc

How much vegetable in a day?

Try to add some form of vegetables with 2-3 major meals – breakfast, lunch, and dinner. Consider having vegetables in raw as well as in cooked form. Therefore, plan to keep salad as well as vegetable stew, soup, curry in daily diet.

Do not overcook vegetables. Avoid deep-frying, barbequing, sauteing of vegetables. Try boiling, steaming, stewing methods for cooking. (1) (8) (9)

Wash vegetables thoroughly before cooking or making salads. Remember your immunity is already compromised and you can’t afford to have any food poisoning at this moment.

Fruits

Indian diet for cancer patient after chemotherapy6

Fruits are your friends.  Just like vegetables, fruits are also a great source of fiber, vitamins, minerals, antioxidants, and phytonutrients.

Add  2-3 types of local fruit to a daily diet. As usual, consider bringing variety in your fruit choices also. It’s best to have one citrus fruit (lemon, sweet lime, amla, orange, etc) or guava to ensure vitamin C supply from natural sources. Besides this, any other fruit ( banana, apple, watermelon, papaya, grapes, cantaloupe, pomelo, etc) can be taken as per the season and availability.  (15) (16)

Prefer freshly cut whole fruits over fruit juice. Avoid pre-cut fruits or salads completely. Consider having fruits as mid-morning snacks.

Colors are the key

Add natural colors in the form of vegetables and fruits to the diet. Feel free to bring variety and make sure you pick some vegetables from each category every week. (1)

Watch for these colors –

Colour –  vegetablePhytochemicals present
Red – Tomato, red grape, watermelon etcLycopene
Red & Purple – Berries, grapes, plum etcAnthocyanin, Polyphenols
Orange – Carrot, mango, pumpkin etcAlpha & beta carotene
Orange & yellow – Cantalope, peach, orange, ripe papaya etcCryptoxanthin, flavanoids
Yellow & green –  spinach, asparagus, honeydew melon, turnip greens etcZeaxanthin, Lutein
Green – Cabbage, broccoli, cauliflower etcSulforaphanes, Indoles
White & Green – spring onion, garlic, onion etcAllyl sulphides

Caution: Avoid packaged fruit juice and vegetable juices. There is nothing real in it. Generally, these drinks are loaded with various forms of sugar and synthetic flavor.

Milk and milk product

Indian diet for cancer patient after chemotherapy7

Milk is a good choice for supplying protein, calcium, vitamin B2, and B12. If you don’t have a history of lactose intolerance or milk allergy, consider adding milk and milk product in daily diet. Toned or double toned milk is comparatively easy to digest than whole milk. Add homemade chena/ paneer, curd, buttermilk, chaas, etc – as the form you enjoy. (10) (11)

How much of milk and milk product daily?

If you are a vegetarian and have no issue in digesting,  a big glass of milk ( 250-300 ml) in any preferred form should be enough for you.

Plan to finish your lunch with a cup of buttermilk/ curd for better digestion.  You may have chena with any preferred cereal as breakfast or snack. 

Nuts and seeds

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Nuts and seeds are loaded with good fat, protein, vitamins, minerals, and phytonutrients. Feel free to have a handful of unsalted, roasted, or overnight soaked nuts and seeds daily. Make a mixer of nuts and seeds – walnut, almond, cashew, pistachio, sesame seed, pumpkin seed, flaxseed, sunflower seed, etc and store in a glass jar. Consider having a handful of this mixture either in the morning (overnight soaked) or in the evening (unsalted roasted). (17) (18) (19)

Eggs/ fish /chicken/ meat

Indian diet for cancer patient after chemotherapy9

It’s needless to mention that it’s the category that will provide you first-class protein, vitamins, minerals, and especially vitamin B12. Consider enjoying these as a small part of your diet. If you eat only eggs, consider having 4-5 whole eggs a week. If you eat everything then add anyone nonveg item in daily diet. It may be a whole egg or a medium size of fish, 2-3 pieces of chicken or meat. Yes, try to avoid red meat as much as you can. But you can still enjoy 2 pieces of meat maybe once a month.

Caution: Avoid over-cooked meat, processed meat – salami, sausage, bacon, hot dogs, and meatball, ready to cook non-veg snacks/finger foods, etc at all costs. (5) (6) (7)

Shall I switch to a plant-based diet?

Indian diet for cancer patient after chemotherapy10

It’s your choice. Do not force yourself. If you are enjoying fish/ chicken/ meat/ egg as a part of your tradition since childhood then feel free to eat non-veg foods but as a small part of your daily diet as mentioned before.

It’s important to understand the problem starts with non-veg foods when taken in excess. Therefore be very careful about the portion size.

If you stop enjoying fish, chicken, then there is no harm in considering a shift to a plant-based diet. But again whatever diet you follow always remember, moderation is the key. (20)

I am a vegetarian, do I need protein supplements?

After going through chemotherapy/ radiation/ surgery, your body needs to heal. However, that doesn’t always mean you need protein in excess. Your protein requirement depends on your body weight. If you are being able to eat normal food and having a good appetite, then even if you are a vegetarian, pulse, and milk products, nuts and seeds are enough to supply the protein that your body needs at this time. Unless there is any dire need, supplements are definitely not advised.  (21)

What are the “dire need” situations for supplements?

  • You cannot eat
  • You don’t have appetite
  • You are extremely weak
  • Your body weight has reduced markedly
  • You have other complications where you can’t have pulses, milk  products

 Fats and Oil

Indian diet for cancer patient after chemotherapy 12

However you think to avoid fats and oil, it’s not possible and it’s not actually desired too.  You need good fats for energy as well as for absorption of micronutrients. Avoid any sort of refined oil at all cost. Refined oil is a potent cause for creating inflammation in your body. You are not in a condition to afford such risk. Look for kachhi ghani/ cold pressed/wood churned oil as cooking medium. Choose your oil as per your traditional use and local availability. Kachhi ghani mustard oil, double filtered groundnut oil/ sesame oil are good choices. (22) (23)

Research suggests that extra virgin olive oil is beneficial for reducing inflammation and better health. However, getting pure extra virgin olive oil (EVOO) is not very easy. Good quality of EVOO is extremely expensive so may not be a sustainable choice. Apart from these, it’s not suitable for the Indian style of cooking rather better to use as salad dressing, etc.

You may consider investing in good quality ghee, as it is a perfect cooking medium for Indian cuisine. Focus on quality than quantity. Try to restrict your oil/ fat intake to 5-6 tsp per day.

Choose fat wisely –

Good fatBad fat
Any cold pressed/ kachhi ghani/ double filtered oil – kachhi ghani mustard oil, double filtered groundnut oil/ sesame oil. Ghee, homemade butterAny Refined oil – refined rice bran oil, refined soyoil, refined sunflower oil, refined sesame oil, refined olive oil etc, margarine , vanaspati

Caution: Do not reheat the used oil for next day’s cooking or even for next dish. (24)

Sugar & Salt

Indian diet for cancer patient after chemotherapy12

Let’s admit that most of us love sugar. You do have sugar cravings at times. Refined sugar is bad. Just like refined cereal and refined flour, this feeds the cancer cell to grow. Therefore, you must avoid refined sugar. However, most of the refined sugar comes from hidden sources such as biscuits, cold drinks, packaged juices, packaged ready to cook/ eat foods, etc.

Let me remind you not to trust foods that claim to contain “zero sugar”, Even if they don’t contain sugar but add an artificial sweetener like aspartame to make the product tasty. In most packaged and ultra-processed food products, sugar is added in various names like maltose, dextrose, corn syrup, etc. There are 65 names of sugar. If you read the food label carefully you will find most of the processed foods contain huge amounts of refined flour, refined oil, refined salt, and refined sugar in various names. It’s needless to say that is the deadliest combination for you.  You can’t afford to feed your cancer cells once again. So stay away from these foods. (25) (26) (27)

Does it mean you can’t have sugar or salt at all?

No, you can still enjoy sugar and salt but restrict consumption to 2 tsp of sugar and 1 to 1.5 tsp of salt in a day.  Try hard not to cross the allowance.

How about tea/ coffee?

Indian diet for cancer patient after chemotherapy14

The same rule of moderation applies here. Having 1- 2 cups of tea/ coffee in a day is fine but definitely not 4-5 cups. You can enjoy green tea/ black coffee/ filter coffee/black tea/ Indian chai using no or pinch of sugar. Try to place your tea/coffee in between two meals for better absorption of meals.  You may think of drinking turmeric tea or any herbal tea also once in a while. As mentioned earlier, try to keep the variety here too. Instead of having the same type of tea/coffee try something new every other week. (28) (29)

How about using spices?

Indian spices are famous for their medicinal properties. Turmeric, cinnamon, garlic, onion, ginger, etc has incredible power to control inflammation. Don’t go overboard and start drinking kara every single day. Rather enjoy moderate spices in cooked food. Feel free to have turmeric tea, cinnamon tea sometimes.

But I can hardly eat…

If you are still struggling to get your appetite back or fix another chemo/ radiation-related complications here are few tips for you that may help  –

  1. Eat small meals – Try 5-7 small meals a day
  2. Try one bowl method –  Instead of having a thali for lunch and dinner, try a balanced meal in a bowl. Add  1-2 serving of any cereal, pulses, vegetables  of your choice. Mix well. Use few drops of lemon juice or ghee for enhancing the taste.
  3. Try to keep the consistency semi solid
  4. Cereal- milk smoothie/ vegetable- fruit smoothie/ stew/ soup/ khichri (combining any cereal, pulse and vegetables of your choice) are convenient options
  5. Keep the quantity low but make it energy dense using ghee/ MCT  on top.

Is food enough?

Indian diet for cancer patient after chemotherapy16

No, when you are eating food you are just supplying the raw materials that your body is longing for. The nutrients must get assimilate into your body to show the magic. Therefore you must be mindful of the absorption of nutrients.

Heavy medication, surgery/ chemo/ radiation, etc have left a huge impact on your overall health. Fix your gut first. The gut is the area where all the nutrients get absorbed. Consider having some form of fermented food – dosa/idli/ curd/ buttermilk/ overnight soaked rice etc. You may also consider having probiotic shot after consulting your doctor.

Engage in some form of physical activity that you enjoy on a daily basis. It could be walking, yoga, running, gym, jogging, dancing anything. Start with 10 minutes and slowly increase the time up to 40 minutes to 1 hour.  If possible, ensure exposure to sunlight for some time. Remember vitamin D is essential and the sunlight is the best source one can have. (30) (31) (32)

Quit alcohol consumption, chewing tobacco and smoking as early as possible.

Sleep well. Sleep is the best detox for your body. Let your body heal on its own while sleeping. Make sure you finish dinner early and after 2 -3 hrs of dinner, try to sleep deep. (33)

Lastly try to manage your stress. Practice meditation, breathing exercise to release stress.

Bottom line

You are a warrior. You fought well so far and you are still fighting. Good food will provide the fuel to fight more. Follow an Indian diet as per your tradition with locally available ingredients.  Adopt a sustainable diet and healthy practices to win over cancer. You can do it. All the best.

Dr. Soma Chakrabarty

http://wellnessmunchcom.wordpress.com

Dr. Soma Chakrabarty has done her Ph.D. in Food and Nutrition in 2017. She is based in Hyderabad. She has 12 yrs of working experience in nutrition. Dr. Soma guides people to modify eating behavior and achieve the goal of wellness. She believes in a sustainable diet that helps people to live rather than survive.

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2 Comments

  • Great article Soma! A much needed discourse on Indian diets for cancer since majority of the dietary advisory focuses on diets from the Western World or Far East Asia, it is particularly welcoming to see you have addressed the palatability issues. Saturated fats are associated with cancer risk, what would your advise be for a cancer patient in terms of % of total calories? Would the standard recommendation of 10% be applicable?

    • Absolutely. The standard application will be fine, though it may vary case to case based on the type of cancer, other complications and the condition of the patient.

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