Posted on May 26, 2020
Kimberly Mugler, RDN, LDN
Eating a nutritious diet is an important
factor in the treatment of myeloma. Along with getting enough sleep and
physical activity, a healthy diet can help you feel your best and support your
body during myeloma treatment. Several symptoms of myeloma and the side effects
of myeloma treatments might require specific nutrition recommendations.
Guidelines on healthy eating for people with
myeloma do not vary greatly from healthy eating guidelines for everyone else.
Some of the main aspects of a healthy diet for myeloma are discussed below.
While these nutritional guidelines are safe for most people, you may have
additional health concerns — such as food allergies or stomach conditions —
that require special consideration. Always consult with your doctor or a
dietitian before making major changes to your diet.
Make Plants the Focus
A good goal is a plant-based diet, which
emphasizes plant foods but can include meat and dairy products in moderation. A
plant-based diet often coincides with a Mediterannean diet. This is an eating
pattern rich in fruits, vegetables, whole grains, low-fat dairy, lean meat and
other proteins, and healthy fats. Unhealthy, saturated fats like those found in
butter and fried foods should be limited to less than 10 percent of your total
calorie intake for the day. One of the advantages of a plant-based diet is
maximizing your antioxidant intake. Antioxidants such
as vitamin A, vitamin C, vitamin E, beta-carotene, and lycopene fight free
radicals and can help prevent cancer.
“Day 3 of plant-based diet,” wrote one
MyMyelomaTeam member. “So far, so good. I was afraid I would be starving, but I
am satisfied.” Another member neatly summed up the basics of the plant-based
diet: “Eat everything in moderation. But more veggies, and yes, get enough
protein.”
Plant Compounds That
May Help Fight Cancer
Preliminary research suggests ursolic acid may
decrease tumor growth by regulating mitochondrial function through metabolic
pathways. Foods that contain ursolic acid include apples, basil, rosemary, and
cranberries. Cooking with these ingredients or consuming these foods can’t hurt
you, but taking supplements with these ingredients is not currently
recommended.
Cruciferous vegetables contain compounds
called glucosinolates, which may help with cancer prevention and recurrence.
There is research proving this compound can help with lung, colon, breast, and
prostate cancer. More research is needed to clarify relationships and evidence
of the health effects of glucosinolates on other forms of cancer. Cruciferous
vegetables include broccoli, Brussels sprouts, and cauliflower.
Curcumin, also known as turmeric, is a compound
that has anticancer properties. The spice may target different cell-signaling
pathways, including growth factors and cytokines, which may help with cancer
prevention or recurrence. Curcumin has poor bioavailability, meaning it has low
absorption rates and fast elimination from the body, but studies suggest that
black pepper may enhance absorption. The research on this compound is
preliminary, and further clinical trials are needed to assess its
effectiveness.
One MyMyelomaTeam member enjoys finding delicious
ways to incorporate turmeric. “I slice up sweet potatoes like fries and
sprinkle turmeric, black pepper, garlic and onion powder with olive oil and
bake at 400 for about 40 minutes. Don't know if it helps, but my daughter and I
enjoy eating them.”
While curcumin, cruciferous vegetables, and
ursolic acid may not have specific relationships with blood cancers, they
contain healthful compounds for immune health. These may help fight infections
— a common complication of myeloma and its treatment.
Fiber
Fiber is a neglected, yet crucial, component
of healthy eating. Fiber comes from foods like vegetables, fruits, whole
grains, beans, nuts, and seeds. Fiber stimulates proper digestion, aids in
glycemic control, manages healthy lipids, and promotes a balanced gut
microbiota. For optimal health, women need at least 25 grams of fiber per day,
and men need at least 35 grams of fiber per day.
Fiber can help with some side effects of
myeloma treatment. “My specialist told me to eat Kashi Go cereal — the one with
13 grams of fiber and a digestive probiotic,” wrote one MyMyelomaTeam member.
“Really made a difference in my diarrhea.”
For some people living with myeloma, a
high-fiber diet may irritate the stomach and worsen nausea. In these cases,
your doctor may recommend a low-fiber diet instead.
Using the Plate Method
The plate method is a
simple visual technique to help you accomplish a balanced diet and aid in
portion control. Too much of even a good thing can be a bad thing, which makes
portion control and distribution important. To use the plate method:
·
Half of your plate
should include vegetables — the more colors, the better.
·
One-fourth of your
plate should contain protein, such as chicken, fish, or legumes.
·
One-fourth should
contain a healthy starch, such as brown rice, quinoa, or sweet potato.
The plate method helps you quickly and
visually understand the ratio of the foods you are eating. “I know that I feel
so much better when I eat more veggies than starches,” shared one MyMyelomaTeam
member. This goal is easy to achieve using the plate method.
Your meal should also contain a healthy fat
like olive oil, avocado, nuts, or seeds. Fruit can be enjoyed with a meal or as
a snack, along with a source of protein or fiber to help control blood glucose
and feel “full.” For instance, pair an apple and almond butter, grapes and
string cheese, or bell pepper strips and hummus.
Part of a healthy meal distribution includes
treating yourself to foods you crave — in moderation. It is healthier to have a
small serving of your sweet of choice than to restrict yourself and possibly
end up overdoing it later.
One MyMyelomaTeam member shared how they watch
their sugar intake: “You will want to watch anything that spikes your glucose,
so refined sugar should be off the menu. But agave syrup is OK as long as you
stick to one teaspoon a day.”
Aim for a Healthy
Weight
Maintaining a healthy weight is crucial for
good overall health. You should consume enough calories to maintain an
appropriate weight for your size or enough calories to gradually lose weight if
you are overweight or obese.
It can be hard to maintain a healthy weight
and prevent malnutrition if you are experiencing nausea, vomiting, diarrhea,
loss of taste, or loss of appetite. During these times, prioritizing
nutrient-dense, high-calorie foods is a must. Maintaining your weight with
calories and preserving your lean muscle mass with protein are of equally high
priority.
If you or your doctor is worried about weight
loss during or after myeloma treatment, choose foods dense in both nutrients
and calories. Some good options are:
·
Nuts
·
Nut butters
·
Avocados
·
Beans
·
Chicken
·
Fish
·
Yogurt
Making smoothies and soups are popular ways to
load up on healthy foods if you don’t feel like eating solid foods. Soups and
smoothies are easy, versatile dishes to disguise nutritious foods like flaxseed
meal, chia seeds, nut butters, beans, and vegetables to help amplify health.
Increasing your meal frequency, or eating small snacks throughout the day
rather than large meals, can help you obtain adequate calories as well.
Maintaining physical activity can also produce a healthy appetite.
Taking corticosteroids, such as Dexamethasone, can
contribute to weight gain in people with myeloma. One MyMyelomaTeam member
asked, “How does everyone deal with the weight gain from taking steroids? Are
there foods to eat to help with this?” Another responded, “The good news is
that it comes off again quickly when you go off of [the corticosteroid]. You
can eat foods that purge your body of excess liquid, such as cucumbers, ginger,
blueberries, artichokes, and watermelon.”
Managing Anemia
Individuals with myeloma often
experience anemia — a
condition caused by a deficiency of red blood cells or iron. Anemia causes
fatigue and can often be managed with nutrition. Individuals with anemia will
need to pay attention to their iron intake. There are two forms of iron — heme
iron and nonheme iron. Heme iron includes animal sources — meat, poultry, and
fish — and is about 15 percent absorbable by the body. Nonheme iron includes
plant-based sources — legumes, grains, and vegetables — and is only 3 percent
to 8 percent absorbable. There are several things that can help increase or
decrease iron absorption. It is worth noting that taking excess iron can
lead to nausea, vomiting, and liver damage.
A helpful guideline is to include a dietary
source of vitamin C at every meal, especially meals with a source of iron.
Vitamin C enhances the absorption of iron in the body. Dietary sources of
vitamin C include citrus fruits, bell peppers, cruciferous vegetables, and
tomatoes. It is important to note that coffee and tea can significantly
decrease iron absorption. These beverages should not be included with meals
that contain iron-rich foods.
“I know when I kind of cheat from my normally
healthy diet to keep my red blood cells, white blood cells, and platelets up, I
totally feel the difference,” wrote one MyMyelomaTeam member. “I feel
sluggish.” When another member asked for advice on how to combat anemia, he was
advised: “Leafy green vegetables, lean red meat, iron supplements if OK with
your doctor. I take a B12 supplement under my tongue.”
A rare form of anemia, called megaloblastic anemia,
may be caused by a deficiency in vitamin B12 and folic acid. Megaloblastic
anemia may occur in people with some types of blood cancer. Below are lists of
the top food sources containing vitamin B12 and folic acid.
Good Sources of
Vitamin B12:
·
Clams
·
Fortified cereal
·
Tuna
·
Nonfat plain Greek
yogurt
·
Salmon
·
Beef
·
Chicken
·
Eggs
·
Nutritional yeast
Good Sources of Folic
Acid:
·
Spinach
·
Fortified cereal
·
Black-eyed peas
·
Asparagus
·
Brussels sprouts
·
Broccoli
·
Avocado
Diet and Kidney Damage
Between 20 percent and 40 percent of
people living with myeloma will develop kidney failure to some degree. If the
results of your blood and urine tests show signs of kidney damage, your doctor
may give you specific dietary recommendations. Limiting foods high in
potassium, sodium, and phosphorus may be necessary, depending on the specific
nature of your kidney problems. Your health care provider will monitor your
blood test results to assess whether restriction of one or more of these
nutrients could help prevent further damage.
If so, you may be asked to limit:
·
Foods high in
potassium, such as oranges, bananas, spinach, zucchini, and peaches
·
Foods high in
phosphorus, such as cheese, wheat bread, peanut butter, nuts, and seeds
·
Foods high in sodium,
such as processed foods, packaged snacks, condiments, salad dressings, sauces,
and restaurant or takeout foods
Staying Hydrated
Drinking enough fluids is important for
nutrient transportation, joint health, blood pressure regularity, and so much
more. Staying well-hydrated also supports kidney function, an important concern
in people with myeloma. Water is your best choice for staying hydrated. Avoid
or limit sugary drinks like fruit juice, soda, and sweetened teas. If you don’t
enjoy drinking water, try adding fresh fruit, fruit extract, or low-sugar
sports drinks like G2 by Gatorade, Propel flavored electrolyte water, or
Vitaminwater Zero.
MyMyelomaTeam members are very aware of the
importance of hydration. “Stay hydrated!” is a common reminder between members
on the social network. “Everyone have a mentally sharp, physically comfortable,
and hydrated day,” wished one member.
Limit alcohol to no more than one drink per
day for women and two drinks per day for men. Time your intake of coffee and
tea to avoid limiting your iron absorption, as mentioned above. Alcohol and
caffeine can also make it harder to stay hydrated. “Caffeinated beverages and
alcohol are dehydrating, so they don't count 😇,” said one MyMyelomaTeam member.
Do’s and Don’ts of
Food Safety With Myeloma
Food safety is incredibly important for people
living with myeloma, who often deal with a weakened immune system. For
instance, Revlimid (Lenalidomide) can
cause leukopenia — low
white blood cell count. If you undergo a stem cell transplant, you will likely
be more susceptible to foodborne illness than individuals who receive other
treatments for myeloma.
Follow these safe food handling do’s
and don’ts to avoid foodborne illnesses.
Food Safety Do’s:
·
Cook all meat and fish
thoroughly.
·
Cook eggs thoroughly —
not runny or sunny-side up.
·
Wash produce well
before you peel it. Consider soaking fruits and vegetables in a solution of
apple cider vinegar and water to kill bacteria.
·
Refrigerate deli
meats, even dry-cured sausages.
Food Safety Don’ts:
·
Eat products
containing raw eggs, such as cookie dough or homemade mayonnaise.
·
Drink unpasteurized
milk or juice.
·
Eat soft cheese such
as brie, blue cheese, or Gorgonzola.
·
Eat from salad bars
and buffets, since food sits longer and is more likely to become contaminated.
·
Eat alfalfa sprouts or
other raw sprouts.
·
Drink well water,
unless it has been boiled for one minute or filtered.
Check Your Facts:
Nutrition and Supplement Claims
It can be challenging to read health claims
regarding nutrition supplements and cancer and try to decipher what is legitimate
and what may be far-fetched marketing claims. There is little science-based
evidence proving a specific nutrient or supplement to be effective in the
treatment of cancer.
It is important to always consult with your
doctor before trying any supplement or herb. It may have a negative impact on
your cancer treatment. For instance, green tea supplements can interfere with
the effectiveness of Velcade (Bortezomib),
which is used to treat multiple myeloma and mantle cell lymphoma. Similarly,
the popular herbal supplement St. John's wort is known to reduce the
effectiveness of Gleevec (Imatinib), a drug used to treat
chronic myeloid leukemia and Philadelphia-positive acute lymphoblastic
leukemia.
Here are some facts about nutritional supplements from
the Office of Dietary Supplements at the National Institutes of Health:
·
Dietary supplements do
not have to be proven effective before they are marketed.
·
Just because a product
is natural does not mean it is safe.
·
Since some nutrients
are already supplemented in foods you eat, you may wind up accidentally taking
an unsafe amount.
·
You are more likely to
experience side effects from supplements if you take them in high doses, if you
take them instead of prescribed medications, or if you combine several types of
supplements.
It’s a Challenge, but
You’re Not Alone
Many MyMyelomaTeam members are inspired to
make healthy changes like improving their diet when they are first diagnosed.
But changing eating habits can be hard, especially when they impact so many aspects
of our life. As one MyMyelomaTeam member wrote, “I'm trying to do a better job
of eating whole foods. It's not easy when you have eaten a poor diet all your
life.”
Eating healthier requires learning how to plan
meals, choose healthy foods, and perhaps try new ways of cooking. It can become
even more complicated when family members are not on board. When you join
MyMyelomaTeam, you gain a support network of more than 6,000 people living with
myeloma who understand the challenge of trying to adopt a nutritious diet.
Members of MyMyelomaTeam often share recipes
and discuss their efforts to eat healthy and improve their diets. Here are a
few examples of conversations about diet and nutrition:
Do you feel better when you eat a healthy
diet? What steps do you take to maintain good nutrition while living with
myeloma? Comment below or post on MyMyelomaTeam.
References
2. Anticancer effect of ursolic acid
via mitochondria-dependent pathways (Review) — Oncology Letters
No comments:
Post a Comment