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Food for thought in cancer


KUALA LUMPUR: The onslaught of cancer and aggressive chemotherapy usually takes a toll on a patient’s body.As cancer progresses, the body becomes malnourished, while chemotherapy weakens the immune system.At this stage, avoiding food contamination and getting adequate nutrition is of utmost importance.Cancer patients are encouraged to go on a neutropenic diet (a diet for people with weakened immune systems), said dietitian Nur Hayati Azmi before the “Neutropenic Diet Cooking Demo” by executive chef Mohamad Hanafi Mohamed last Thursday for cancer patients and their caretakers at KPJ Ampang Putri, Kuala Lumpur.

“A neutropenic diet helps protect patients from bacteria and other harmful organisms found in some food and drinks,” she explained.Nur Hayati said that if a person’s immune system is not working well, the body may have a hard time protecting itself from bacteria such as E. coli, Salmonella and Listeria.Patients are encouraged to start the neutropenic diet early, even before treatment begins, she said.

A patient who has too few white blood cell count (absolute neutrophil count less than 500 cells/mm³) should follow the neutropenic diet, she said.She said that people with chemotherapy-related neutropenia are prone to infections while they wait for their cell counts to recover.“During this period, the doctor would advise certain precautions such as wearing a face mask, avoiding those with a cold, washing hands regularly, and follow food safety guidelines thoroughly,” she said.The neutropenic diet generally requires food to be cooked, said Nur Hayati. “Beef, chicken, fish, and eggs need to be cooked completely to ensure that all bacteria are destroyed.“That means no raw or rare meat or runny yolk,” she said.Those on the diet should also avoid salads and fruit bars, and deli counters, she said.While most people prefer homemade food, Nur Hayati said homemade juices and dressings are generally not encouraged as there is a tendency of cross-contamination while making them.

Avoid all uncooked vegetables and most uncooked fruits, she said.Patients should eat fruits that have thick skins that can be peeled off such as bananas or oranges.Cooked vegetables, canned fruits and juices are safe to eat, she said.

“If patients still want to eat raw vegetables and fruits that do not need peeling, they have to wash it properly using cold water, salt water or a vege wash,” she said.Asked if cancer patients can eat deep-fried foods, Nur Hayati said that patients can eat such food, but the oil used for frying should be used only once and not recycled.Eating fried food should be minimised, and if it is eaten, it is best to use palm oil for frying as it is the most stable oil for frying, she said.Since cancer induces weakness and wasting of the body, Nur Hayati said patients need to eat food high in calories and protein so the body can fight the cancer.“They need a lot of energy to fight the disease,” she said, adding that supplements help to top up their nutritional needs, while some exercise is helpful in overcoming fatigue.

The prevalence of malnutrition in patients with cancer has been reported to range from 20% to more than 70% in studies carried out worldwide, she said.Malnutrition among cancer patients could lead to diminished tolerance to therapy, low survival rates, reduced quality of life and longer hospital stay, she said.She added that 60% of head and neck and gastrointestinal patients lose weight upon starting treatment.“For those who do not have the appetite to eat, they should eat small and frequent portions, even if it means eating 10 times a day,” she said.

Asked if cancer patients could consume sugar (many believe that cancer cells feed on sugar, so it shouldn’t be eaten), Nur Hayati said that such patients need a balanced diet and they also need some sugar for energy.She also said that it is better for patients to eat natural food and avoid processed food.Chef Hanafi said that with the neutropenic diet, patients can eat the food they like as long as they are cooked.Cancer patients need to avoid medium-cooked meats and eat meats that are well-done, he said. Although patients cannot take fresh salads, they can prepare salads using cooked carrots, pumpkin, corn and apples and toss them with a dressing, he said. - The Star