Nutrition and Stomach Cancer

Presentation by:

Denise Gabrielson, HBSc, BASc,  MSc(C), RD, Registered Dietitian

Department of Oncology, Haematology and Palliative Care

St. Michael's Hospital

Presented on October 17, 2016

Presentation Summary

The following is a summary of the original presentation. Please click the image below to view the original PDF document


General recommendations:

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  •  maintain an ideal body weight
  • Consume more fiber, fruits, vegetables and whole grains 
  • Limit sugar, salt, red meat, alcohol and processed meat.
  • If possible, avoid using supplements and try to attain nutrients from diet. Speak to a doctor before using any supplements
  • eating is a challenge during treatment. You will most likely lose weight. Even though weight loss is normal, you should make every effort to conserve and gain weight.
  • Prioritize high protein and calorie foods each meal.
  • add fats to slow down digestion (reduce dumping syndrome).
  • eat by the clock rather than waiting to feel hungry
  • Eat small, frequent high energy and high protein meals.

  • Physical Activity: Can stimulate appetite, improve quality of life, reduce length of hospital stay, promote immune functioning, reduce symptoms of fatigue, pain, nausea from treatment.
  • Sugar: There is no direct link between sugar and cancer, however, too much sugar can lead to obesity which does have a direct link to cancer. Sugar is an energy source for ALL body cells (e.g. brain, muscle, etc.), they do not preferentially feed cancer cells. Sugary food should be limited because they tend to be nutrient-poor foods and can result in dumping syndrome.
  • Red/ Preserved/Processed Meat: There is a strong link between red meat, preserved meat, processed meat and stomach cancer. Red meat should be limited and preserved and processed meat should be avoided
  • Alcohol: There is a strong link between consuming more than 3 drinks/day and stomach cancer. Alcohol can also worsen treatment symptoms and dumping syndrome. Alcohol should be limited.
  • Salt:There is a strong link between eating salty foods and stomach cancer. Limit salt intake to less than 5g/day

Healthy Eating

There are three essential nutrients in the body that are necessary for bodily functioning. Essential nutrients cannot be synthesized by the body, so must be attained through diet.

  1.      Proteins: Important for tissue growth and repair, immune function and muscle strength.
  2.      Fats: Important source of calories. Needed for transport of nutrients and building new cells. Fats can slow down digestion and absorption
  3.    Carbohydrates: All carbohydrates are broken down into sugars which are the primary source of energy for ALL body cells. Sugars empty from the gastrointestinal tract at different rates. Complex carbohydrates, such as whole grains, have health benefits and empty at a slower rate into the gastrointestinal tract. This makes it more gentle on the body of someone who is sugar sensitive. Fruits and vegetables are an excellent source of energy, vitamin, minerals, fiber and phytochemicals which boost the immune system.

Healthy Eating During Treatment

Eating can be very difficult during treatment. You may experience weight loss due to side-effects of treatment or as a symptom of the cancer. Most importantly: eat as well as you can! The body's needs and abilities may change during treatment. You may not be able to eat as much but it is important to make every bite count. Over time eating will become more enjoyable. Your body will need to adjust to your new normal so don’t be too hard on yourself!

Chemotherapy and Radiation Side effects
Loss of appetite, nausea, vomiting, diarrhea, constipation, feeling of fullness, taste Changes, sore mouth, fatigue

Common Post-Gastrectomy Side effects
Decreased food intake, malabsorption, fast intestinal transit time, dumping syndrome, slow stomach emptying and lactose intolerance.

  1. Fat Maldigestion: Digestive enzymes are needed to breakdown and absorb fats. Maldigestion occurs when there is reduced digestive enzyme production or mixing of food with enzyme.
  2. Lactose Intolerance: May require experimentation with lactose to see how much you can tolerate
  3. Dumping Syndrome: usually it is worst right after surgery but will lessen over time. The length of time varies between individuals. there are two types of dumping syndrome, early and late dumping syndrome with different side effects. To reduce dumping syndrome eat more frequent small meals, eat slowly, chew or blend food, sit upright, limit sugar, limit fluid with meal. Make each meal count: include protein and high fibre
Dumping Syndrome.jpg

 Promoting Weight Gain

  • Eat small, frequent high energy and high protein meals.
  • Eat by the clock
  • keep a calorie log to monitor how much you eat and what foods work for you
  • add fats to slow down digestion (reduce dumping syndrome).
  • Prioritize high protein and calorie foods each meal.

Nutritional Supplements

You may need to add high calorie/protein nutritional supplements to your diet. Several commercial supplements are available; understand the balance between sugar-protein-calories in each supplement to avoid dumping syndrome. High protein/calorie homemade smoothies can be a better alternative to sugary commercial products

Dietary Supplements
Eating a varied diet is the best way to get all needed nutrients. Malabsorption can be a problem during treatment making it difficult to get the nutrients you need.

  • Some supplements can interfere with cancer treatments. Speak to your doctor, pharmacist or dietitian before starting ANY supplements
  • If you had a total or partial gastrectomy you may need vitamin B12, folate, iron, calcium and vitamin D supplementation since some of these require stomach acid for absorption
  • For guidelines please view the original document (top of the page) or speak to your doctor, pharmacist or dietitian.

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