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Health Information
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Wednesday, January 07, 2009
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Special Diets For
Special Needs
When you
have special needs because of your illness or treatment, your
doctor or registered dietitian may prescribe a special diet.
They also may suggest a commercial product to help you meet
your nutritional needs. In the following sections, you will
find guidelines for several special diets used during cancer
treatment. You also will learn about products that can boost
nutrition and where you can buy them. Remember that special
diets and products to improve nutrition should be used only
as recommended by your doctor or registered dietitian.
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Special diets
are an important tool for correcting nutritional problems
that occur during cancer treatment. For example, a soft
diet may be best if your mouth, throat, esophagus, or stomach
is sore. Or, if your treatment makes it difficult for you
to digest dairy products, you may need to follow a low-lactose
diet. Some diets are well balanced and can be followed for
long periods of time. However, some special diets should
be followed for only a few days because they may not provide
enough nutrients for the long term.
- Only your doctor
or registered dietitian should decide whether you need a special
diet and for how long. If you are already following a special
diet for another health problem, such as diabetes or high
cholesterol, you and your doctor and registered dietitian
should work together to develop your new plan.
- Guidelines for
common special diets appear in this section, including:
- Clear-liquid diet.
- Full-liquid diet.
- Soft diet.
- Fiber-restricted
diet.
- Low-lactose diet.
- For each diet,
you will find a brief explanation of when the diet usually
is recommended, the major foods it includes, and a suggested
meal pattern. This information will help you follow the diet
recommended by your doctor or registered dietitian. If you
think you need a special diet, talk with your doctor or registered
dietitian.
Clear-Liquid
Diet
- Clear-liquid diets
are useful if the body can't handle the softest foods or heavy
or thick liquids. Patients usually follow this type of diet
after surgery or before stomach or bowel surgery. Patients
with severe nausea and vomiting may also have this diet. A
clear-liquid diet of ten lasts 1 to 2 days or until you can
drink or eat other beverages and foods. It cannot meet the
daily servings suggested in Figure 1 (except for fruit juices), but it helps
ensure that your body doesn't lose too much fluid as you recover
and become ready for a regular diet.
 Click Here to see the Clear Liquid Diet table and
suggested menu.
Full-Liquid
Diet
- You may follow
a full-liquid diet when your body can digest all liquids but
can't handle solid food yet. Your doctor or registered dietitian
may recommend this diet after surgery or when you can't chew
and swallow food. All liquids served at room or body temperature
are part of this diet. This diet can include most of the recommended
food groups in Figure 1, except meat. Extra milk has been included
to ensure adequate protein. When planned properly, this diet
can be used for long periods. In these instances, your doctor
may prescribe a commercial supplement and/or certain vitamins.
However, you should only take these if your doctor or registered
dietitian recommends them.
- If you must follow
a full-liquid diet over a long period, you can increase the
protein and calorie content of the diet by:
- Adding nonfat
dry milk to beverages and soups.
- Adding instant
breakfast powder to milk, puddings, custards, and milkshakes.
- Adding strained
meats (such as those in baby food) to broths.
- Adding butter
to hot cereal and soups.
- Including sugar
or syrup (glucose) in beverages.
- Using smooth ice
cream in desserts and beverages.
- Using prepared
breakfast mixes in milk or milkshakes.
Click Here to see the Full-Liquid Diet and sample
menu. 
Soft
Diet
- A soft diet is
useful when your body is ready for more than liquids but still
unable to handle a regular solid diet. Soft food is easier
to eat than regular food when the mouth, throat, esophagus,
and/or stomach are sore. This soreness can occur to these
parts of the body during and after radiation therapy or during
chemotherapy. A soft diet can be used for long periods because
it contains all needed nutrients. The diet consists of bland,
lower fat foods that you soften by cooking, mashing, pureeing,
or blending.
- The table lists
foods included in a soft diet as well as foods you should
try to avoid. Keep in mind, however, that you may be able
to eat some of the "excluded" foods without any discomfort
or problems. In general, though, it is probably best to avoid
fried or greasy foods and foods that may cause gas.
 Click Here for the Soft Diet and sample menu
Fiber
Restricted
- Your doctor or
registered dietitian may recommend a fiber-restricted diet
if your gastrointestinal (GI) tract cannot digest fiber in
foods. This type of diet is often used after GI surgery before
patients return to their regular diet. A fiber-restricted
diet also may be needed when treatment, such as radiation,
damages the bowel or when the GI tract becomes irritated.
- A fiber-restricted
diet limits the amount of vegetables, fruits, cereals, and
grains that you can eat. It also limits to two cups per day
the amount of milk and milk products, such as cream, yogurt,
and cheese, that you can eat. Milk does not contain fiber,
but it leaves a residue in the GI tract that can irritate
the bowel and cause diarrhea and cramping. The diet also is
helpful for the many cancer patients who have a hard time
digesting the milk sugar, lactose. (See the section, "Low Lactose Diet".) A fiber-restricted
diet can be changed easily, depending on how you feel after
eating certain foods. Use the diet in this booklet as a guide
and discuss any changes with your doctor or registered dietitian.
- There may be times
when a low-residue diet, which is more limited than a fiber-restricted
diet, is needed. On the low-residue diet, you may be able
to eat most strained vegetables and fruit juices, such as
white potatoes without skin, and tomato juice. All other forms
of vegetables and fruits may be excluded from the diet. The
low-residue diet also limits the amount of fat and dairy products
you can eat. Your doctor or registered dietitian will let
you know if you need to follow a low residue diet.
- Your registered
dietitian may gradually increase fiber and milk products in
your diet according to how well you handle them.
- Click Here to see the Fiber Restricted Diet and
menu.
Low-Lactose
Diet
- All milk products
contain lactose (or milk sugar). The doctor or registered
dietitian may recommend a low-lactose diet after radiation
therapy to the intestines, which often makes lactose hard
to digest for a time. Fermented milk products, such as buttermilk,
acidophilus milk, sour cream, and yogurt, usually are easier
to handle than whole milk. You also can buy low-lactose milk
or use liquid drops or caplets that help break down the lactose
in milk and other dairy products. Lactose is often used as
a filler in many products such as instant coffee and some
medicines. Carefully read labels on commercial foods to see
if they contain lactose or any milk products or milk solids.
- Lactose tolerance
varies from person to person. Ask your doctor or registered
dietitian about choosing allowed foods and about low-lactose
dairy products that you can buy at the grocery store.
 Click Here to see the Low-Lactose Diet and menu.
Commercial
Products To Improve Nutrition
- If you cannot
get enough calories and protein from your diet, commercial
nutrition supplements, such as formulas and instant breakfast
powders, may be helpful. There also are products that can
be added to any food or beverage to boost calorie content.
These supplements are high in protein and calories and have
extra vitamins and minerals. They come in liquid, pudding,
and powder forms. Prepackaged blenderized diets made from
whole foods also are available. These are a convenient and
inexpensive alternative to homemade preparations. Most commercial
nutrition supplements contain little or no lactose. However,
it is important to check the label if you are sensitive to
lactose. (See the section, "Low Lactose Diet.")
- These products
need no refrigeration until you open them. Thus, you can carry
nutrition supplements with you and take them whenever you
feel hungry or thirsty. They are good chilled as between-meal
and bedtime snacks. You may want to take a can or two with
you when you go for treatments or other times when long waits
may tire you. Ask your registered dietitian which supplements
would be best for you.
- Many supermarkets
and drugstores carry a variety of commercial nutrition supplements.
If you don't see these products on the shelf, ask the store
manager if they can be ordered. You also may want to ask your
doctor or registered dietitian for information about products
for special patients. Be sure to ask for manufacturers' names,
and, as mentioned above, be sure to read the label to see
if any of the products contains lactose.
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