June 3, 2015

Fight Fatigue with Your Fork

By cancerconnect

Fight Fatigue with Your Fork

Fatigue can be a debilitating side effect of cancer treatment, but food choices can make a real difference in maintaining energy.

We all know what it’s like to feel a little tired—maybe you hit a midafternoon slump at work or you can’t quite get up the energy to jump out of bed after a night of fitful sleep. But if you’re a cancer patient, you may also know what it’s like to feel genuine fatigue, and that’s a totally different story.

Fatigue is not the same as tiredness. Everyone feels tired now and then, but fatigue is characterized by an overwhelming lack of energy that is not relieved by sleep. Some patients refer to it as “paralyzing.”

Fatigue is one of the most common side effects of cancer and its treatment. It can result from medications, anemia, infection, stress, poor nutrition, inadequate rest, and more.

“In your regular life, fatigue is when you feel tired and you’re lying on the couch after work and then your friend calls and invites you to the movies and you suddenly have a new burst of energy because that sounds like great fun,” says Carolyn Katzin, MSPH, CNS, a nutritionist with more than 20 years’ experience helping cancer patients. “But with cancer it’s a different kind of fatigue. You don’t get that new burst of energy. That reserve is just not there.”

The lack of reserve can wreak havoc on a cancer patient’s daily life. Suddenly, a task as simple as grocery shopping feels tantamount to scaling Mount Everest.

Food Is Fuel

There is no silver bullet for fighting fatigue. It has so many different causes and patterns that it may require the use of many strategies for effective treatment. There is one thing that might help, though, and it is something you can control: food.

Cancer treatment increases the nutritional demands of the body. The body is working to fight cancer, fight infection, and cope with the effects of treatment. It kicks into overdrive and it needs fuel—in the form of calories.

Because food can be such a fun, delicious, and social experience, we sometimes forget that the primary purpose of food is to fuel our bodies, in much the same way as we use gas to fuel our cars. If your car runs out of gas, it will sputter to a halt. The same is true for your body.

Not all food is created equal, however. Some foods will boost your energy, whereas others will leave you feeling drained. The trick is learning to identify the highest-quality fuel for your body.

Building and Stoking the Fire

Your body doesn’t need just food in the fight against fatigue—it needs the right kinds of food, in the right quantities, and at the right times. What you eat, what you don’t eat, and how often you eat are the keys to increasing your energy.

According to Katzin, maintaining stable blood sugar levels is imperative. Although blood sugar has become a common catchphrase, do we really understand what it means? It requires us to think about how food breaks down in the body.

Think of feeding your body as similar to feeding a fire. We use both paper and wood to build a fire. The paper catches fire first and then burns out quickly; the wood more burns slowly over a longer period of time. We can look at food in much the same way. Some foods act like paper because they deliver sugar into the bloodstream quickly and then fizzle out; other foods act like wood and deliver sugar more slowly over a longer period of time, providing a more sustainable form of energy. If you want to keep your internal fire—your energy—burning, you want to keep your blood sugar at a consistent, stable level, rather than letting it spike and dip.

Balance Blood Sugar

But how do you identify which foods are the paper and which foods are the wood? One helpful resource is the glycemic index, which ranks foods according to their effects on blood sugar levels. Foods that are lower on the glycemic index are usually higher in fiber, so they deliver sugar more slowly over time.

“Low glycemic index foods provide the best type of energy,” says Katzin. These are foods such as green vegetables, raw carrots, whole-wheat bread, brown rice, wild rice, oatmeal, and sweet potatoes. In contrast, cancer patients may want to avoid high glycemic foods such as white rice, white bread, pasta, corn, soda, cookies, and candy.

In addition to choosing low glycemic foods, Katzin recommends eating small, frequent meals to maintain stable blood sugar. This is the equivalent of throwing an extra log on the fire so that it doesn’t burn out. It’s easier to keep that fire going than it is to rebuild it. Similarly, it’s less taxing on the body to keep blood sugar stable rather than to try to raise it after it has plummeted.

Pack in the Protein

Maintaining stable blood sugar is just one part of the equation in the fight against fatigue. It is also important to consume nutrients that help build a strong body.

Cancer patients need to eat a little more protein than they would under normal circumstances. Protein helps repair body tissue, strengthen the immune system, and ensure growth. When our bodies are deficient in protein, we have a lowered resistance to infection and it can take longer to recover from illness. As such, additional protein is critical during and after cancer treatment because it helps prevent infection and heal tissue damage.

Good sources of protein include fish, poultry, dairy products, lean meat, nuts, and legumes. Katzin suggests eating protein in an easy-to-digest form, such as whey protein powder, which can be added to a smoothie.

Beware the Bonk

Some foods are so tempting; they taste great and seem to provide a quick burst of energy—right up until the “bonk,” when your blood sugar drops and you’re left feeling lethargic, cranky, and exhausted.

When you’re already feeling fatigued, you can’t afford to sacrifice precious energy for the quick high that sugar and caffeine might offer. Saying no to sweets and soda might be your biggest safeguard against a downward spiral of exhaustion.

“The problem with refined sugar is that it is delivered into your bloodstream so fast,” says Katzin. “Some people feel immediately quite energetic and then they feel quite tired rather quickly. It’s like a pendulum; what goes up must come down.”

Katzin also cautions against stimulants that have caffeine in them, such as coffee, green tea, dark chocolate, and guarana. “It doesn’t really serve you to try to override it by taking in a bunch of stimulants because, in the end, the fatigue is going to be even worse. It’s sort of like trying to spend your way out of an overdraft. It just doesn’t work.”

Drink Up

Dehydration is a common problem associated with cancer treatment. It can result from vomiting, diarrhea, fever, infection, or simply inadequate liquid intake. Many cancer patients get so dehydrated that they have to receive fluids intravenously.

Dehydration is exhausting and very taxing to the body. The best way to deal with dehydration is to prevent it. It is important to consume water, as well as electrolytes, which are minerals such as sodium and potassium that are essential to health. Many sports drinks on the market offer a proper balance of electrolytes; however, these are often also loaded with sugar, so it is important to read labels carefully.

Facing Down Fatigue
“Fatigue is very disturbing to a lot of people, especially high-energy people who are used to being very functional,” says Katzin. But, she cautions, “Fatigue is a normal side effect of cancer, so it’s not to say we shouldn’t feel fatigue—because it’s the body’s natural response—but there are some things we can do to boost energy.”

Food won’t eliminate fatigue altogether, but it will provide the body with the vital energy it needs to function and heal. Although this seemingly simple remedy can be challenging for cancer patients faced with nausea, vomiting, and appetite loss, Katzin insists that it is important. She recommends that patients think of eating in the same way they approach their medication: “You have to take it at certain times and at a certain dose—it’s the same with food.” She emphasizes that maintaining good nutrition is critical to coping with cancer treatment and its side effects.

“Just be kind,” Katzin says. “Think of food as a way of nourishing yourself, giving to yourself, healing yourself.”

Eating for energy doesn’t mean you have to obsess over your diet. When choosing foods, simply ask yourself, Will this energize me or deplete me? Then choose accordingly.

Eating for Energy

  • Eat small, frequent meals.
  • Choose low glycemic foods such as whole grains, brown rice, oatmeal, and green vegetables.
  • Eat a little more protein than normal (easy-to-digest protein, such as whey powder, is best).
  • Choose healthy fats, such as olive oil or almond butter.
  • Stay hydrated.
  • Avoid stimulants, such as caffeine and chocolate.
  • Avoid refined sugar.


Peanut Butter Sesame Seed Bars
Excellent source of folate, niacin, zinc, and vitamins B1, B2, and B6. Good source of vitamin A, calcium, and iron.

½ cup vanilla protein powder
¾ cup skim dry milk
1 cup dry oatmeal flakes
¾ cup low-fat peanut butter
½ cup honey
2 tablespoons warm water
2 tablespoons sesame seeds

Combine ingredients in a mixing bowl. Spray a 9-by-9-inch baking pan with oil and press the mixture into the pan. Refrigerate for at least 30 minutes before cutting into rectangular bars.

Serves 12
Prep time: 5 minutes
Stand time: 30 minutes
Calories: 143
Protein: 9 grams (g)
Carbohydrates: 25 g
Fat: 2 g
Calories from fat: 9%
Cholesterol: 1 milligram (mg)
Dietary fiber: 2 g

Apple Pie Smoothie
Excellent source of folate, calcium, iron, zinc, and vitamins B1, B2, B6, B12, and C. Good source of vitamin A.

2 tablespoons vanilla protein powder
¼ cup apples, chopped
Dash of nutmeg
½ teaspoon cinnamon
1 cup skim milk
3 ice cubes

Blend ingredients together and serve chilled.

Serves 1
Prep time: 10 minutes
Calories: 184
Protein: 16 g
Carbohydrates: 27 g
Fat: 1 g
Calories from fat: 6%
Cholesterol: 4 mg
Dietary giber: 4 g

Frank’s Bountiful Breakfast
Excellent source of calcium, iron, zinc, and vitamins B1, B2, B6, B12, and C. Good source of vitamin A.

2 tablespoons applesauce
4 tablespoons cottage cheese
1 tablespoon whey protein powder
2 tablespoons Greek-style yogurt
1 teaspoon ground cinnamon
½ teaspoon ground cardamom
cinnamon bark

Optional: dried cranberries or raisins

Combine ingredients in a bowl and serve chilled; garnish with cinnamon bark.

Serves 1
Prep time: 5 minutes
Calories: 284
Protein: 20 g
Carbohydrates: 33 g
Fat: 8 g
Cholesterol: 65 mg
Dietary fiber: 2 g

Tags: Cancer Prevention