Nicola Scott is Senior Haematology Dietitian at St James Hospital Leeds, where she’s been helping patients for the past eight years. Here Nicola answers your questions, providing expert information about diet during and after transplant.
How can I change my diet to reduce my infection risk?
Many foods contain small amounts of bacteria and fungi – this isn’t normally a problem. But as your immune system is recovering after a transplant you’ll be more vulnerable to infections. So you’ll need to follow a ‘clean’ or ‘neutropenic’ diet. This is all about choosing and understanding what foods are high or low risk and following food safety advice.
A good tip is to find out about clean diet and low risk foods, before you go into hospital. That way you can start to familiarise yourself with the guidelines, so when you and your family are out shopping or preparing food you’ll know what to do. You can also ask family and friends to bring suitable foods in for you while you’re in hospital.
Your hospital should give you more specific advice about clean diet, but you can also read more in a booklet from Leukaemia and Lymphoma Research - 'Dietary Advice for Patients With Neutropenia'. Download it from their website here.
I’ve lost my appetite, lost weight and feel low in energy. What can I do to tackle this?
Losing your appetite, losing weight and feeling tired are common side effects during and after a transplant. You might not feel like eating, but good nutrition will play an important part in your care and recovery. Your dietitian can help you come up with ideas about boosting your appetite, energy levels and maintaining weight. Some top tips are:
- Try and make meal-times as relaxed and calm as you can.
- You don’t have to stick to a 3 meals-a-day routine, you can have small meals or snack 5 to 6 times a day.
- Make sure you have snacks and easy to prepare food on hand - such as yoghurts, ice-creams and cereal bars.
- Don’t be afraid of ready meals or convenience foods when you’re feeling tired. As long as you follow the manufacturer’s guidance and heat them up properly they’re fine.
- Try ‘food fortifying’ – add high, calorie protein rich foods to your meals or snacks, like butter and cheese in a baked potato or cream in your soup. Although you might normally follow a low-fat diet, adding these foods in for a short time will boost your calorie count and protein intake.
- Some of this advice might seem to turn your normal diet on its head. You’ll probably need to change back to a ‘healthier’ diet, but that can come at a later stage when you’re further into your recovery and your weight and energy levels are up.
In general, advice about diet will change at different points during the transplant process – so it’s good to be aware of that.
Food tastes different now - is this normal?
Yes, this is very normal and is caused by treatments such as chemotherapy, infection and medication affecting your taste buds. This tends to gradually go back to normal. You dietitian should talk to you about what exactly tastes different and what can help. If food tastes a bit like cardboard or cotton wool then you could opt for ‘tart’ foods like citrus fruits.
If things taste metallic then this could be down to the iron in red meat, so try switching to different sources of protein like chicken, turkey, fish or lentils.
If all your food is tasteless then avoid bland foods and opt for stronger flavours that will heighten your sense of taste – use marinates and spices to make your meals more interesting.
Take care of your mouth – keep it refreshed and get rid of stale tastes. Try rinsing with salty water or bicarbonate of soda, chew sugar free gum or mints and brush your teeth regularly.
Will a healthy diet help with my recovery?
Everybody needs a balanced diet for health - you need to make sure you’re getting food from all the major food groups. During your transplant and in the recovery phase your body needs more nutrients to rebuild and repair cells and tissue and to develop new ones.
If you had your transplant to treat a blood cancer, you’ll probably want to reduce the risk of your cancer returning, or having a new diagnosis of cancer. Although there’s no strong evidence at the moment the best advice is to follow World Cancer Research Fund’s tips for leading a healthy lifestyle.
Further on into your recovery if you’re trying to lose weight, or change your diet, then aim to limit fats and sugary food, control your portion size and keep active. A good starting point is to keep a food diary for a couple of days. This will give you an idea of what you might need to change.
Try focusing on one goal at a time when it comes to making changes to your diet.
Find out more: We hope you found those answers useful. For more information about diet and life after transplant you can download our free publication 'The Seven Steps: the next steps' If you’d like to receive more content like this in the future sign up to Before, During, After, Anthony Nolan’s quarterly enewsletter for patients and their families.
DISCLAIMER: At Anthony Nolan we take great care to provide up-to-date and accurate facts about stem cell transplant. We hope the information here will help you to look after yourself. Each transplant centre will do things differently, so this blog is just a general guide and isn’t intended to replace advice from your doctor and transplant team. Please speak to your transplant team for more details about your own situation as they will be able to give you personalised, specific advice.