ONS Article

Posted 11 months ago

Oral Nutrition Supplements – The Unsung Heroes

Those with cancer can begin to lose weight before treatment due to the effect cancer has on the body. When cancer is present, the body requires increased calories, protein, and fluids due to the increase in metabolic stress. Simultaneously, the immune system will release cytokines that can decrease appetite. This pathophysiology of cancer in conjunction with treatment-induced side effects can lead to malnutrition. It is critical to maintain an adequate nutritional status during treatment to decrease severity of treatment side effects, decrease risk of hospitalization, increase effectiveness of treatment, and enhance compliance with the duration of treatment. Nutrition is important no matter what your current weight.

To help manage these side effects and prevent malnutrition, oral nutrition supplements can be the greatest support to ensure enough calories, protein, and fluids are consumed. There are many different supplements on the market, making it difficult to decide which one is best. Listed below are some popular supplements and indications for use.

Poor appetite and Weight Loss

Ensure Complete (350 calories, 30g protein): This is a highly concentrated supplement that is easily available and drug stores and grocery stores. Many popular protein drinks found in stores are made to provide extra protein without a high amount of calories. This supplement packs a punch with 30 g of protein and 350 calorie,s making it one of the best options or maximizing everything you eat and drink.

Boost Very High Calorie (530 calories, 22g protein):  With a super high calorie content, some people rely on drinking multiple of these in a day to get in a full day of calories

**Make into smoothies for a meal replacement

Diabetes and/or treatment associated hyperglycemia

There are many different supplements that contain a low amount of carbohydrates on the market. Especially with a health-conscious culture, many shelf-stable drinks contain mostly protein. This is a great choice if dealing with any treatment-associated hyperglycemia or preexisting diabetes. Be aware, it should be used to supplement, not replace meals. To regulate blood sugars, sugar needs to be present in some capacity. If minimal calories/carbohydrates are consumed throughout the day, this can be just as dangerous, if not more dangerous, than overconsuming carbohydrates. It is critical to provide the body with enough carbohydrates to support its fight against cancer. To transform these drinks into meal replacements, use them as a base for a smoothie and add high calorie ingredients like avocado, coconut milk, nut butters, and chia seeds. Depending upon the added ingredients, smoothies can be upwards to 1000 calories.

*Protein powders can be added to smoothies in place of a premade drink and usually contain a low amount of carbohydrates.

Plant-Based Smoothies

Popular plant-based smoothies like Orgain, Kate Farms, and Compleat are available for those with diet restrictions. If not following a very restrictive lactose-free diet or vegan diet, the above supplements would still be a great option as they are usually made with whey protein powder. It is always a good measure to review the ingredient list and ensure there are no possible triggers that could further increase treatment side effects.

Renal Impaired

Kidneys are responsible for digesting protein and clearing the body of toxins. If their functioning is impaired, moderation of protein and carbohydrates is usually recommended. Always check with your doctor or nephrologist to evaluate appropriate needs.

Suplena (430 calories, 10.6g protein): The lower protein and high fiber (6g) content make this a great choice for those with kidney disease not on dialysis or protein calorie malnutrition. The fiber helps maintain blood sugar levels and the low protein decreases the amount of toxic byproducts in the blood

Nepro (420 calories, 19g pro): Those on dialysis or that have an extremely poor appetite may need a higher protein content. This supplement will satisfy a high protein and calorie need and is usually available at drug and grocery stores.

**Pro-tip: If planning to make these supplements into smoothies, purchase a vanilla flavored drink that allows for flavor versatility. Side effects can change flavor preference throughout treatment and this helps decrease food waste by allowing for different types of smoothies.

Please contact our dietitians to assist in choosing the best supplement for you and to help manage any side effects that you experience. We are here to keep you healthy, nourished, and stronger during your fight against cancer!