Eating Well while coping with the symptoms of Illness

Making good food choices is very important for everybody, especially if you live with a chronic illness such as TB, Cancer or AIDS. Good nutrition will help you to improve your immune system to fight infections, increase your body ‘s strength and to feel better for longer.

Poor nutrition and weight loss in people living with a chronic illness such as cancer, TB and AIDS are of great concern. Infections and medication used to treat the illness often causes symptoms that leads to poor nutrition and weight loss. The following guidelines will help a person living with a chronic illness to cope better with the symptoms of the disease and to prevent poor nutrition and weight loss.

Try to prevent unwanted weight loss!

To prevent weight loss you should eat foods that will give you extra energy and protein, for example:

• Full cream milk and -products (milk powder, maas, yoghurt) can be added to food to give more energy and protein.
• Add oil and fats such as margarine, butter and mayonnaise to food for extra energy and to improve the taste of the food. If you have diarrhoea or feel uncomfortable after eating extra fats, try to eat less fats and oil.
• Sauces and gravies can give extra energy and helps to make the food easier to swallow.
• Sugar or honey adds taste and extra energy to your food. You can also eat puddings and ice cream for extra energy.
• Eat food between meals to make sure you eat enough.

Let us look at how you can cope with the symptoms of illness that can cause you to eat less and lose weight.

What can I do when I don’t feel like eating?

Illness, depression and loneliness may cause you to lose your appetite. Try the following to make sure that you eat enough
to keep your body strong.

• Foods like sugar, milk powder and oil provide lots of energy even in small amounts. It should be added to other foods where possible.
• Try not to eat alone – shared meals are much more enjoyable.
• Enjoy your meals in a pleasant setting (with music, under a tree or in a park) to make the meal more enjoyable.
• Do not stick to fixed meal times – eat whenever you feel like eating.
• Light exercise like walking increases the appetite.
• Drink liquids that provide a lot of energy throughout the day, like milkshakes, sweetened fruit juices and home made soups.
• Eat the food you like most – this way you are likely to eat more.
• Avoid strong smelling foods like cabbage and coffee if it causes you to lose your appetite.
• If the medicine you take causes a loss in appetite, ask a health worker whether you can take the medicine after meals.

Suffering from heartburn and bloating?

• Enjoy small meals more regularly to avoid feeling uncomfortable.
• Foods such as beans, onion, cabbage, broccoli, cauliflower and soda drinks forms gas and should be avoided for a while.
• Spicy foods that contain lots of curry, pepper or other spices, as well as greasy and fried foods, make heartburn and bloating worse.
• It helps to eat slow and chew food well.
• Wait for at least two hours after a meal before lying down.
• Alcohol, coffee, peppermint and chocolate might worsen the heartburn and should rather be avoided.
• Stay away from cigarettes and smoking, it worsens heartburn and is not good for your health.
• Try to drink plenty of liquids such as clean water and tea.

Try to drink the liquids between meals and not with or just before meals, as it can cause the stomach to feel uncomfortably full.

Coping with nausea and vomiting…

Medication often causes nausea and vomiting. Try the following to feel better:

• Eat small frequent meals – nausea is worse if the stomach is empty.
• Wait until you feel a bit better before taking a meal, but do not skip the meal.
• Avoid spicy and greasy food.
• Enjoy lightly salted and dry foods like crackers and dry cereal before getting out of bed in the morning and during the day.
• Drink liquids slowly through a straw between meals.
• Add a little bit of lemon juice or a slice of lemon to cold drinks.
• Try eating food cold to prevent the smell of food making you nauseous. The body usually tolerates cold food better.
• Keep the room well ventilated.
• Sit up for a while after eating - wait at least 20 minutes before lying down, to avoid vomiting.

What about fever?

When you have fever, you need to replace the fluid that got lost through sweat.

Drink lots of liquids - more than just to quench your thirst.

If you really do not feel like eating, you can make soups from beans, potatoes, carrots or any other vegetables that you have available that will give energy and nutrients to the body.

Use food to treat constipation

Constipation is when your stools are hard and difficult to pass.

• Avoid using laxatives or any “cleansing agents” like enemas. Laxatives and enemas causes your body to loose valuable nutrients and is just a short term solution that does not handle the real problem.

Rather try to:

• Enjoy more foods that contain lots of fibre (roughage), such as oats, unsifted maize, whole-wheat bread, raw vegetables and fruits with the skin.
• Eat less refined and processed foods such as white flour products (cakes, pies, etc.).
• Drink plenty of water and other liquids.
• Be more active! Regular walks will help to relieve constipation.

Struggling to stop diarrhoea?

Diarrhoea is when you have three or more loose watery stools in a day. The most common causes of diarrhoea are:

• dirty drinking water
• poor hygiene
• infections
• medication.

Diarrhoea can cause poor nutrition, because the food passes through the body so quickly that the body cannot use it. The person also eats less because they have a poor appetite. With diarrhoea, the body dries out because so much body fluid is lost – this is called dehydration. Dehydration is very dangerous and people can die of it.

What should I do when I have diarrhoea?

• Drink lots of liquids to replace fluid in the body. To make a rehydration drink, take one liter of water that has been boiled and cooled, add to this 8 teaspoons of sugar and half a level teaspoon of salt. Drink sips of this mixture as often as possible.

Some foods to avoid / reduce intake:

• Illness can cause the body not to be able to use lactose (a sugar naturally found in milk). This can cause diarrhoea, therefore use less milk and milk products. Sour and fermented dairy products like maas and yoghurt can be used if your diarrhoea is not too severe. You can also use lactose free drinks or soy infant formulae.
• Foods that contain a lot of fat, oil, lard or butter such as fried foods, sausage, fat cakes can make the diarrhoea worse.
• Nuts, seeds and whole wheat bread may irritate the gut and worsen diarrhoea.
• Coffee and other foods like cola drinks and chocolates contain caffeine and act as a stimulant that can worsen diarrhoea.
• Gas-producing foods like cabbage, dried beans and peas, cauliflower and broccoli as well as spicy foods and large amounts of sweets may make diarrhoea worse.

Rather eat more…

• Food like grated, peeled apples or pears, oats or potatoes which contain soluble fiber that keeps water in the gut.
• Apple, pear, peach and grape juice are usually well tolerated.
• Foods like potatoes and bananas contains the mineral potassium which is lost during diarrhoea.
• Eat as often as you can to make up for weight and nutrient losses.

Poor hygiene can cause diarrhoea, therefore it is important to:

• Wash hands with soap and water before handling, preparing, serving or storing foods.
• Wash hands with soap and water after using the toilet or changing a baby’s nappy.

If diarrhoea persists, seek advice from your local clinic.

Coping with taste changes

Taste changes are caused by side effects of medication, poor nutrition and infections.

• If meat tastes bitter or like metal rather eat chicken, fish, milk products, dried beans and peas for protein.
• Cold food or food at room temperature often tastes better than hot foods.
• Use more seasonings, sauces or lemon juice over your food.
• Eat your meal with small sips of liquids.
• It helps to use salt water to rinse your mouth frequently.
• Sipping water with a small amount of lemon juice added to it before meals can also help to improve the taste of food.
• Practice food oral hygiene.

Eating with a sore mouth and throat

Sores in the mouth and throat are common with various illnesses. These sores are uncomfortable and painful but not life threatening. The danger is that these sores can make it difficult to eat or swallow, causing people to eat less and lose weight.

Avoid foods that may irritate the mouth and throat such as:

Sour foods: oranges, lemons, pineapple and tomatoes.
Sticky foods that is hard to swallow, such as peanut butter.
Dry, rough foods like popcorn, potato chips and hard, raw vegetables.
Spicy and salty foods that may irritate the mouth and throat.

Some tips to give relief:

• Eat your food at room temperature. Food or drink that is too hot or too cold can be a problem. Enjoy foods and drinks that do not irritate the mouth or throat.
• Choose soft, smooth or moist foods such as mashed potato, minced meat, creamed vegetables; soft porridge, soups, scrambled eggs, ice-cream, custard and puddings.
• It is easier to eat if you moisten your food with sauces or gravies.
• Drink a sip of liquid before each bite or dip hard and dry food like toast, biscuits and rusks in drinks like tea or soup to soften them before eating.
• Use a straw to drink liquids.
• Chew gum or eat candy to increase saliva in the mouth - it makes it easier to swallow food.
• Try to suck on frozen fruit juice or ice, it makes your mouth numb before eating.

Oral hygiene is very important!

- Prent infection by keeping your teeth and gums clean.
- If your gums are painful and you cannot brush your teeth, it will help to rinse your mouth with a bit of bicarbonate of soda mixed in water.

Coping with swallowing problems

If you struggle to swallow food, try to thicken liquids with milk powder, baby cereal, cornstarch or instant mashed potatoes to make it easier to swallow.

• Foods in a meal that have the same soft texture are easier to swallow. Puree or mash food if necessary.
• Rather avoid sticky food like peanut butter or slippery food like jelly that is not easy to swallow.
• Popcorn can irritate your mouth and cause choking.
• Try to sit upright during meals and stroke the throat downward to make swallowing easier.

Remember..

• If symptoms of disease does not improve, ask advice and assistance from your local health clinic.
• It is difficult to eat enough when you are not feeling well, but it is definitely worth the effort! Eating well will keep
  you stronger for longer and prevent infections!

Issued by:

The Department of Health
Directorate Nutrition
Private Bag X 828
Pretoria 0001
Tel: 012 312 0000
Fax: 012 323 7457

AIDS Helpline: 0800 0123 22