Eating Well When You Feel Unwell
- Aug 30, 2025
- 13 min read
Fitting meals and snacks into a busy schedule of medications, doctor’s visits and treatments can be overwhelming at times. When eating itself is difficult your meals may become infrequent and irregular.
While missing an occasional meal does not hurt most people, it is important to remember that good nutrition can help you maintain our strength, immune system and energy level. Patients who are well nourished:
Better tolerate the side effects of chemotherapy, radiation and other treatments or medications.
Replace damaged tissues more rapidly
Heal wounds faster
Develop fewer infections or complications from surgery
Feel better with a more positive approach to life.
Eat enough to avoid losing more than 1 ½ - 2# a week. This type of loss is the result of missing 750 to 1,000 calories a day, eventually leaving you malnourished. You will notice a loss of muscle and strength and your immune system will not work as well. “Failing to thrive” can lead to interruptions in the normal schedule of your treatment, making it less effective.
But avoid excess. Not all cancers lead to weight loss and weight gain is rarely a goal. Add in only the “extras” you need to maintain your weight. Ask to talk to a dietitian if you aren’t sure what your goals should be.
GOOD NUTRITION DOESN’T HAVE TO BE “HEALTHY”
When most people are asked about what they consider a “healthy” diet, they mention many things: foods low in fat and sugar, lots of fresh fruits and vegetables, home-made rather than processed foods, and variety in each meal.
Whether a diet is healthy for you or not depends on several things.
Your current nutrition status.
How much you are able to eat at one time without feeling too full or becoming nauseated.
How many calories you need to maintain your weight.
How much energy you have to shop for and fix meals.
Whether you are able to tolerate the foods you consider “healthy”.
Any other problems you might be having with eating. Many patients complain of a lack of appetite and changes in taste and getting full on small amounts of food. This can be aggravated by dehydration, uncontrolled nausea, pain, constipation or diarrhea and/or fatigue.
Good nutrition may mean very different diets for different groups of people, depending on their goals and can change at different stages of treatment.
Generally, it means eating foods every day that give you the calories, protein and fluid you need to fuel and repair your body. This food must also provide the vitamins and minerals that help your body use the energy from food and build the new tissues that are needed to repair damaged tissues in the body.
When possible, it is best to get this variety by eating a variety of foods. The plate model, “basic four” or “food pyramid” all include the same components: fruits and vegetables, dairy products, grains and protein sources that make up a “balanced diet”.
Check your weight weekly to follow your progress.
RETHINKING JUNK FOOD WHEN BALANCE ISN’T EVERYTHING
Patients often find it difficult to eat the way they did when they felt well. It’s often easier to use fast food and other convenience foods they may think of as “junk food”.
Still, some “junk food” can be a good choice. Ice cream, tacos, pizza, fried chicken, hamburgers and other sandwiches provide needed nutrients and are quick and easy too. Many fast-food chains also have salads and juices available and some grocery stores, such as Whole Foods, offer a wider variety of home-style foods.
The real problem for many patients is the fact that they cannot eat the amount of food they used to eat. Because of this, they cannot eat the volumes needed to eat a “healthy” low-fat diet and still get in enough calories to avoid excess weight loss.
Candy, cookies, soft drinks, chips and other foods made primarily from fat or sugar are often considered “empty calories”. The calories they provide do not bring many, if any, other nutrients with them. For people with a normal appetite including these options can lead to unwanted weight gain. However, for patients who have lost weight and need to avoid further losses, these foods can be useful since the calories are packed into a small volume.
Eating too many “empty calorie” foods may mean you are not hungry for other more nutritious foods. However, eating them along with other foods can help you get the nutrients you need and some extra calories too.
POOR APPETITE
Lack of hunger is a major reason that many people do not eat enough. It can be caused by many things including anxiety, dehydration, exhaustion, pain, and some side effects of treatment.
Even when you don’t feel like it, it is important to try to re-establish a regular eating pattern and eat well.
Schedule small, frequent meals and snacks. You should be eating or drinking something every 2 ½ - 3 hours. You can think of it as a “preschool schedule” or as a scheduled medication providing a “dose” of food. Setting cell phone timers can help to remind you to eat when others are not around. Cell phone alarms work great!
Create a list of ideas for snacks and meals and post it your refrigerator. This is a work in progress that you should continue to update. It limits stress at meal and snack times, for you and your family!
Editing a list is much easier than creating one.
Rotation keeps variety in your diet, avoiding “burn out”
It helps guide your shopping trips/lists.
Be sure the list includes the “extras” that add more calories. These are discussed later in this booklet.
Lower your expectations from food: “What do I think I can tolerate today?” Don’t expect it to “sound good”.
Keep snacks visible nearby to encourage eating. Pack a cooler next to your chair if you find it difficult to get up.
Pace eating with TV commercials. Drink or eat a bit with each commercial. At program breaks, get up and walk for 5 minutes around the house. Exercise improves appetite and digestion.
Simplify preparation. Use convenience foods. Give friends recipes to prepare for you. Freeze the leftovers for later.
Check www.aicr.org for One Pot Meals and Eating Solo pamphlets.
Drink high calorie fluids between meals or as meal replacements. Try fruit juices/nectars, milk/chocolate milk, milkshakes, smoothies, eggnog, Ovaltine. Commercial supplement drinks include Ensureä, Boostä, or generic options. Carnation Breakfast Essentialsä. Try juice-like options such as Boost Breezeä, Ensure Clearä, Odwallaä, and Bolthouse Farmsä drinks. Most will taste best chilled.
Diet restrictions followed prior to treatment (for example, low fat) should be eliminated if possible. Consult your MD.
Make sure other problems that limit eating are well controlled. Avoid diarrhea, constipation, nausea, pain and dehydration.
CAREGIVER ISSUES
Friends and family often feel that helping you get enough to eat is one of the few ways they can contribute. They may even feel responsible if you are losing weight despite their efforts. It is not unusual for control battles to develop. Cancer patients may feel as if their loved ones are forcing them to eat when they do not feel like eating. Clear communication can help.
Ask your family to help remind you of meal and snack times. They can shop for and prepare the foods you select from the list. Once the food is served, it becomes your responsibility to do the best you can.
Take advantage of “good days”.
Let your family know that we evaluate your progress over a week’s time, not day to day.
TOO TIRED TO EAT?
Exhaustion is a normal feeling when you are sick. It is a sign your body is fighting off illness. Adequate rest is helpful but you will not regain your energy when you are missing significant amounts of calories. Your body will draw on its reserves, including the protein stored in your muscle. Losing these reserves will seriously affect your strength, aggravating fatigue.
It is difficult to cook when you are tired but the following suggestions may make meals a little easier to manage.
Eat simple snacks for mini-meals, at least 4 – 5 times a day. Remember to set your cell phone timers as reminders.
Take advantage of convenience foods. Everyone is busy these days so there are more choices at the supermarket. Try frozen pizza, hors d’oeurve size quiche, mac and cheese.
Avoid the “superman/woman” syndrome. Let friends help. Most want to do something for you and will be grateful for ideas that are truly useful.
Give them a recipe you’d enjoy but are too tired to make.
When simply getting up is difficult, arrange to have foods packed in a cooler near your bed or chair.
Use delivery services. Since 2020, grocery stores, restaurants and fast food chains all have delivery services. Try Grub Hub, Door Dash, etc.
If your ability to physically prepare meals is affected, ask your social worker or dietitian about applying for free meal delivery through Project Angel Heart.
Save some energy by using plastic or paper dishware that does not require washing.
Take advantage of good days to cook and freeze meals.
Make every bite count. Limit low calorie foods and fluids: diet sodas, teas, coffee and “lean” versions of foods.
MICROWAVE MAGIC
Microwaves have really changed the way we all cook. They speed up the cooking process and may dirty fewer dishes.
Many frozen items are now available for the microwave. Frequently they cook in less than a third of the time it would require in a conventional oven. You can find breakfast foods as well as lunch and dinner items. Walk the frozen aisle!
Baked potatoes can be fixed in about 8 minutes in a microwave or an hour in the oven. They make a great base for toppings that turn them into a meal.
Grate cheese and add sour cream for a light meal.
For a spicier option, add canned chili, taco meat, or “Sloppy-Joe” mix and microwave again. Add cheese, sour cream or avocado for additional calories.
Use canned cream soups as a sauce and add tuna or ham and microwave until hot.
Sweet potatoes are great too. Don’t forget the butter, brown sugar, syrup, honey and/or cinnamon.
Quesadillas are made using two tortillas with grated cheese sprinkled between, then warmed in the microwave for 30 – 60 seconds or on a grill for a couple minutes on each side. They make quick snacks and can have grilled chicken, canned beans or taco meat added. Sour cream adds calories, and hot sauce adds flavor many appreciate.
Mini pizzas can be made with English Muffins, canned tomato or pizza sauce, cooked meat and cheese. Microwave or broil until bubbly.
Tuna melts are quick. Add tuna, sliced tomatoes and cheese to an English Muffin and broil.
WHEN THE CUPBOARD IS BARE . . .BASIC SUPPLIES FOR QUICK MEALS
Keeping your pantry and refrigerator stocked with basics will help to pull together a quick meal or snack fast. The following list includes some of the supplies you may want to have available.
Refrigerator
Hard-boiled eggs. These can be prepared in large quantities and stored unpeeled in a covered container for up to a week. Egg salad and deviled eggs are easy to make and are often well tolerated. Chopped egg is a great addition to baked potatoes and salads as well.
Chopped, cooked meats; frozen in small amounts in freezer bags. They defrost quickly in the microwave or warm water and can be added to soups, baked potatoes, spaghetti sauce, chili or stews. Shredded and mixed with mayonnaise the meats become a sandwich spread. Canned fish, chicken, ham or turkey.
Sour cream and cream cheese.
Cheese: sliced and/or shredded.
Prepackaged puddings, custards and yogurt
Milk, juice, sodas
Full fat mayonnaise and condiments, margarine, butter, salad dressings.
Pantry
Peanut butter and other nut butters. These are an easy source of calories and protein when spread on toast, celery, and crackers, or added to milkshakes or hot cereals.
Canned tuna, salmon, or chicken. These can be used for sandwiches, mini-melts or fried in patties with cracker crumbs and egg.
Canned soups are a great base for making cream sauces to pour over baked potatoes, rice or noodles.
Canned beef stew, spaghetti, “Sloppy Joe” mix, chili, chicken chili, and/or corned beef hash.
Pork and beans, refried or baked beans. These are great mashed on toast, crackers or in tortillas. They can be added to baked potatoes or topped with cheese on their own. Refried beans with cheese soup mixed in can be a favorite.
Boxes of macaroni and cheese, ramen, rice mixes, pasta mixes, scalloped or augratin potatoes. Extra cheese and/or meat can be added after cooking.
Cold breakfast cereals. Add sliced fruit, dried fruits and/or chopped nuts. Try half and half on top.
Packets of instant hot cereals. Eat them alone or stir in a package of vanilla instant breakfast. Add fruit, brown sugar, walnuts, syrup or honey.
Instant hot chocolate, instant breakfast packets, Substi-meal or Scandishake powder.
Condiments: Syrup, honey, brown sugar
Produce
Potatoes, squash
Vegetables you like to eat (with dips, peanut butter, dressings, etc.)
Fruits
Freezer
Pizza, potpies, Nancy’s Petite Quiche
Frozen dinners Stouffers, Marie Callendar’s and other high calorie options
Frozen vegetables
Waffles, pancakes, breakfast entrees
High calorie ice-cream and sorbet
Juices, Bacardi Drink Mixes
DRINKING YOUR CALORIES . . . BLENDER OPTIONS
Whatever the cause of their eating problems, many people find it easier to “drink their calories” than to eat solid foods. Patients who drink only water, tea or coffee can have the most difficulty taking in enough calories. While there are many products on the market, there are many homemade options as well.
Carnation Breakfast Essentials powder added to whole milk provides similar calories to canned formulas and may be preferred by patients who like and tolerate dairy products.
Use the recipes that follow to make your own milkshakes, or consider smoothies, eggnog or other high calorie beverages. Use your imagination and choose higher calories versions of ice cream, yogurt, etc.
MILKSHAKE BASICS:
1 cup vanilla ice cream
1 pkg vanilla Carnation instant Breakfast
(CIB, 130 cal) or Scandishake (440 cal)
4 oz half and half
VARIETIES OR ADDITIONS
Banana Nut | ½ tsp black walnut extract ½ ripe banana 625+ calories, 15 grams protein |
Peppermint | ½ - 1 tsp peppermint extract 2 drops red food coloring 550+ calories, 15 g protein |
Coffee | 1 pkg instant coffee dissolved in 1 T hot water 550+ calories, 15 g protein |
Chocolate Mint | Substitute chocolate CIB ½ tsp mint/peppermint extract 550+ calories, 15 g protein |
Chocolate Almond | Substitute chocolate ice cream and CIB 1/2 tsp. almond extract 550+ calories, 15 g protein |
Peach | 2 canned peach halves 625+ calories, 15 grams protein |
MILKSHAKES WITH A TART TWIST
Orange Frappe | 2 oz each lemonade and orange juice 4 oz half and half ½ cup orange sherbet 4 oz canned apricots 570 calories, 6 grams protein
|
Lemon Flip | 4 oz each buttermilk and lemonade 6 oz vanilla ice cream 565 calories, 20 g protein
|
Raspberry Fluff | 8 oz raspberry yogurt 4 oz half and half 2 oz cranberry juice 430 calories, 13 g protein |
COMMERCIAL SUPPLEMENT DRINKS
Canned nutritional supplements can be very convenient options for meals/snacks. It pays to shop! Check store brands and compare prices at drug stores and grocery stores.
Try several brands until you find one you like. Your dietitian or social worker may have samples to try.
Higher calorie options are best; dilute them if needed.Try Ensure Plus, Boost Plus or generic options. All are lactose-free.
Juice-like options: Boost Breeze and Ensure Clear include ~9 g of protein.
Lower carb options for diabetics:Boost Diabetic, Glucerna
Juven contains nutrients that limit loss of muscle as long as calories are adequate.
“Additions” can add variety! Most drinks taste better chilled.
Add 2 tablespoons of pudding, in the flavor of your choice, to vanilla supplements.
Blend in ice cream or add a cup of berries or canned fruit.
Stir in a small can of fruit nectar.
Dissolve two spoons of instant coffee, flavored if you like, in a little boiling water. Stir into a can of vanilla supplement.
Every manufacturer has recipe booklets with ideas on ways to expand the use of their products. Contact them.
ADDING CALORIES TO FOODS YOU LIKE TO EAT
Dealing with problems that make eating difficult can limit your intake to a fraction of your usual volumes. When this happens, it is always helpful to pack calories into the smallest amount of food possible. Remember that this is a temporary situation that requires extraordinary measures even though using extra fat and sugar may not seem “healthy". You are now eating very small amounts and the totals will not be harmful.
This is not a time you will suddenly learn to like foods you have never liked. It is possible, however, to add calories to foods you tolerate, even if they are usually low in calories. Increasing calories in meals and adding snacks between meals can limit your weight loss.
MILK OR DAIRY
Milk alone is good but try going up one level in fat content. If you usually drink skim, try 1 or 2%.
Add Carnation Breakfast Essentialsä
Make homemade milkshakes using the recipes included, or add ice cream to a base of Ensure or Boost.
EGGS, often well tolerated any time of the day
Mix grated cheese or cream cheese into scrambled eggs. This also softens the texture.
Melt cheese on fried eggs or add sauces like “Hollandaise”.
Use extra mayonnaise in egg salad or deviled eggs.
Consider meat, cheese and avocado in omelets.
BREADS AND CEREALS
Add fruit, raisins, or nuts to cereals. Top with half-and-half, sugar, jelly or syrup.
Stir Carnation Breakfast Essentialsä into hot cereal. Its vanilla taste “disappears” into the cereal.
Enjoy croissants sandwiches with cheese, avocado, etc.
Top pancakes, French toast, or waffles with spreads, syrup or fruit and whipped cream.
Top crackers with cheese, nut butters, or cream cheese.
Eat toast with peanut butter, jam or honey.
SALADS AND VEGETABLES
Use regular rather than low-fat salad dressings. You can make your own with olive oil and vinegar.
Top with cheese, meat, nuts, beans, peas, avocado, bacon bits and/or egg.
Try high calorie dips, ranch dressing, hummus or peanut butter with raw vegetables.
Add margarine, butter, cream or cheese sauces, and/or sour cream to cooked vegetables or potatoes.
Use butter, sour cream, or yogurt to add flavor and calories to cooked vegetables like potatoes, beans, carrots, squash.
MEATS & MAIN DISHES
Add gravies to meats.
Add extra cheese to pizza, macaroni and cheese, spaghetti, other casseroles.
Add sour cream to dishes.
Add mayonnaise, cheese, avocado, or bacon to sandwiches.
·Enjoy breaded and/or fried foods as tolerated.
SOUPS AND STEWS
Make soups with milk instead of water. Stir in 2 Tbsp. extra dry skim milk powder to recipes.
Add chopped cooked meats and top with cheese.
Adding olive or canola oil during cooking will add 120 calories per tablespoon
FRUITS, DESSERTS AND SNACKS
Add coconut, nuts, sour or whipped cream to fruit salad.
Snack on dried fruit or add it to cereals.
Spread peanut butter on slices of fresh fruit.
Fruit in heavy syrup has twice the calories.
Add whipped cream or ice cream to puddings, pie, Jell-0ä, fruit, or hot chocolate.
Enjoy chips with guacamole, bean or sour cream dips.
Eat nuts! They provide protein and healthy fat.
EXTRAS THAT COUNTAdding 500 calories per day avoids 1# weight loss/week
| 55 calories per 1/6 medium |
| 94 calories/T |
| 190 – 260 calories/ounce |
| 90 calories/Tablespoon |
| 120 calories/Tablespoon |
| 330 calories, 7g protein |
| 4 calories/gram protein |
| 45 cal/teaspoon |
| 70 cal/Tablespoon |
| 60 cal/Tablespoon |
| 100 cal/oz |
| 100 cal/oz |
| 100 cal/Tablespoon |
| 130 calories/package |
| 550?calories/package |
* includes healthy fats
# includes protein
IDEAS FOR BETWEEN MEAL SNACKS
Carbohydrates combined with proteins will limit “rollercoaster” blood sugars and improve energy
· Bagels or English Muffins with Cream Cheese or Peanut Butter* · Cereal and milk/fruit/nuts*Hot cereal with walnuts* | · Individual Pizzas* · Jello with whipped cream · Milkshakes* or Smoothies(Ask a dietitian for recipes) |
· Cheese and Crackers* | · Milk and Cookies* |
· Cheese* or Cinnamon Toast | · Nachos and Cheese* |
· Crackers with peanut butter* | · Nuts and milk* |
· Chips with Guacamoleor refried bean dips* | · Pastries · Peanut Butter on apples* |
· Cookies/cake and milk | · PBJ Sandwich* |
· Cream Cheese/Nut bread* | · Nancy’s Petite Quiche* |
· Custard or Pudding | · Quesadillas* |
· Deviled Eggs · Egg Salad Sandwich* | · Root Beer Float · Sherbet, or Ice Cream |
· Dried Fruits · Energy Bars* · Frozen yogurt or ice cream with syrup · Fruit Pie a la Mode · Hummus* with pita, crackers or vegetables | · Tortilla with refried beans*and cheese/avocado · Trail mix* · Tuna Sandwich/crackers* · Waffles and Syrup · Yogurt* with fruit/granola |
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