Healthy Living: Cardamom
By Renu Gulati
Choti Elaichi (Hindi Name)
Ela (Sanskrit name)
Elettaria Cardomum (BotanicalName)
Native to South India, cardamom is a herbaceous perennial plant from the ginger family. It is sweet, pungent and heating and is helpful for cough, breathlessness, burning urination and haemorrhoids. It improves digestion and enhances the flavour of food. Cardamom has antiseptic, antioxidant, antispasmodic, carminative, digestive, diuretic, expectorant, stimulant, and tonic properties. A good source of minerals and vitamins, cardamom contains potassium, calcium, sulphur, and magnesium along with iron and magnesium as well as vital vitamins, including riboflavin, niacin, and vitamin C.
It contains essential phytonutrients that are proven to hunt down and destroy free radicals. Research shows that consuming cardamom on a regular basis can prevent certain cancers.
- To use cardamom for digestive problems, you can eat the seeds, sprinkle ground cardamom on your food or make a cup of cardamom tea. Cardamom tea can be made by coarse grinding two cardamom pods with their skins. Add ground cardamom to a cup of water, bring to the boil then simmer for a couple of minutes.
- Simply chew on a cardamom pod after every meal or whenever you need to freshen up your breath.
- Drink a cup of cardamom tea or rinse your mouth with lukewarm cardamom tea twice daily. It will work as an effective antiseptic mouth rinse.
- For sexual weakness drink I cup of hot milk with ½ teaspoon of ghee and a pinch each of cardamom and hing.
- For cough and breathlessness take a pinch of cardamom, a pinch of rock-salt mixed with 1 teaspoon of ghee and ½ teaspoon of honey mixed together into a paste.
- For relief from burning urination, take a pinch of cardamom in ½ cup of cucumber juice 2 times a day.
- Drinking tea and coffee is highly stressful to the adrenal glands. Add a pinch of ginger and cardamom to tea/coffee to reduce this effect.
- Gargle with a mixture of 1 teaspoon of powdered cinnamon and 1 teaspoon of powdered cardamom to relieve hoarseness from the throat.
- Grind together 2 – 3 pods of cardamom, a small piece of ginger, 2 – 3 cloves and few coriander seeds. Add the powder into warm water and consume it for instant relief from indigestion, bloating, and gas.
- Add a pinch or two of cardamom powder and half a teaspoon of turmeric to a glass of warm milk to ease inflammation.
- Add a few drops of cardamom essential oil to a pot of boiling water for steam inhalation to relieve a stuffed nose or blocked sinuses.
Healthy Living: Fenugreek
By Renu Gulati
Methi (Hindi name)
Methika (Sanskrit Name) Trigonellafoenum-graeceum (Botanical name)
Part Used: Green leaves of the fresh plant or the light brown seeds.
Fresh fenugreek leaves are cooked and eaten as a vegetable dish in India. The leaves have a cooling effect and are beneficial in the treatment of indigestion, anaemia and inflammation. Fenugreek cleanses and detoxifies the body by drawing out waste matter and expelling it.
The dry seeds are commonly used in cooking to flavour and spice various foods. They are rich in vitamins, minerals, iron and calcium and are easily assimilated. They are beneficial for weakness, particularly of the nervous, reproductive and respiratory systems. They are also useful in treating neuralgia, paralysis, constipation, bloating, productive cough, asthma, bronchitis, and chest congestion as well as a sluggish digestive system.
The leaves and seeds of fenugreek are both known to possess antimicrobial, antioxidant, antidiabetic, anti-inflammatory and antiviral properties.
Modern research has shown that regular long term use of fenugreek seeds reduces fat deposits and lowers cholesterol and sugar levels in the body..
- Fenugreek improves breast milk secretion hence 1 teaspoon of its seed paste or powder can be administered to a lactating mother once or twice a day.
- For tiredness or bodyache, eat a spoonful of fenugreek seeds daily.
- The powdered seeds can be made into an effective poultice for painful and swollen rheumatic joints as well as for boils as they have draining and healing properties.
- Mix 1 teaspoon each of fenugreek powder, lemon juice and raw honey. Consume it twice daily to fight cold and flu symptoms.
- To get rid of a sore throat, gargle with warm fenugreek tea twice daily.
- Fenugreek contains compounds that have estrogen-like properties, which help reduce menstrual-related discomforts. These compounds even ease menopausal symptoms like hot flashes, depression, and mood fluctuations. Plus, the high iron content in fenugreek aids new red blood cell production to make up for the loss of blood. Drink warm fenugreek tea twice daily to reduce menstrual discomforts.You can also use fenugreek leaves in your cooking, especially in soups and dahls.
- Diabetics can eat 1 teaspoon of fenugreek seeds an hour before each meal. The powder of the seeds can also be taken or a decoction of the seeds made and drunk like a herbal tea.
- As a beauty aid, coarse grind 2 teaspoons of fenugreek seeds, mix with a little yoghurt or honey to make an exfoliating scrub. Gently rub on the face to prevent pimples, wrinkles and blackheads and enhance complexion. Leave on the face for 15 mins and then wash with warm water.
- Fenugreek seeds make the hair silky and lustrous, preserve the natural colour of the hair and eliminate dandruff. Soak 4 tablespoons of the powdered seeds overnight in 2 litres of water to make a cold infusion. Use the infusion in the morning to wash your hair.
- A popular traditional Indian recipe made in winters is fenugreek laddus. These are made by powdering the seeds and roasting them with wheat flour in pure ghee to which sugar has been added. On cooling slightly, a couple of tablespoons of this mixture are shaped into small round balls. One laddu with a cup of milk makes a nourishing winter breakfast. Also these laddus are given to women after childbirth to enable them to recover their strength quickly and enhance lactation. A simpler version of this laddu is a laddu made with fenugreek powder mixed with melted jaggery and made into small balls.
- Avoid taking fenugreek in large amounts, as it can lead to side effects like nausea and diarrhea.
- Before using this herb on the skin or scalp, do a patch test to reduce the possibility of skin irritation and rashes.
- Do not use this herb during pregnancy. It has the potential to induce labour.
- If you take any medications, consult your doctor before including this herb in your diet.
Healthy Living: Fennel
By Renu Gulati
Fennel (English name)
Sauf( Hindi name)
Foeniculumvulgare( botanicalname) Madhurika( sansksritname)
Fennel is sweet, astringent and cooling. It is unctuous and calming. It acts as a digestive aid and as a diuretic. It helps to get rid of intestinal worms and can relieve hemorrhoids. In addition to its popular use as a breath freshener, it helps relieve a number of ailments and facilitates better health due to its stomachi, carminative, antispasmodic, anti inflammatory, antimicrobial,expectorant, diuretic, emmenagogue, depurative, anticarcinogenic and antioxidant properties.
It contains vitamin C, potassium, manganese, iron, folate, and fibre. It is also rich in phytonutrients and has a high concentration of volatile oils.
Fennel seeds’ emmenagogue properties promote and regulate menstrual flow. The herb also has phytoestrogens that help with issues like premenstrual syndrome, menopausal disorders, and breast enlargement. Studies have shown that fennel can help reduce symptoms of dysmenorrheal or painful menstruation. Apart from menstrual benefits, fennel is traditionally used as a galactagogue to promote lactation in nursing mothers.
- Munching on a few fennel seeds will sweeten and refresh your breath after a meal and get rid of bad breath after an odorous meal.
- Drinking fennel tea on a regular basis helps flush out excess fluids from the body as it works as a diuretic. It can also relieve menstrual problems. Fennel tea can be made by boiling 1 tsp of fennel seeds with a cup of water.
- Dry roast, grind and sieve fennel seeds and consume one-half teaspoon of the powder with warm water twice daily to induce weight loss.
- For indigestion chew ½ tsp roasted fennel seeds and cumin seeds after each meal.
- For acute diarrhea, mix ½ tsp each of fennel powder and ginger powder and take 2/3 times a day.
- For acute cold/cough and upper respiratory congestion, chew 1 tsp fennel seed powder with 1 tsp of natural sugar 2 or 3 times a day
- For edema, take fennel tea made from 1 tsp fennel seeds steeped in 1 cup boiling water, twice a day.
- In cases of burning urination, drink fennel tea with 1 tsp of natural sugar
Healthy Living: Cumin
By Renu Gulati
Cuminum Cyminum (Botanical name)
Cumin, known as Jeera in Hindi and Jeeraka in Sanskrit is an aromatic seed that can be used by all constitutions. Cumin is an essential ingredient in Ayurveda cooking because of its unique taste and numerous medicinal qualities. Cumin kindles the digestive fire and enhances the assimilation and absorption of nutrients. It helps reduce excess gas and can act as a mild pain reliever. Stomach pain, nausea and diarrhea can be relieved by cumin.Cumin is an excellent source of fibre, antioxidants and anti-flatulent properties and is a great remedy to cure constipation, bloating and heaviness.
Modern research has found that cumin can help fight cancer, due to the ingredient cuminaldehyde, which has been shown to slow the growth of tumours. It also has characteristics that accelerate the production of certain anti - carcinogenic enzymes, which can aid the prevention of colon cancer. Cumin is an excellent source of iron and therefore beneficial for anaemia. It also contains Vitamin E, which enhances skin tone and texture. Consumption of cumin helps regulate sleep pattern, especially for people who suffer from insomnia.
- To relieve fever, mix equal quantities of cumin seeds, coriander seeds and fennel seeds. Add I tsp of this mixture to 1 cup boiling water. Steep for 10 minutes then drink
- For stomach pain, make a mixture of 1/3 teaspoon cumin powder, a pinch of hing and a pinch of rocksalt. Mix and chew well. Follow with warm water.
- For nausea or stomach upset, make a tea from 1 teaspoon cumin seeds and a pinch of ground nutmeg in 1 cup boiling water steeped for 10 minutes.
- For some relief from menstrual pain, roast cumin seeds in an ungreased iron pan/griddle until they smell pungent. Slowly chew a teaspoonful followed by 1 tablespoon of aloe vera juice.
- Chew a teaspoon of dry roasted cumin seeds to cure constipation.
- Mix half a spoon of powdered cumin into a glass of pomegranate juice to get relief from IBS.
- Mix equal amounts of powdered cumin and cardamom and take this three times a day to get relief from bloating due to gas.
- Make cumin tea using one teaspoon of cumin seeds with a 1cm piece of ginger in one litre of water to boost a weak immune system. To maintain the integrity of the immune system you can also replace normal water with cumin water by boiling one teaspoon cumin in 5 liters of water and drinking that instead of regular water
- Add I/2 teaspoon of powdered cumin to boiled water, allow it to cool and add a pinch of cardamom powder to it. Gargle with this water to keep your mouth fresh and free from any smell or mouth diseases.
- A face pack made from the paste of one teaspoon cumin seeds, one teaspoon of sandalwood powder and half a teaspoon of turmeric is useful against acne and enhances complexion.
Healthy Living: Coriander
By Renu Gulati
Coriandrum Sativum (Botanicalname) Dhanyaka (Sanskrit)
Coriander is sweet and cooling. It suits all constitutions.It helps digestion, can reduce fever and is a diuretic.
Coriander has multiple health benefits. It is a source of dietary fibre, manganese, iron and magnesium.In addition, coriander leaves are rich in Vitamin C, Vitamin K and protein. They also contain small amounts of calcium, phosphorous, potassium, thiamin, niacin and carotene.
- For burning sensation in the urethra or excessive thirst, mix 1 teaspoon of coriander seeds and ½ tsp each of amalaki (dried or powdered) with natural sugar in 1 cup boiling water. Steep overnight and drink it first thing the next morning.
- For fever take ½ teaspoon each of coriander and cinnamon and ¼ teaspoon dried ginger. Steep this mixture in a cup of hot water for 10 minutes then drink.
- For conjunctivitis, make an eye wash by steeping 1 teaspoon of coriander seeds in 1 cup boiling water for at least 15 mins. Strain well and cool. Wash the eye with this infusion.
- A tea made from equal portions of cumin seeds, coriander seeds and fennel seeds is an excellent digestive aid. Use about 1 teaspoon of this mixture per cup and steep in hot water for 10 minutes.
- To treat Leucorrhoea, take 10gms of Coriander seeds and soak them in 100ml of water over night and drink the water in the early morning. It gives relief in 7 to 8 days in most cases.
- To stimulate appetite and improve digestion, make a paste by mixing a handful of coriander leaves, ½ teaspoon Black pepper, a pinch of rock Salt and ½ teaspoon Cumin powder.
- To treat mouth ulcers,make a paste of Corianderleaves and apply on the mouth ulcer 2 to 3 times a day
- For effective treatment of menstrual cramps, boil 5-6 Coriander seeds in a cup of water for 2-3 minutes and drink the liquid.
- To pacify excessive thirst, boil a cup of water with 1 teaspoon of Coriander seeds for a few minutes and drink.
- ChewCoriander seeds to get rid of bad or foul smelling breath.
Healthy Living: Black Pepper
By Renu Gulati
Kali Mirch (Hindi name)
Marica (Sanskrit name)
Piper Nigrum (Botanical name)
Pungent and heating, black pepper is useful for digestion, cough, worms,promoting healthy lungs and heart. It has a host of health benefits and is therefore used extensively in Ayurvedic medicine. Health benefits include improving appetite and digestion, relieving gas and congestion, facilitating weight loss and enhancing immunity. Black pepper has been found to contain iron, potassium, calcium, magnesium, manganese, zinc, chromium, vitamins A and C, and other nutrients.
Research shows that black pepper can increase the assimilation of the compound curcumin (found in turmeric) twentyfold. Curcumin helps fight cancer, infection, and inflammation.
Black pepper powder is usually added to savoury dishes after cooking, otherwise volatile oils tend to evaporate and diminish its flavour. Freshly ground black pepper has the most flavour.
- For indigestion and heaviness in your stomach, take a glass of buttermilk mixed with one-quarter teaspoon each of black pepper and cumin powder.
To get relief from indigestion, mix equal quantities of ground black pepper, dry ginger and rock Salt. Add 1/3 teaspoon of this mixture to a glass of buttermilk and consume it.
- Massage your belly with black pepper oil mixed with a carrier/base oil to relieve gas pain.
- To clear congestion and phlegm drink a glass of warm water with ½ teaspoon black pepper 2-3 times a day before meals.
- For hoarseness of voice, take ¼ teaspoon of black pepper powder and 1 teaspoon of melted warm ghee after food.
- For cough take 1/4 teaspoon of black pepper and 1 teaspoon honey after food.
- To treat pus in the gums, take finely powdered black pepper, mix with salt and massage over the gums.
- For muscular pains, take a tablespoon of black pepper powder fried in sesame oil for some time. Apply this on the painful areas.
- To get relief from toothache, boil a tablespoon of black pepper in 1 cup of water, cool and strain it and use the water to gargle.
- For weight loss, take a cup of water mixed with 2 teaspoons of lemon juice, 1 teaspoon of honey and a 1/4 teaspoon of black pepper powder 2-3 times a day.
- To increase appetite, consume 1 tablespoon of jaggery mixed with 1/2 teaspoon of black pepper everyday before meals or with the first morsel of food.
Healthy Living: Ginger
By Renu Gulati
(Zingiber officinale) is one of the most ancient and sattvic among
herbs and is grown all over India throughout the year. It is referred
to as maha aushadhi (great medicine). In Sanskrit it is also called
vishwabhesaj (the universal medicine). A Sanskrit sloka likens
ginger to a lion and all diseases to small animals which run away and
disappear when the lion appears.
Fresh ginger root is pungent and heating and has an alkaline effect on
the body. Although it balances all doshas, pitta individuals should use
it in moderation, Dry ginger on the other hand is pungent and heating.
Those with excess body heat are advised to take fresh ginger rather
than dry ginger (sunthi) and that too in moderation. It is also
advisable to consume less ginger in the hot summers.
Both types of ginger kindle digestive fire and improve digestion,
absorption and assimilation of food. Ginger can improve circulation,
relieve congestion, help break down blood clots and may aid in
preventing heart attacks. It is a good home remedy for common cold,
cough and breathlessness. Fresh ginger increases immunity. It is a keen
stimulant for the digestive, respiratory and nervous systems and helps
to revitalise sluggish circulation and remove dullness and inertia.
Chewing a small quantity of adraka with salt before meals is good for
health. It enhances digestive fire, taste perception and purifies the
tongue and throat. Chewing adrak is not advisable in diseases like
leprosy, anaemia, dysuria, bleeding diseases, ulcers, fevers and
- To improve digestion take a 1cm piece of ginger with salt just before a meal or eat it with the first morsel of food.
- For respiratory problems lick a teaspoon of ginger juice mixed with
honey or make a herbal tea by simmering fresh or dry ginger with equal
quantities of black pepper and tulsi.
- Hot ginger tea is useful in bringing on a delayed menstrual period and
in relieving menstrual cramps. Take 1cm of ginger and boil in a cup of
water till the liquid is golden brown.
- A mixture of 1 tsp each of fresh ginger juice and lime juice after food
aids digestion and relieves excess gas, constipation and lower
- A mixture of fresh ginger juice and fresh onion juice helps calm nausea and vomiting
- Rubbing a little fresh ginger around the belly button will help stop diarrhea and abdominal pain
- A mixture of 1 tsp each of fresh ginger juice and honey taken 2-3 times a day helps relieve sinus congestion
- For cold cough congestion and flu symptoms, make a cup of tea with 1 tsp each of dry ginger, cinnamon and fennel
- A mixture of 1 tsp each of ginger juice and lime juice and 2 pinches of
rocksalt relieves hoarseness of the voice, chest pain, wheezing and
- An application of ½ tsp dry ginger powder paste made with dry ginger
and water applied on the forehead helps a sinus headache. Hot bodied
individuals should be careful as it may cause a slight burning of the
skin. Always wash the area after treatment.
- Homemade ginger ale is a delicious and nutritious drink. Wash and cut a
medium sized piece of ginger. Simmer it with a glass of water until the
water is reduced by half and is a dark yellow colour. When cool, strain
out the ginger. Add sugar or honey to taste. If needed add water.
Healthy Living: Turmeric
By Renu Gulati
one of the most widely researched spices, turmeric has been found to
have antioxidant, antibiotic, antiviral, antibacterial, antifungal,
anticarcinogenic, and anti-inflammatory properties.
(Curcuma longa) belongs to the Ginger Family (Zingiberaceae).
Known as Haldi in Hindi and Haridra in Sanskrit, it is native to
Southern Asia and requires a temperature of 20-30 degrees centigrade
and a good amount of rainfall to survive. It is harvested annually for
its rhizome. The rhizomes are boiled and dried before they are
ground into a powder. Fresh turmeric root looks a little like ginger
but inside it can be red or yellow. The red is called kumkum and is
considered sacred. Only the yellow root is used in cooking and
medicinally. It is a potent medicinal spice that is used in the kitchen
regularly and almost in every kind of food in India. It is also used in
many religious ceremonies in one form or other.
Turmeric is pungent, bitter, dry and
heating. It bestows colour, cures diseases of the skin, is helpful in
diabetes, diseases of the blood, dropsy, anaemia and ulcers.
As one of the most widely researched spices, turmeric has been found to
have antioxidant, antibiotic, antiviral, antibacterial, antifungal,
anticarcinogenic, and anti-inflammatory properties. It helps digestion,
maintains the balance of intestinal flora, reduces gas and has tonic
properties. It is recommended in the treatment of indigestion, poor
circulation, cough, chest congestion, skin disorders, diseases of the
blood diabetes, anaemia, ulcers and for the healing of wounds and
The main active ingredient in turmeric is curcumin or diferuloyl
methane, which laboratory studies have shown does have anticancer
effects on cancer cells. A phase I clinical trial looked at giving
curcumin to 25 patients with precancerous changes in different organs.
This study seemed to show that curcumin could stop the precancerous
changes becoming cancer. Research has also shown that there are low
rates of certain types of cancer in countries where people eat curcumin
at levels of about 100mg to 200mg a day over long periods of time.
However, there is still no conclusive research evidence to show that
turmeric or curcumin can prevent or treat cancer.
- For bronchial cough, dry sore
throat, tonsillitis and pharyngitis, cold and chest congestion, boil 1
teaspoon of turmeric with 1 cup of milk for 3 minutes and drink at
- Gargle with warm turmeric water 2-3 times a day to relieve a sore throat
- For external haemorrhoids, apply a mixture of 1/2 teaspoon and 1 teaspoon of ghee locally at bedtime.
- For cuts wounds and fungal nail infections, apply 1/2 teaspoon turmeric and 1 teaspoon aloe vera gel to the affected area.
- For swollen gums, apply turmeric directly to the affected area of the mouth.
- Turmeric is good for the eyes,
especially for conjunctivitis and sore eyes. Bring to a boil 1 teaspoon
of turmeric in a cup of water. Strain through a muslin cloth and wash
the eyes regularly with this liquid or apply a gauze soaked with this
water on the eyes.
- A poultice of turmeric paste with
ghee or oil applied hot is an effective treatment for sprains, bruises
wounds and inflammatory troubles of the joints
- Turmeric taken with an equal amount of amla powder or fresh amla juice and honey can be used in the treatment of diabetes.
- Turmeric can be used externally on
the skin for a radiant and smooth complexion and for the treatment of
pimples. Turmeric ubtan or scrubs have been traditionally used to
beautify brides at Indian weddings.
- A pickle made with fresh Turmeric
in the winter season boosts immunity. Cut the Turmeric into thin long
pieces and add lemon juice and salt.
High Energy and Protein Dietary Advice for People with Cancer
By Liz Bradley & Joanna Grey
and Jo are both dieticians working at Addenbrookes Hospital in
Cambridge, UK. Both have had specialised experience working with
people suffering from cancer. Liz and Jo are Rama Foundation volunteers.
Many people with cancer find there are times when they cannot eat as much as usual and they may lose weight.
that lose weight when they are unwell tend to lose muscle rather than
fat and this can make you feel weaker, be more prone to infections and
can make it more difficult to cope with any cancer treatments.
high energy and protein diet will help you to avoid losing weight,
helps your body to re-build damaged tissues, fight infection, and cope
with the side effects of illness. If you are not eating as well as you
would normally, the following tips may help you to eat more. Although
you may have previously been restricting the fat or sugar in your diet
to manage other medical conditions such as diabetes or high blood
pressure, this is less relevant now that you have cancer.
Eat “little and often”
include snacks between meals and before bed. Keeping snacks at easy
reach may help you to eat more often. Here are some snack ideas:
- Biscuits, cakes , gurkipatti (peanut with jagerry) and tilpatti (sesame snap)
- Bread dunked in sugary milk / tea
- Fruit (fresh and dried) withkulfi,ice cream or custard
- Cheese on toast
- Bhajis, pakoras, spring rolls, samosas, Bombay mix
- Desserts such as sugary yoghurt,barfi, rasgulla and gulabhjamun, rasmalai , halwa
- Chips, nuts, peanuts, savoury biscuits, aalootikki
Try not to get out of the habit of eating. You actually need to eat to stimulate your appetite.
Make the most of the times you feel like eating.
Don’t worry if it isn’t “normal‟ foods at “normal‟ times.
Experiment with different foods. You may find that you like things you don’t usually eat.
Accept offers from friends and relatives to help with cooking and shopping.
Sometimes the smell of food will be appetising while at other times it
may put you off. If this happens, try to keep away from the kitchen
while food is being prepared, or eat cold foods, which often have less
Avoid drinking with meals as this may fill you up and spoil your appetite.
Fortify your food:
If you are only eating small portions the following tips may help you
to get more calories without necessarily having to eat more food. Start
by buying full fat foods.
Fortified Milk: Add
2tablespoons of milk powder to 1 cup of full cream milk. This can be
used in the usual way in drinks, on cornflakes/dalia, in making mithai.
To savoury foods add oil, ghee, butter, milk powder, coconut milk/cream, nuts and seeds.
To sweet foods add fortified milk, sugar, honey, syrup, ice cream, evaporated milk, nuts and seeds.
Add coconut cream, butter, extra ghee to curries
Spread ghee or drizzle oil on breads
Add 2 tablespoons of milk powder to a portion of porridge, rice pudding, milk puddings and custard
Ideas for nourishing drinks:
Hot drinks such as:
Milo, Horlicks, Ovaltine other malted milk drinks
Soups can be made with fortified milk
Milkshakes with added ice cream and flavourings
Fruit smoothie - blend fruit with milk, ice cream/yoghurt and honey/malt.
Ice cream soda can be made by adding ice cream to a fizzy drink
Fruit juice and fizzy drinks (avoid low calorie ones)
Nourishing powdered drinks such as Complan,are available. They will provide you with more energy if you make them with full fat milk.
These powders can also be added to foods to increase their nutrient content.
Malnutrition in Cancer
By Mrs Artika Datta
Rama Foundation- Trustee and Treasurer
Datta who has a B.Sc. Honours in Nutrition and an M.Sc. in Dietetics
from King’s College, London works at Addenbrookes hospital at
Cambridge. Artika specialises in Motor Neuron Disease and has a
particular interest in palliative care in which she is actively
|Mrs Artika Datta
One of Main Factors of Malnutrition Is Poor Appetite
- Malnutrition affects 40-80% of cancer patients (Ollenschlager et al, 1991; Kern & Norton, 1998)
- Prevalance of malnutrition depends on the tumour type, location, stage and treatment (Shike, 1996)
- Risk of malnutrition increases with multi-modality treatments
80% of patient's in advanced stages have cancer cachexia (or wasting
syndrome which is loss of weight, muscle atrophy, fatigue, weakness,
and significant loss of appetite) (Goo and Hill, 2003)
- Up to 85% of patient with gastro-intestinal tumours are malnourished (Stratton et al., 2003)
- In head and neck cancers the incidence of malnutrition can range from 40 to 58% (Connally, 2004; Grobbelaar et al., 2004)
46 and 61% of patients with lung cancer and mesothelioma experience
weight loss before diagnosis and treatment (Brown and Radke, 1998)
- 75-80% of
patients with head an neck cancers have significant weight loss
(>10% of body weight) during treatment period (Hammerlid et al.,
Consequences of Malnutrition
- It is the most common cause of decreased food intake
- 1 in 4 people diagnosed with cancer have loss of appetite
- It can be caused by the cancer itself
- And / or
caused by the treatments. Many people find that during treatment for
cancer there are times when they are unable to eat and drink as normal
- Emotions such as fear or depression can also take away a person's appetite
Malnutrition affects both the quality of life and survival in patients with advanced disease
Dietary modifications to overcome reduced appetite
- Muscle wasting, weakness and fatigue
- Impaired immune function, increased infection rate
- Apathy, depression, self neglect, reduced will to recover
- Poor quality of life .Failure to complete chemotherapy
- Reduced respiratory function
- Delayed wound healing
- Poorer outcomes
- Readmission to hospital
- Immobility and social isolation
- Higher incidence of psychological
and psychiatric disorders such as depression, causing a marked
alteration of quality of life and a drastic reduction of performance
status (Ottery 1995)
- Some evidence that weight-losing patients have a reduced global QoL (Dahele & Fearon 2004)
Ideas to Fortify Diet
- Little & often eating pattern
- High protein / energy meal options
- Eating what the patient fancies
- Food fortification
- Food & fluids separately
- Nutritional Supplements
- Use of appetite stimulants which include
- Can stimulate appetite, however side effects include fluid retention,
muscle weakness, osteoporosis & skin fragility
- Megestrol Acetate - Shown to have beneficial effects on cancer related anorexia & weight loss
- Aiming to use 1 pint (568ml) of full cream milk / day and adding it to soups and porridge (sweet Dalia)
- Using full cream milk to make dahi
- Grated khoya or paneer can be added to vegetable curries, soups
- Add evaporated milk to dahi and daal
- Add syrup to ice cream, or sugar and fruit puree to natural yogurt
- Add ghee or butter to daal and sabji,
3 rusks - 123 Kcal - 3.9 G protein
200ml Whole milk – 132 Kcal - 6.5 G protein
1 Samosa (filled with potato and peas)- 308 Kcal – 4.67 G protein
193g Kheer - 282 Kcal – 8 G protein
2 Rasgullas – 304 Kcal – 8 G protein
Moong daal Dalia - 268 Kcal - 11 G protein
Oral Nutrition Supplements
Oral Nutritional Support
- A simple, non-invasive method of increasing nutrient intake
- Most oral nutritional supplements are nutritionally complete
- Majority contain 1-1.5 kcal/ml, but also available as ‘concentrated’ feed (2kcal/ml)
- Protein content varies from 4 to 10g/100ml
- Oral nutritional supplements (ONS) considered when nutritional intake is insufficient despite nutritional counseling.
- ONS used
-To supplement food intake if the patient is unable to eat enough
-To replace food
- Available in liquid form, soups, powders, and other consistencies such as puddings
Tips for Combating Common Dietary Problems in Cancer
with advanced stage cancer often suffer from a number of problems which
adversely affect their intake and digestion of food. Dietician Artika
Datta has outlined some simple remedies to help deal with these
- Try dry or salty foods
- Eat small, frequent meals
- Sip cool, fizzy drinks
- Try ginger flavoured food and drink
- Try cold foods
- Avoid highly spiced, rich or fatty foods
- Avoid dry, rough or hard foods
- Avoid highly spiced, salty or acidic foods
- Have soft, mashed foods with sauce or gravy
- Drink plenty of nourishing fluids
- Cold foods and drinks can be soothing to a sore mouth
Try adding crushed ice to drinks and eating ice cream or soft milk
- Ensure good oral hygiene
- Treat any infections
- Eat foods that you like the taste of
- Sharp tasting foods can help
- Use pickles or chutneys
- Use different seasonings, experiment with herbs and spices
- Ensure good oral hygiene
Too Tired to Cook or Eat
- Be positive about what you do eat, every mouthful counts
- Remember that cold meals can be as nutritious as cooked meals
- Convenience foods are a useful standby and can be just as nourishing
If you have a freezer, try to prepare food in advance and store it for
when you are not feeling so well
- Accept offers of help with cooking and shopping from friends and family
- Try to make food and drink as nourishing as possible
- If you cannot face big meals, try to have smaller ‘ready to eat’ snacks and drinks on a regular basis
- Have frequent sips of drinks
Sucking ice cubes or ice lollies may help to keep your mouth moist
- Keep foods moist with lots of sauces and gravies
Some foods such as chocolate and pastry may stick to the roof of your
- Boiled sweets may help to keep your mouth fresh
- Artificial saliva solutions are available from your doctor if these are appropriate for you
- Drink plenty of fluid
Eat small, frequent meals made from light foods – dairy produce, white
bread, pasta or rice
- Avoid highly spiced or fatty foods and eat your meals slowly
- Anti diarrhoea medication
- Have plenty of fibre in your diet
Favourite natural remedies are syrup of figs, prunes and prune juice
- Aim to drink at least 2 litres a day
- Gentle exercise
If the constipation is due to medicines that you are taking (such as
painkillers or anti-sickness drugs) you will need to take laxatives
Difficulty in Chewing or Swallowing
- Soft or puree foods will be easier
Adding sauces and gravies to every day foods may be enough to help
If you need a puree consistency, blend every day foods using extra milk
or creamy sauces to help make smoother consistency
Puree different foods separately so that they can be tasted e.g. keep
vegetables all separate
Eating Well with
a Feeding Tube
by Deep Shikha
Deep Shikha has worked
as a dietitian with the Rajiv Gandhi Cancer
Institute and Research Centre, Delhi, since
2012. She has a M.Sc in food and nutrition,
and a P.G Diploma in Dietetics, food and
Cancer patients often tend to
have poor nutrition and low body weight. Dietitian
Deep Shika discusses how patients can maintain
a healthy diet, even with a naso-gastric feeding
Nasogastric tube (NG) feeding,
or "Ryles tube feeding", as it is generally
known, is not uncommon in head and neck cancer
patients. When a malignancy is such that it prevents
swallowing of food through the mouth, a feeding
tube becomes necessary to maintain nutritional
levels in the body. Working as a dietitian in
a cancer institute which sees thousands of patients
from all over India is a challenge and often involves
providing wholesome nutrition to patients who
are on NG tube. These patients are facing emotional
upheaval and physical discomfort at the same time.
While in other hospitals, patients may come with
a fever or a fractured bone and are optimistic
of their return to good health, in a cancer hospital,
when patients come to know of their diagnosis,
they frequently break down emotionally and are
overcome with the fear of death.
A Ryles tube is not a very
convenient thing to have. The liquefied food needs
to be given slowly through the tube over a number
of hours as, if the feed is given quickly, it
can flow into the gullet which is very unpleasant
and makes the patient feel sick. Also, the patient's
attendant's movement tends to become restricted
during the feeding. For this reason, many attendants
prefer to give the feed overnight so that they
can move about in the day time.
Generally, a light vegetable
broth of carrots, beetroot, beans, washed daal
and broken wheat is nutritious. The ingredients
are boiled and blended, and water and salt are
added to taste. Often the mixture has some butter
added at the end. A curd feed, thinned with water
and a little sugar is also a good option. For
diabetics, the same can be given with salt instead
of sugar. For those who prefer khichri feed, rice
and washed daal with some fresh cottage cheese
and a little bit of butter provides a balanced
meal with carbohydrates and proteins. Light vegetables,
daal, or black chickpea soups are excellent for
keeping the body's nutritional levels up.
are essential in proper nutrition
convincing patients and their carers of good
Ryles tube feeding practices and dispelling
unfounded beliefs becomes part of the job.
I have come across patients' family members
who refused to let their patients have turmeric
as they thought "yellow-coloured"
foods had to be avoided during jaundice. Turmeric
is, however, completely harmless and in fact
acts as a natural anti-biotic.
As health care professionals,
when we step inside the hospital for a day's work,
we keep in mind that cancer patients have a very
special need of empathy, good care, love and large
doses of motivating words. A good, nutritious
diet adds to the physical and mental strength
Nasogastric Tube Feed: Some
1. Milk Feed
Cut the edges off the bread and crumble the
the crumbs well with sugar and milk;
Sieve all ingredients so that they become
a homogeneous whole.
2. Vegetable Broth
vegetables and boil them with the washed daal
and broken wheat;
the boiled ingredients to a smooth paste consistency;
Add salt to taste and a dash of butter
3. Curd Feed
to taste instead of sugar for a diabetic patient
- Add water
and some sugar (replace with salt for diabetics)
Blend all three ingredients.
4. Kedigree (khichdi)
- Boil the rice, washed
daal, cheese, with salt and turmeric powder;
- Blend the
ingredients well and boil again;
Add a dash of butter at the end.
5. Custard Feed
- Custard powder
- Heat the milk and add
custard powder and some sugar to it;
- Stir till no lumps of
custard powder are visible.
6. Mixed Vegetable Soup
- Bottle gourd
- Salt to taste
- Pepper to taste
- Boil all vegetables along
with the coriander;
- Blend the boiled ingredients
by adding some water;
- Boil again, adding salt
and pepper to taste;
- Add a dash of butter (optional)