Hi all. I had surgery/chemo/radiotherapy 5 years ago. At that time I lost 30-35lbs. I was never obese - just on the upper end of my healthy BFP. Quite a lot of my weight loss was in fat, but I certainly lost muscle too. It got so I couldn't walk more than 10 minutes. It took me 3/4 years to get my weight back up to the sort of level my nutritionist wanted, but I know it's more in fat than muscle. I have had 2 lung operations and since the 2nd one my energy and exercise levels have seriously reduced too. Lazy. Tired.

I have been told that on the chemo I'm starting in 10 days, I can expect to lose 2kg (about 4-5lbs) a session - 6 sessions one every 3 weeks. I need to fight hard to keep/gain weight in between, and I am particularly concious that I need to gain muscle, and I need to improve my protein intake.

For various reasons, I cannot cope with meat like I used to, or fish. My partner is a die-hard meat eater, the fattier the better, generally roast. Just the smell makes me have to leave the room - or deep fat frying. We just cannot share meals most of the time. I have become a very uninspired and lazy cook - most of the time I really do not know what to eat. My diet consists of far too much cheese/dairy product and pasta/potatoes. I'm generally fine with green vegetables, carrots etc. - well, not bad, but I really need to change my protein intake method.

Could any of you suggest some EASY-COOK non-meat protein rich recipes, please? Sadly I also have problems sourcing meat-replacement products such as tofu etc. - I have discovered to my dismay that there is no vegan/vegetarian shop near where I live, and French supermarkets havn't discovered the concept yet! So mostly it's going to have to be nuts and pulses, but can't be too dry for saliva reasons. Eggs are ok although for some reason I don't use them often.

Or protein supplements? I don't know anything about them - they gave me some protein enriched pasta to try a few years back and it was yukky.

I do have high cholestoral - I used to have a very healthy low fat diet, but since I was working on putting weight on, I switched to high fat, high dairy product intake - and sugary things which I never used to eat much of either - lurve my choccy biccies and Magnum now! But the chemo consultant encouragingly said 'Something that might make you ill in 20-25 years time is absolutely not something that you have any need to worry about'. Yay.

Many thanks for all suggestions!

Christine and Cheryl will know far more than I do but I can recommend a couple of things.

Whey protein (a milk product without the fat and other less desirable things) is readily available in the health food or fitness aisle of the supermarket. Or in fitness stores.

Skim milk powder added to smoothies is also good.

I dislike most meats now, mainly because I can't chew them but also because I just don't fancy meat. I try to eat pulses and eggs to provide me with proteins from non-dairy sources.

I have a recipe cut out from the local newspaper for a peanut raisin smoothie with a soy milk base. The recipe is by the winner of Masterchef NZ so it might be more palatable than it sounds.

I add whey protein to my smoothies everyday, to my oatmeal in the morning with berries, and it is easy to add to many other things depending on flavor that you get. (Start with vanilla since it goes with most things easily). Health food stores have it for body builders, but Walmart sells two brands at the best prices. Consumers Union which tests health food claims and supplements for actual content recommends 6 Star brand which Walmart has for about 20 bucks.

With your cholesterol issue, you want to be conscious of where your protein is coming from, but there are plenty of sources that shouldn't make that worse if you are disciplined about what you choose.

As to protein consumption you should shoot for about 1/2 gram of protein per pound of body weight minimum per day to start. I can get about half my daily need from oral consumption of eggs, fish, nut spreads and humus that I make in my Vitamix, and other sources, but I need the whey protein to make the mark of total needed.

Note there is a new study out that is related to the loss of muscle mass from aging -Sarcopenia (I'm well into this process) and it speaks to the benefits of doubling up on protein intake. Please note that proteins alone will not help with all this is you are really sedentary. But even moderate exercise and activity will help put a modest about of muscle mass on, if you are consistent with it.

http://www.sciencedaily.com/releases/2015/01/150130121613.htm

In the right column of this page there are other stories about protein and muscle that you may find interesting.

Sarcopenia is drastically accelerated from radiation because of chronic oxidative stress and damage to neuromuscular junctions that then inhibit the natural autosynaptic process of motor neurons which begins the decline.

Cholesterol, particularly LDL levels > 100, increases the risk of carotid accumulation of cholesterol plaque that contributes to stroke out, post radiation. Oxidative stress speeds up the destruction of the artery walls which then prohibits efficient vasodilation/constriction to keep plaque from accumulating, whether it is calcium or cholesterol plaque.

The missing piece in viewing the physical decline is the restricted blood flow that creates atrophy, muscle weakness and further catabolic destruction. Without addressing the blood flow, aging accelerates.

If you are able to eat, supplementary protein powders are mostly beneficial for feeding muslces during exercise activties. There are many high-protein, low fat or at least low "bad" fat options. Lipids or fats are essential to the nerve myelin and other neuromuscular function and a pure low-fat diet, post radiation, is not a good option.

Without knowing more history, conventional or standard nutrition guidelines are only a starting point and I don't believe any two people are the same.

Hello, I just want to add my 2 cents worth.
Kris has lived on a liquid diet for 4 years now. He blends all his meals.
As he has a high oral calcium requirement due to non functioning Parathyroid, by necessity he does have a high dairy diet. He has lots of full cream high calcium milk, yoghurt, icecream, and cream. He blends these with raw eggs, chicken, fish and any other meats that we have in the house. I make soups that he blends with the dairy products. Can add nuts/ nut butters, tofu, hummus, anything you like really. Also milk powder for the whey protein.
The really interesting point for me is that Kris has been taking Statins for 20 years with no effect on his Lipid profile.
Since he has been on this high dairy, high fat diet his Lipids are perfect. The cardiologist even asked what his diet was so that he could recommend it to other patients! I am beginning to rethink the notion that high fat is bad.
Hope all goes well for you Mungolina.
Tammy

[quote]Sarcopenia is drastically accelerated from radiation because of chronic oxidative stress and damage to neuromuscular junctions that then inhibit the natural autosynaptic process of motor neurons which begins the decline. [/quote]
Geez Ed,
That's a mouthful. Is the bottom line here radiation treatment damages body tissues so it is even more important to get more physical exercise that gets blood flowing throughout the body, particularly the areas damaged by radiation?

In that case, my multiple daily neck stretching exercises that I do to minimize the muscle tightness and cramping also get more blood flowing through there as an added benefit.

Don, the bottom line is that radiation is believed to cause premature aging. The muscle wasting and many things like bladder and bowel control, even digestive motility issues are clinical signs that present with the regular aging process. I have not only broken that cycle, I have reversed aging, according to clinical presentation. I am in a mad dash figuring out how to address the cardiovascular disease aspect before it kills me. It takes a lot more blood flow than stretching, based on how advanced my particular case is.

If increased blood flow is a key component in your answer to your continued existence than aren't there any other studies that focus on this approach? There are many drugs that increase blood flow thru the body so I would think that a seemingly simple study could check this out.

Yes, there are many studies all over the world and no, it isn't as simple as throwing a blood thinner at it. Doctors just let people die because, much like aging, once the blood vessels are shot, there really is not a lot of options.

Keep in mind, blood vessels, like the digestive tract, have smooth muscles. These muscles, along with the heart, help move the blood and valves keep it from going backwards. Veins send out oxygenated blood through arteries and return blood for oxygenation via veins.

I have posted this a few times but the treatment most successful for this, radiation induced fibrosis and osteoradinecrosis, worldwide, has consisted of Pentoxyphylline/alpha Tocopherol with HBOT and to a lesser degree, a bisphosphonate called Clodronate, which is not available here.

Pentoxyphylline is a vasodilator, while alpha Tocopherol is a very old form of vitamin E, which is a blood thinner, among other things. Pentoxyphylline has an unusual characteristic of forcing blood into areas blood doesnt't flow, unlike HBOT that actually creates new capillaries. The bisphosohonate removes the calcium.

As soon as the weather breaks, I will do another round of Etidronate, a bisphosphonate. I chose this because it is one of the few that does not contain nitrogen, which I believe can trigger the nitric oxide cycle that begins the oxidative stress cycle from trauma. I hope to combine this with some HBOT.

For whatever reason, these studies are being done in Europe but not a lot of activity here, most likely because of funding, combined with the random nature of how all this presents.

I believe I understand why some previous studies weren't successful or better, what combinations of activity and medication that is most effective. I have reduced the recommended dose by 1/3 (2 times/day vs 3) mostly because the combination with bisphophonate gets pretty brutal. I worked through it, but I think most people would stop when it gets difficult, as there may be less progression or they may still be treatable, in the eyes of the doctors. I'm just running out of time.

Well, if you want to put on weight, you have to eat more calories than what your daily "maintenance calories" are. Something in the order of an extra 500 calories per day will give you approximately a one pound weight increase over one week. In order to encourage muscle growth, you have to work those muscles and not just sit around and put on fat. I know it's certainly not easy to do if you're feeling tired, but remember that energizing feeling you get after a good workout. Find something physical to do, that you enjoy and agrees with you. If you can lift some weights, great. If you don't have access to anything like that (or just are not that way inclined), doing some bodyweight exercises at home will be helpful. Adding a few basic pieces of equipment can add some variety and they don't have to take a lot of space depending on what you choose. I have a pullup bar that I mount on a door, an inflatible stability ball, and a set of dumbbells. Just remember that you have to pick something that is going to build muscle - high cardio things like running don't cut it here, and will just burn off your calories without adding much muscle mass. If you're not already working out very much, it is important to start out slow! Do some pushups, situps and some pilates-type exercises and increase the amount daily.

I hear you on being sick of the high fat/high dairy diet. It was the same for me. Definitely you'll want to add whey protein powder to your diet. There are quite a few different types with various additives out there, but you'll probably want to pick a more basic plain whey protein. I always have vanilla on hand, and rotate between other flavours for a second option.

There are lots of non-meat sources that are high in protein. Quinoa, lentils, chickpeas (garbanzo beans), edamame (soybeans), greek yogurt, etc. Nuts have a lot of protein but they are also very high in fat. If you can tolerate chicken or turkey breast meat, it is also higher in protein and relatively low in fat.

Recipes will vary on what foods you can tolerate and what is available to you. I like to make a big pot of chili overnight in my crock pot, using a variety of beans and chickpeas. Add in some Indian dishes like daal to get your lentils, and chana masala for some more chickpeas. I also buy the edamame that you just pop in the microwave for a few minutes and steam in a bag (or the already shelled ones that I can add to a stirfry).

I'm not sure how you will tolerate any of that while on chemo, however. Soups, smoothies and fresh vegetable juice might be all you can handle. If you don't have a blender, I'd highly recommend that you get one. It'll become your best friend.