Ask Tufts Experts: Food Choices When Tired; Eating During Chemotherapy

I tend to make less healthful food choices when I’m tired. Is this a real thing, or is it just me?

José Ordovás, PhD, leader of the Nutrition and Genomics Team at the Human Nutrition Research Center on Aging answers: “You are not alone in noticing a tendency to make less healthful food choices when feeling tired. It is plausible that lack of sleep can affect your food choices and lead to a preference for less nutritious options. Although we do not have enough data to say for sure there is a causal relationship, studies have found that lack of sleep is associated with unhealthy food choices and an increase in overeating.

“Sleep plays an important role in regulating hunger and appetite-related hormones, such as ghrelin, which is assocated with hunger, and leptin, which is responsible for signaling fullness. Lack of sleep has been found to elevate ghrelin levels and decrease leptin levels, leading to increased hunger and appetite. Moreover, it also impacts brain regions that influence our thoughts about food.

“A study done by University of Chicago researchers found that sleep-deprived participants were unable to resist ‘highly palatable, rewarding snacks,’ like cookies, chips and candy. Researchers found that sleep restriction boosts a signal that may increase the pleasure and satisfaction gained from eating. However, it is important to note that further research is needed to deepen our understanding of the mechanisms linking inadequate sleep with the increased risk of weight gain.

“The relationship between sleep and dietary intake may go both ways: a systematic review of studies found that consumption of healthy foods was associated with better sleep quality, while higher intake of processed foods and foods high in added sugars was associated with lower sleep quality.”

I am undergoing chemotherapy. I have very little appetite, and sometimes just the smell of food makes me nauseous! How can I get proper nutrition at this important time?

Hannah Wolf, MS, RD, a registered dietitian with a clinical focus on oncology nutrition, answers:

“Please talk to your healthcare provider about your concerns. It is important to maintain good nutritional status during cancer treatment. Side effects from chemotherapy (such as nausea and taste changes) can make eating a challenge. Dietary advice for people undergoing chemotherapy varies depending on the side effects an individual experiences. Here are some tips my patients have found helpful:

➧ During cancer treatment, your body may need extra calories and protein, as well as healthpromoting vitamins and minerals.

• Incorporate a variety of protein rich foods, such as lean meats, poultry, fish, eggs, legumes, and milk products—whatever is tolerable. Some people find drinking proteinrich smoothies (made with plain Greek yogurt, milk, and or nut butter) helpful. Canned liquid supplements are an option as well.
• Eat small, protein-rich snacks throughout the day, such as Greek yogurt, half a sandwich, or cheese with whole grain crackers.

➧ If you are experiencing nausea, try room temperature or cold food. This limits odors that turn some people off. Ginger can be helpful with nausea.

➧ Maintain good hydration. Keep a reusable water bottle by your side.

➧ Taste changes are not uncommon in people undergoing chemo. If you have a metallic taste in your mouth, use plasticware instead of metal forks and spoons.

➧ If food tastes bland or off, try adding lemon to food or beverages.

➧ Keep your mouth very clean. Make a mouth rinse by adding one teaspoon baking soda and one teaspoon salt to a quart of water. This can neutralize off tastes, and it is beneficial for those suffering from mucositis (sore, inflamed mouth) as well. Store it in the refrigerator and use as needed.

➧ Get some movement and exercise. Even though it may feel counter-intuitive when you’re feeling run down, moving can actually get your energy up, and it helps maintain muscle mass. “You’ve got this!”

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