Diet therapies are specially designed diets prescribed for medical and or general nutritional reasons.
Maintenance of adequate nutritional status and fluid balance is an important component in the care of a child diagnosed with cancer. The physiological effects of the cancer itself, in addition to the numerous side effects of the necessary treatment, frequently interfere with the child’s ability to ingest, digest, and absorb food and fluid.

The objectives of diet therapy include:

• To increase or decrease body weight
• To rest a particular organ
• To adjust the diet to the body’s ability to use certain foods
• To produce a specific effect as a remedy (e.g. regulation of blood sugar in diabetes)
• To overcome deficiencies by the addition of food rich in some necessary element (e.g. supplementing the diet with iron in treating anaemia)
To provide ease of digestion by omitting irritating substances such as fibre, spices, or high-fat foods.

Types of diets and indication for use

There are two main types of diets, these are;

• Regular Diet or prophylactic; the regular diet is composed of all types of foods and is well balanced and capable of maintaining a state of good nutrition. This is the diet everyone consumes.
• Modified or therapeutic diets; this includes all diets which are modified from the regular diet and are intended to meet specific patient nutrient needs i.e. soft diet, liquid diet, high calorie diet, high protein diet, low calorie diet, low protein diet, high residue diet, low residue diet, low sodium diet, bland diet, low carbohydrate-high protein diet.

Due to the broadness of the diets, we shall discuss those which deal with the most common feeding challenges of children with cancer.

• A liquid diet consists of foods that are in a liquid state at body temperature.
• This type of diet is indicated in some post-operative cases and in acute illnesses for patients who have difficulty chewing, swallowing or digesting food.
• The patient needs to be fed at least 170g of the feed every 2 hours while the patient is awake.
• The best option is to give regular foods blended and strained in liquid including black tea or coffee, clear fruit juices (apple, grape, and cranberry), popsicles, and fruit drinks.

A Soft diet is soft in texture and consists of liquids and semi-solid foods. It is indicated in certain post-operative cases, for those who cannot tolerate a regular diet, in acute illnesses, and in some gastrointestinal disorders.

• The high-calorie diet is of a higher caloric value than the average patient normally requires. It is indicated when an increase of total calories is required by malnourished, underweight or post-surgical, patients like those battling cancer, burns, and fevers. The increase in calories is obtained by supplementing or modifying the regular diet with high-calorie foods or commercial supplements, by giving larger food portions, or by adding snacks. It is given to meet a need for energy caused by rapid metabolism that accompanies certain conditions such as fever, hyperthyroidism, poliomyelitis, and other acute illnesses.
• Good sources of high-calorie foods include: whole milk, cream, sweets, butter, margarine, fried foods, gravy sauces, and ice-cream. Between-meal feedings consisting of milk, milkshakes, cheese, cookies, or sandwiches are recommended but these feedings should not interfere with the patient’s appetite at mealtime.

• Protein is essential for tissue growth and regeneration. A high-protein diet is indicated in almost all illnesses e.g. nephrosis, liver cirrhosis, infectious hepatitis, burns, or radiation injury.
• The daily recommended intake of proteins for children is at least 0.9g/kg of body weight per day. A high-protein diet therefore should provide a minimum of 1.5g of protein per kg of body weight per day.
• Supplement the regular diet with high-quality protein foods, such as meat, fish, cheese, milk, and eggs.

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