What to Eat After Treatment to Prevent Recurrence?

What to Eat After Treatment to Prevent Recurrence?

Key Takeaways  

- After treatment, it is essential to support growth, bone health, metabolism, and reduce the risk of secondary cancers through diet.  

- Dietary recommendations include "Two Not, Three More, Four Less." Two Not: No smoking or drinking, no reliance on supplements; Three More: More fruits, vegetables, and mushrooms, more whole grains, more plant proteins; Four Less: Less sugary drinks, less high-fat and high-sugar processed foods, limit red and processed meats, and less salty food.  

- No single superfood can prevent recurrence. A healthy, balanced diet can lower the risk of recurrence. The motto is to "eat a rainbow," so the more variety and colors, the better.  

- Long-term multidisciplinary follow-up ensures that healthcare professionals support children's healthy growth.  

 

How to Eat for Better Recovery and Recurrence Prevention?  

 

After treatment, many parents ask if their children can eat in school cafeterias and when they can dine at restaurants. The primary concern is food safety. As long as the restaurant has a business license, it will have health permits. Typically, school cafeterias are also regulated by the government and have high food safety standards. Once the child has stopped medication and has normal blood counts, they can be treated like any other child.

 

If the child has just stopped medication and is still weak, it may be wise to continue with dietary restrictions for an additional 3 to 6 months to lower infection risks. For children who have undergone bone marrow transplants, there is generally little difference from normal children once they have stopped medication.

 

How Eating Well Helps Recovery and Prevents Recurrence?  

 

Firstly, eating well is vital. Nutrition plays a significant role throughout the cancer treatment process. Ensuring a good diet and a healthy lifestyle not only aids in curing the disease but also supports long-term growth and enhances quality of life.

 

What’s the Importance of Eating Well After Treatment?  

 

Growth and Development  

 

Parents usually face two situations: the first is when children eat poorly during treatment due to discomfort, leading to being underweight and having low muscle mass. In this case, after treatment, it is crucial to provide them with more nutritious food to help them catch up on their growth and development.

 

The second situation is overweight and obesity, particularly common among children with blood cancers, such as those with acute lymphoblastic leukemia. After treatment, the rate of obesity is higher than that of their peers. This increases the risk of cardiovascular diseases, metabolic disorders, and secondary cancers, so parents need to help their children manage their weight.

 

In either case, it is highly recommended for parents to take their child to a nutrition clinic for follow-up, where clinical nutrition specialists can assess and provide guidance. Younger children may also seek growth and development monitoring from pediatric healthcare providers. Children with brain tumors or kidney tumors may require follow-up with an endocrinologist.

 

Bone Health  

 

During treatment, children's bone health can be affected. We can help restore bone health through two aspects: diet and exercise.

 

(1) Diet  

In addition to eating well, it is essential to pay attention to calcium intake. This can come from food sources such as dairy products, dark leafy greens, tofu, shrimp skin, and seaweed. However, if the child has undergone high-dose hormone treatment or has some osteoporosis, calcium supplements may be necessary. 

 

Typically, it is not recommended to measure blood calcium levels, as it doesn't indicate if the child is calcium deficient. Instead, dietary intake and X-rays are better indicators. If following up in the oncology department, doctors usually perform X-rays every 1-2 years to check bone health and osteoporosis issues. 

 

Another crucial nutrient is vitamin D, which is primarily synthesized in the skin through sunlight exposure. Therefore, it is advisable to get some sun or use supplements. Blood tests can determine vitamin D levels; if a deficiency is found, additional vitamin D supplements may be necessary.

 

(2) Exercise  

After treatment, children may still feel weak and tired. Parents should encourage them to be active—if they can stand, they should not lie down; if they can walk, they should not stand still. If possible, allow children to play with peers and engage in outdoor activities, starting in less crowded areas where they can enjoy nature. 

 

For children with physical limitations in exercise, such as those with osteosarcoma or brain tumors, rehabilitation therapy may be needed. Tailored exercises can improve their physical abilities, and movement is essential for long-term health and quality of life.

 

Metabolic Health  

 

To help children reduce the risk of high blood sugar, high cholesterol, high blood pressure, and secondary cancers, the first step is to maintain a healthy weight, followed by adhering to the "Two Not, Three More, Four Less" dietary guidelines.

 

Two Not: No smoking or drinking, no reliance on supplements.  

Smoking and drinking are well-known carcinogens, and even healthy individuals should avoid them; the risks are higher for children who have had cancer. Many parents seek out alternative remedies out of fear of recurrence. However, it is important to note that no single food can guarantee a reduced recurrence rate. Only a healthy dietary pattern can help improve overall health and thus lower the risk of recurrence and secondary cancers.

 

Three More: More fruits, vegetables, and mushrooms; more whole grains; more plant proteins.  

(1) More Fruits, Vegetables, and Mushrooms  

Aim to have vegetables at every meal, fruits every day, and mushrooms weekly. The more colorful and diverse the fruits and vegetables, the better. It is advisable to ensure that half of the vegetables are deep yellow, deep red, or dark green, such as carrots, tomatoes, broccoli, and spinach. These colors represent rich plant nutrients with some anti-tumor properties. 

 

Cruciferous vegetables are particularly recommended, with a goal of eating them at least five times a week. These include cabbage, broccoli, bok choy, and other varieties, which can be rotated in the diet.

 

(2) More Whole Grains  

What are whole grains? For instance, white rice is polished rice. If you’ve seen paddy rice, you’ll notice it has a brown layer of bran and germ after the hull is removed. Brown rice, which includes bran, white rice, and germ, qualifies as a whole grain.

 

Oats, brown rice, and whole wheat flour are also whole grains. It is recommended to replace some polished rice with whole grains, such as adding sorghum or oats to white rice, or combining with sweet potatoes and corn. Children who have undergone treatment may have weaker digestive systems, so introducing whole grains should be gradual. Start with a small amount of brown rice or legumes and gradually increase, aiming for half of the main carbohydrate sources to come from whole grains and mixed grains.

 

(3) More Plant Proteins  

If the child’s growth has caught up with their peers, it’s not necessary to have meat at every meal. Instead, focus on plant proteins from sources such as tofu, green peas, and soybeans. Red beans and mung beans can be cooked with rice to provide excellent plant protein. Nuts and seeds are also rich in plant protein, and mixing legumes with rice can effectively supplement protein. Aim for 1-2 meals a week to include more legumes, or mix legumes with rice to make a healthy grain dish, which is also beneficial for cancer prevention.

 

Four Less: Less sugary drinks, less high-fat and high-sugar processed foods, limit red and processed meats, and less salty foods.  

(1) Less Sugary Drinks  

Sugary drinks negatively impact cardiovascular health and metabolism, increasing the risk of pancreatic issues and secondary cancers. Therefore, it’s advisable for children to avoid sodas and limit juice consumption to no more than one cup a day (the size of a disposable cup). For children under 10, half a cup is sufficient. Freshly squeezed juice is preferable to fruit-flavored drinks (which are mainly water and fructose syrup). Eating whole fruits is a better choice, with a daily recommendation of about two fist-sized servings.

 

If children enjoy sweet beverages, consider mixing a little orange juice with water or adding sliced fruits and vegetables to water. Using attractive cups can make drinking more enjoyable for children.

 

(2) Less High-Fat, High-Sugar Processed Foods  

Many children love chips, pizza, fried chicken, sweets, and spicy snacks, which are all processed foods that can negatively affect blood sugar, lipid levels, and blood pressure, increasing the risk of secondary cancers. However, moderation is key; it’s okay for children to enjoy treats during celebrations, such as birthdays.

 

(3) Less Red and Processed Meats  

Red meats include pork, beef, lamb, and horse meat. Consuming them in excess can raise cancer risks, but this doesn’t mean they must be eliminated entirely. It’s best to avoid red meat at every meal and to choose healthier cooking methods, such as steaming, braising, or stir-frying, instead of grilling, which can create harmful compounds that increase inflammation and cancer risk.

 

Processed meats like sausages, cured meats, and bacon should be limited, as they also raise cancer risks. These foods often feature in traditional celebrations, and having them occasionally during holidays is acceptable, but frequent consumption is not advisable.

 

(4) Less Salty Foods  

Excessively salty foods can also increase cancer risk. For example, Chinese salted fish is recognized as a Group 1 carcinogen by the World Health Organization, raising the risk of digestive system cancers. Foods like pickles and fermented vegetables are also high in salt and should be consumed sparingly. During cooking, controlling high-sodium seasonings like salt, soy sauce, and bean pastes is crucial. Instead, using herbs like ginger, star anise, and fennel seeds can enhance flavor, along with ingredients like eggs, shiitake mushrooms, shrimp skin, tomatoes, and fruits like pineapple and mango, which can also be used to enhance the taste of dishes.

 

How to Achieve a Balanced Diet?  

 

A comprehensive and balanced diet provides excellent nutrition, with each food category—vegetables, grains, fruits, and proteins—being represented. Here’s a daily dietary recommendation for reference:

 

Vegetables: Aim for at least 2-3 fist-sized servings (the child's own fist) with a variety of colors, including deep red, yellow, and green, making up half of the servings.

 

Grains and Legumes: Serve as the main carbohydrate source, with 2-3 fist-sized servings, half of which should come from whole grains and mixed grains.

 

Fruits: Provide 1-2 fist-sized servings, prioritizing those high in vitamin C, such as kiwis, citrus fruits, guavas, berries, apples, and pears.

 

Proteins: Include meat, eggs, poultry, fish, shrimp, and crabs in a fist-sized serving (or two palm-sized portions). Limit red meat and processed meats (like cured meats and sausages).

 

Additionally, water is the best beverage, and a small handful of nuts or seeds is sufficient. Choose plant oils over animal fats, as animal fats can increase inflammation. Mushrooms are also very healthy, so aim to include them weekly. Dairy is also an option; if cow's milk causes digestive issues, consider lactose-free milk or products for children needing to catch up on growth.

 

We recommend "eating a rainbow," aiming for variety and richness in color, as this benefits not only children but the entire family’s health and can lower the risk of cancer in adults.

 

Aim to consume at least 12 different foods daily and 25 different foods weekly. For example, a main dish of mixed grains can combine various rice and beans, easily reaching seven or eight ingredients, plus vegetables and meat to easily meet the 12-item goal. The "rainbow" colors from fruits and vegetables are beneficial plant nutrients, such as lycopene, anthocyanins, carotenoids, lutein, zeaxanthin, resveratrol, and flavonoids. These nutrients are best obtained through food, as supplements cannot replace them.

 

I know that parents and children have gone through a challenging journey together. I hope everyone can make informed choices, using professional resources wisely and engaging in long-term multidisciplinary follow-ups while treating children as normal kids. Overprotectiveness can hinder their healthy growth.

 

We hope every child can return to school and society to pursue their dreams and find their place in the world. Every child is a little warrior, and they should be proud of themselves upon returning to school, feeling appreciated by their peers for their bravery rather than facing rejection. Through our collective efforts, we can help children embrace society gently.

 

Finally, I would like to share a photo of a doctor in the pediatric ICU at Johns Hopkins Hospital in the USA. She was once a pediatric cancer patient herself, and after her recovery, she pursued medicine to help others like her. Now, she is a dedicated and compassionate doctor, well-loved by the children. I wish for every child to grow up healthy and achieve their dreams, just like her.

 

Professional Ignites Hope!  

 

Course Instructor: Sun Lingxia  

Former Clinical Nutritionist at Johns Hopkins Hospital  

Content Edited by: Xia Yu  

Editing by: Zuo Jia  

Typesetting: Xia Yu  

Proofreading: Xiu Xiu