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Diet and Lymphoma: Nutrition Tips for Feeling Your Best

Updated on May 25, 2021
Medically reviewed by
Todd Gersten, M.D.

Eating a nutritious diet is an important factor in feeling your best while living with lymphoma. Along with sufficient sleep and exercise, getting enough of the right foods for a healthy body and immune system will help you heal during and after lymphoma treatment. Several side effects of lymphoma and its treatments may improve with specific nutrition recommendations.

Guidelines on healthy eating for people with lymphoma aren’t very different from healthy eating guidelines for everyone else. Some of the main aspects of a healthy diet for lymphoma are discussed below. While these nutritional guidelines are safe for most people, you may have additional health concerns — such as food allergies or conditions that affect digestion — that require special consideration. Always consult with your doctor before making major changes to your diet.

Plenty of Plants

A diet focused on plant foods is nutritious and beneficial for people living with lymphoma. A plant-based diet emphasizes plant foods, but isn’t necessarily vegetarian or vegan. You can center your diet around plants, but include meat and dairy products in moderation.

The Mediterranean diet is considered one example of a plant-based diet. This is an eating pattern rich in fruits, vegetables, whole grains, low-fat dairy, lean meat and other proteins, and healthy fats. Unhealthy, saturated fats like those found in butter and fried foods should be limited to less than 10 percent of your total calorie intake for the day.

Many MyLymphomaTeam members report making changes in their diets to include more plants and whole foods. “I tried to go vegan for three months, but it didn’t last for me,” said one member. “I have adopted some of the vegan ideas.” Another member wrote, “I've been changing my diet to include more fish and fresh vegetables.” “I wiped out processed foods from my diet, eating heart healthy, and cooking for my husband,” said another member whose spouse is living with follicular lymphoma.

Antioxidants

One of the advantages of eating a plant-based diet is maximizing your antioxidant intake. Antioxidants fight free radicals and can help prevent cancer. Examples of antioxidants include:

  • Beta-carotene and lycopene — Found in apricots, carrots, pumpkin, sweet potatoes, and bell peppers
  • Vitamin A — Found in spinach, chard, carrots, squash, and sweet potatoes
  • Vitamin C — Found in broccoli, leafy greens such as turnip and mustard, cantaloupe, oranges, lemons, strawberries, tomatoes, and bell peppers
  • Vitamin E (alpha-tocopherol) — Found in avocado, peanuts, sunflower seeds, and boiled spinach

Getting antioxidants from foods has been shown in studies to provide benefits, while taking antioxidants as nutritional supplements has not. Researchers believe that antioxidants may require the combination of other nutrients and plant chemicals, such as polyphenols, in order to be active in our bodies.

Other Plant Compounds Beneficial for Treating Cancer

Preliminary research suggests ursolic acid may decrease tumor growth by regulating mitochondrial function through metabolic pathways. Foods that contain ursolic acid include apples, basil, rosemary, and cranberries. Cooking with these ingredients or consuming these foods can’t hurt you, but taking supplements with these ingredients is not currently recommended.

Cruciferous vegetables contain compounds called glucosinolates, which may help with cancer prevention and recurrence. There is research proving this compound can help with lung, colon, breast, and prostate cancer. More research is needed to clarify relationships and evidence of the health effects of glucosinolates on other forms of cancer. Cruciferous vegetables include broccoli, Brussels sprouts, and cauliflower.

Curcumin is a compound that has anticancer properties. It may target different cell-signaling pathways, including growth factors and cytokines, which may help with cancer prevention or recurrence. Curcumin has poor bioavailability, meaning it has low absorption rates and fast elimination from the body, but studies suggest that black pepper may enhance absorption. The research on this compound is preliminary, and further clinical trials are needed to assess its effectiveness.

While antioxidants, curcumin, cruciferous vegetables, and ursolic acid may not have specific relationships with blood cancers, they contain healthful compounds for immune health. These may help fight infections — a common complication of lymphoma and its treatment.

Fiber

Fiber is a neglected, yet crucial, component of balanced eating. Fiber comes from starchy foods like vegetables, fruits, whole grains, beans, nuts, and seeds. Fiber stimulates proper digestion, aids in controlling blood glucose, manages healthy fats, and promotes a healthy gut. Optimally, women need at least 25 grams of fiber per day, and men need at least 35 grams of fiber per day.

For some people living with Hodgkin lymphoma or non-Hodgkin lymphoma, a high-fiber diet may irritate the stomach and worsen nausea. In these cases, your doctor may recommend a low-fiber diet instead.

Try the Plate Method

The plate method can help you accomplish a balanced diet and aid in portion control. Too much of even a good thing can be a bad thing, which makes portion control and distribution important. To use the plate method:

  • Half of your plate should include vegetables — the more colors, the better.
  • One-fourth of your plate should contain protein, such as chicken, fish, or legumes.
  • One-fourth should contain a healthy starch, such as brown rice, quinoa, or sweet potato.

Your meal should also contain a healthy fat like olive oil, avocado, nuts, or seeds. Fruit can be enjoyed with a meal or as a snack, along with a source of protein or fiber to help control blood glucose and feel “full.” For instance, pair an apple and almond butter, grapes and string cheese, or bell pepper strips and hummus.

Part of a healthy meal distribution includes treating yourself to foods you crave — in moderation. It is healthier to have a small serving of your sweet of choice than to restrict yourself and possibly end up overdoing it later.

Maintaining a Healthy Weight During Lymphoma Treatment

Maintaining a healthy weight is crucial for good overall wellness. You should consume enough calories to maintain an appropriate weight for your size or enough calories to gradually lose weight if you are overweight or obese.

Unintended Weight Loss

It can be hard to maintain a healthy weight and prevent malnutrition if you are experiencing nausea, vomiting, diarrhea, loss of taste, or lack of appetite. During these times, prioritizing nutrient-dense, high-calorie foods is a must. Maintaining your weight with calories and preserving your lean muscle mass with protein are of equally high priority.

Losing enjoyment in food can make it even more difficult to eat enough. “I am still waiting to get my taste buds back after 15 radiation treatments,” said one MyLymphomaTeam member. “I haven’t been able to eat solid foods, and tomorrow will be 30 days with absolutely no taste of any kind.” Another member wrote, “I have noticed I can’t eat all the foods I used to eat. The cancer really has changed what I can tolerate.”

If you or your doctor is worried about weight loss during or after lymphoma treatment, choose foods dense in both nutrients and calories. Some good options are:

  • Nuts
  • Nut butters
  • Avocados
  • Beans
  • Chicken
  • Fish
  • Yogurt

Making smoothies and soups are popular ways to load up on healthy foods if you don’t feel like eating solid foods. Soups and smoothies are easy, versatile dishes to disguise nutritious foods like flaxseed meal, chia seeds, nut butters, beans, and vegetables to amplify wellness. Increasing your meal frequency, or eating small snacks throughout the day rather than large meals, can help you obtain adequate calories as well. Getting physical activity can also produce a healthy appetite.

One MyLymphomaTeam member wrote, “Recently I started drinking smoothies with kale, and I have more energy and feel better. I make them myself with fruits and vegetables.” Members often share recipes for their favorite soups, which include chicken soup with matzo balls, hamburger soup with cabbage, and vegetable soup with lentils.

Unintended Weight Gain

Some MyLymphomaTeam members struggle with weight gain rather than weight loss, especially when they are prescribed corticosteroids. “I really think my biggest enemy most days is the steroids,” said one member. “Has anyone gained a lot of weight and lost it after remission? At this point, I’m more worried about my weight than my cancer.”

Members share what has worked for them to lose excess weight due to lymphoma treatment. “I found the best way to lose weight was to eat small meals,” wrote one woman. “Breakfast, lunch, snack (usually half a banana for the potassium), and dinner.” Another member posted: “Quit [my] big [soft drink] habit and sweets, now have lost weight.”

Eating To Fight Anemia

Individuals with leukemia often experience anemia, a condition caused by a deficiency of red blood cells or iron. Anemia causes fatigue and can often be managed with nutrition. Individuals with anemia will need to pay attention to their iron intake. There are two forms of iron — heme iron and nonheme iron. Heme iron includes animal sources — red meat, poultry, and fish — and is about 15 percent absorbable by the body. Nonheme iron includes plant-based sources — legumes, grains, and vegetables — and is only 3 percent to 8 percent absorbable. There are several things that can help increase or decrease iron absorption.

A helpful guideline is to include a dietary source of vitamin C at every meal, especially meals with a source of iron. Vitamin C enhances the absorption of iron in the body. It is important to note that coffee and tea can significantly decrease iron absorption. These beverages should not be included with meals that contain iron-rich foods.

A rare form of anemia, called megaloblastic anemia, may be caused by a deficiency in vitamin B12 and folic acid. Below are lists of the top food sources containing vitamin B12 and folic acid.

Sources of Vitamin B12

  • Clams
  • Fortified cereal
  • Tuna
  • Nonfat plain Greek yogurt
  • Salmon
  • Beef
  • Chicken
  • Eggs
  • Nutritional yeast

Sources of Folic Acid

  • Spinach
  • Fortified cereal
  • Black-eyed peas
  • Asparagus
  • Brussels sprouts
  • Broccoli
  • Avocado

Kidney Damage

Some people with lymphoma experience kidney damage. If your lab results show signs of kidney damage, your doctor may give you specific dietary recommendations. Limiting foods high in potassium, sodium, and phosphorus may be necessary, depending on what is causing your kidney problems. Your health care provider will monitor your blood test results to assess whether restriction of one or more of these nutrients is warranted. If so, you may be asked to limit:

  • Foods high in potassium, such as oranges, bananas, spinach, zucchini, and peaches
  • Foods high in phosphorus, such as cheese, wheat bread, peanut butter, nuts, and seeds
  • Foods high in sodium, such as packaged snacks, condiments, salad dressings, sauces, and restaurant or takeout foods

Fluids

Drinking plenty of fluids is vital while receiving chemotherapy for lymphoma. Adequate hydration is also important for nutrient transportation, joint health, blood pressure regularity, and so much more. Water is the best choice of hydration. Avoid sugary drinks like fruit juice, soda, and sweetened teas — or keep them to a minimum. If you don’t like the taste of water, try adding fresh fruit, fruit extract, or low-sugar sports drinks like G2 by Gatorade, Propel flavored electrolyte water, or Vitaminwater Zero. Alcohol should be limited to no more than one drink per day for women and two drinks per day for men. Time your intake of coffee and tea to avoid limiting your iron absorption, as mentioned above.

MyLymphomaTeam members often recommend their preferred drinks.

  • “Zipfizz is my friend. It is a vitamin pack energy drink. Helps me get home from work.”
  • “I drink water called Simple Truth, which I can only find at Kroger. It has all the electrolytes you need. I carry a bottle around all the time.”
  • “Want to mention a V8 juice product that I like — Pomegranate Blueberry. Very good and healthy.”
  • “I add raspberry-flavored electrolyte powder to my water, and I can get that down without a problem. Ginger tea and buttermilk have also helped.”

Avoiding Foodborne Illness

Food safety is incredibly important for people living with lymphoma, who often deal with a weakened immune system due to leukopenia (low white blood cell count). If you undergo a stem cell transplant, you will likely be more susceptible to foodborne illness than individuals who receive chemotherapy and radiation alone.

Follow these safe food handling do’s and don’ts to avoid foodborne illnesses.

Food Safety Do’s

  • Cook all meat and fish thoroughly.
  • Cook eggs thoroughly — not runny or sunny-side up.
  • Wash produce well before you peel it. Consider soaking fruits and vegetables in a solution of apple cider vinegar and water to kill bacteria.
  • Refrigerate deli meats, even dry-cured sausages.

Food Safety Don’ts

  • Eat products containing raw eggs, such as cookie dough or homemade mayonnaise.
  • Drink unpasteurized milk or juice.
  • Eat soft cheese such as brie, blue cheese, or Gorgonzola.
  • Eat from salad bars and buffets, since food sits longer and is more likely to become contaminated.
  • Eat alfalfa sprouts or other raw sprouts.
  • Drink well water, unless it has been boiled for one minute or filtered.

Be Cautious of Nutritional Supplement Claims

Many websites and products make health claims about nutritional supplements and cancer. It can be challenging to decipher what is legitimate, evidence-based fact and what may be far-fetched marketing claims. There is little scientific evidence proving a specific nutrient or supplement to be effective in the treatment of cancer.

It is important to always consult with your doctor before trying any supplement or herb. It may have a negative impact on your cancer treatment. For instance, the popular herbal supplement St. John's wort is known to reduce the effectiveness of imatinib (Gleevec), a drug used to treat chronic myeloid leukemia and Philadelphia-positive acute lymphoblastic leukemia. Similarly, green tea supplements can interfere with the effectiveness of bortezomib (Velcade), which is used to treat multiple myeloma and mantle cell lymphoma.

As you read about health claims, keep in mind these facts about nutritional supplements from the Office of Dietary Supplements at the National Institutes of Health:

  • Dietary supplements do not have to be proven effective before they are marketed.
  • Just because a product is natural does not mean it is safe.
  • Since some nutrients are already supplemented in foods you eat, you may wind up accidentally taking an unsafe amount.
  • You are more likely to experience side effects from supplements if you take them in high doses, if you take them instead of prescribed medications, or if you combine several types of supplements.

Eating To Feel Your Best

The best diet for you depends on many factors, including your specific response to lymphoma treatment. The most common side effects of chemotherapy and radiation include loss of appetite, early satiety (feeling full too soon), nausea, vomiting, dry mouth, mouth sores, taste changes or loss of taste, difficulty swallowing, constipation, and diarrhea — all of which can impact how you eat.

Your doctor, a registered dietitian, or a nutritionist can provide recommendations for alleviating these side effects and maintaining a nutritious diet that will help you feel your best.

The Challenge of Changing Eating Habits

It’s challenging to change eating habits, especially when you are living with lymphoma. Sometimes you may feel like giving up. “I eat the same way I ate before I had cancer,” said one member. “I'll feel miserable enough later.” But remember, making the effort to improve your nutrition is an investment in your well-being. As another member put it, “I have been focusing on eating well and getting lots of rest so my body will be ready to fight this!”

You are not alone. When you join MyLymphomaTeam, you gain a support network of more than 12,000 people who understand what you’re going through. Members of MyLymphomaTeam often discuss their efforts to eat healthy and improve their diets.

Do you feel better when you eat a healthy diet? What steps do you take to maintain good nutrition while living with lymphoma? Comment below or post on MyLymphomaTeam.

All updates must be accompanied by text or a picture.
Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Review provided by VeriMed Healthcare Network. Learn more about him here.
Kimberly McCloskey, R.D.N., L.D.N. is a Philadelphia-based registered and licensed dietitian who specializes in weight management and behavioral change. Learn more about her here.

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