Non-diet nutrition for people living with cancer
What is the non-diet approach?
The non-diet approach is based on an evidenced-based framework of intuitive eating. The idea is that you reject restrictive diets to recognise your body’s natural signals or cues around eating. It is a weight-neutral approach to health which means you focus on healthy behavior goals rather than the number on the scales.
The intuitive eating approach was developed American Registered Dietitians Evelyn Tribole and Elyse Resch in 1995 (1) and since then there are many research studies supporting its use (2).
The intuitive eating approach is based on 10 principles (3) which can be used so you find a balanced and enjoyable way of eating without guilt. So, can you follow this when you are living with cancer? Yes, you can! Let’s go through each of the principles and see how they can help you eat well with cancer.
The 10 principles of intuitive eating
1. Reject the Diet Mentality
Following ‘diets’ where food is restricted to lose weight often don’t work and lead to you regaining weight which leads to feelings of guilt and lack of achievement. Restrictive diets which remove whole food groups also means you are missing vital nutrition which is not a good idea for people with cancer as they need good nutrition to maintain their energy levels and cope with treatment.
Diet culture is all about unrealistic ‘food rules’ for example it’s ‘diet culture’ telling you that you shouldn’t eat that piece of cake or biscuit because it’s ‘bad for you’. However maybe during cancer treatment that might be something you can actually taste and tolerate so enjoy!
2. Honor Your Hunger
This is about recognising the cues/signals that your body is giving you to say ‘I’m hungry’ so you can stop eating as you know you are full. During cancer your natural hunger cues or appetite may be affected by cancer treatments so it is important to recognise that your body needs nutrition regularly every 3-4 hours even if you may not feel hungry. This is just temporary and is important to provide you with energy and nutrients. After cancer treatment when your appetite is returning to normal then it’s the time to start learning your hunger and fullness cues again.
3. Make peace with food
This is all about giving yourself permission to eat all foods. This can be tricky to follow when you are living with cancer when food can be a way of ‘controlling’ what is happening to your body. If you have cancer and have a small appetite it may be useful to add more energy and protein to you food (you can read more about this here) however if you view foods as ‘good’ or ‘bad’ you may find it harder to include these foods. Having a neutral approach to foods makes it much easier to include all foods with no guilt or bad feelings attached.
A special mention about medically advised restrictive diets. When you have certain types of cancer treatment your medical team may ask as you to restrict foods such as fibre after bowel cancer surgery or avoid high risk foods during chemotherapy. These types of restrictions and advice are important to follow as long as you are advised and it may be useful to shift your focus from what you can’t have, to what foods you can add to your diet to feel satisfied. Working with a dietitian can help you shift the focus and advise you on foods which you can enjoy to provide enough nutrition during this time.
4. Challenge the ‘food police’
The ‘food police’ is that negative voice in your head or from others that are telling you to follow unrealistic food rules. For example, comments like ‘should you be eating that?’ ‘do you think you should eat sugar, dairy etc etc.. with cancer’ or ‘I’ve been bad today’- because you ate a biscuit! Challenge that, no food should hold that much power over you!
5. Discover the satisfaction factor
This is about enjoying the whole experience of eating, enjoying the taste, smell, texture of food and the environment you are in. This can help you feel truly satisfied so you find just the right amount of food for you to feel full and content.
During cancer treatment you may experience taste changes or a small appetite that makes it harder to enjoy the experience of eating. Take time to focus on the experience of eating, keeping it relaxed and maybe use a smaller plate so it feels more manageable. You will find more advice on this here.
After cancer you may still experience taste changes or foods that you connect with being unwell. So, focus on enjoying food again, try new tastes, recipes, eating with friends and family and keep it relaxed.
6. Feel your fullness
This is about listening to your body's signals that tell you that you are no longer hungry. When you are starting to explore this, a good tip is to practice eating more slowly and pause to check whether you are still hungry during your meal. It may feel strange at first but it may prompt you to notice when you feel comfortably full then you know it’s ok to stop.
As I mentioned above during cancer treatment you may experience reduced appetite or lack of hunger so you may feel full quicker than you usually do. Here it is still important to recognise your feelings but you may need to adjust you eating pattern to several smaller meals/snacks to make sure you are receiving enough nutrition.
After cancer treatment if you have experience reduced appetite, you may need to start re-learning your body’s hunger cues. I use a ‘hunger and fullness scale’ during my sessions to help identify these feelings.
7. Cope with your feelings without using food
We eat for many other reasons other than nourishment for example when we are stressed, bored or upset. Eating when you are dealing with big emotions may make you feel better in the short term which is a completely valid coping strategy BUT shouldn’t be the ONLY method you have. Having a cancer diagnosis is a very emotional and stressful time so you may have turned to food for comfort. And that's ok, it served the purpose at this time and gave you the comfort you really needed (remember no guilt about food!). Intuitive eating helps you recognise situations when food is meeting another emotional need so you can develop other coping strategies.
8. Respect your body
This is all about respecting your amazing body for how it is NOW and being proud of it! During and after cancer your body will have gone through so much and may feel or look different to how it was before. We are also all different shapes and sizes some of which is predetermined by our genetics (just like eye colour), so by respecting your body now, will make you feel better so you make positive choices about food and exercise.
9. Movement -feel the difference
Should exercise should all be about ‘burning calories’ and ‘losing weight’ – NO! Instead focus on how different movements makes your body feel. During cancer treatment your energy levels may be lower so you not feel up to going out. But how does it feel when you do go for that short walk? - maybe you can switch off from cancer for a while and feel the air or warm sun on your face. Focusing on the feeling that movement creates makes you more keen to get up and do it again and again (you can read more about this in my blog "The hidden secret to regular exercise" )
10. Honour your heath with gentle nutrition
This is the last piece of the puzzle and is all about making food choices that are positive for your health and make you feel good!
So intuitive eating isn’t just about eating everything you want without thinking...? did you think that previously? Whist you can do that, we know you will feel better and have more energy if you also eat some carbohydrates, fruits and veggies and protein. Other examples of gentle nutrition are aiming to include all the foods groups (carbohydrates, protein, fat, vegetables) at each meal because you know that makes you feel good and satisfied or keeping your water bottle with you during the day so you stay hydrated and don’t confuse hunger with dehydration.
When you are living with or recovering from cancer taking a gentle nutrition approach is about helping you achieve the ‘balance’ of the right nutrition for your health but also about bringing back the joy to eating.
I hope you found this interesting and helpful. If you would like to learn more about how this approach could support you, get in touch and book a free call.
1. Tribole, E., & Resch, E. (2020). Intuitive eating: A revolutionary anti-diet approach. St. Martin's Essentials.