Eating to Reduce Fatigue

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“For three years during the 10-year period between my two breast cancers I experienced overwhelming and debilitating fatigue. No physical reason could be found. I wasn't depressed. I just lived with it, and eventually the fatigue slowly lifted. ”

Diana Dyer M.S., R.D.

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Fatigue is harder to pin down than just "being tired." You get tired from running errands, managing your kids' lives, working in your garden, or taking an exercise or yoga class. When you're tired at the end of a day, if you get enough sleep you usually feel better the next day. Fatigue is daily lack of energy, a kind of weakness or inertia that you feel throughout your whole body. It's a loss of interest in people and the things you normally like to do. Physical exhaustion blends with low spirits, and you wind up with fatigue.

What causes fatigue?

If you're in the midst of breast cancer treatment, your body is in a war against cancer. It needs all its resources to fight the disease and recover from the effects of treatment, so it shuts down your energy for other activities that would take away your strength from the battle. Fatigue is the result.

Fatigue is the most common side effect of cancer treatment. Some doctors estimate that 9 out of 10 people experience some fatigue during treatment.

Complex and varied factors cause fatigue, even after breast cancer treatment is completed. Nausea and pain, hot flashes, steroids, stress, and depression all may contribute to fatigue. And maybe you're trying to keep doing way too much without the time or energy to get it all done. What you eat can also affect your fatigue:

• Poor nutrition may play a role in causing fatigue. Eating less and not getting enough of the nutrients you need because of treatment side effects can cause fatigue.
• You may be dehydrated because you've been vomiting or have had diarrhea after treatment. Or maybe you're just too tired to keep drinking liquids. This can lead to an imbalance in electrolytes and can make you feel weak.

How to fight fatigue

You can fight fatigue by eating enough and trying to get all the nutrients you need. Create a healthy diet that is full of fruits and vegetables and whole grains. Make sure you eat foods that help you meet any new nutritional goals you and your doctors have set.

If you're fighting fatigue, it's important to make sure you're getting enough protein as well as total calories. These amounts will be different for different women. Together, you and your registered dietitian and your doctor can come up with an eating plan that works for you.

Here are some general guidelines for how much protein and calories you need:

• If your weight is staying about the same during treatment, you need 15 calories a day for each pound you weigh. So if you weigh 160 pounds, you need 2,400 calories a day to maintain your weight.
• If you've lost weight during treatment, add another 500 calories to your daily diet. So if you weighed 130 pounds and lost weight during treatment, you need 1,950 plus 500, which equals 2,450 calories a day.
• Protein helps heal and rebuild tissues. During treatment, eat half a gram of protein for each pound you weigh. So if you weigh 160 pounds, try to get 80 grams of protein in your diet each day.

You should also make sure to get enough vitamins and minerals. Getting these nutrients from foods rather than from supplements is best. But if you aren't eating very much because of treatment side effects, ask your doctor about taking a multivitamin.

Also make sure you're drinking enough liquids, especially water. If you have side effects such as vomiting and diarrhea, you need to drink more liquids than normal. Besides water, good choices are fruit juice, milk, and broth. Caffeinated beverages (coffee, tea, soda pop) actually can dehydrate you, so stick to other choices.

How to eat when you're fatigued

• Cook in bulk. When you have the energy to cook, make a large batch of something nutritious (vegetable pasta, tuna casserole, rice and beans) and freeze it in single-serving containers. Then when you're too fatigued to cook, you can quickly heat one container and eat. If your friends or family offer to cook for you, ask them to do the same.
• Eat a lot when you're feeling good. Try to eat your biggest meal when you have the most energy and the biggest appetite. If you get tired by the end of the day, eat more at breakfast and lunch.
• Eat several nutritious snacks during the day to boost your calorie and protein intake. String cheese, raisins, yogurt, baby carrots, and cut-up vegetables are easy to keep handy. This way you don't have to face eating a big meal.
• Try a prepackaged liquid nutritional supplement or an energy bar rather than skip a meal entirely. Every little bit helps.

How to get more protein in your diet

Good sources of protein include lean meat, fish, poultry, dairy products, nuts, dried beans, peas and lentils, and soy. To get more protein each day, try some of these tips.

• Add cheese to sandwiches, fish, vegetables, soups, casseroles, pasta, rice, and noodles.
• Add lean meat, fish, or tofu to pasta sauce, casseroles, chili, soups and sauces. Stir-fry it with vegetables for a quick and delicious meal.
• Use milk instead of water in cooking when possible.
• Eat hard-boiled eggs. Keep them in the refrigerator as a snack. Add chopped hard-boiled eggs to salads and sandwiches.
• Add nuts, seeds, or wheat germ to casseroles, breads, cookies, cakes, muffins, pancakes, and cereal. Sprinkle it on ice cream and fruit.
• Add several kinds of beans to pasta sauce and chili.
• Add peanut butter to sandwiches, toast, crackers, muffins, and fruit slices. Use it as a dip for raw veggies.
• Use yogurt as a dip for fruit and veggie slices or cookies.
• Add frozen yogurt or ice cream to your decaf coffee or tea or hot chocolate.
• Mix cottage cheese with salsa and chopped avocadoes to make a tasty dip.