Define Meal Pattern and Feeding Considerations?

The meal pattern and the feeding considerations include the following:

- Meal timings play an important role in ensuring adequate food intake. Cancer patients often complain of decreased ability to eat as the day progresses. This might be because of delayed gastric emptying, decreased production of gastric secretions and mucosal atrophy of the gastroilltestinal tract. Small frequent meals with greater emphasis in the morning is recommended.

- Patients with altered taste sensations may benefit by increased use of flavourings and seasonings particularly those which are rich in antioxidants (mint, coriander, turmeric etc.)

- Some patients may experience meat aversions due to chemotherapy. This may necessitate the elimination of red meats (lamb, pork, buffalo, cow etc.) which are stronger in flavour as compared to lean meats (marine foods, chicken etc.). For such patients alternative sources of protein should be incorporated in the diet. - Semi-soft/ full fluid diets should be given to those who experience dysphagia, have lesions in the mouth or oesophagus.

- High energy nutrient dense dishes (cream soups, creamed vegetables, puddings/souffli, honey/ jam toppings on fruit, milk shake, custard, sandwiches with cheese1 egg, addition of dextrose, sugar etc. to fruit juice, milk shakes etc.) should be served to facilitate a high energy intake.

- Although oral route is always the preferred form of feeding, it is recommended to use alternative methods of feeding (enteral, parenteral) as a supplement/ substitutes according to the feasibility. Soy-based or milk-based formulas are very popular for long-term enteral feeding particularly for home-based patients. TPN solutions comprising of glucose and a mixture of amino-acids which provide 25-35 Kcal/kg day and 1.2 to 2.0 gm protein per kg per day are also frequently ulilized to help in maintaining a good nutritional status.