Nutrition Counseling

Karmanos offers assistance for patients in need of nutritional instruction. Our registered dietitians provide patients and their loved ones with the opportunity to discuss any nutritional topic such as special diets, herbal medicines and dealing with eating difficulties.

Our goal is to provide patients and their loved ones with the opportunity to obtain firsthand nutritional counseling. All patients, family members and friends, and staff may participate.

A clinical dietitian is available by appointment by calling 1-800-KARMANOS (1-800-527-6266).


Nutrition During Treatment

Your nutritional needs vary depending on your disease, cancer treatment, and your metabolism. It is important to remember that not everyone has difficulty with nutrition. 

If you have any questions about nutrition or how to eat during your cancer care, please call 1-800-KARMANOS (1-800-527-6266) and ask to speak with our registered dietitian. You may also ask your doctor or nurse to consult our dietitian for you at your next visit.

General Nutrition Guidelines

Nutrition is defined as the food that is eaten and how the body uses it through digestion and absorption. Energy taken in is measured by calories. Calories come from carbohydrates, fats, and proteins available in the foods we eat. Every person has a different metabolism and this determines how many calories a day we need to maintain our weight and health. Height, weight, age, sex, activity and stress contribute to the amount of calories needed. Illness, surgery, chemotherapy, and radiation are a few examples of stress.


Carbohydrates are the main source of energy for the cells in our bodies. Most foods contain carbohydrates. Examples of carbohydrates are breads, cereals, pasta, fruits, vegetables, milk and desserts. Carbohydrates have four (4) calories per gram and are a source of quick energy.


Fat is a concentrated source of energy that contains nine (9) calories per gram. It helps our body use the fat-soluble vitamins (A, D, E and K) and it provides essential fatty acids vital for body processes. It is changed to energy when carbohydrates are not available. Examples of fats are butter, margarine, oils, meats, nuts, olives, and avocados.


Protein is used to repair and replace cells that have been damaged or grow old. Our body requires protein for proper functioning of muscle, skin, hair, hormones, blood and digestive enzymes. Protein provides four (4) calories per gram. Examples of high protein foods are eggs, milk, cheese, yogurt, meats, poultry and fish.

Making calories count during therapy

There are five main food groups in the food pyramid. The pyramid calls for eating a variety of foods from each group to get the nutrients you need. Serving sizes are generally smaller than most people realize. It is important when you are under treatment for cancer to choose your food wisely. If you are losing weight, try to choose high calorie foods and drinks when possible.

The amount of food that counts as one serving is listed below. If you eat a larger portion, count it as more than one serving. For example, a dinner portion of spaghetti would count as two or three servings of pasta. Be sure to eat at least the lowest number of servings from the five major food groups each day. You need them for the vitamins, minerals, carbohydrates, and protein they provide. Try to pick the lowest fat choices from the food groups if you are not losing weight. If you are losing weight, chose items with higher fat or calories. No specific serving size is given for the fats, oils, and sweets group because you should use them sparingly unless you experience weight loss.

What counts as one serving?

Milk, Yogurt, and Cheese

  • 1 cup of milk or yogurt
  • 1 1/2 ounces of natural cheese
  • 2 ounces of processed cheese

Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts

  • 2-3 ounces of cooked lean meat, poultry, or fish
  • 1/2 cup of cooked dry beans
  • 1 egg, or 2 tablespoons of peanut butter count as 1 ounce of lean meat


  • 1 cup of raw leafy vegetables
  • 1/2 cup of other cooked or raw vegetables
  • 3/4 cup of vegetable juice


  • 1 medium apple, banana, orange
  • 1/2 cup of chopped, cooked, or canned fruit
  • 3/4 cup of fruit juice

Bread, Cereal, Rice, and Pasta

  • 1 slice of bread
  • 1 ounce of ready-to-eat cereal
  • 1/2 cup of cooked cereal, rice, or pasta

The following hints to increase calories should be used only if you are having problems with weight loss. Some cancer treatments may cause weight gain. If this is the case, do not use these hints.

Hints to increase calories and/or protein in milk:

  • Use sour cream or yogurts made from whole milk as a dip for vegetables or try them in gravy or sauces or as a dressing for fruit.
  • Use half-and-half instead of milk in cream soups, puddings, custard, or over cereal.
  • Make double strength milk by adding milk instead of water to the recipe on the container of dry skim milk powder, then use it in puddings, gravy, custard, over cereal or any other way milk is used.
  • Add ice cream to your favorite drinks such as pop, juice, or milk.
  • Blend fruit (fresh, frozen, or canned) or nuts with cottage cheese for a dessert or as a spread for crackers or bread. Also use it as a dip for fresh fruit. Add calories by adding pasteurized (not raw) honey to slightly sweeten the dip.

Hints to increase calories and/or proteins in meats:

  • Prepare meats in batter and fry or cook in gravy or sauce.
  • Use peanut butter with bread, crackers, fruit, or with vegetables.
  • Use shrimp, tuna, crab meat, ham or cheese in sauces and serve over rice, noodles, mashed potatoes, or a favorite bread.
  • Add chopped, hard cooked eggs to salads, dressings, casseroles, creamed meats, meat loaf, etc.
  • Add extra butter, half-and-half to scrambled eggs
  • Melt cheese on sandwiches, hamburgers, hot dogs, and vegetables


Some vegetables contain more calories than others. Choose higher calorie vegetables if you are losing weight.

High calorie vegetables

  • Corn
  • Dry beans or peas
  • Lentils
  • Lima beans
  • Parsnips
  • Sweet potatoes or yams
  • White or red potatoes

Medium calorie vegetables

  • Beets
  • Carrots
  • Green peas
  • Mature onions
  • Rutabagas
  • Turnips
  • Winter squash (acorn hubbard, etc.)

Low calorie vegetables

  • Asparagus
  • Broccoli
  • Brussel sprouts
  • Cabbage
  • Cauliflower
  • Celery
  • Cucumbers
  • Greens
  • Lettuce
  • Mushrooms
  • Peppers
  • Radishes
  • String beans
  • Summer squash
  • Tomatoes

Calories are increased when you eat vegetables served with cream sauce, cheese sauce, gravy, margarine, butter, salt pork or bacon drippings, or sour cream.


Fruits vary in the amount of sugar and calories. Choose higher calorie fruits if you are losing weight. 

High calorie fruits

  • Applesauce (sweetened)
  • Apricots
  • Avocado
  • Baked apple
  • Banana
  • Dates
  • Dried fruits
  • Figs
  • Rhubarb (cooked and sweetened)
  • Watermelon

Moderate calorie fruits

  • Blackberries
  • Blueberries
  • Boysenberries
  • Cantaloupe
  • Cherries
  • Cranberries
  • Currants
  • Fresh apples
  • Gooseberries
  • Grapefruit
  • Grapes
  • Honeydew melons
  • Mango
  • Mulberries
  • Nectarines
  • Oranges
  • Peaches
  • Pears
  • Pineapple
  • Plums
  • Raspberries
  • Strawberries
  • Tangelos
  • Tangerines

General guidelines for fruit:

  • All fruits are a good source of nutrition.
  • Fruits canned in syrup and frozen sweetened fruits are higher in calories than fresh, water-packed, or juice-packed fruits.
  • Canned fruit juices with added sugar or honey are a good source of calories.
  • Calories may be added to any fruit or fruit salad by adding pasteurized honey, sugar, non-dairy creamer, cream (plain, whipped, or sour), and white corn syrup.
  • Remember to wash all fruits and vegetables well before eating or cooking.

General tips to increase calories and/or protein

  • Add raisins, dried fruit, granola, dry milk powder, and/or chopped nuts to muffins, cookies, breads, cakes, and stuffing. Bake in pies and turnovers.
  • Add wheat germ to meat, stuffing, casseroles, breads, muffins, pancake or waffle recipes, and sprinkle on fruit, cereal, ice cream or yogurt. Use in place of breadcrumbs.
  • Add cream or half-and-half, sugar, pasteurized honey, or fruit to dry cereals
  • Add pasteurized honey, butter, cream, brown sugar, nuts, coconut, jelly, jam, or fruit to hot cereal.

Food supplements

There are many food supplements. If you are losing weight and unable to eat more, try a food supplement. Try eating a comfortable amount of food at meal time and use food supplements as a snack. If you are unable to eat solid food, two cans of supplement need to be taken to replace a meal. If you have other medical problems such as lactose intolerance or sugar diabetes, please talk to your doctor or nurse before using any supplements!

Some examples of ready-to-use food supplements include:

  • Ensure
  • Isocal
  • Boost
  • Resource shake plus
  • Resource fruit beverage

Supplements that can be mixed with milk:

  • Carnation Instant Breakfast
  • Slim Fast
  • Nestle's Sweet Success
  • Scandishake

Low-carbohydrate/high protein food supplements:

These supplements should be used only if you are eating enough carbohydrates (example mashed potatoes, bread) and you cannot eat meat or eggs. Do not use as your only source of food. Using only high protein drinks without other calories can cause kidney problems.

Supplements for use to increase protein only:

  • Slim Fast Low Carb
  • Atkins' Advantage Low Carb

Lifetime of Healthier Eating

  • Make changes gradually. Habits are hard to change. Focus on one dietary improvement or change at a time. Work on this improvement until it becomes a habit. Then move on to the next improvement.
  • Shop and stock for health. Stock your kitchen with healthy foods. Don't have foods on hand that don't fit in with your healthy eating plan.
  • Make healthy eating convenient. Make foods that are part of your plan convenient and accessible. Have fruit on the counter or in the refrigerator. Have ready to eat vegetables in the refrigerator for snacks. Have healthy frozen dinners and vegetables ready to pull out when you're too rushed or tired to cook.
  • Have regular mealtimes. Don't skip meals. Getting too hungry is a setup for overeating or indulging in less healthy eating.
  • Try to eat when hungry, not for emotional or social cues. If you have regular mealtimes, you will be hungry for meals, but not too hungry that you overeat.
  • Satisfy hunger. Eat more, but take in fewer calories. Focus on consuming more nutrient rich foods, such as vegetables, fruits and grains. These foods typically have more nutrients and fewer calories. For example 2 1/2 cups of broccoli is equal to the calories in 2 1/2 tsp. of salad oil or a small cookie (about 100 Cal.) Which would fill you up more?
  • Try to have a schedule as much as possible. A schedule of when to eat, as well as a schedule to sleep will reduce unplanned and haphazard eating.
  • Try to exercise daily for 30 minutes, such as a brisk walking. Plan your exercise when your day begins.
  • Lower your expectations for quick weight loss. Slow, gradual weight loss is much more likely to result from lifetime changes that will help keep the weight off. Even losing 1/2 pound a week will result in a loss of 26 pounds over a year.
  • Plan for your eating and exercise until your positive changes are habits. As the saying goes Failing to plan is planning to fail"