Diet and nutrition

Eating well is essential to overall health and wellbeing. It can also help to prepare your body for lymphoma treatment, and in your recovery. 

On this page

What is a healthy diet?

What difficulties with eating might lymphoma cause?

What can I do if I am gaining weight?

What can I do if I am struggling to keep my weight?

Frequently asked questions about lymphoma, food and nutrition

What is a healthy diet?

Your diet should include:

• fruit and vegetables
• carbohydrates
• protein (including dairy or dairy alternatives as a source of protein)
• fibre
• fat
• fluids. 

We give brief information about each of these below. You can find out more about food types on the NHS website.

What are the recommendations on healthy eating?

The UK government sets out recommendations on healthy eating in their Eatwell guide. You can also find guidance on what to feed young children on the NHS website.

If it is difficult for you to afford to buy food, you might be able to access some through a food bank. You can find out more about food banks on the Government website.

If you have a balanced diet with all food groups, you wouldn’t usually need to take additional supplements. If you are low in certain vitamins, such as B12 and folate, your clinical team will give you the supplements you need. 

Chrissie Kirby, Haematology and Transfusion Nurse Specialist

Eatwell guide

The Eatwell Guide below is available to download on the UK Government website. This version is for people whose diet does not restrict any food groups. 

The Vegetarian Society produce an Eatwell guide for people who follow a vegetarian diet that does not contain fish or meat.

The Vegan Society produce an Eatwell guide for people who follow a vegan (plant-based) diet.

Fruit and vegetables

Fruits and vegetables give you fibre, vitamins and minerals. 

The recommendations are to eat at least 5 portions (of around 80g each) of different fruits and vegetables per day. A 30g portion (1 tablespoon) of dried fruit also counts as one portion. 

As a rough guide, the following examples count as one portion:

• an apple, banana, slice of melon or a handful or two of berries
• 3 heaped tablespoons of cooked vegetables or cooked, tins of cooked pulses or beans
• 7 cherry tomatoes or a cereal bowl of salad leaves.

The NHS website gives more information about what counts as one of your five a day. 

The World Cancer Research Fund also produce a set of resources that you can download free of charge. These include posters on what counts as a 5 a day portion for adults and what counts as a 5 a day portion for children. You can also download or order a copy of their guide on eating well during cancer.

Carbohydrates (starchy foods)

Carbohydrates (‘carbs’) are the main way your body gets energy. They provide fibre, vitamins and minerals.

Carbohydrates should make up around a third of your daily food intake. 

Foods high in carbohydrates include:

• rice, potatoes, bread and pasta – brown, wholegrain or wholemeal varieties provide more fibre than other options
• grains, such as quinoa and cous cous.

Protein

Your body needs protein to grow and repair itself, as well as for muscle strength and immune system functioning.

You might need more protein than usual to help your body heal during and after your lymphoma treatment. If you are losing weight, ask your medical team how to make sure you are getting all the nutrients you need. If it is appropriate for you to gain weight, they can help you to do so safely.

Foods that are high in protein include meat, fish, eggs and dairy products. Plant-based foods include beans, lentils, nuts, seeds, nut butters, hummus, tofu and meat substitutes made from a plant-based protein called mycoprotein.

White fish is a good source of protein. There are also lots of nutrients in oily fish, such as salmon, trout and mackerel.

Chrissie Kirby, Haematology and Transfusion Nurse Specialist

Meat

If you eat meat, healthy choices are those that have little fat (sometimes labelled on packaging as ‘lean’), grilled cuts of fresh, unprocessed white meats, like chicken and turkey without the skin on. 

Meat can be a good source of vitamin B12, which helps to keep blood cells and nerves healthy. However, you can also get B12 through dairy products, fish and pulses.

Chrissie Kirby, Haematology and Transfusion Nurse Specialist

What about red meat?

Red meat (such as beef, lamb and pork) is also a good source of protein and minerals such as iron and zinc. However, the UK government recommends that you limit the amount of red and processed meats (foods that are smoked, cured or have had salt or chemical preservatives added to them) to 70g per day. There is information about meat in your diet on the NHS website.

You can find information about red meat and processed meat on the World Cancer Research Fund’s website. 

Dairy or dairy alternatives

It is recommended that you include dairy products or dairy alternatives in your diet. These provide calcium (which is important for bone health) and zinc (a mineral with various functions, including helping wounds to heal) and protein. They can also be a good source of vitamin B12.

Milk, yoghurt and cheese are a good source of dairy. If you are lactose intolerant or follow a vegan diet, you can meet your calcium requirements with calcium-fortified non-dairy alternatives, such as coconut milk, dairy-free yoghurts and soya products. 

Some dairy products are generally healthier than others. For example, vegetable-oil spreads are lower in saturated fat than butter. However, if you are trying to gain weight, your medical team might advise that you eat some higher-fat dairy or dairy alternative products.

As with anything, it’s about moderation. While spreads tend to be lower in fat than butter, they are more processed. Some people choose grass-fed butter over regular butter as it can be high in healthy fats and contains fewer additives. 

Chrissie Kirby, Haematology and Transfusion Nurse Specialist

Fibre

Fibre helps with the health of your heart and digestion. Foods that come from plants are usually high in fibre, for example fruits, vegetables, cereals and potatoes. Aim to eat 30g of fibre each day. The NHS website gives tips to help get more fibre in your diet.

Fat

There are different types of fat. Often, people mean saturated fat when they talk about fat.

Although some people think of fat as ‘bad’, it is important in giving you energy, and vitamins. Our bodies also need essential fatty acids to work well. 

If you are trying to gain weight, your medical team might advise that you eat some higher-fat dairy or dairy alternative products.

Unsaturated fats

Unsaturated fats help to keep your heart healthy and lower your cholesterol.

These often come from plant-based foods such as seeds, nuts, olives, and avocados. You can also include them in your diet by using spreads or oils made from corn, olive, rapeseed, sunflower, soya, or sesame.

Essential Fatty Acids (omega-3 and omega-6 fats)

Although there is no government recommendation on how much, you need to eat a small amount of essential fatty acids (omega-3 fats and omega-6 fats) for your body to work properly. The outer layer (membrane) of every type of cell in your body is made from them. They are also needed for your heart and brain to function well. 

You can get omega-3 fats by eating:

• oily fish, such as sardines, salmon or mackerel
• walnuts, flaxseeds and linseeds
• green, leafy vegetables.

Some foods (such as eggs or fish products) might also be fortified with omega-3. 

If you don’t eat fish, you can still get omega-3 by eating seeds, nuts, tofu and vegetables like broccoli and spinach.

Chrissie Kirby, Haematology and Transfusion Nurse Specialist

You can get omega-6 fats by eating:

• nuts – raw or unflavoured are the healthier choice
• seeds
• vegetable oils or spreads, such as rapeseed, corn, or sunflower.

If you do not eat fish, then you are able to obtain omega 3 by eating seeds, nuts, tofu and vegetables like spinach. 

Saturated fats

Limit your intake of saturated (‘sat’) fats. This type of fat is found in foods such as fatty cuts of meat, cakes, and many processed foods, such as sausages and crisps. Too much saturated fat increases health risks including heart disease and stroke.

The UK Government recommends that:

• adult females should eat no more than 20g of saturated fat a day
• adult males should eat no more than 30g of saturated fat a day
• children should eat less than this, although they do not give a specific amount. 

If you are trying to gain weight, your medical team might advise that you choose some foods that have a higher fat content. For example, dairy foods that are high in energy, such as full cream milk or full fat yogurts. 

Check the food labels on packaging to see how much of each type of fat it has in it. There are also apps available to help you to check nutritional content, for example, the government’s food scanner app.

Drinks

The general recommendation is to drink around 1.5 to 2 litres (roughly 6 to 8 glasses) each day. It’s particularly important to drink plenty if you are losing extra water from your body, as is usually the case in the summer months. You will also need more water if you have symptoms of lymphoma such as sweating, or side effects of treatment, such as sickness (vomiting) and diarrhoea. Drinking plenty of fluids can also help to ease constipation, and to improve urinary or bladder problems.

All types of fluid count, except for alcohol. Tea and coffee contain caffeine – for which there is mixed evidence about whether it makes you wee more (has a diuretic effect).

I advise patients not to have only tea or coffee as part of their fluid intake each day. Try to drink water and, if you don’t enjoy plain water, try sparkling or adding sugar free squash or flavoured low sugar alternatives.

Chrissie Kirby, Haematology and Transfusion Nurse Specialist

Back to top

How lymphoma might affect your eating

Some lymphoma treatments can cause side effects that make it difficult for you to eat as you usually would. For example, you might experience bowel problems (such as diarrhoea or constipation) or sickness (nausea and vomiting). You might have changes in taste, or struggle to eat because of a lower appetite or feeling full soon after you start to eat.  If you experience dry, sore mouth (oral mucositis) as a side effect, symptoms such as mouth ulcers might make it painful to eat and drink. It can be helpful to try to reduce irritation to your mouth, for example, by eating soft foods and avoiding citrus fruits.

The realities of treatment and side effects can make it difficult to eat. Sometimes, even a sip of water can be a challenge. If you feel sick, have lowered appetite, mouth ulcers or your sense of taste and smell are affected, you could set yourself little targets. For example, drinking a small glass of water or eating a piece of toast. This can be less overwhelming than a large plate of food.

Corrin, diagnosed with diffuse large B-cell lymphoma

In some cases, the position of the lymphoma might make you feel full more quickly than usual and not want to eat very much. This could happen, for example, if the lymphoma is in your spleen or tummy (abdomen). Some people who have an donor (allogenic) stem cell transplant might have lower appetite if graft-vs-host disease develops in their gut.

The emotional impact of living with lymphoma can also have an impact on eating.

If you struggle to eat or drink:

• Speak to a member of your medical team. They can offer you advice. In some cases, they might offer you a referral to a dietitian, who can give you specific guidance about how to improve your nutritional intake. There is more information about the role of a dietitian in our frequently asked questions section.
• Do not take any supplements without seeking medical advice as some could interact with lymphoma treatments and other medications in unwanted ways.

We offer some tips below, and you’ll find more in our living with and beyond lymphoma book. You might also be interested in the top tips for healthy eating that our Facebook Support Group members have shared.

Changes in taste

A possible side effect of some chemotherapy and some targeted treatments, is that food tastes different. During your treatment, you might also be more at risk of developing infections, such as mouth (oral) thrush. This can make food that you usually like taste strange. 

Many people say food tastes bland to them during treatment for lymphoma. Other people describe a metallic taste in their mouth, with some foods (particularly beef) tasting metallic. It’s also quite common for food to taste salty, bitter or sweeter than usual, or you might find that it doesn’t taste of much.

During treatment, my taste could change from one day to the next. I found that eating small bites was helpful, trying different tastes like crackers, small jacket potatoes, soup. It was helpful to have family members and friends who tried to understand this and support me.

Corrin, diagnosed with diffuse large B-cell lymphoma

The effects of treatment on your taste can change over time. For example, foods that you didn’t enjoy earlier in your treatment might start to taste good again, although this can take some time. Once you finish treatment, taste changes should start to fade away.

If you’re losing weight, ask your medical team for advice to help you to get enough energy and nutrients through your diet, and to prevent further weight loss.

If your food doesn’t taste of much, you could try:

• adding herbs, spices, sauces, dressings, pickles, yeast extract and chutneys
• drizzling fruit sauces onto desserts or adding berries.

If changes in taste affect your enjoyment of drinks, you could try:

• ‘sharp’ tasting fizzy drinks, such as lemonade or ginger beer
• herbal teas if you stop enjoying tea and coffee during treatment for lymphoma. 

Lower appetite or feeling full soon after you start to eat

Some lymphoma treatments can lower your appetite or make you feel full soon after you start to eat. 

This can happen:

• as a side effect of chemotherapy
• if you have lymphoma in your gut (gastrointestinal tract) or spleen
• if you have radiotherapy to your gut
• due to the emotional impact of lymphoma, like heightened anxiety and stress.

Tips you might like to try if your appetite is low or you feel full soon after you start to eat:

• eat little and often with snacks between meals
• try not to drink too much too soon before you eat – you might find it helps not to drink for around 30 minutes before your food
• choose foods that are high in energy and protein – this can help if you are losing weight due to lymphoma and its treatment
• if you are eating out, order a smaller portion – you could order a starter, side dish or something from the children’s menu
• if you are struggling to eat enough, talk to a member of your medical team for advice.

Boosting energy and protein if you need to gain weight

If you need to gain some weight, it can be helpful to eat foods that are high in energy and foods that are high in protein. 

Examples of foods that are high in energy:

• cheese or dairy free cheese alternatives
• nut butters
• full-fat milk-based products, for example whole milk and yoghurt
• full-fat dairy-free products, such as coconut milk and yoghurt.
• oats and seeds
• avocados. 

You can add more energy to your food by using products such as olive oil and butter when you cook. Milk powder or vegan alternatives can be added to cold puddings such as mousses.

Cancer Research UK has suggestions for high-energy drinks that you can try making yourself, as well as those that you can buy.

Examples of foods and products that are high in protein:

• meat, fish, eggs
• meat alternatives like tofu, seitan and soya
• beans, lentils, chickpeas and other pulses or legumes
• dairy products like milk, cheese and yoghurt
• fortified almond milk, fortified oat milk, and soya milk.

Cancer Research UK has more suggestions for boosting energy and protein levels.

Macmillan Cancer Support also has information about cancer and weight loss, including about the building up diet – this is high in energy and protein, and designed to help people who have lost or are losing weight, or who find it difficult to eat enough. 

Back to top

What can I do if I am gaining weight?

Weight gain can be a side effect of some steroid treatments – this can happen whether you eat more than usual or not. 

In general, it’s best to avoid dieting during treatment as it can make it harder for your immune system to recover. Your height and weight are also important in calculating treatment doses. 

Instead of dieting, focus on eating a healthy diet, doing exercise, and giving your body energy to help with your recovery. Ask your medical team for advice if you are unhappy with your change in weight.

Back to top

What can I do if I am struggling to keep my weight?

There can be many reasons for difficulties in keeping weight, for example, changes in taste, a lower appetite, and heightened stress. 

Speak to your medical team if you are struggling to keep your weight. This is important, so that they can give you advice to help you get the nutrients you need. In some cases, this might include referring you to a dietitian. You can read more about how a dietitian could support you in our frequently asked questions section.

Back to top