Cancer and Nutrition During COVID-19

It seems that, during these challenging times of self-quarantine, we are all thinking more about food. Whenever we speak with a friend, we are likely to ask: What are you cooking? We know the important symbolism and metaphors of love and nurturing that home-cooked meals bring. Since most of us now have more time to consider our meals, there has also been a lot of cooking going on!

The markets near me are often depleted of flour and yeast as people spend more time baking. One of my patients told me that her 14-year-old daughter spends hours daily in the kitchen and is producing cakes, eclairs, and cookies to feed the neighborhood. At my house, my husband has begun to bake bread and approaches it like a science project. The results have been delicious.

There isn't much new to say about nutrition and cancer. Although there are many books and articles that purport to give nutritional advice to treat or prevent or even cure cancer, we know that there is no data to support those claims. The solid suggestions are not very different than the usual recommendations about a healthy diet: lots of fruits and vegetables, reduced red meat and convenience foods, no nitrates, etc. At BIDMC, there are dieticians who can meet individually with oncology patients to make suggestions that can be helpful in specific situations. For example, if someone is trying to gain weight or has a very limited appetite or needs particular nutrients, they can help.

Nutrition: What Has Changed During COVID-19?

So what is new or relevant to say about nutrition during the pandemic? There are a few unique twists to the standard What are we having for dinner? question. A big one is the need to avoid markets as much as possible. This requires serious meal planning, sitting down with paper and pencil and inventorying your cupboards and refrigerator and figuring out three meals a day for at least a week, and maybe more, at a time. After the big shop (and more on that in a moment), the reality is that the pickings get slimmer as time passes, and we need to be flexible regarding substitutes and condiments that can pick up an otherwise boring meal.

A more serious concern is the shopping. Each of us has to make our own decision on whether we feel safe, masked and gloved, going to a grocery store. It depends on our individual medical situation, our anxiety level, and the realities of the stores near us. If you live in the city, it is likely that markets are more crowded than they are in rural areas. Find out what precautions the stores near you are taking to keep their staff and customers safe.

Most stores have an early morning hour for seniors and those who are immunocompromised. Honestly, I have heard mixed reports of these arrangements, and suspect it depends on the location and the day. You might do just as well to go at a different time, hoping it is an off hour for many shoppers.

Many people opt to use grocery shopping services, but it can be tough to find availability and delivery. Consider your neighbors; there may well be people near you who would be happy to add your shopping list to their own. Since high school and college students are home, you may be able to hire one to do your shopping.

And what about those groceries once they are on your kitchen counter? The standard advice about washing fruits and vegetables has not changed; there is no need to scrub them down, just do what you usually do. Follow the standard guidelines about safe cooking, and there is no additional problem. Some cancer patients, such as people post-bone marrow transplant (BMT), have special rules about raw fruits and vegetables, but this is not a worry for most of us. Many are choosing to wipe down packaged goods, cans or boxes, and a disinfectant wipe suffices.

It is easy to go online and find lists of how long viruses (note: this is not COVID-specific) can last on various surfaces; it ranges from a few hours to a few days. The experts all agree that there is very minimal risk of becoming infected from a box of oatmeal or a can of soup, but you can make your own decisions about how to clean, or not, all your groceries. I know a few people who just leave all their non-perishable goods in the trunk of the car or on the porch for a few days, and then store things per usual.

To summarize, there are no particular rules about what to eat during the pandemic. There are no foods or diets that guarantee you won't become infected. There is also no evidence that the virus is transmitted via food, so you don't need to worry about who has been handling your food. This means that take out is fine as long as the logistics of transfer are carefully followed.

All in all, food is one of life's pleasures, and this is a time to really try to care for ourselves kindly. You may be using your extra time to cook more or to try new dishes or cuisines, or you may be sticking with familiar comfort foods. Whatever works for you is the best suggestion.