AML Management: Feel Better With Food and Physical Activity

If you’re receiving treatment for acute myeloid leukemia (AML), it probably feels like a lot of things are outside your control. But there are many small choices you can make each day — doable steps that can help you feel better inside and out.

“It’s important to have achievable nutrition and exercise goals to support your physical and mental health,” says cancer specialist Hetty Carraway, MD, MBA. In other words: Eating well and getting physical exercise will help you stay strong both in body and mind.

AML nutrition

When you’re undergoing cancer treatment, you need to keep up your strength. Good nutrition helps your body heal and boosts your immune system to ward off infections. People who are well nourished may also tolerate chemotherapy side effects better.

Unfortunately, AML (and AML treatment) can make it hard to get all the calories your body needs to stay strong. You may have nausea or just lack any appetite (especially since chemotherapy can damage your taste buds and foods may lack flavor). Your favorite foods might suddenly taste strange and, as a result, you may not be as interested in eating them as you once were. “Foods taste different, which can make you less interested in eating,” says Dr. Carraway.

So how should you approach meals in this strange new world? Ideally, aim for three balanced meals a day. But that may not always be possible. “Make sure you’re taking in enough calories, and focus on foods that work for you. Everyone can be different in this regard,” Dr. Carraway emphasizes.

For some people, that might look like one big meal a day plus a nutrition shake. Others might do better with several smaller meals spread throughout the day. Some people might crave lots of fruit, while others have no appetite for it.

The goal: a balanced diet with good sources of protein, fruits, vegetables and carbohydrates. But it’s OK to let your appetite guide you in your quest for calories. “Whatever works for you, keep doing it,” she says.

Acute myeloid leukemia: Foods to eat

These tips can help you consume enough healthy calories, even when you don’t feel like eating.

• Choose foods that pack a punch: To add calories, use healthy fats (like avocado and nut butters) or blend cooked foods with high-calorie liquids such as gravy, cream or broth. If solid foods aren’t working for you, try high-calorie liquids such as soups and shakes.
• Supplement your diet: Turn to liquid meal replacement drinks or protein shakes when you don’t have the stomach for a solid meal. These meal replacement drinks contain a balanced set of the nutrients you need.
• Stay hydrated: Drink plenty of fluids throughout the day. If plain water isn’t appetizing, try seltzer or flavored waters instead.
• Listen to your body: Eat when you have an appetite, even if that means most of your calories come from one big meal.
• Get creative: Find new ways to get the nutrients you need. If your stomach is turned off by the thought of eating a piece of whole fruit, could you make a fruit smoothie instead? If a glass of juice isn’t appealing, what about a popsicle?
• Enlist help: A nutritionist can help you find foods that are appetizing and nutritious, Dr. Carraway says. “Working together, you can find a well-balanced diet that will set you up for success.”

One word of caution: While your main goal is to get enough calories, there’s one calorie source you should steer clear of. “Alcohol is directly toxic to the bone marrow, so definitely avoid drinking alcohol when undergoing chemotherapy,” Dr. Carraway says.

AML food safety

During AML treatment, your body is more vulnerable to infections. To reduce the risk of foodborne infections, take these steps:

Do:

• Choose pasteurized milk and juices.
• Clean fruits and veggies well before you eat them.
• Toss leftovers that have been in the fridge for more than three days.
• Wash hands and kitchen surfaces well when preparing foods.
• Cook meat and eggs thoroughly. (But don’t leave them at room temperature to thaw or marinate.)

Don’t eat:

• From buffets, salad bars and bulk food bins.
• Foods beyond their freshness date.
• Raw fish dishes like sushi or uncooked oysters.

Living with AML: Physical activity

AML and its treatment often bring weakness and fatigue. So exercise might be the last thing on your mind. But moving your body each day can help you feel better physically and emotionally, Dr. Carraway says.

Regular physical activity can:

• Improve sleep.
• Improve energy levels.
• Help you remain independent.
• Reduce anxiety and improve mood.
• Help maintain muscle mass and boost physical strength.

Not all exercises are appropriate for people with AML. Because of the risk of bleeding and infection, doctors will recommend you avoid certain activities such as golf, swimming and contact sports.

It’s always a good idea to talk to your care team before starting a new activity, to make sure it’s safe and appropriate. But most people with AML benefit from regular walking, Dr. Carraway says. “It’s safe, gentle and helps you maintain your strength and endurance.”

She encourages her patients to try to walk 1 to 3 miles each day. “You may not be able to do that all at once, but you can plan for several smaller bouts of activity each day,” she says. “Some days, if you’re not feeling well, that’s not possible. But if movement is part of your routine, it’s easier to stick with it when you’re feeling up to it.”

“Routine activities like walking will help you keep up your muscle strength and maintain your independence,” she adds.

Living with AML isn’t easy. But by setting small, attainable goals in your everyday life, you can help your mind and body stay strong.