Diet and nutrition

Getting the right advice on eating well

The dietary advice that qualified health professionals who specialise in NETs give will vary depending upon a person’s symptoms, diagnosis, treatment (including previous treatment) and any other medical conditions.

If you have been given specific dietary advice by a qualified healthcare professional (such as a dietician, specialist nurse, or doctor) then follow that advice as it will be tailored to you. You can always discuss information on this page further where it is relevant.

Seek advice from a qualified healthcare professional specialising in NETs if you are losing weight or are severely restricting your diet.

If you do not have symptoms and are maintaining your weight then follow healthy eating advice for the general population as shown in the example opposite.

Healthy eating advice for the general population

Source: Public Health England in association with the Welsh Government, Food Standards Scotland and the Food Standards Agency in Northern Ireland

This general advice does not suit everyone, If you are experiencing specific symptoms or losing weight then the following advice might be helpful. Discuss your symptoms with your NET team.

Loss of appetite and weight loss

As someone living with NETs, you may lose your appetite if you are feeling unwell due to various symptoms and treatment side effects. This can also lead to weight loss.

Although you may not feel like eating, remember that getting good nutrition and avoiding losing large amounts of weight are an important part of your treatment. Eating well can also help you to cope better physically and emotionally with the effects of NETs cancer and cancer treatment.

Ask your doctor for advice about ways to relieve other gastrointestinal symptoms you may have, such as nausea, vomiting, constipation or stomach pain.

Tips for getting nutrition when your appetite is poor

• Eat five to six small meals a day.
• Determine which times of day you are hungry, make sure to eat at those times, and do not limit how much you eat.
• Choose snacks that are high in calories and protein, such as yogurt, cheeses, eggs, milkshakes, ice cream, flapjacks and other biscuits, puddings, nuts (and nut butters), and hummus.
• Keep your favourite foods on hand for snacking
• Add calories and protein to foods by adding cheesy or creamy sauces, butter, cheese, cream cheese, cream, and nuts or ground nuts.
• Drink fluids between meals, rather than with meals. Drinking during a meal may make you feel full too quickly
• Choose nutritious or filling drinks, such as full fat or semi-skimmed milks, milkshakes or smoothies.
• Ask family members or friends to get groceries and prepare food for you when you are too tired shop or cook, and consider buying precooked meals or order your groceries online.
• If you find large portions overwhelming then use a smaller plate to serve yourself.  You can always go back for more.

Most of us get the vitamins and minerals we need from our diet, including from foods that have been fortified with specific vitamins and minerals. However, some people are at a higher risk of certain deficiencies due to medications, treatments, surgeries, or if experiencing diarrhoea or carcinoid syndrome.

Speak to a member of your NET team about whether or not you should be on any specific vitamin or mineral supplements.

Fat soluble vitamins

Vitamins A, D, E, and K are fat soluble vitamins, meaning that they are generally absorbed with fat via the digestive system into the bloodstream.

If you are unable to absorb fat normally (which is usually seen in the form of steatorrhea) you are at a higher risk of deficiencies in fat soluble vitamins and may require supplementation.

Vitamin D is also made in the body with sunlight. If you do not have much exposure to the sun, or you experience steatorrhea you might be at an increased risk of vitamin D deficiency. Vitamin D levels can be checked by a blood test. Many countries recommend supplementing vitamin D. Contact your doctor or specialist nurse to discuss whether or not you need to take a vitamin D supplement.

Niacin (vitamin B₃)

If you have carcinoid syndrome you are at higher risk of niacin deficiency. This is because the amino acid tryptophan, which is normally used to produce niacin in the body, is used up to produce serotonin instead (a hormone that produces carcinoid syndrome symptoms).

Increasing your intake of tryptophan by ensuring you eat a good source of protein with each meal can help.

Good sources of protein include beans and pulses, soy products, nuts, seeds, eggs, milk, cheese, yoghurt, meat, fish, and poultry.

Your NET team can also discuss with you whether you need to take a niacin supplement.

Please talk to your NET care team about any specific concerns you may have about diet and nutrition.

Probiotics include supplements, foods and drinks that contain live bacteria and yeasts that are good for your gastrointestinal (digestive) system.

Some people living with NETs may find these helpful to take, especially if you have suffered with diarrhoea for a long time, or if you have taken (or are still on) antibiotics. Some people who experience bloating, wind (flatulence) or constipation have found probiotics helpful.

You can find probiotic supplements available for sale in most supermarkets and include capsules, yoghurts, yoghurt drinks and kefir that contain the ‘good’ bacteria lactobacillus or bifidobacterium.

Please talk to your NET care team about any specific concerns you may have about diet and nutrition.