Nutrition guide for neuroendocrine tumour patients

Nutrition guide for neuroendocrine tumour patients

Patients with neuroendocrine tumours often experience an alteration in nutrition and metabolism due to excessive production of gastrointestinal hormones, peptides, and amines. These alterations result in reduced food intake, malnutrition, diarrhoea, altered gastrointestinal tract motility, and loss of appetite.

To overcome these nutritional challenges, patients with neuroendocrine tumours (NETs) must focus on their diet. Dietary planning is an integral part of the multidisciplinary management of neuroendocrine cancer patients. Consuming an adequate diet can lower the complications, helps in recovering faster and improves strength and energy.

NETs patients may wonder about the specific dietary sources to be included, foods to avoid, and various changes to prevent and manage the disease. So without any further ado, let’s read the right and wrong food choices for patients with NETs.

Foods to eat

Patients who are not losing weight, have controlled associated symptoms and are not on a prescribed diet should prefer a healthy eating diet. A healthy diet should be high in fruits, vegetables, whole grains and low in saturated fats, salt, and extra sugars.

Basics of a healthy diet for NETs patients:
  • Cover two-thirds of your plate with plant-based foods like vegetables, fruits, whole grains or beans
  • Use herbs and spices with anti-inflammatory properties such as turmeric to prepare your food items.
  • Increase the phytochemical content in your diet, including:
    • Red, orange and green fruits & vegetables such as carrots, watermelon, tomatoes and leafy greens: Rich in carotenoids which acts as antioxidants and helps to improve immune response.
    • Cruciferous vegetables including broccoli, kale, brussels sprouts and cauliflower: Rich in indoles, which reduces tumour growth.
    • Apples, citrus fruits and green tea: Rich in flavonoids that reduces inflammation and detoxify the body.
    • Green tea, grapes, wine, berries, and apples: Rich in polyphenols which acts as antioxidants and prevents inflammation.
    • Cherries, citrus fruits and rosemary: These are rich in terpenes which help to strengthen immunity and protect body cells from becoming cancerous.
  • Include fibre-rich foods that help reduce cancer by managing weight, controlling blood sugar and cholesterol levels, and promoting bowel regularity.
  • Choose lean proteins such as fish and skinless poultry over red meat and always opt for the best quality animal foods.
  • Drink plenty of water and fluids, including green tea and fresh juices, instead of sugary and processed drinks.

To know more about healthy eating during cancer and post-cancer phase, explore ‘Diet recommendations for cancer patients.

Moreover, according to research Mediterranean diet is very helpful to accomplish the needs of nutrition in a patient with NETs, but in a revised way. It is named as Mediterranean diet 4.0.


The Mediterranean diet 4.0 modified for patients with NETs
(Adapted from Nutr Cancer. 2020 Nov 4;1-10. )
Foods to avoid

There are certain types of foods that need to be restricted or avoided by NETs patients as they can lead to various health problems and affect treatment efficacy and compliance. Therefore, you must have knowledge about which foods can trigger your situation and make it worse.

Foods containing amines

Amines are naturally present in many foods. These arise from protein breakdown or the fermentation process. These are known to provide flavour to the foods. Foods containing intense flavour will also contain high amounts of amine.

Foods high in amine can trigger carcinoid tumours to produce more hormones to cause carcinoid syndrome further. Therefore, it is best to avoid foods high in amines.

Amine foods to avoid:
  • Salted, smoked or pickled fish or meats
  • Alcohol
  • Aged cheese (Blue cheese, Roquefort, Cheddar and chemebert)
  • Fermented foods like tempeh, tofu, miso, soy, kimchi, sauerkraut or fish sauce.
  • Yeast extract meats like processed, marmite/vegemite or nutritional yeast
Amines to limit:
  • Caffeine, cocoa, dark or milk chocolate
  • Fruits like banana, avocado, raspberries and coconut
  • Nuts like brazil nuts, peanuts and fava beans and broad beans
Lactose containing foods

Among patients with inadequate digestion or diarrhoea, lactose-reduced milk or limiting lactose-containing foods like buttermilk, curds, bread and dairy solids etc., can be beneficial. However, there is no need to cut these products. Please consult your physician and only limit it to a certain level.

Other food sources to avoid

These are some other food sources that a patient needs to avoid while planning the diet. It includes:

  • High alcohol intake
  • Carbonated drinks
  • Gas forming foods
  • Foods with insoluble fibre (only less than 10 grams per day)
  • Fried, greasy and processed foods
  • Hot spicy, and acidic foods
  • Sweetened and sugary foods
Tips for improving poor appetite and weight loss

Patients with NETs often experience loss of appetite due to various symptoms and treatment side effects. Prolonged loss of appetite results in weight loss; thus, it is vital to improve appetite. Below are some tips for getting good nutrition when you don’t feel like eating:

  • Eat five to six small meals a day
  • Don’t limit how much you eat
  • Determine times of day when you are hungry and make sure to eat at those times
  • Prefer snacks rich in calories and protein, such as nuts, eggs, and cereal
  • Drink fluids between meals, rather than with meals as intake of fluids during eating makes you feel full too quickly
  • Choose nutritional drinks such as fortified milk or whole milk, if you are unable to eat much solid food
Putting it All Together

A healthy lifestyle with a combination of diet, exercise and stress management is vital for maintaining the physical and mental well being of NETs patients. These dietary guidelines for NETs can help plan a nutritious diet that significantly helps in the faster recovery of patients. But it is essential to consult your doctor, or registered dietitian for specific dietary and activity guidelines as every individual’s nutritional needs vary depending upon genetic makeup, age, and medical conditions.

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