The right selection of foods during and after treatment will meet your body’s needs for protein, vitamins, and other nutrients, and it can make a major difference in your quality of life as well. Uncomfortable symptoms such as gas, bloating, and constipation are common in women with ovarian cancer, but those symptoms can be minimized with the right diet and plenty of fluids. The foods and supplements you should try to incorporate in your diet will depend on where you are in your treatment journey for ovarian cancer, says Anna Taylor, RD, a registered dietitian with Cleveland Clinic’s Center for Human Nutrition. “For example, people have different nutrition needs while actively undergoing treatment or recovering from surgery or a complication than they would after treatment,” says Taylor. Keep reading to find out expert recommendations on diet and supplements for optimal health and healing during and after your ovarian cancer treatment. RELATED: How Is Ovarian Cancer Diagnosed?

Why You Need a Balanced Diet: Food and Caloric Intake After Ovarian Cancer Treatments

Treatments for ovarian cancer, including surgery and chemotherapy, can affect your body’s needs for specific nutrients, according to Amanda Nickles Fader, MD, the vice chair of gynecologic surgical operations at Johns Hopkins Health System in Baltimore. “These treatments may also impact a woman’s eating habits and how the body digests and absorbs food,” says Dr. Fader. There are four main goals for nutrition during ovarian cancer treatment, says Fader.

Ensure that personal nutrient needs and calorie goals are met.Eat a well-balanced diet.Maintain a healthy weight.Avoid losing muscle.

“The body requires more calories and certain nutrients such as protein during and after treatment in order to fight and heal. Staying hydrated and eating enough calories, protein, and other nutrients during this time helps maintain muscle stores, prevent treatment delays, boost the immune system, and minimize side effects of treatment,” says Taylor. Sometimes it’s hard to eat enough calories and protein after treatment because you may feel full because of bloating or constipation, says Taylor. “Small frequent meals can help in this situation; try to include some protein with each meal, and snack whenever possible to help meet your total protein needs, she suggests. RELATED: The Stages of Ovarian Cancer and What They Mean

Creating a Balanced Diet

You may wonder what exactly is meant by a “balanced diet,” especially if you have ovarian cancer. “In this case, a balanced diet would include all six food groups, while emphasizing minimally processed foods from each group,” says Taylor. This falls in line with the American Cancer Society’s general recommendations to decrease risk for cancer and cancer recurrence while also supporting adequate nutrition and a healthy weight, she says. A balanced diet full of whole, nutrient-rich food is the best way to get the nutrition you need, says Fader. “Some supplements can be useful if you have a specific deficiency, but most studies have found that the risks of high dose supplements usually outweigh the benefits,” she says. If you are considering any supplements or vitamins, you should consult your healthcare provider first, she says. “Avoid taking vitamins at more than 100 percent of the daily allowance (daily value) unless you have a nutrient or vitamin deficiency and have been directed to take more by your healthcare provider,” says Fader. Taylor recommends the following foods and servings for each of the six groups:

Protein foods Eggs and egg whites; skinless poultry, fish, and shellfish, as well as lean red meat in moderation; nut butters; legumes (like lentils, beans, soy, and peas); and nuts and seeds (if tolerated)Dairy and dairy alternatives Greek yogurt, cottage cheese, milk or milk alternatives and cheese (in moderation). Many dairy foods are also good sources of proteinFruits Mostly fresh and frozen — 2 to 3 servings per dayVegetables Mostly fresh and frozen — 3 to 5 servings per dayStarches Whole grains (if tolerated) such as oatmeal, quinoa, barley, brown and wild rice, whole-wheat pasta, whole-grain bread, and starchy vegetables, including sweet potatoes, potatoes, peas, and winter squashHealthy fats Olive oil, nut butter, avocado, and nuts and seeds (if tolerated)

It’s also important to drink plenty of fluid, mostly in the form of water, says Taylor. “I recommend at least 64 ounces (oz) a day,” she says. Keep in mind that if you experience certain side effects the recommendations may be different, says Taylor. “For example, if someone is having diarrhea or has an increased risk for bowel obstruction, then high fiber foods would not be typically recommended,” she says. RELATED: 5 Tricks for Getting Enough Fruit and Veggies

Special Dietary Concerns for Digestive Issues With Ovarian Cancer

“Women undergoing ovarian cancer treatment may experience nausea, vomiting, diarrhea, heartburn, and bloating or early satiety, which is feeling full after eating relatively small quantities of food,” says Fader. “All of these digestive issues can affect a woman’s nutritional status and also her desire to eat,” she says. Unfortunately, these issues are relatively common during and after treatment for ovarian cancer, says Taylor. There are ways to help minimize these symptoms, which can include constipation or diarrhea, gas and bloating, and increased risk for bowel obstructions, Taylor says.

Gas and Bloating

Try small, frequent meals to avoid large portions.If you’re lactose intolerant, avoid high-lactose foods like cow’s milk and ice cream.Avoid straws, carbonated beverages like soda or beer, and chewing with your mouth open, all of which can cause you to swallow air and contribute to bloating.Avoid fatty greasy meals, which are digested slowly and can therefore lead to bloating.Certain healthy foods are gas-forming, including beans and cruciferous veggies such as broccoli, cauliflower, Brussels sprouts, cabbage, and bok choy. “This is because they contain sulfur and raffinose, a carbohydrate that is difficult for the body to break down,” says Taylor. You may want to limit these foods if you are feeling bloated or try cooking them thoroughly, which will help break down those compounds.

Constipation

Drink at least 80 oz of fluid each day.Stay active with low-intensity exercise, such as a daily 20 to 30 minute walk, to improve digestive motility.If you are not at risk for a small bowel obstruction, incorporate high fiber foods, like fruits, vegetables, whole grains, beans, nuts, and seeds. Aim for at least 25 to 35 grams (g) of fiber per day.Ask your healthcare team if fiber supplements, stimulant or osmotic laxatives, or stool softeners are a good option for you.

Diarrhea

Drink plenty of caffeine-free, low-sugar fluids throughout the day. Drink at least one cup of fluid after each loose bowel movement. Avoid sugary drinks (even juice), as well as caffeine, as these can make diarrhea worse.Limit insoluble fiber such as the skins and peels of produce, and other “roughage” and increase soluble fiber sources including rice, bananas, oatmeal, potatoes without skin, and applesauce.Avoid fatty, greasy foods and limit sweets.

Risk for Bowel Obstruction

A bowel obstruction is a blockage in the intestines that prevents foods and fluids from passing through the intestines, and it sometimes occurs in people with ovarian cancer. “If you have a history of a bowel obstruction, or your healthcare team says you are at risk for developing a bowel obstruction, there are many foods that can increase your risk for this issue,” says Taylor. Examples of foods to avoid if you are at risk for developing a small bowel obstruction include:

Fresh or dried fruit and skins (except bananas — they’re fine), canned pineapple or fruit cocktail, and coconutRaw vegetables, cooked or raw corn and mushrooms, stewed tomatoes, potato skins, cabbage, beans, peas, and legumesCoarse whole grains, bran, any grain with seeds or whole spices, popcornMeat with casings, chunky peanut butter, nuts

If you don’t have a history of a bowel obstruction and you’re not at risk, there is no reason to avoid these foods, says Taylor. RELATED: Ovarian Cancer: Myths vs. Facts

Nutrition Needs During and After Treatment

There are some foods that can help fuel you while you’re actively going through treatment or surgeries for ovarian cancer, says Taylor.

Greek yogurt is a form of protein that’s rich, soft, moist, easy to eat, and fiber free. “It’s a nice choice for people at risk for bowel obstruction,” says Taylor.Creamy peanut butter is a healthy fat that also contains protein and is easy to mix into smoothies or oatmeal or to spread on toast or apples.Eggs are protein-rich, easy to digest, nice as a breakfast food or snack or in a stir-fry.Bananas are a healthy fruit that contains vitamins, soluble fiber, and carbohydrates to give your body fuel. “They’re a great addition to smoothies or cereal,” says Taylor.Cottage cheese is rich in protein and it’s soft and easy to eat. “It’s also fiber-free and a good choice for people at risk for bowel obstruction,” she says.Rice is great for stir-fries, soups, and side dishes, easy on the stomach and digestive tract, and a good calorie and carbohydrate source during treatment.

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Foods to Avoid During Treatment

It’s important to discuss what foods you should avoid when undergoing treatment with specific chemotherapy regimens, says Fader. A few foods to avoid:

Grapefruit and Seville oranges: “In some women these fruits can interact with certain medications, says Fader.

Raw or undercooked seafood or meat: “Chemotherapy can impact a woman’s immune system and ability to fight off infection, and so raw or undercooked seafood or meat, which can harbor bacteria, should not be consumed because foodborne infections can be harder to fight off with a compromised immune system,” says Fader. Developing infections during surgery or chemotherapy may result in delays in cancer treatment, she adds.

A Healthy Weight Can Reduce Cancer Risk

There’s evidence that excess body weight can increase the risk for many types of cancer, including ovarian cancer, and so maintaining a healthy body weight is important, says Taylor. According to a study published in the journal PLoS One, a higher BMI is associated with a slight increase in the risk of ovarian cancer, particularly in women who never used menopausal hormone therapy. “For this reason, we recommend not just eating a healthful balanced diet but also choosing portions to support a healthy weight. A good rule of thumb is to aim for half a plate of produce at each meal, with a daily goal of at least five handfuls of fruits and vegetables per day,” says Taylor. RELATED: Ovarian Cancer Resources: Information and Support