Produced 2009 by Accessible Format Production, RNZFB, Auckland
This edition is a transcription of the following print edition:
Copyright © 2007 Cancer Society of New Zealand Inc
PO Box 12700, Wellington, 6011.
First Edition 2007
ISBN 0-908933-72-X
Reprinted 2009
The Cancer Society’s aim is to provide easy-to-understand and accurate information on cancer and its treatments. Our Living with Cancer information booklets are reviewed every four years by cancer doctors, specialist nurses, and other relevant health professionals to ensure the information is reliable, evidence-based, and up-to-date. The booklets are also reviewed by consumers to ensure they meet the needs of people with cancer and their carers.
This edition of Got Water?/He Wai? includes a new feature in response to suggestions from those who review our booklets, and to meet the needs of our readers. Our key messages and important sections have been translated into te Reo Māori. Our translations have been provided by Te Taura Whiri i te Reo Māori/the Māori Language Commission’s Hohepa MacDougall, and have been peer-reviewed by his colleagues.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher.
Advanced Cancer/Matepukupuku Maukaha
Bowel Cancer/Mate Whēkau Pukupuku
Breast Cancer/Te Matepukupuku o ngā Ū
Chemotherapy/Hahau
Lung Cancer/Matepukupuku Pūkahukahu
Melanoma/Tonapuku
Prostate Cancer/Matepukupuku Repe Ure
Radiation Treatment/Haumanu Iraruke
Secondary Breast Cancer/Matepukupuku Tuarua ā-Ū
Sexuality and Cancer/Hōkakatanga me te Matepukupuku
Understanding Grief/Te Mate Pāmamae
What Do I Tell the Children?/He Aha He Kōrero Maku Ki Āku Tamariki?
Being Active When You Have Cancer
Talking To A Friend With Cancer
When Someone Has Cancer
When You Have Cancer
This booklet has been produced to inform and offer suggestions for people who have a dry mouth and those caring for someone with a dry mouth. Dry mouth often means you can no longer eat the food you usually do and this makes choosing food difficult.
The booklet has sections on food choices and preparation tips, many of which have been contributed by people with a dry mouth.
This information is a general guide and it is not intended to replace advice from your doctor, dentist, or registered dietitian. If you have questions about your condition or the quality of your diet, please consult your doctor, dentist, or registered dietitian.
I waihangatia tēnei pukapuka hei whakamārama, hei hoatu whakaaro hoki mō ngā tāngata mate waha maroke, mō rātou rānei e tiaki ana i tētahi tangata e mate ana i te waha maroke. Ko te tikanga kua kore e taea e koe te kai ngā kai i kainga e koe ki mua. Ka uaua te mahi kōwhiri kai. He wāhanga kōwhiri kai kei roto i te pukapuka nei me ētahi kōrero mō te whakataka kai ā, i tukuna mai te nuinga o ēnei e ngā tangata mate waha maroke.
He aratohu whānui ngā kōrero o te pukapuka nei, ehara i te mea ka whai mana ake i ngā kōrero a tō rata, tō kaitiaki niho, tō mātanga-ō rānei. Mehemea he pātai āu e pā ana ki tō mate, ki te kounga o tō rārangi kai rānei, me whai tohutohu mai i tō rata, tō kaitiaki niho, tō mātanga-ō rānei.
What is dry mouth? - 3
Why is saliva important? - 4
Symptoms of a dry mouth - 4
What causes a dry mouth? - 6
Ways to treat symptoms of a dry mouth - 7
Tips on living with a dry mouth - 9
Mucositis/Stomatitis - 11
Tips for living with a sore mouth - 12
Tips for keeping teeth healthy - 13
What’s out there for me to use? - 16
Eating or dining out tips - 18
Food groups and recommended daily amounts - 22
Foods you may need to avoid - 24
Constipation - 25
Food preparation tips - 28
Comments and suggestions from people living with a dry mouth - 32
Sample menu - 35
Meal ideas - 37
Recipes - 40
Write down your own recipes - 55
Suggested websites and organisations - 57
Notes - 58
Feedback - 63
Page 3
It occurs when your body produces too little saliva to wet the inside of your mouth.
Dry mouth can cause problems with speech, taste, chewing, and swallowing.
You also have a greater risk of getting dental decay and infections in your mouth.
The medical name for dry mouth is Xerostomia (zeer-oh-stoh-mee-ah).
Ka puta i te wā kāore e taea e tō tinana ki te waihanga hūare hei whakamākūkū i tō waha.
Ka puta pea he raruraru mō te kōrero, mō te whakamātau kai, te ngaungau me te horomi – nā runga i te waha maroke.
Ka kaha ake te mōrea mō te pirau o ō niho me te puta o ngā tahumaero ki roto i tō waha.
Ko te ingoa rongoā mō te waha maroke ko te Xerostomia.
Page 4
Saliva lubricates and wets your mouth and lips.
Saliva helps to:
make it easier to chew and swallow
protect your mouth from bacterial and fungal infections
keep your teeth strong and protect them from decay.
These may include some of the following:
difficulty chewing, swallowing, or speaking caused by lack of saliva or changes in the thickness of your saliva
sticky dryness in the mouth
thick and stringy saliva
cracked lips or corners of the mouth
dry, rough tongue
burning tongue sensation
mouth or tongue sores or mouth ulcers
difficulty or pain in wearing dentures
taste changes
difficulty speaking clearly
bad breath.
Page 5
Tērā pea ka pā ētahi o ēnei e whai ake:
uaua te ngaungau, te horomi me te kōrero nā te kore hūare, nā te rerekē rānei o te mātatoru hūare
ka tāpiapia, ka maroke te waha
ka mātotoru, ka pakaua te hūare
kua pātotoi ngā ngutu me ngā kokonga o te waha
kua maroke, kua mātoetoe te arero
ka wera te arero
ka puta he kea, he keha rānei ki te waha me te arero
he uaua, he mamae te mau niho more
ka rerekē te rongo kai
uaua te kōrero pai
hā kino.
Page 6
Some auto-immune conditions, such as Sjögren’s syndrome,* cause the body to attack itself, destroying glands such as the salivary glands. Parkinson’s disease, HIV/AIDS, diabetes, and some psychiatric illnesses, such as anxiety disorders, can also cause a dry mouth.
People who have head and neck radiation treatment may be at high risk of getting a dry mouth, as the salivary glands can be damaged by radiation during radiation treatment.
Drugs used in chemotherapy may cause saliva to be thick, making the mouth feel dry. This is usually temporary.
Dry mouth is a side effect of many medications. Anti-depressant medications and mood stabilising medications can often cause salivary glands to make less saliva. Dry mouth is also a side effect of medications used to treat chronic pain, allergies, and high blood pressure.
* Sjögren’s (show – grins) syndrome is a condition in which the body’s immune system attacks its own exocrine glands (glands in the body that produce moisture, e.g. sweat, saliva, etc.).
Page 7
Injury to the head, neck, or a stroke can damage the nerves that cause the salivary glands to make saliva.
Check with your doctor whether your medication is contributing to your dry mouth. There may be another that does not cause this side effect.
Chewing on sugar-free gum will help to stimulate saliva if there is still some part of your salivary glands working.
Some people will develop intolerance to peppermint and this will affect the types of toothpaste, washes, and sugar-free gum you choose.
Sipping water helps to keep your mouth moist.
Artificial saliva spray may help.
Saliva stimulants, such as pilocarpine and cevimeline (currently not available in New Zealand) can be used to treat a dry mouth. They are useful, but do have side effects, and are not a solution for everyone. Talk to your dentist about treatment options for you.
Page 8
"Sipping water (sometimes milk), sucking mints, gum, or just sucking something works for me."
Photo:
Transcriber's Note: A glass of water. End of Note.
End of Photo.
Uiuitia tō rata mō ō rongoā me tō waha maroke. Tērā pea he rongoā pai ake me te kore whai pānga weriweri.
Mā te kai piangaungau korehuka hei āwhina kia rere te hūare mehemea kei te mahi tonu ō repe.
Ka āhua piki te kino o te peppermint ki ētahi a, ka whai pānga ki ētahi o ngā momo paniaku, horoi waha, me ngā piangaungau korehuka ka kōwhiria e koe.
Mā te inuinu wai e āwhina kia noho māku tō waha.
Tērā pea ka āwhina ngā rehu hūare.
Page 9
Ka taea te whakamahi whakaongaonga hūare pēnei me te pilocarpine rāua ko te cevimeline (kāore e taea ēnei i roto o Aotearoa). Heoi anō, ehara i te mea he pai mō te katoa, ka whai pānga ētahi. Kōrero ki te kaitiaki niho e pā ana ki ngā huarahi maimoatanga.
Carry a bottle to sip water or sugar-free drinks, such as lemon-flavoured water or weak iced tea, often. Most commercially prepared drinks, juices, energy drinks, etc. are very acidic, and can damage your teeth. They should be avoided if possible.
Sip fluids during your meals.
Chew sugar-free gum or suck on sugar-free sweets to stimulate saliva (these can be harmful to teeth).
Alcohol and smoking cause dry mouth symptoms to worsen so avoid them if possible.
Limit the amount of drinks containing caffeine if possible, as it may make your dry mouth worse.
Applying artificial saliva gel or vegetable oil at night may help to relieve your dry mouth.
Have a bottle or a glass of water by your bed to save you a trip during the night.
Use a humidifier at night.
Page 10
“Use salt and water to gargle and rinse your mouth.”
“Hold water or ice in your mouth.”
“Ask your doctor about thrush lozenges.”
“Put gel on with cotton buds.”
“Avoid foods that will aggravate the situation.”
Kawea he pātara hei inu wai, hei inu waireka korehuka rānei pēnei i te wai whai paku rēmana i roto, te tī ngoikore, tī hukapapa hoki, kia kaha tonu te inu. He tino kaha te matū o te nuinga o ngā inu hoko, ngā tarawai, ngā inu pūngao, arā atu, arā atu ā, ka tūkinotia ō niho. Me karo ēnei mēnā ka taea.
Me inuinu kūtere i ngā wā kai.
Me ngaungau i te piangaungau korehuka, me ngote rānei i ngā rare korehuka hei whakaongaonga huare (he kino pea ēnei mō ngā niho).
Ka kaha ake te mate o te waha maroke i te mahi inu waipiro me te kai paipa, nā reira me karo ēnei.
Page 11
“Whakamahia te tote me te wai hei horoi i tō waha.”
“Pupuritia he wai, he hukapapa rānei i roto i tō waha.”
“Uiuitia tō rata mō te āhua o ngā thrush lozenges.”
“Pania te pia mā ngā miroao.”
“Karohia ngā kai whakapōrearea i a koe.”
Kia iti ake te inu i ngā inu e mau ana i te caffeine i roto, kei kaha ake te mate waha maroke.
Me panipani he pia huare tāwhaiwhai, he hinu huarākau rānei i ngā pō hei āwhina i te mamae.
Pupuritia he pātara, he karaehe wai rānei i te taha o tō moenga kia kore koe e pōrearea ki te haere i te pō.
Whakamahia he pū tango haumākū i ngā wā o te pō.
Mucositis/Stomatitis is the swelling, irritation, and ulceration of the mucous tissue of the mouth.
Ko te Mucositis/Stomatitis, ko te pupuhitanga, ko te māngeongeo me te kea o ngā huare kakaru o te waha.
Page 12
“I find carbonated drinks are painful on the tongue, but the effect can be reduced by stirring the drink with a fork to release a lot of carbon dioxide. I call this the ‘forking’ technique. In the early months after radiotherapy, even a small glass of lemonade caused pain until it was ‘forked’.”
Eat soft foods that are easy to chew and swallow.
Avoid foods that irritate the mouth (see page 24).
Eat foods which are cool or at room temperature: extreme temperatures, i.e. very hot or cold foods, may irritate a sore mouth.
Drinking through a straw may help because it ‘bypasses’ the sore mouth.
Ice chips or flavoured ice pops can help numb the mouth.
Use a non-alcohol mouth rinse.
Avoid smoking and alcohol.
Page 13
Kainga ngā kai ngāwari ki te ngaungau, ki te horomi hoki.
Karohia ngā kai māngeongeo mō tō waha (tirohia te whārangi 24).
Kainga ngā kai āhua makariri, ngā kai ōrite te pāmahana ki te rūma; Ka māngeongeo pea tō waha i ngā kai wera, ngā kai tino makariri rānei.
Tērā pea mā te whakamahi i te ngongo e āwhina, nā te mea, e kore te inu e pā ki tō waha mamae.
Ka āwhina te maramara hukapapa, te aihiporaka rānei kia noho kēkerewai ai tō waha.
Me whakamahi ngā horoi waha kore waipiro i roto.
Me karo te mahi kai paipa me te inu waipiro.
Limit drinks that contain sugar because they encourage dental decay.
If you do have drinks containing sugar, have them only during meals.
Page 14
Artificial sweeteners, such as aspartame* and saccharine, are okay.
Using a straw to drink may help as it ‘bypasses’ most of your teeth.
Chew sugar-free gum or suck sugar-free sweets after meals to help stimulate saliva.
Gently brush and floss your teeth after meals and before bed.
Use fluoride toothpaste.
Visit your dentist every 3–6 months. If you are on a Benefit, ask if you are eligible for any extra financial assistance.
Whakaitia te inu i ngā inu whai huka – kei pirau noa iho ngā niho.
Mehemea ka inu koe i ngā inu whai huka, me inu i te wā kai anake.
He pai noa iho ngā huka tāwhaiwhai pērā ki te aspartame** me te āwenewene.
* People with the very rare condition of phenylketonuria are unable to break down phenylalanine and so should not use aspartame.
** Ruarua ngā tāngata ka pāngia e te phenylketonuria; inahoki, kāore e taea e rātou te whakamahea i te kaha o te phenylananine. Nā runga i tērā, me kaua rātou e whakapā ki te aspartame.
Page 15
Ngangautia te piangaungau korehuka me ngote rānei ko ngā rare korehuka i muri i te kai hei whakaongaonga i te huare.
Kaua ngā tangata e mate ana i te mate puiaki nei, te phenylketonuria, e whakamahi i te aspartame, nā te mea kāore rātou e kaha ki te wāwāhi i te phenylalanine.
Kia ngāwari noa iho te paraihe i ō niho i muri mai i te kai, i mua hoki i tō haerenga ki te moe.
Whakamahia te paniaku fluoride.
Haere ki te kite i tō kaitiaki niho ia 3 ki te 6 marama. Mehemea kei runga koe i te penihana, tērā pea ka āhei koe mō ētahi āwhina pūtea tāpiri.
“I find that I have more food trapped between my teeth after a meal than before I had treatment. Rinsing the mouth is certainly necessary, but I find that the daily flossing of my teeth has become much more important than before. I find it most helpful when cleaning my teeth to rinse my mouth first, floss, rinse again, clean them, and then after my night-time clean I apply tooth mousse.”
Page 16
Biotène Gentle Mouthwash
Chlorhexidine 0.2%, 0.1% – various brands
NeutraFluor 900 Mouth Rinse
Savacol (chlorhexidine gluconate 0.2%).
Biotène Dry Mouth Gum (with xylitol) (not available in New Zealand)
Recaldent chewing gum*
Trident Sugar Free Gum
Wrigley products – sugar free
Wrigley’s Extra Sugar Free Gum for kids (with xylitol)
Extra Professional (with xylitol)
Look out for any gum with xylitol.
Pilocarpine, and cevimeline, which is currently not available in New Zealand but is used overseas, can be used to treat dry mouth. However, they do have side effects and are not an answer for everyone. You may wish to ask your doctor/ dentist about them at your next appointment.
* Recaldent chewing gum is available from dentists and it is mainly used to decrease tooth decay and sensitivity rather than treating dry mouth. You may like to ask your dentist or dental hygienist about this product.
Page 17
Any sugar-free sweets that contain xylitol or any other artificial sweeteners
SMINT Mints (with xylitol).
Luborant
Oral Balance Moisturizing Spray (with xylitol)
Oral Balance Moisturizing Gel (with xylitol)
Oralube.
Biotène Antibacterial Dry Mouth Toothpaste
Bicarbonate containing toothpaste
Chlorhexidine gels
NeutraFluor 5000 Toothpaste
Oralbalance Gel
Other fluoridated toothpastes
Tooth mousse (these are available from your dentist).
These are just a few examples of what may be available at chemists or shops. Please talk with your dentist if you have any questions about what is suitable for you.
** Caution – sugar-free sweets can also be acidic, i.e. berry flavours, therefore, use them in moderation.
Page 18
If eating at a friend’s house, it may be helpful to let them know your food preferences.
If you can, plan ahead and choose a restaurant which has a menu that suits your needs.
Take your own bottle of water or ask for water at your table.
Cut your food to bite-size pieces: it will make eating easier.
If possible, rinse your mouth at the end of the meal.
Photo:
Transcriber's Note: Three people talking and laughing over dinner. End of Note.
End of Photo.
Page 19
Ki te kai koe ki te kāinga o tētahi o ō hoa, he pai mehemea ka whakamōhio atu koe mō ngā kai pai ki a koe.
Ki te mahere whakamua koe, kōwhiria he wharekai pai te hāngai o ngā kai ki ōu hiahia.
Haria tōu ake pātara wai, me pātai wai rānei i te wharekai.
Āta tapahia ō kai kia pakupaku, kia māmā ake te kai.
Mehemea ka taea, he pai te paku horoi i tō waha i muri i te kai.
Photo:
Transcriber's Note: A glass of water being poured. End of Note.
End of Photo.
Page 20
Hydration first! Make sure you remember to bring your water bottle as there might not be a good source of water where you are.
Call ahead or ask the organisers if there will be any sauces, gravies, or dips available.
Bring your own sauces/gravies (see page 53 for salsa recipe).
If you are short for time, a quick solution would be to call into a supermarket or dairy on the way and buy a can of tomato puree or tomato-based sauce.
Hydration i te tuatahi! Kaua e wareware tō pātara wai kei kore noa iho he wai i reira.
Waea atu i mua tō haere ki te pātai mehemea ka wātea he wairanu, he toutou rānei.
Me hari rānei ko ōu ake whakaranu/wairanu (tirohia te whārangi 53 mō ngā tohutaka salsa).
Mehemea kai te tere pau te wā, he tere ake pea te peka atu ki tētahi toa tiki kēne tōmato tātari, tētahi wairanu ā-tōmato rānei.
Page 21
Photo:
Transcriber's Note: A tablespoon of oil being poured from a glass bottle. End of Note.
End of Photo.
Page 22
|
Type of food |
Suggestions |
|---|---|
|
Beverages At least (8 glasses daily) |
Water is the best! |
|
Breads and Cereals (6 servings) |
Choose soft bread, oatmeal, or other cooked cereals and, if tolerated, pancakes, rolls or waffles. Choose wholemeal and wholegrain breads if possible as they contain more fibre, and can help to prevent constipation. |
|
Lean Meat, Fish, Eggs, and Legumes (1 serving) |
These foods are good sources of protein, iron, zinc, and other nutrients. Meat, such as the tender cuts that are braised, stewed, creamed, or minced, are recommended. Meat alternatives include scrambled eggs, baked beans, or lentils. "Lean meats are more difficult to eat than fatty ones, but there are some tips for making them easier to chew and swallow. Using oil is a good idea otherwise the temptation is to 'go for the fat'. I also find that root vegetables, such as potato and kumara, are very helpful when combined with gravies or sauces, as they keep the moisture in contact with the food while I chew and swallow it." Brian |
* Ministry of Health, New Zealand (2003). "Food and Nutrition Guidelines for Adults", Ministry of Health, New Zealand.
Page 23
|
Type of food |
Suggestions |
|---|---|
|
Lean Meat, Fish, Eggs, and Legumes (1 serving) |
"Not all types of fish are easy to eat. Oily fish, like salmon, are great, but those with firm flesh, such as warehou, tend to wad in the mouth and become difficult to eat. They're easier to eat when a sauce is added. Homemade fish pies are a great example." Brian |
|
Fruits and Vegetables (5+ servings) – Three vegetables and two pieces of fruit |
Fruit and vegetables provide good sources of fibre, vitamins, and minerals. Try cooked pumpkin, mashed potatoes, kumara, banana, or soft melons (watermelons). Canned or stewed fruits are suitable. |
|
Milk and Milk Products (2 servings) – Choose low fat |
Milk and cheese are great sources of calcium. Milk products, such as ice cream, milkshakes, smoothies, yoghurts, custards, and puddings with sauces are easy to eat and are nutritious. |
|
Fat, Sugar, and Salt (use sparingly) |
Foods low in fat, sugar, and salt are healthy choices. Fats such as oils, butter, and margarine are best to use sparingly because they contain a lot of energy (calories) |
NB: If you have weight problems or any specific questions regarding your diet you may like to talk to a dietitian.
Page 24
Foods high in acid, salt, or that are highly spiced may harm your mouth without the protection of saliva. People who have a dry mouth have reported difficulty eating the following:
oranges
grapefruit
tangerines
mandarins
kiwifruit
fresh tomatoes.
curry
chilli
chips.
toast
crackers
cakes, buns, muffins, or scones.
Page 25
“Abrasive breads (especially those with seeds and whole grains) and cereals (especially mueslis), are very difficult to eat when your tongue is sensitive to abrasive foods. Muesli softens after soaking — either by adding milk a few minutes before you eat it, or by mixing it with yoghurt and leaving it in the fridge to soften overnight.”
Have three regular meals a day.
Drink plenty of fluid – at least eight glasses daily.
Aim for 30 minutes of moderate physical activity most days of the week.
Aim to eat 30g–35g of fibre each day when possible.
Choose wholemeal or wholegrain breads.
Include baked beans, peas, and lentils in your meals.
Include bran cereals at breakfast.
Page 26
Transcriber's Note: The original print table has been split into three separate tables according to the Food Category. The three categories are: Breads and Cereals; Vegetables and Fruits. End of Note.
Breads and Cereals
|
Food name and weight (grams) |
Fibre (grams) |
|---|---|
|
Molenberg Balance* 1 slice (28g) |
2.0 |
|
Bürgen Oatbran & Honey* 1 slice (37g) |
2.5 |
|
Freya's Wholemeal Grain* 1 slice (42g) |
3.3 |
|
Ploughmans Hearty Wholemeal & Grain* 1 slice (38g) |
2.4 |
|
Vogel's All Natural Soy & Linseed* 1 slice (34g) |
1.6 |
|
Sanitarium San Bran* (1/2 cup, 30g) |
11.0 |
|
Kellogg's All-Bran* (1/2 cup, 30g) |
7.0 |
|
Hubbards Berry Berry Nice* (1/2 cup, 60g) |
4.4 |
|
Sanitarium Museli Simply Natural* (1/2 cup, 54g) |
5.7 |
Vegetables**
|
Food name and weight (grams) |
Fibre (grams) |
|---|---|
|
Baked beans, canned (1 cup, 283g) |
16.3 |
|
Beans, red kidney (1 cup 187g) |
11.0 |
|
Broccoli, boiled (1 cup, 164g) |
5.2 |
|
Cabbage, red (1 cup, 90g) |
2.5 |
|
Carrots (1 cup, 157g) |
5.0 |
|
Cauliflower (1 cup, 138g) |
4.0 |
|
Corn, creamed (1 cup, 281g) |
16.2 |
|
Lentils (1 cup, 209g) |
4.0 |
|
Parsnip (1 – 22.5 x 5.6cm diameter) |
5.9 |
|
Peas, dried (1 cup, 194g) |
11.4 |
|
Peas, green, frozen, boiled (1 cup, 164g) |
8.5 |
|
Silverbeet, boiled (1 cup, 168g) |
5.6 |
Page 27
Fruits**
|
Food name and weight (grams) |
Fibre (grams) |
|---|---|
|
Apricots, dried (1 cup, 137g) |
10.5 |
|
Avocado (1 – 162g) |
7.1 |
|
Banana (1 – 128g) |
2.0 |
|
Blackberries, fresh (1 cup, 123g) |
4.6 |
|
Dates, dried (1 cup, 188g) |
8.0 |
|
Figs, dried (1 cup, 210g) |
15.8 |
|
Mango, fresh (1 cup, 176g) |
5.5 |
|
Peaches, dried (1 cup, 122g) |
8.9 |
|
Plums, stewed, without sugar (1 cup, 263g) |
3.4 |
|
Prunes, dried, fresh (1 cup, 170g) |
10.9 |
|
Raisins or sultanas (1 cup, 154g) |
3.0 |
|
Raspberries, fresh (1 cup, 136g) |
3.2 |
|
Rhubarb, stewed (1 cup, 265g) |
4.3 |
Photo:
Transcriber's Note: A bowl of cereal topped with berries. End of Note.
End of Photo.
* Registered brand names
** Figures obtained from Foodworks Professional Editor (2005). Ver. 4.00. 1194.
Page 28
A stick blender, counter-top blender, or food processor can be used to blend soups, salsa, mince, sauces, and pureed meals.
You can make your home-made, canned, or packet soup more nutritious by adding noodles, lentils, macaroni, and/or extra vegetables.
Adding cream, cream cheese, custard, ice cream, margarine, vegetable oil, milk, or cheese to your meals is one way of adding extra calories if you need to gain weight.*
Pureed meals can be stored in containers and frozen for later use. They can then be defrosted using the microwave, or thawed in the fridge and reheated thoroughly. Additional liquid can be added if needed.
Pureed meat often loses its colour and flavour.
Try adding tomato paste or puree, soya or Worcestershire sauce, herbs, and mushrooms.
Pureed vegetables, such as silverbeet and other green vegetables, can look dull and unappealing.
Try mixing with a little mashed potato or add a small amount of instant potato flakes to help improve the appearance and texture.
Page 29
Tasty combinations include swede and carrot, carrot and parsnip, and beans and parsnip.
If you are experiencing extreme dryness, try milkshakes blended with ice blocks and a small amount of vegetable oil. The oil* helps to coat your mouth.
Ka āhei koe ki te whakamahi whakahanumi rākau, whakahanumi paparahua tāwhirowhiro rānei, hei whakahanumi hupa, salsa, miti kōnatunatu, ngā wairanu, ngā kai kua tātaria.
Ka taea e koe te whakapai ake i te kai tōtika mā te tāpiri kihuparāoa, lentils, tīkohu parāoa me ngā huawhenua.
Mā te tāpiri kirīmi, tīhi kirīmi, kahitete, aihikirimi, margarine, hinu huarākau, miraka, tīhi rānei ki o kai, tētahi huarahi ki te tāpiri pūngoi mehemea e hiahia ana koe kia taumaha ake.
Ka āhei koe ki te whakaputu kai kua tātari ki roto i ngā puoto katahi ka whaka haupapatia. Ka taea te whakawera anō mā te ngaruiti mā te waiho rānei ki roto i te pouaka tio rewa ai, katahi ka āta whakawera; he pai noa iho te rau wai anō ki roto.
* Oily foods can also help moisten your mouth. Go easy on the amount if you are overweight.
Page 30
I te nuinga o te wā, ka ngaro te tae me te kakara o te mīti penupenu.
Ka pai ake pea mā te tāpiri tōmato kukū, tōmato tātari rānei, te whakaranu soya, whakaranu Worcestershire rānei, te amikuka, te hārore rānei.
Kāore e pai te āhua o te huawhenua tātari pērā ki te korare hiriwa me ērā atu momo korare huawhenua.
Ka pai ake pea mā te tāpiri rīwai penupenu, mā te tāpiri paku rīwai whā rānei hei whakapai ake i te āhua me te kakano.
Pai tonu te kīnaki i te pōwhata me te kāroti, te kāroti me te uhitea, te pīni me te uhitea.
Mehemea kei te tino kaha maroke tō waha, whakamātauria te mirakaranu kua whakaranu me te aihiporaka me te paku hinu noni hei uhi i tō waha.
Page 31
Photo:
Transcriber's Note: A bowl of rice. End of Note.
End of Photo.
Page 32
“Drink water.”
“Always eat with water on the table.”
“Sip water with each mouthful if necessary.”
“Take small amounts and soft foods.”
“Mash vegetables, cut meat into small pieces, and cut big pills.”
“Don’t put too much in your mouth.”
“Meat and vegetables should be well-cooked and served with suitable sauces or gravy. Baking needs fillings or icing.”
“If you’re serving cold corn beef, make parsley sauce to moisten the meal.”
“Heat some food on defrost in the microwave. I find it makes them softer.”
Page 33
Photo:
Transcriber's Note: Fresh herbs. End of Note.
End of Photo.
“Casseroles are easier to eat than roasts, or chops. Thinner sauces are easier to eat. Cooked fruit is easier to eat than fresh. Vegetable soup is an easier way of eating vegetables.”
“Mash hard foods.”
“Lightly boil or poach eggs.”
“Sprinkle nice (heart tick) oils over anything dry.”
“Gravies and sauces help to get food down.”
“Try to add liquid to the meals.”
“I always make gravy, sauces, and custards as needed.”
Page 34
Photo:
Transcriber's Note: A bottle of milk. End of Note.
End of Photo.
Page 35
The following sample menu is included as a guide only and should not be used to replace any individual consultation with a dietitian. The recipes for the highlighted meal items are available in the recipe section.
If your traditional diet includes food different from those listed below, talk to your dietitian.
Transcriber's Note: The original print table has been reproduced here as a list. End of Note.
1 cup porridge or ½ cup cereal (soaked with milk)
½ cup of milk*
½ cup of tinned fruits or stewed fruit (e.g. prunes)**
1 glass water
150ml pottle of lite yoghurt
* Use trim milk or calcium enriched milk, especially if you are watching your weight.
** Watch the amount of sugar used and don't forget to brush your teeth. Alternatively, you can use artificial sweeteners.
1 banana
1 ½ glasses water
Page 36
½ tin baked beans* or spaghetti
¼ cup cheese** on
x2 wholemeal toast/bread
or as a toastie pie
½ cup of fruits [e.g. peaches (in fruit juice/light syrup)]
2 glasses water
* Baked beans are a good fibre option for your meal.
** Try using cheese that are lower in fat, such as Edam or Cottage Cheese.
1 cup milkshake*
milk
½ banana
handful of berries
* Try adding some oil. It helps coat the insides of your mouth. However, do watch the amount if you are watching your weight.
Chicken and Tomato Rice
1 ½ cups rice (cooked)
100g chicken breast/thigh fillets*
tomato pasta sauce
vegetables**
cheese*** - 20g
2 ½ glasses water
* Trim off the skin if you are watching your weight.
** Adding more vegetables can help increase your fibre intake.
*** Try using cheese that are lower in fat, such as Edam or Cottage Cheese. Watch the amount you use if you are watching your weight.
Page 37
Yoghurt (fresh or frozen) or ice cream
Sandwiches – with ham/egg/grated cheese,** minced chicken and mayonnaise, peanut butter
Ice blocks – Popsicles.
# High in fibre: a good alternative if you suffer from constipation and are in need of more fibre.
* Trim/CalciTrim/Anchor Xtra are recommended, especially if you are watching your weight.
** An example of lower fat cheese is Edam/Cottage Cheese.
Page 38
Photo:
Transcriber's Note: A rice dish and a bowl of soup. End of Note.
End of Photo.
Baked beans or spaghetti with grated cheese* on bread
A bowl of soup, e.g. Pumpkin Soup or Green Velvet Soup, with bread
Sandwiches with a serving of meat, egg, vegetable, or cheese fillings
Egg noodles, stir-fried vegetables
* An example of lower fat cheese is Edam/Cottage Cheese.
Page 39
Scrambled eggs with bread (not toasted)
Salmon steak on rice with green beans
Pork with Prunes and Apricots
Springtime Pie
Chicken and Tomato Rice.
The recipes above in darker type are in the following recipe section.
Photo:
Transcriber's Note: Fresh garlic, eggs and spaghetti. End of Note.
End of Photo.
Page 40
The following recipes have been contributed by people with a dry mouth.
Here are some of their comments and suggestions.
“All those sachet sauces in the supermarket are perfect for those pressed for time. Just add more liquid than stated on the packet. I double it and if it is too runny, thicken with cornflour or simmer to reduce the quantity of liquid. This means, with the wide range of choices these days, that you can pick whatever meat base you like. I tend to add ingredients to the sachets instead of bottle/jar sauces because of their cost. I use a lot of these sauces for mince dishes.”
“Herbs are no problem. If anything, I have tended to increase the amounts stated in recipes simply for my own enjoyment. It is all a matter of taste and experimentation and for those who cook it can be fun.”
Photo:
Transcriber's Note: Close up of fresh vegetables. End of Note.
End of Photo.
Page 41
Charlene E. Tan, Christchurch
2 cups medium grain rice
1 tablespoon oil
4 chicken breast/thigh fillets (sliced)
1 ½ cups water/chicken stock
1 cup tomato pasta sauce
1 green capsicum (sliced)
1 cup peas
½ cup pitted black olives (optional)
¼ cup cheese*
Heat oil in a frying pan over a moderately high heat.
Cook chicken till lightly brown (5 minutes).
Add rice and stock. Bring to boil.
Reduce heat and simmer 10 minutes, stirring occasionally.
Add remaining ingredients, except cheese, and simmer for 5 more minutes.
Sprinkle with cheese and serve.
* An example of lower fat cheese is Edam or Cottage Cheese. Use a small amount if you are watching your weight.
Page 42
B. Tucker
Potatoes plus any other vegetables
2 tablespoons butter/margarine*
2 tablespoons flour
1 cup milk**
Salt and pepper
½ teaspoon wholegrain mustard
1 cup grated cheese***
Parboil vegetables which have been cut into bite-sized chunks until just soft. Melt butter/margarine in a small saucepan. Stir in flour and cook until frothy. Gradually add milk, stirring constantly. Stir over a medium heat until the sauce boils and thickens. Cook for a further 2 minutes. Season with salt and pepper to taste. Add mustard and half of the cheese. Pour mixture over vegetables in a greased casserole and top with breadcrumbs or crushed cornflakes and sprinkle with remaining cheese. Bake for 20 minutes at 180–200°C.
* Use a smaller amount if you are watching your weight.
** Trim/Calcium enriched milk is recommended if you are watching your weight.
*** An example of lower fat cheese is Edam or Cottage Cheese. Use a small amount if you are watching your weight.
Page 43
Sophie Hall, Dietitian, Christchurch Public Hospital
400-500g mixed beans/lean mince (optional)
2 cloves crushed garlic
1 medium onion finely chopped
1 tin diced tomatoes (adds extra liquid)
1 tin chilli beans
Herbs, e.g. an Italian herb mix, cumin, oregano, coriander
Salt and pepper
Brown the onion and garlic in a pot or a wok. Add the mince and brown if you’re including mince. Add the tins of tomatoes, chilli beans, and herbs and then heat through. Season with salt and pepper to taste. Serve with pita pockets, soft tortillas, or on rice.
“You can also add your favourite cooked vegetables to the mix as you like. I like to add corn, carrots, and capsicum.”
Page 44
Andrew Oversluizen, Weymouth
2 celery stalks
2 large onions
1 whole pumpkin
3 garlic cloves
1 tablespoon of mild curry powder
½ cup cream*
Dice onions and sauté them in a large soup pot using a slurp of olive oil. When the onions are cooked through, add crushed garlic cloves and curry powder and combine these flavours. Dice celery and chop pumpkin into bite-sized pieces and add to the pot. When pumpkin is soft, mash with a potato masher or stick blender until it is smooth and serve. Garnish with a dash of cream. Add salt to taste. Serve with French stick or other bread.
* Use low fat cream, yoghurt, or low fat sour cream; or use a smaller amount if you are watching your weight.
Page 45
Photo:
Transcriber's Note: Two pumpkins. End of Note.
End of Photo.
Page 46
Peter Cox, Forrest Hill
4 pork chops or equivalent weight in other cuts or diced meats
2-3 [spice] cloves or ¼ teaspoon ground cloves
Salt and pepper to taste (sparingly)
1 litre stock (chicken or vegetable, powder or cube)
Flour (to coat pork)
1-2 cups of wine (or water)
2 tablespoons olive oil
12 pitted prunes
2 large onions (finely chopped)
1 crushed garlic clove
12 dried apricots or half a can of apricot pieces
Coat the pork in flour. Heat oil in frying pan, add pork and cook until brown.
Remove and put to one side. Add onions, garlic, and cloves. Heat or fry for 3-4 minutes before adding the pork. Stir the ingredients together along with salt and pepper to taste and heat through for a few minutes. Add stock, wine (or water), prunes, and apricots and stir to combine. Place in a casserole dish in the oven uncovered for 30 minutes at 100°C.
OR
Continue at a slow simmer in a stove top pot or an electric fry/skillet pan for at least an hour.
“This recipe can be covered and stored in the fridge, and heated up the next day.”
Page 47
Felicity Tompkins, Auckland
3 cups mixed greens (spinach, silverbeet, celery, broccoli, asparagus, or cauliflower), sorrel, parsley, tarragon, etc.
1 small onion
1 small potato
2 ½ cups chicken stock
2 tablespoons margarine (optional)
½ cup sour cream* (optional)
1 cup milk**
¼ teaspoon nutmeg (grated)
Salt and white pepper
Lemon slice – garnish
Wash and finely chop all the vegetables and place them in a large saucepan over a moderate heat. Add the chicken stock and bring to boil. Cover and cook until the vegetables are tender. Use a stick blender or a food processor to puree. Add margarine, cream (if desired), milk, nutmeg, and salt and pepper to taste. Bring to almost boiling, but do not boil. Serve warm, garnish with a slice of lemon if desired.
* Use low fat cream, yoghurt, or low fat sour cream; or use a smaller amount if you are watching your weight.
** Trim/Calcium enriched milk is recommended, especially if you are watching your weight.
Page 48
Photo:
Transcriber's Note: Egg plant. End of Note.
End of Photo.
Page 49
Charlene E. Tan
1 eggplant
400g tin peeled tomatoes (in juice)
1 tablespoon salt
2 tablespoons brown vinegar
¼ cup oil*
1 tablespoon sugar
1 onion
1 clove garlic
2 red peppers
8 black olives
1 stick celery
Salt and pepper
Cut eggplant into cubes. Sprinkle with salt, mix well, place in a colander for one hour. Rinse the eggplant under cold running water then pat dry. Heat the oil in large frying pan. Add peeled, roughly chopped onion, diced peppers, and sliced celery. Cook over a moderate heat for 5 minutes while stirring. Add eggplant and stir while it cooks for a further 5 minutes. Add the tin of tomatoes with the juice to pan. Add the vinegar, sugar, and crushed garlic and cook for 2 minutes longer. Add sliced olives and stir well. Simmer uncovered over moderate heat for 15 minutes. Season with salt and pepper.
“These are delicious on chops, steak, etc. — anything dry and difficult to cope with.”
* Use a smaller amount if you are watching your weight.
Page 50
Audrey Anderson, Whakatane
3 or 4 medium tomatoes
½ teaspoon brown sugar
Margarine*
Salt and pepper
Cut tomatoes in half and put in a shallow microwave proof dish. Sprinkle with salt and pepper, brown sugar, and a small knob of margarine (on each half of tomato).
Cook 3-4 minutes on high.
* Use a smaller amount if you are watching your weight.
Page 51
Nan Stone, Murray’s Bay
1 cup breadcrumbs broken by hand – use up stale bread
1 cup mashed banana
1 cup mixed fruit – can include chopped ginger, apricots, etc.
2 dessertspoons sugar* (can vary to suit)
1 egg
1 teaspoon baking soda
Scatter of sunflower seeds (optional)
Mix all together well. Steam in a greased pudding basin for 2 hours. Turn out on to a plate. This keeps well in the fridge.
“This is excellent hot or cold. It is very soft and smooth. Dairyfree, it can also be made with gluten-free bread for those who need it. Vary the fruits. It’s even acclaimed by guests.”
* Use a smaller amount if you are watching your weight, and don’t forget to brush your teeth; or replace sugar with Equal, Splenda, or Sucaryl.
Page 52
Charlene E. Tan
1 pint (~ 500ml) milk*
3 eggs
1 ounce (~ 25g) sugar**
1 teaspoon vanilla essence
1 pinch of salt
1 nutmeg
Heat milk. Lightly beat the eggs with a pinch of salt. Add the sugar and essence into the hot milk. Pour into a pie dish, grate nutmeg over the top and bake one hour at 160°C. To prevent over-heating stand the pie dish in a pan of water.
* Trim/Calcium enriched milk is recommended, especially if you are watching your weight.
** Use a smaller amount if you are watching your weight, and don’t forget to brush your teeth; or replace sugar with Equal, Splenda, or Sucaryl.
Page 53
Charlene E. Tan
6-7 diced firm tomatoes
1 medium onion, chopped finely
½ cup diced cucumber
2 tablespoons coriander/mint
1 bunch of parsley (chopped finely)
2-3 cloves of garlic (finely chopped)
1 tablespoon lemon juice
Salt and pepper – optional
Finely dice tomatoes. Chop up all the rest of the ingredients. Toss it all together.
Page 54
Charlene E. Tan
1 cup plum jam
2 teaspoons soy sauce
2 dashes tabasco sauce (optional)
1 clove garlic (crushed)
1 teaspoon of lime
Blend all the ingredients together for 2 minutes.
“These dips and sauces are great to make when you are going over to friends. They are suitable to use as dips for crackers or breads, as well as toppings on your meat for your main dishes.”
Page 55
These pages are for you to write down your own recipes and great tips.
Transcriber's Note: Blank page for your notes. End of Note.
Page 56
Transcriber's Note: Blank page for your notes. End of Note.
Page 57
Cancer Information Helpline: 0800 CANCER (0800 226 237)
Website: www.cancernz.org.nz
Website: www.arthritis.org.nz
Street address: Level 2, 166 Featherston Street, Wellington
Postal address: PO Box 10-020, Wellington
Phone: (04) 472-1427 Fax: (04) 472-7066
Website: www.mentalhealth.org.nz
Street address: 81 New North Road, Eden Terrace, Auckland 1021
Postal address: PO Box 10051, Dominion Road, Auckland 1446
Tel: (+ 64 9) 300-7010 Fax: (+ 64 9) 300-7020
Resource Centre: (+ 64 9) 300-7030
Resource Centre email: resource@mentalhealth.org.nz
The suggested websites (other than our own) are not maintained by the Cancer Society of New Zealand. We only suggest sites we believe offer credible and responsible information, but we cannot guarantee that the information on such websites is correct, up-to-date, or evidence-based medical information. We suggest you discuss any information you find with your cancer care health professionals.
Page 58
You may wish to use this space to write down any questions you want to ask your doctors, nurses, or health providers at your next appointment.
Whakamahia tēnei wāhi wātea hei tuhi pātai e hiahia ana koe ki te pātai i tō rata, ngā tapuhi, ngā kaiwhakarato hauora rānei mō te wā e hoki atu ai koe.
Transcriber's Note: Blank page for your notes. End of Note.
Page 59
Transcriber's Note: Blank page for your notes. End of Note.
Page 60
Transcriber's Note: Blank page for your notes. End of Note.
Page 61
National Office
PO Box 12700, Wellington 6011
Telephone: (04) 494-7270
Auckland Division
PO Box 1724, Auckland 1023
Telephone: (09) 308-0160 Covering: Northland
Waikato/Bay of Plenty Division
PO Box 134, Hamilton 3216
Telephone: (07) 838-2027 Covering: Tauranga, Rotorua, Taupo, Thames, and Waikato
Central Districts Division
PO Box 5096, Palmerston North 4410
Telephone: (06) 364-8989
Covering: Taranaki, Wanganui, Manawatu, Hawke’s Bay, and Gisborne/East Coast
Page 62
Wellington Division
52-62 Riddiford Street, Wellington 6021
Telephone: (04) 389-8421
Covering: Marlborough, Nelson, Wairarapa, and Wellington
Canterbury/West Coast Division
PO Box 13450, Christchurch 8011
Telephone: (03) 379-5835
Covering: South Canterbury, West Coast, and Ashburton
Otago/Southland Division
PO Box 6258, Dunedin 9016
Telephone: (03) 477-7447
Covering: Urban and rural Otago and Southland
Cancer Information Helpline
0800 CANCER (226 237)
www.cancernz.org.nz
Page 63
Got Water? He Wai?
We would like to read what you thought of this booklet: whether you found it helpful or not. If you would like to give us your feedback please fill out this questionnaire, cut it out, and send it to the Information Manager at the address at the bottom of the following page.
Transcriber's Note: Blank areas for you to fill in are indicated by the word blank. Tick boxes are indicated by the words (Tick box). End of Note.
1. Did you find this booklet helpful?
Yes (Tick box)
No (Tick box)
Please give reason(s) for your answer: blank
2. Did you find the booklet easy to understand?
Yes (Tick box)
No (Tick box)
Please give reason(s) for your answer. blank
3. Did you have any questions not answered in the booklet?
Yes (Tick box)
No (Tick box)
If yes, what were they? blank
Page 64
4. What did you like the most about the booklet? blank
5. What did you like the least about the booklet? blank
6. Any other comments? blank
Personal information (optional)
Are you a person with cancer, or a friend/relative/whānau? blank
Gender: Female (Tick box); Male (Tick box)
Age: blank
Ethnicity (please specify): blank
Thank you for helping us review this booklet. The Editorial Team will record your feedback when it arrives, and consider it when this booklet is reviewed for its next edition.
Please return to: The Information Manager, Cancer Society of New Zealand, PO Box 12700, Wellington 6011.
Page 65
The Cancer Society of New Zealand offers information and support services to people affected by cancer. Printed materials are available on specific cancers and treatments. Information for living with cancer is also available.
The Cancer Society is a major funder of cancer research in New Zealand. The aim of research is to determine the causes, prevention, and effective methods of treating various types of cancer. The Society also undertakes health promotion through programmes, such as those encouraging SunSmart behaviour, healthy eating, physical activity, and discouraging smoking.
The Cancer Society would like to thank for their reviews, advice, and contributions:
Charlene E. Tan, Dietitian, Christchurch
We would also like to acknowledge that this booklet was first created as part of research for the University of Otago, Post Graduate Diploma in Dietetics.
Helen Brown, Community Dietitian, Nurse Maude Association, Christchurch
Dr Jane Elmslie, Dietitian/Researcher, Psychological Medicine, Christchurch School of Medicine
Jonathan Rea, Dietitian, Lea Stening Health, Christchurch
Lea Stening, Director, Senior Paediatric & Sports Dietitian, Lea Stening Health, Christchurch
Tory Crowder, Dietitian, Auckland City Hospital
Dr David Hay, Oral Medicine Specialist, Oral Health Regional Services, Auckland District Health Board, Auckland
Cancer Society Information Nurses, Meg Biggs, Julie Holt, and Liz Wright Sarah
Stacy-Baynes, Information Manager
Many thanks to the Cancer Society volunteers who agreed to be photographed for our booklet covers. Our thanks also to Brian and Lee Sheppard, and those affected by dry mouth and their carers who reviewed our drafts and gave us many valuable suggestions, quotes, and recipes to include in the booklet.
Lindsay Keats of Lindsay Keats Photography in Wellington took the photograph for our booklet cover.
Charlene Elaine Tan is from Singapore, and she is the first Asian Paediatric Dietitian working with the Cancer Society on a national project.
Her qualifications include: BSc (Human Nutrition), Post Graduate Diploma (Dietetics), New Zealand. She is a Registered Dietitian with a Certificate in Paediatric Nutrition, Melbourne Royal Children’s Hospital.
Charlene specialises in paediatrics, weight control, and behaviour management; and has a strong interest in geriatrics, diabetes, and working with ethnic groups. She works voluntarily for the Christchurch City Council (CCC) as an Asian Advisor for the Settlement Network Support Group programme. Charlene’s understanding of the special nutritional needs of various ethnic groups proved invaluable to the city when she helped the Special Olympics New Zealand planning committees who hosted the Special Needs Olympic Games in Christchurch in 2005.
Aside from running dietary clinics at Lea Stening Health at Ilam and Lincoln branches, Charlene works as a researcher for new information/research articles contributing to Lea Stening Health’s LeaAz newsletter and publications. She also takes care of the adult and paediatric outpatient clinics at the local Christchurch Public Hospital.
As part of her post graduate study in Dietetics, Charlene undertook research into ‘dry mouth syndrome’. She is thrilled and honoured to be given the chance to be involved in the development of this booklet, which helps people with a dry mouth.
Page 66
Any question, any cancer
0800 CANCER (226 237)
Cancer Information Helpline
www.cancernz.org.nz