Ultimate Lymphoma Cancer Diet Guide: Top Foods to Boost Your Health and Fight Cancer

Lymphomas, malignancies of lymphoid tissue, are the most common form of hematologic cancer in the developed world. They are classified as either Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL). While lymphomas generally affect lymph nodes or lymphoid tissue, such as the spleen, they can also affect extranodal tissue, such as the lung, liver, or gastrointestinal tract. Nutritional considerations play a vital role in managing lymphoma, both in terms of reducing risk and supporting treatment.

Understanding Lymphoma

Non-Hodgkin lymphomas (NHL) are characterized as B-cell (90%) or T-cell lymphomas, depending on the lymphoid cell of origin. The classification of NHL has more than 40 distinct subtypes. The presentation of NHL is highly variable and can have an acute onset with a rapidly enlarging mass, constitutional symptoms (e.g., fever, night sweats, and weight loss), and/or laboratory abnormalities (e.g., elevated serum LDH and uric acid). It can also present insidiously with slowly enlarging lymph nodes, hepatomegaly and/or splenomegaly, and progressive cytopenias.

Hodgkin lymphoma (HL) is characterized by the histologic presence of the Reed-Sternberg cell. There are 5 types of HL, differentiated by histologic appearance: Nodular sclerosing, Mixed cellularity, Lymphocyte depletion, Lymphocyte-rich (classical Hodgkin disease), and Nodular lymphocyte-predominant. HL most often presents as a painless adenopathy or mass. A mediastinal mass on chest x-ray is the second-most-common presentation. Some patients develop constitutional symptoms such as fever, night sweats, weight loss, and pruritis.

The Role of Diet in Lymphoma

A healthy diet can help you feel your best and may be an integral part of cancer prevention and treatment. This includes lymphoma, a cancer that forms in your lymphatic system and affects lymphocytes, which are cells in your immune system. Diet alone can’t treat lymphoma, but it’s still essential. What you eat during treatment can greatly impact how you feel. Lymphoma treatment involves a combination of chemotherapy medications, monoclonal antibodies, steroids and sometimes radiation therapy. These treatments can cause side effects like decreased appetite, nausea, changes in taste and mouth sores. This is where the right diet comes in.

General Dietary Recommendations

The healthiest eating is mostly based on plant foods like vegetables, fruits, whole grains, beans, and nuts/seeds. They also include healthy protein sources, such as beans, fish, or poultry, while limiting red and processed meats. Studies have shown that these dietary patterns are linked to a lower risk of cancer, certain other diseases, and early death.

Read also: Managing Canine Lymphoma with Diet

Plant-Based Foods: Vegetables (including beans) and fruits are full of vitamins, minerals, fiber, and other substances that may help prevent cancer. Eating vegetables and fruits may also control weight, since they are low in calories, high in fiber, and have lots of water. Whole grains keep all parts of the original grain, so they have more fiber and nutrients than refined (or processed) grains. These include things such as whole wheat, brown or wild rice, oats, and corn. Studies show that eating whole grains might lower the risk of colorectal cancer. Dietary fiber is found in plant foods such as beans, whole grains, fruits, vegetables, nuts, and seeds. Eating these foods may help prevent excess body weight, which can lower the risk of cancer.

Protein Sources: The ACS recommends eating more protein from fish, poultry, and beans instead of red meat.

Foods to Include: An ideal lymphoma diet is different for each person because it depends on your preferences and the side effects you’re experiencing. If you’re trying to avoid weight loss during treatment, focus on nutritious, calorie-dense foods.

Foods to Favor

Eggs.
Nuts, seeds and nut butters.
Small amounts of full-fat dairy products like Greek yogurt, cottage cheese and whole milk.
Whole grains like whole-wheat bread and pasta, oats, brown rice and quinoa.
Eat plenty of fresh fruits and vegetables you enjoy. They offer vitamins, minerals and fiber that can help keep your energy levels up. If your mouth is sore, make a smoothie or eat soft, cooked fruits and veggies.

Foods to Limit or Avoid

Processed meat has been cured, smoked, salted, or fermented to improve or preserve ﬂavor. Examples include bacon, sausage, hot dogs, and deli meats.
Added sugars and other high-calorie sweeteners (such as high-fructose corn syrup) are often used in sugar-sweetened beverages and energy-dense foods (for example, traditional “fast food” or ultra-processed foods (or UPFs). These highly processed foods are usually high in fat, sugar, refined grains, and salt.
Animal fats like fatty meats, processed meats, lard and butter.
Sugar, including added sugars in desserts, sweetened drinks and processed foods.
White, refined grains like white bread, pasta and rice.
Avoid or cut back on alcohol, caffeinated drinks and diet soda.

Specific Dietary Considerations for Lymphoma

A limited number of studies have addressed associations between diet and risk for lymphoma. The following factors have been under study for possible roles in reducing risk:

Reducing Intake of Animal Products:

A meta-analysis concluded that individuals eating the most red meat had a 10% greater risk of NHL when compared with those eating the least, and for diffuse B-cell lymphoma, this risk increased to 20%. Those consuming high amounts of red meat also had a 17% increased risk for diffuse large B-cell lymphoma specifically.
In the European Prospective Investigation Into Cancer and Nutrition study, a high (compared with low) intake of poultry was associated with a 22% greater risk for B-cell lymphoma, although no consistent associations between red and processed meat and lymphoma risk were observed in this cohort.
In one meta-analysis, the risk for NHL was roughly 25% greater for persons who drank the most milk, compared with those who drank the least.
Echoing these findings, another meta-analysis of 16 studies revealed that those who consumed the most milk had a 41% higher risk of NHL when compared with those who consumed the least, although yogurt was associated with a 22% lower risk.

Reducing Intake of Saturated Fat and Trans Fats:

One case-control study revealed that high saturated fat intake is significantly associated with HL.
In a case-control study of diet and NHL including 1,642 NHL cases and 5,039 controls, individuals in the highest tertiles of total, saturated, and monounsaturated fat intake had approximately 50% higher risk compared with those in the lowest tertiles.
In the Nurses’ Health Study, women in the highest quintile of trans fats consumption had 2.4 times the risk of NHL, compared with those in the lowest quintile.

Increasing Intake of Fruits and Vegetables:

When the highest category of fruit and vegetable intake was compared with the lowest, a meta-analysis found a roughly 20% lower risk for NHL in high consumers, a difference that appeared to be due mainly to vegetable rather than fruit intake.
Previous research that compared women eating 3 daily servings of fruits and vegetables with those who ate 6 or more servings per day found the higher consumers had a 40% lower risk for NHL.

High Vitamin A and C Intakes:

The observed benefits of fruits and vegetables in relation to lymphoma prevention may be in part attributable to vitamin C and pro-vitamin A carotenoids.
In the Women’s Health Initiative study, total vitamin A intake (from foods and supplements) was inversely related to the risk for NHL, while total vitamin C intake was inversely related to the risk for large B-cell lymphoma.

Gluten-Free Diet for Individuals with Celiac Disease:

Patients with celiac disease have a 25% greater risk for malignancy overall, a 60% greater risk for gastrointestinal malignancy, a 14 times greater risk for small intestine carcinoma, and a 6-9 times greater risk for NHL when compared with the general population.
The risk for cancer overall is reduced considerably with a gluten-free diet, but poor adherence to such a diet is a risk factor for enteropathy-associated T-cell lymphoma.

Maintenance of a Healthy Weight:

Studies suggest that being significantly overweight or obese may increase the risk for lymphomas.
In overweight and obese persons, the risk for diffuse large B-cell lymphoma was found to be 14% and 29% greater, respectively.
A meta-analysis of 22 prospective studies found that each 5 kg/m2 increase in BMI was significantly associated with a 6% increase in NHL risk.

Serum Vitamin D Status:

Several studies suggest that low circulating levels of 25-hydroxyvitamin D are associated with poorer prognosis, higher rates of relapse, significantly longer hospital stays, and a decreased rate of remission in patients with hematological malignancies, including HL and NHL.

Addressing Treatment Side Effects Through Diet

Treatments, such as chemotherapy and radiation therapy may affect a person’s appetite, digestion, and weight. Below are some potential treatment side effects, along with some tips for preventing and alleviating these side effects.

Weight Loss: People receiving chemotherapy or radiation therapy may lose weight due to appetite loss or nausea. The following tips can help a person boost their calorie intake and maintain a healthy weight:

adding commercial, grade A honey or jams to foods
choosing high fat options where possible, such as drinking whole milk rather than skim milk
adding cheese or sauces to dishes, such as pasta
adding butter or oil to bread, potatoes, or vegetables
snacking frequently throughout the day

Weight Gain: As part of the treatment protocol for NHL, doctors may prescribe steroids, which can cause the following side effects: increased hunger, fluid retention, and weight gain. A person’s weight typically returns to normal once they stop steroid treatments. In the meantime, a person should continue to eat a nutritious diet. Anyone concerned about weight gain while taking steroids can talk with their healthcare team for further advice.

Nausea: Chemotherapy and radiation therapy can cause nausea. To alleviate nausea, people can try the following:

Eating plain foods: Plain foods, such as toast, crackers, and rice, are often easier to digest.
Eating ginger: Ginger can aid digestion and reduce feelings of nausea. Some ways to incorporate ginger include: adding ginger root or powdered ginger to food, eating ginger biscuits or small pieces of crystallized ginger, and drinking ginger tea.
Minimizing food smells: Strong food smells may trigger feelings of nausea. People can minimize food smells by: eating cold foods, such as sandwiches and salads, waiting for heated foods to cool before eating, and cooking food in a microwave rather than on the stove, to help contain the smells.

Changes to Taste: Medications for NHL may alter a person’s taste perception of foods and beverages. To counter this, people can try the following:

adding flavoring to food, in the form of herbs, spices, sauces, or chutneys
trying herbal teas if tea and coffee lose their flavor
maintaining good oral hygiene to help prevent oral thrush and other oral infections that can change a person’s taste perception
switching to plastic cutlery to reduce metallic tastes

Diarrhea: Some people may experience diarrhea as a side effect of cancer treatment. People who experience this side effect should drink plenty of fluids to prevent dehydration. Some options include: plain water, foods, such as soup, Jell-O, and popsicles, and fluids to replace lost electrolytes, such as broths, coconut water, and sports drinks. If diarrhea is an ongoing issue, people can speak with their healthcare team to discuss dietary changes or medications that may help.

Constipation: Some people may experience constipation, and they should talk with their healthcare team about taking laxatives. Laxatives help stimulate bowel movements or loosen the consistency of stools, so they are easier to pass. People may also find relief in the following ways:

Increasing their fiber intake: Fiber draws water into the stool, making it bulkier and easier to pass. People can increase their fiber intake by eating more fruits and vegetables.
Increasing their water intake: Water helps soften stool, as well.
Exercising: Gentle exercise helps stimulate the bowels and promote regular bowel movements.

Other Important Considerations

Food Safety: Food safety is incredibly important for people living with lymphoma, who often deal with a weakened immune system due to leukopenia (low white blood cell count). To avoid foodborne illnesses, follow safe food-handling practices.

Nutritional Supplements: While dietary supplements can provide some benefit, they also have risks. Dietary supplements are not regulated the same way as medicines are. Eating a diet rich in vegetables, fruits, and other plant foods may lower cancer risk, but there’s little consistent evidence that dietary supplements do the same. Always check in with your doctor before taking any supplement or herb. Some may have a negative impact on your cancer treatment.

Hydration: Drinking plenty of fluids is essential while receiving chemotherapy for lymphoma. Water is the best choice for hydration. Avoid sugary drinks like fruit juice, soda, and sweetened teas - or keep them to a minimum.

Specific Diets and Lymphoma

Research has shown that eating the right foods can help prevent non-Hodgkin lymphomas. Bode recommends a plant-based diet.

Plant-based Mediterranean diet: A plant-based Mediterranean diet has anti-inflammatory effects that can help you avoid all types of non-Hodgkin lymphomas. A plant-based diet may also help prevent other cancers and conditions like heart disease. A plant-based Mediterranean diet includes:

Fresh fruits and vegetables, which should make up a large portion of your diet.
Legumes.
Nuts and seeds.
Whole grains.
Starchy vegetables like baked potatoes or sweet potatoes.
Extra virgin olive oil.
Fish, especially types high in omega-3 fats like salmon and sardines.
Eggs (up to one yolk per day, but no limit on egg whites).

Diets to avoid: The ketogenic diet is a restrictive plan that focuses on low-carb, high-fat and protein foods. And though this diet may benefit people who have a certain type of brain tumor, it isn’t helpful for any type of lymphoma. The alkaline diet is all about eating certain foods that are thought to change your body’s acid or pH levels which then can improve your health. But your body regulates its pH well on its own. And though the alkaline diet focuses on eating whole foods, it does limit protein and other nutrients that are vital. And you may have heard of the Budwig diet, which is often touted as a diet that slows the spread of cancer. The diet calls for eating large amounts of polyunsaturated fats (think flaxseed oil, honey or cottage cheese), which can cause digestive issues. There’s limited research on the benefits of the Budwig diet and it can cause nutritional deficiencies.

Practical Tips for Implementing Dietary Changes

Focus on Small, Gradual Changes: Don't try to overhaul your entire diet overnight. Start by incorporating one or two new healthy habits each week.
Plan Your Meals: Planning your meals in advance can help you make healthier choices and avoid impulsive decisions.
Read Food Labels: Pay attention to the ingredients list and nutrition facts panel on packaged foods.
Cook at Home More Often: Cooking at home gives you more control over the ingredients and portion sizes in your meals.
Seek Professional Guidance: A registered dietitian can provide personalized recommendations and support to help you make sustainable dietary changes.

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