In the last of our three-part series for National Nutrition Month®, Colleen Gill, MS, RDN, CSO, a registered oncology dietitian, speaker and author, shares some tips and ideas for smoothies that her patients and their caregivers have found useful.

The fatigue many people with pancreatic cancer experience, along with other side effects of cancer treatment, can make eating solid foods more difficult than drinking fluids. While slow, gradual weight loss is common with pancreatic cancer, significant and rapid weight loss is concerning since it can lead to breakdown of muscle and loss of strength, compromising your ability to continue normal activities and remain independent.

Although commercial oral nutrition supplements are a convenient option for patients struggling with weight loss and loss of appetite, it’s also possible to make a variety of homemade drinks with your blender. Making smoothies allows for increased variety and control over sweetness and can add vitamins, minerals, fiber and phytochemicals from whole foods. Here are some helpful hints for making your own smoothies:

Smoothie Ingredient Options

Protein sources:

  • Tofu, silken (blends best) or block (2 ½ ounces = 1/6 of a one-pound block)
  • Yogurt, kefir
  • Milk, lactose free if needed
    New milk alternatives are constantly emerging, but can vary significantly in protein content, so check labels and varieties.
  •  Protein powders per preference: whey, soy, egg, pea
  • Peanut or other nut butters/powders

Phytochemicals (chemicals produced by plants), fiber, vitamin, and mineral sources:

  • Fist size portion of fruit: fresh, frozen, or canned; 4 oz 100% fruit juices
  • Mild flavored vegetables
  • Herbs and spices
  • Wheat germ or bran

Healthy fat sources:

  • Ground flaxseeds
  • Canola, olive or flax seed oils
  • Nut butters
  • Avocado


  • Frozen yogurt, ice cream, sherbets and sorbets; bananas

While most of these ingredients can be found at the grocery store, a few may only be available only in specialty health food stores.

Helpful Hints for adapting recipes:


  • Can be increased with a flavored soymilk or yogurt; or by adding small amounts of honey, jam or maple syrup to taste
  • Can be decreased by adding a few frozen cranberries to the mix


  • Increase fiber sources like wheat germ, bran and flax seed gradually from one teaspoon to one tablespoon, typically no more than 2 tablespoons
  • Always include more fluid as you increase your fiber intake
  • If fiber is causing loose stools, GI distress, or you’ve been told to follow a low fiber diet, avoid fruits with seeds, flax, bran and wheat germ


  • Every bottle of oral supplements or cup of yogurt or milk provide 250 – 300 mg of calcium
  • Choosing calcium-fortified tofu, soy drinks or orange juice can also increase calcium intake
  • Research shows that 500 mg of calcium is the most that can be absorbed at one time, so drink the recipes with high calcium sources over 1 – 2 hours and divide any calcium supplements needed between a couple meals. Ideally, you’ll get a total of 1,200 (men) to 1,500 (women) mg/day.


  • Choose brands of soymilk and tofu that are highest in protein
  • To increase protein further add dried skim milk (11 g per ¼ cup); peanut butter (8 g/2 tbsp) or whey protein powder


  • If more calories are needed, add up to 1 tablespoon of canola or flaxseed oil before blending (125 calories, 14 g of fat)
  • Try adding honey, jams/jellies, maple syrup and nut butters

Mouth Sores

  • Avoid fruits that contain tiny seeds, such as some berries
  • Avoid acidic fruit juices
  • Buttermilk or yogurt may be soothing to the mouth

Immune Suppression

  • Wash fresh fruits and vegetables carefully, especially if you’ve been told that your white blood cell count is low
  • Always follow safe food preparation guidelines. When in doubt, throw it out!
  • Cover tofu with fresh water and refrigerate in a sealed container; change water daily and use within one week

Cost Savings

  • Buy wheat bran, wheat germ or flaxseeds in bulk. Remember to grind flax!


  • Powdered or liquid vitamins can be added to smoothie recipes when a multivitamin is recommended, but you find it difficult to swallow pills

Patients should always consult with their doctor or registered dietitian before making any changes or additions to their diet. PanCAN strongly recommends that patients have access to pancreatic enzymes and see a registered dietitian.

Contact a PanCAN Patient Services Case Manager
For free, in-depth and personalized information on diet and nutrition, contact PanCAN Patient Services.