Fact sheet–BMT long-term follow up fact sheets

Published: May 2022.

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Diet and nutritional health

This fact sheet is for people who have had a blood and marrow transplant (BMT).

BMT patients may experience health complications in the months or years following the transplant. Long-term follow up has an important role in the early detection of any health issues.

This fact sheet has general information about ways to look after your health. If you have specific concerns, speak to your BMT team or your doctor for further information and advice.

Why is diet and nutritional health important after a BMT?

After a BMT, many patients have an increased risk of other health conditions including diabetes, heart disease, high blood pressure, high cholesterol, obesity, osteoporosis and secondary cancers. Eating a healthy and nutritious diet may reduce your risk of developing these conditions.

What can affect my nutritional health after a BMT?

Some people have difficulty maintaining their weight after a BMT and are at risk of malnutrition due to diarrhoea, nausea, dry mouth, poor appetite, infections, or oral and gastrointestinal graft versus host disease (GvHD).

Other patients may return to their normal diet quickly after a BMT but gain weight because of inactivity, illness and increased appetite, which may be related to side effects of your medication.

In some cases, you may also have a low white cell count (neutropenia) and will need to remain careful with food safety even after a BMT.

The effects of BMT can also lead to other diseases including osteoporosis (decreased bone mass) and vitamin deficiency and diabetes.

What are the symptoms?

You may experience weight gain or weight loss following BMT.

Nutritional problems may also lead to bone fractures, muscle loss, fatigue and changes in your blood sugar. If you experience any concerning symptoms, speak to your doctor.

How are diet and nutritional health issues diagnosed and managed?

A dietitian can give you advice on your nutritional needs post-transplant.

During follow-up appointments with your BMT team, you may be weighed and have further tests and investigations, including measurements of you blood lipids, cholesterol, fasting blood sugar and a bone mineral density scan, to assess your nutrition and bone health.

If you have gastrointestinal symptoms you may be referred to a gastroenterologist who may recommend a gastroscopy or colonoscopy.

If you have diabetes or osteoporosis you may be referred to an endocrinologist to diagnose and manage diabetes related bone disease.

If you have any heart or vascular problems or any risk factors for heart disease you may be referred to a cardiologist for further investigation.

Your BMT team will work with these specialists and you to ensure all risks are monitored.

How can I look after my diet and nutritional health?

In the years after a BMT you may find it difficult to eat a balanced diet and to maintain your weight. Your nutritional needs may also vary depending on what symptoms you have, what medications you take and whether you have GvHD.

A dietitian can give you individual advice on returning to and maintaining a healthy balanced diet, including:

  • adjusting your diet to meet your needs based on issues post-transplant
  • nutrition support and supplements, if needed for weight loss or gain
  • adequate amounts of calcium and vitamin D for good bone health.

Strategies to help your diet and nutrition

  • Cook in bulk and freeze meal portions to help during times when you feel fatigued.
  • Buy pre-cut meat and vegetables.
  • Use simple base recipes that you can vary to suit your tastes.
  • Try soups, smoothies and purees if you have a dry mouth.
  • Eat healthy snacks such as nuts and grapes.
  • Accept help from family and friends when it’s offered.
  • Seek a review from your local health service dietitian. If one is not available, consider a private accredited practicing dietitian.

Where can I find further information?

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