Homemade smoothies or store-bought protein shakes can be very helpful for filling calorie and protein gaps when eating is more challenging due to a cancer diagnosis, or side effects of treatment. Calories and protein in fluid form may be easier to tolerate if your mouth is sore or dry, or you’re experiencing chewing or swallowing problems. If nausea, fatigue, or lack of appetite is an issue, sipping a smoothie or protein shake over the day maybe an easier way to meet your needs with less effort. Whether you blend your own, or opt for the convenience of a store-bought shake, experimenting with smoothies early in treatment can help you determine your preferences. 

Smoothies can be meal replacements if needed, but ideally would be taken between meals to supplement calories and protein from smaller meals. Smoothies can be consumed all at once or divided into smaller portions and spread throughout, based on your preference. If possible, avoid drinking smoothies in the two-hour window before your next meal to preserve your appetite at mealtimes. 

Making homemade smoothies using ingredients you prefer is the best way to customize protein shakes. Building a nutrient-rich smoothie from scratch involves combining several ingredients that all offer value to your shake:   

• Base Ingredient: Provide the fluid foundation for your smoothies, such as diluted 100% fruit juice, dairy or plant-based milk, kefir, or a store-bought protein shake like Orgain. 

• Protein: Protein powder, plain Greek yogurt, powdered milk, pasteurized egg (like Eggbeaters), and silken tofu can elevate protein shakes to possible meal replacements, not just beverages. 

• Add-ins Contribute More Nutrients: Blend in fresh or frozen fruits, vegetables, flax meal, wheat germ, oatbran, or chia seeds to add vitamins, minerals, phytonutrients (natural antioxidants and anti-inflammatories), and fiber to your shake. 

• Calorie Boosters: Adding fats like avocado, nut butter, and/or neutral oils will bump up the calorie content of a smoothie.   

Mix it up

Using the list below for ideas, follow these steps to mix and match smoothie ingredients to suit your tastes.  

  Choose your base:  

• Start with ½ to 1 cup of liquid  

• Add frozen banana slices or 4-6 ice cubes to adjust the texture  

• Have additional fluids on hand to thin your smoothie as needed 

Add plant-based, nutrition-rich foods:  

• Start with 1/2 to ¾ cup of fruit for every 1 cup of base 

• Add fresh or frozen fruits and vegetables  

• Try spinach, kale, ¼ of a small beet, carrots, peaches, mango, apples, blueberries, raspberries, strawberries, blackberries, banana, pineapple, cantaloupe, kiwi, orange, grapefruit, or anything else that sounds appealing 

• Add wheat germ, flax meal, oat bran, and chia or other seeds for fiber and additional nutrients 

 Blend in a protein powder:  

• Use 1-2 tbsp or 1 scoop of powder per your preferences; most contain 15-25 grams of protein/serving 

• Avoid protein powders with additional compounds added for bodybuilders in case these additives may interact with your treatment or medications   

Boost the calories (as needed): 

• Use avocado oil (40 calories/tsp), nut butters (95 calories per Tbsp), avocado (80 calories per ¼ fruit), and/or Benecalorie (330 calories, 7 gm protein/1.5 oz container) 

• Blend oils and extra calorie add-ins well to help incorporate with the rest of the ingredients   

Extracts and other additives: 

• Experiment with extracts, using about ½ tsp/cup of smoothie 

 Adjust consistency: 

• To thin, use more of the liquid base or water 

• For a thicker drink, reduce the amount of liquid, and/or add frozen banana slices, plain yogurt, avocado, chia seeds, or ice 

• When using silken tofu mix 1/2 cup tofu with 1/2 cup of your base ingredient (add more tofu for a thicker consistency 

 Other tips 

• If you are sensitive to cold temperatures let ingredients warm to room temperature before mixing (do not leave refrigerated items out longer than 1 hour) 

• To save time, double or triple your recipe and drink in smaller 4-8 oz portions; refrigerate leftovers in a container with a lid so you can shake to remix before serving 

• Pour smoothie into an insulated mug and carry your drink to go when needed 

Another option for protein shakes is to buy them pre-mixed in bottles. Considerations:   

• If you’re using pre-made smoothies to get more calories choose the “plus” versions, which average 100 calories more per 8 oz bottle than the regular “original” versions 

• Some protein shakes are high in protein but low in calories 

• Examples are Muscle Milk, Premier Protein shakes, and Ensure Max Protein (150-160 calories per 11-14 oz bottle) 

• These can be used as a smoothie base to provide the protein 

• If you prefer organic, Orgain protein shakes contain all organic ingredients in 250 calories and 16 gm protein per bottle (calories can be added by blending with add-ins as above) 

• Most pre-mixed protein shakes come with a screw-on cap so can be easily served in smaller portions with leftovers stored in the refrigerator as needed 

• Many other protein shakes exist at varying price points, including: 

  • Ensure Enlive (350 calories/20 gm protein per 8 oz) 

  • Ensure Complete (350 calories/30 gm protein per 10 oz) 

  • OWYN vegan protein shakes (varying calories and protein) 

  • Bolthouse Farms Protein Plus shakes 

  • Naked Protein Smoothies and many others 

• Serving sizes generally range from 8 – 15 ounces; check the calorie and protein content per volume to see what best fits your needs