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 should you need to add them to your routine. 

How to Incorporate Smoothies into Your Eating Plan 

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 broken into half-shake portions and spread over the day if that’s better tolerated.  If possible, avoid drinking smoothies in the two-hour window before your next meal to preserve your appetite at mealtimes.  

Smoothies from Scratch  

Mixing smoothies from preferred ingredients is the perfect way to customize protein shakes to your tastes.  Building a nutrient-rich smoothie from scratch involves combining several ingredients that all contribute something of value to your shake:   

• Base Ingredient – this provides the fluid foundation for your smoothie, such as dairy or plant milk, kefir or a store-bought protein shake like Ensure, Boost or Orgain. 

• Add-ins to Contribute Good Nutrition – blending in fruits, vegetables, flax meal, wheat germ, oat bran or chia seeds adds vitamins, minerals, phytonutrients (natural antioxidants and anti-inflammatories) and fiber to optimize the nutritional value of your shake. 

• Protein – protein powders, Greek or regular yogurt, powdered milk, pasteurized egg (like Eggbeaters) and tofu are what make a protein shake a possible meal replacement, not just a beverage. 

• Calorie Boosters – adding healthy fats is the easiest way to crank up the calorie content of a smoothie.   

• Flavor – mixing in different flavors adds variety and enables you to experiment with flavor combinations as needed. 

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 1 cup  

• Add 4-6 ice cubes to add texture and volume 

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

Add plant-based, nutrition-rich foods:  

• Start with 1/2 -3/4 cup of fruit for every 1 cup of base 

• Add frozen fruits and vegetables, or freeze fresh fruits and vegetables in a freezer bag for 30 minutes before using  

• Try spinach, kale, cucumbers, 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 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 body builders in case these additives may interact with your treatment or medications 

• Blend protein well, or shake with liquid base in a protein Blender Bottle to avoid clumping 

• Protein powder may not be needed if your base already provides a good source of protein, such as a bottled protein shake 

Boost the calories (as needed): 

• Use canola oil/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 

• Start with 1Tbsp syrup, honey or instant coffee and adjust as needed to taste 

 Adjust consistency: 

• To thin, use more of the liquid base. 

• For a thicker drink, reduce the amount liquid, and/or add 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 

• To save time, double or triple your recipe and drink in smaller 4-8 oz portions; store 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 

Store Bought Options Another option for protein shakes is to buy them premixed in bottles. Considerations:   

• If you’re drinking smoothies, you’re probably having trouble eating enough calories. Opt for bottled “plus” versions of protein shakes, like Ensure Plus or Boost Plus, both of which provide 100 calories more per 8 oz. bottle than the regular “original” versions, which are 220 – 240 calories per 8 oz. 

• Some protein shakes are high in protein but low in calories.  Examples of these 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 come with a screw-on cap so can be easily served in smaller portions with leftovers stored in the refrigerator as needed.  

• Countless other protein shakes exist at different 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.  Servings sizes generally range from 8 – 15 ounces.  Check the calorie and protein content per volume to see what best fits your needs.