After being diagnosed with chronic lymphocytic leukemia (CLL), eating well is essential to feel your best. The stress of diagnosis, the symptoms of leukemia, and the side effects of CLL treatment can take a toll on your well-being and energy levels.

“I don’t have any major problems yet, but trying to explain to my husband and family members how I’m feeling is hard,” said a MyLeukemiaTeam member. “My energy levels are low, and I need a nap every day to perk up.”

Whole grains are a rich source of fiber, vitamin E, B vitamins, and antioxidants.

Choosing the right food to fuel your body is a positive way to influence your overall health. While there’s no official diet to help manage CLL symptoms, here are some options for you to keep in mind during your next trip to the grocery store.

4 Foods To Eat With CLL

Closely related to small lymphocytic lymphoma (SLL), CLL can make you feel limited in what you can do and eat. However, focusing on good foods you can add to your diet (rather than those to cut back on) can help encourage you to try new things you may enjoy.

1. A Colorful Array of Fruits and Vegetables

It’s no secret that fruits and vegetables are good for your health. But for people with CLL, fruits and veggies offer unique benefits that are worth some extra consideration. The skin of fruits and vegetables is high in fiber to support digestion and a healthy body weight. Some of the natural fibers in fruits and vegetables help feed the “good bacteria” in the gut, which is an essential part of the immune system.

In addition, consuming different colors of fruits and vegetables provides a diverse range of vitamins and minerals, including iron. Iron deficiency can occur among people living with CLL and can worsen other CLL symptoms — like fatigue.

Some of the best plant sources of iron include:

• Lentils
• Beans
• Pumpkin seeds
• Tomato products like canned, stewed, or sun-dried tomatoes

Spinach has iron too, but it’s less absorbable than iron from other sources.

Iron deficiency isn’t the only cause of anemia and fatigue in people with CLL. Always have your iron levels checked first, and only take iron supplements if your doctor recommends them.

The natural pairing of vitamin C and iron, often found in fruits and vegetables, boosts the body’s ability to absorb iron from plant sources. Try adding a squeeze of lemon juice as a garnish to your cooked spinach or tossing bell peppers into a tofu stir-fry.

Don’t forget to wash your raw fruits and vegetables very well before eating. Food safety is very important if you’re immunocompromised from CLL or cancer treatments because there’s an increased risk of foodborne illnesses.

Many people with CLL explore the benefits of a plant-based diet to support better health. Even if you’re not interested in eliminating meat and dairy entirely, filling your plate with fruits and vegetables (or making smoothies) is a good way to promote a healthy diet.

2. Lean Proteins

Protein is essential for people with CLL to maintain their muscle mass and immune function. However, the saturated fats that come with high-fat or processed red meats — like pepperoni, bacon, and sausage — make these popular high-protein foods less than ideal.

Filling your plate with colorful fruits and vegetables can help you boost fiber, iron, and vitamin C in your diet.

Fortunately, there are plenty of lean protein options, including plant-based proteins like beans, legumes, nuts, and tofu. Seafood, poultry, and eggs are also good sources of high-quality protein and are generally lower in saturated fat compared to red and processed meats.

People with CLL are prone to infection and other signs of stress on the body. These high-protein foods help support iron levels, bones and muscles, and the immune system.

3. Low-Fat Dairy Products and Nondairy Alternatives

Low-fat milk, cheese, and yogurt offer much-needed calcium and act as another source of protein for people with CLL. Opting for lower-fat varieties — think skim milk or nonfat yogurt versus butter and ice cream — can help you avoid the heartburn symptoms that some people with CLL experience during treatment.

However, if you’re struggling to maintain your weight and can tolerate higher-fat dairy options, they may be good choices to help sneak in extra calories.

If you’re not a big fan of dairy or have trouble digesting it, you can also choose from milk alternatives. Nondairy milk alternatives like almond and soy milk are usually fortified with calcium to provide the same amount you’d get from cow’s milk. You can check the nutrition facts label on the back of the carton to see how much calcium is in your favorite nondairy milk product.

4. Whole-Grain Carbohydrates

Carbohydrates are often considered comfort foods, and that’s OK. Carbs provide quick energy and can be an enjoyable part of your meal. Adding more whole grains can promote heart health, improve blood sugar control, and provide other health benefits. That said, refined grains like white rice, white bread, and noodles are staples in many cultures and can still be part of a balanced diet.

If you’re dealing with bloating and digestive issues from CLL or cancer treatments, you may find that high-fiber whole grains help you stay regular and avoid constipation. Good options for healthy eating include:

• 100-percent whole-wheat bread
• Buckwheat
• Brown rice
• Oatmeal
• Quinoa

Not only do whole grains have more fiber, but they also provide some vitamin E, B vitamins, and other beneficial nutrients and antioxidants.

3 Foods To Avoid With CLL

Unless your doctor tells you otherwise, no foods are off-limits for people with CLL. However, avoiding less nutritious foods may help reduce symptoms, help you feel your best, and prevent additional health problems (like heart disease) that may complicate your condition.

1. High-Sugar Foods and Drinks

The last thing that someone with CLL-related fatigue needs is a sugar crash. Unfortunately, drinking beverages or eating foods with added sugar can put you on a roller coaster of sugar highs and lows that have a net negative impact on your energy levels.

Sugar isn’t always easy to spot. It’s often hidden in processed foods that don’t even taste sweet. For example, store-bought spaghetti sauce, flavored yogurt, and frozen meals can be higher in added sugar (as opposed to naturally occurring sugar) than you might think. That’s why it’s so important to look at food labels and identify how much added sugar you’re getting throughout the day.

If you have trouble figuring out your added sugar intake, ask your oncologist to refer you to a registered dietitian. Some grocery stores even have dietitians on staff who can walk you through the store and help answer questions.

Cooking at home when you have energy can be a helpful way to know what’s in your food and control the ingredients you add. Learning some quick and simple recipes to prepare at home can save you money and give you more control over what you’re putting into your body.

If you’re struggling with weight loss and sweets are the only thing you crave (or the only thing you have been able to tolerate), try to select sweet food or drink options that are nutrient-dense — that is, that are high in protein, high in vitamins, and high in calories. Try to satisfy your sweet tooth with naturally sweet foods. You could, for example, add fruit to a protein smoothie or eat raw vegetables like bell peppers or carrots dipped in hummus as a snack.

2. Ultra-Processed Foods

In some studies, researchers have observed possible links between highly processed foods and negative health effects. Ultra-processed foods are often high in added sugar, salt, fats, and certain additives. Diets high in these foods have been linked to higher levels of inflammation. One study also found an association between eating a Western-style diet and CLL, but the exact reasons for this link are still unclear.

Beverages and foods with added sugar can put you on a roller coaster of sugar highs and crashes that have a net negative impact on your energy levels.

Researchers are just learning how some of the chemical-like additives affect gut bacteria and immunity. In addition, eating more highly processed foods can displace nutritious foods that your body requires to function at its best.

3. Certain Raw Foods

CLL leaves the immune system vulnerable to infections. That includes foodborne illness. Food safety is especially critical for people with CLL and other types of cancer.

Foods must be cooked to safe temperatures and prepared properly. You should also remember to wash fresh fruits and vegetables before preparing them and avoid raw meat, runny eggs, or raw seafood. Unpasteurized dairy and certain soft cheeses also pose a risk. These foods are more likely to contain bacteria that can make you sick, even if healthy people can eat these foods safely.

Talk to Your Doctor

When in doubt, talk to your healthcare team about what’s safe to eat. They may advise you to be stricter about food safety, depending on how severe your condition is and what type of cancer treatment you’re taking.

Your doctor can also tell you if you need to avoid specific foods while taking certain medications for CLL. For example, people taking BTK inhibitors should avoid eating grapefruit and Seville oranges (and drinking their fruit juice) because these fruits can increase drug levels in your body.

Join the Conversation

On MyLeukemiaTeam, people share their experiences with leukemia, get advice, and find support from others who understand.

Have you made any changes to your diet after being diagnosed with CLL? Let others know in the comments below.