Dietetics Leaflet: Build Yourself Up

Leaflet Details

Patient Information

Introduction

This leaflet provides advice on how to increase the protein and energy content of your diet if you have a poor appetite or require support for weight maintenance / gain.

It may not be suitable if you have diabetes or renal disease. If you have either of these conditions, speak to your doctor before using this information.

For specific individual advice ask your doctor to refer you to a Dietitian.

Do You Need Help?

• Have you lost weight recently without trying?
   
• Have your clothes, jewellery or dentures become loose-fitting?
   
• Are you losing your appetite?
   
• Are you eating less?
   
• Do you have any difficulties with swallowing food and drink?
   
• Have you had a recent illness or surgery that has affected your appetite?

If any of the above is true, you could be at risk of malnutrition.

Why Does This Matter?

Becoming malnourished makes it harder for you to fight infections, meaning you may:

• Become ill more easily.
   
• Lose muscle strength, making daily activities such as shopping, cooking, and caring for yourself and others more difficult.
   
• Be at increased risk of falls and developing pressure sores. You may find that any wounds you have will take longer to heal if you are malnourished.
   
• Develop a low mood more easily and struggle to keep yourself warm in cold weather.

Adequate nutrition is especially important if you need surgery, have recently undergone surgery or are recovering from an infection.

What Should You Do About It?

Always tell your GP and / or community nurse - they will be able to offer you advice and if necessary, arrange an appointment with a Dietitian. Monitor and keep a record of your weight to help you and your GP keep track.

The best way to achieve weight gain is to:

• Eat LITTLE AND OFTEN - take small nourishing meals together with nourishing snacks and drinks between meals.
   
• ENRICH your meals, snacks, and drinks with high energy / high protein foods.

Avoid buying ‘diet’ or ‘low fat’ products as these are generally intended for people trying to lose weight.

Micronutrients (vitamins and minerals) are as important for us as energy and protein content of our foods. Trying to have adequate fruits and vegetables is important.

The suggestions below should help increase intake of micronutrients:

• Small glass of vitamin C containing squash or fresh fruit juice **
   
• Frozen berries with cereal, in smoothie or yoghurt
   
• Chopped banana**, dates, or other dried fruit with cereal
   
• Apple, grapes, olives or cherry tomatoes with cheese or humus as a snack
   
• Add canned or fresh fruit to puddings **
   
• A portion of vegetables with meals **
   
• Vegetable or lentil soup **

** These options are suitable if you are on “Easy to Chew” diet.

Top Tips for Improving Your Appetite

• Try to avoid missing or skipping meals! If you don’t feel like eating have a nourishing drink instead. Ask to see a dietitian if you are frequently missing meals.
   
• Aim for 3 small meals and 3 nourishing snacks every day.
   
• Use a smaller plate to avoid being overwhelmed by large quantities and present your food in an attractive way to tempt your appetite.
   
• Your favourite foods are likely to be more appealing- have these more often.
   
• Where possible take a little exercise and get some fresh air as this may help to improve appetite and general feeling of well-being.
   
• If the smell of food is off-putting, make sure the room is well ventilated whilst cooking or avoid hot meals for a while. Cold options like sandwiches, quiche, frittata, hummus, ice cream, yoghurts, and jelly can be just as nutritious as hot foods. You can also use convenience foods and ready meals.
   
• Give your food more flavour by adding herbs, smoked cheese or different sauces, spices, and condiments.
   
• Avoid drinking too much fluid with your meals as this will make you feel fuller. Try to eat your meals first and then have drinks afterwards.
   
• Allow plenty of time for your meals.
   
• Make the most of ‘good days’ or good times of the day. Eat when you feel hungry or if you think you could manage something, even if it is not a mealtime.
   
• Many high-protein milk, yoghurt and dessert products are widely available in supermarkets. These are good choices when you need extra nourishment - experiment with different varieties to find flavours or brands that you enjoy.

Fortify Your Foods

• Aim to use a pint of fortified milk every day.

• You can also use long life, evaporated, or condensed milk.
   
• If you can’t have dairy / lactose - look for soya or hemp milk options (these may be lower in calorie and protein than their dairy alternatives).

Add extra energy by adding high calorie ingredients to food and drinks - suggestions listed below:

If there are any health concerns which have previously required diet restrictions, you should discuss whether you still need to limit these with a health professional.

* sugar in your diet e.g., diabetes

** fat in your diet, e.g., high cholesterol

* If you are a vegan or can’t have dairy products, then please substitute these with suitable plant-based alternatives i.e. coconut cream / soya milk and yoghurts, dairy free cheese.

Some Other Tips

Meal Suggestions

Breakfast

• Porridge or cereal e.g., Shreddies or Weetabix with full-fat milk / fortified milk (soaked in milk**), with honey or golden syrup.
   
• Toast (soft bread for Easy to chew option) with peanut butter, cream cheese, butter / spread and jam, marmalade, chocolate spread or scrambled egg.
   
• Fruit smoothie made with added oats / nut butters**.
   
• Oats with Greek yoghurt or full fat / fortified milk**.
   
• A roll filled with poached or scrambled egg, smoked salmon and cream cheese, smashed avocado, or banana.
   
• A glass of full-fat milk and breakfast biscuits with cream cheese or butter / spread.
   
• Scrambled or poached eggs, or an omelette**.
   
• A glass of fresh fruit juice or vitamin C containing squash**.
   
• Soft fruits like stewed apple or mashed banana with yoghurt or cream**.

** These options are suitable if you are on “Easy to Chew” diet.

Lighter Meals

If you are not managing a main meal, try to have 2 or more lighter meals as well as breakfast.

• Toast (soft bread for Easy to chew option) with scrambled egg, soft cheese, baked beans, mackerel, sardines, or mackerel/salmon pâté**.
   
• Sandwich, roll or jacket potato (flesh only**) with butter and filled with cheese, egg mayonnaise, cold meat, tuna, mayonnaise, hummus, or canned fish.
   
• Breadsticks, pitta or oatcakes with guacamole or humus.
   
• Pitta or a wrap filled with falafel and salad.
   
• Macaroni or cauliflower cheese**.
   
• Ravioli with pesto or other sauces that you enjoy**.
   
• Soup served with a buttered roll or sandwich. For easy to chew liquidise the soup if needed and remove the crust of bread and break the remaining bread in to the soup**.
   
• Canned, homemade, packet or cup-a-soup made with hot milk, fortified with cream, cheese or oil**.
   
• Omelette**, quiche, or frittata**.
   
• Scrambled egg with smoked salmon and avocado**.

** These options are suitable if you are on “Easy to Chew” diet.

Main Meals

• Use ready meals or batch cook your own favourites to make mealtimes simple.
   
• You can have any of your favourite meals like lasagne, spaghetti Bolognese, pies, risottos, curries, steaks and dumplings as main meals.

Fluid

Fluid intake is essential. Not taking enough fluids can lead to problems with dehydration and constipation. Aim for about 1.5-2 litres (3 pints) of fluid a day (unless advised differently). This usually equates to 8-10cups of fluid per day.

Need A Ready-Made Meal?

Meals on Wheels services are available through Surrey Adult Social Care (0300 200 1005), or through companies such as Wiltshire Farm Foods (0800 077 3100), or Oakhouse Foods (0333 370 6700).

Why not try a microwave meal from your local supermarket or organise an online grocery shop if this is more convenient as most supermarkets now provide a delivery service for those who are unable to travel or transport their shopping.

Puddings

Try to have 1-2 desserts per day. If you feel full after your first course, you could have dessert a little later.

• Chocolate or fruit flavour mousse**.
   
• Creamy yoghurts, full fat fruit yoghurt or Greek yoghurt**.
   
• Jellies or instant puddings made with fortified milk, evaporated, or condensed milk**.
   
• Fresh, tinned, or stewed fruit with ice cream, cream, custard, or evaporated milk**.
   
• Chocolate sponge cake** or Crumble or sponge** or fruit pie with custard or cream.
   
• Rice or ground rice pudding with a spoonful of jam, golden syrup, honey**.
   
• Slice of cheesecake.
   
• Sticky toffee pudding with clotted cream**.
   
• Trifle**.
   
• Lemon meringue pie.
   
• Bread and butter pudding**.
   
• Chocolate melts and chocolate pots**.

Tips:

• Use yoghurt, ice cream, cream, or evaporated or condensed milk to add extra calories.
   
• Milk puddings and custards can be made with fortified milk.
   
• Individualised desserts in cans and pots are available for stocking in cupboard and fridge.

** These options are suitable if you are on “Easy to Chew” diet.

Snacks

** These options are suitable if you are on “Easy to Chew” diet

Suggested Meal Plan

** These options are suitable if you are on “Easy to Chew” diet

Further Information

If you have been given this leaflet and have any questions or queries, please discuss these with the medical team overseeing you / your relative’s care.

Helpful Literature: Ask the person who gave you this leaflet for Nourishing Drinks and Puddings leaflet.

USEFUL WEBSITES

The British Dietetic Association

• https://www.bda.uk.com/
   
• https://www.bda.uk.com/news-campaigns/campaigns/campaign-topics/malnutrition.html
   
• https://www.bda.uk.com/food-health/food-facts/all-food-fact-sheets.html
   

Malnutrition Task Force - Advice for eating and drinking well

• https://www.malnutritiontaskforce.org.uk/