Last updated: January 2020
Next review: January 2022
URN: 185

This advice is for when you have a poor appetite or have lost weight or have increased dietary needs eg to help wound healing.

Food First: Some ideas to help improve your appetite

• Have small, frequent meals every 3 hours.
• Avoid drinking before meals as this can make you feel full. Try taking drinks with or after meals.
• If you find preparing meals tiring, make use of frozen or ready-made meals and snacks.
• Try to get outside for some fresh air before meal times.
• Your Doctor may prescribe a multivitamin tablet such as Forceval or you can buy one from your pharmacist

Make the most of your food and fluids

• Small frequent meals and snacks are a good way to increase your calorie intake. Aim to eat every 2-3 hours.
• Fortifying your diet will help to make a small amount of food or drink more nourishing.
• Aim to drink 6-8 cups/glasses of fluid a day. Make these as nourishing as possible. eg milky coffee or hot chocolate instead of tea.

Additional help: ready-made meals

If you are having difficulty preparing meals consider ready-made meals, either from the supermarket or a frozen meal delivery service (Wiltshire Farm Foods, Oak House Foods). Avoid low calorie or diet versions.

If you already have ready-prepared meals, add some glazed vegetables and a slice of bread and butter to help increase the nutritional value.

Wiltshire Farm Foods
Freephone: 0800 773773
www.wiltshirefarmfoods.com

Oakhouse Foods
Freephone: 0845 6432009
www.oakhousefoods.co.uk

Food fortification

Try simple ways to increase the energy and protein content of meals. Initially aim to fortify one dish per meal.

Fortify with oil and butter:

• Add butter or full fat spread to potatoes and vegetables.
• Drizzle olive oil onto pasta.
• Oven roast potatoes and vegetables in oil.
• Spread butter or full fat spread thickly on bread and toast.

Fortify with cheese:

• Sprinkle on top of meals e.g. beans on toast, spaghetti bolognese, soup and casseroles.
• Include it in sandwiches e.g. ham and cheese, cheese salad, cheese and tuna mayonnaise.
• Add to mashed potatoes.

Fortify with sugar, honey and syrup (use sparingly, if at all, if you have diabetes):

• Use in hot drinks.
• Add to porridge and breakfast cereals.
• Add to hot puddings, e.g. pie, crumble or milk based puddings.
• Drink fizzy drinks and cordials that contain sugar.

• Add to mashed potatoes.

Fortify with mayonnaise and salad cream:

• Include in sandwiches, e.g.  tuna mayonnaise and chicken mayonnaise
• Add to salads
• Put on chips or baked potatoes
• Have coleslaw, or other mayonnaise dressed salads as a portion of vegetables.

Fortify with milk and cream:

• Add to soups
• Make custard and milk based pudding with 1/3 cream and 2/3 milk
• Mash into potatoes
• Make cream based sauces for pasta
• Drizzle on top of desserts
• Add to hot drinks, e.g. coffee, hot chocolate. contain sugar

Nourishing drinks: recipes and ideas

Fortified full cream milk (501kcals/31g protein)

• 1 pint (600mls) full fat milk
• 4 tablespoons dried skimmed milk powder eg Marvel or supermarket own brand

Mix 4 tablespoons milk powder with 2-3 tablespoons of the milk and mix to a runny paste. Add the rest of the pint of milk. Store covered in the fridge and use during the day. Drink plain, or try the recipes below.

Hot chocolate or malted milk (approximately 450 calories per serving)

• 150ml fortified milk
• 3 teaspoonfuls hot chocolate powder or malted drink powder eg Ovaltine or Horlicks , 2 tablespoons double cream

Milkshake (360 calories per serving)

• 200ml fortified milk
• 3 teaspoons milkshake syrup or powder

Fruit smoothie (560 calories per serving)

• Blended fruit (e.g. 1 banana and a handful of strawberries) 50-80g
• 200ml fortified milk
• Scoop of ice cream
• Half a carton of creamy fruit yoghurt

Creamy soup (approximately 460 calories per serving)

• 200ml fortified milk
• 1 sachet soup (avoid low calorie or low fat versions)
• 2 tablespoons double cream

Mix the milk with the cream and warm until coming up to boiling point. Add the soup powder and stir until it dissolves.

Iced latte (370 calories per serving)

• 200ml fortified milk
• A teaspoon coffee powder
• A scoop of ice cream
• A tablespoon of double cream

Mix the ingredients together and stir until the ice cream has melted.

Nourishing snacks

Try eating one nourishing snack between each meal(i.e. mid-morning, mid-afternoon, before bed)

Sweet options

• Milky puddings (rice pudding, tapioca, custard, mousse).
• Yoghurt (not low fat), individual trifle or mousse.
• Chocolate, biscuits, cakes, pastries.
• Breakfast cereal (with fortified milk) or cereal bars.
• Tea cake, tea bread, malt loaf with butter/spread and jam.
• Scone with jam and cream.
• Croissants and waffles.
• Dried fruit or fruit and nut mix.

Savoury options

• Cheese, pate or hummus with crackers or biscuits.
• Crisps, nuts, Bombay mix.
• Pork pie, sausage roll, scotch eggs, cocktail sausages.
• Pasties and samosas.
• Toast, crumpets or muffins with butter/spread.
• Peanut butter on toast, cheese on toast, beans on toast.
• Ham sandwich, cheese sandwich.
• Slice of pizza or quiche.

Meal ideas

Breakfast

• Porridge with whole or fortified milk and cream.
• Swiss style, or crunchy muesli cereals with yoghurt (not low fat) and fresh fruit.
• Croissant/waffles/crumpet/bread or toast with butter/spread and jam or chocolate spread/ marmalade/peanut butter or cheese spread.
• Cooked breakfast with egg (e.g. fried or scrambled with whole or fortified milk and butter), bacon or sausage (preferably fried) with buttered toast or fried bread.

Light meals

• Nourishing soup, home made “cream of” or “Big Soup” style.  Add extra cream, cheese, meat or lentils. Serve with buttered bread or crumpet.
• Ham, salami, corned beef, cheese, cream cheese and pineapple, egg or tinned fish sandwiches. Use butter or full fat spread liberally and add full fat mayonnaise or dressing. Try toasted sandwiches as an alternative.
• Fried beef burger, sausage or fish fingers in a buttered bread roll.
• Toast with baked beans and grated cheese, scrambled egg, pilchards, sardines, cheese and Marmite, banana or peanut butter.
• Quiche with potatoes salad and mayonnaise.

Main meals

• Spaghetti bolognaise – fry minced meat, toss spaghetti in butter and add grated parmesan cheese on top.
• Shepherd’s Pie – add cream, whole or fortified milk, butter or cheese to the potato.
• Fisherman’s Pie – add a creamy cheese sauce to the fish and fortify potato as for shepherd’s pie.
• Roast Chicken with condensed mushroom soup sauce or other white sauce served with rice.
• Tinned salmon with parsley sauce and mashed potato.
• Lasagne or pre-packed pasta dish, topped with grated cheese.
• Meat or fish curry – add coconut milk or cream and serve with paratha or puris

Desserts

• Full fat yoghurt or fromage frais.
• Ice cream with tinned fruit or bananas.
• Blancmange or Instant Whip made with whole milk.
• Jelly made with condensed or evaporated milk.
• Tinned or home made milk puddings (rice,sago).
• Pies, tarts and crumbles served with custard or cream.
• Sponge puddings served with custard or cream.

Nutritional supplement drinks

If your appetite is very small, you can buy nutritional drinks such as Build Up® or Complan®. These can be made up with whole milk and  are good for between meals as a nourishing drink. They are available to buy from most supermarkets and pharmacies.

Vitamin supplement

Your GP or nurse may prescribe a multivitamin tablet whilst you have a small appetite or you can buy one from your pharmacist.

Food safety

• Always wash your hands before cooking or handling food. Dry them on a clean towel.
• Some foods can be cooked from frozen (NB read label). Other foods, such as meat, must be thawed thoroughly before cooking. Thaw in a refrigerator and follow packet instructions.
• Keep meat, fish and poultry away from other foods to prevent  contamination. Wash chopping boards and utensils carefully – especially after using them for raw foods.
• Wash fruit and vegetables thoroughly before use.
• Allow hot foods to cool before putting in fridge or freezer.
• Use plastic containers/tubs or cover food to store in the fridge. Do not leave food in cans.
• Only keep leftover food for 2 days in the fridge and not beyond the ‘use-by date’.
• Do not let rubbish build up in the kitchen or kitchen bin.
• Keep pets away from food and work surfaces in the kitchen.

Diabetes

If you have diabetes and you normally check the sugar (glucose) in your urine or blood, you should continue to do this regularly and contact your Practice Nurse or Diabetes Nurse if you have trouble keeping your results within normal limits.

Healthy heart

If you have a high cholesterol level you can still follow the advice in this booklet whilst you need to improve dietary intake or to gain weight. Vegetable fats/oils are healthier choices than animal fats, so use a  full fat olive based spread instead of butter, and use vegetable oil (rapeseed or olive oil) for cooking.

Choose less of the fatty meats and pastry items but have more dried fruit, nuts, flapjacks, fruit bread or teacakes with spread and jam for  snacks. Nourishing drinks can be made with fortified whole milk but avoid adding cream.