Do you have a small appetite?

Transcription

1 Do you have a small appetite? Exceptional healthcare, personally delivered

2 Appetite and Health Sometimes when you are unwell your appetite is reduced and you are unable to eat as much as you would normally. Eating enough calories, protein, vitamins and minerals is important to help you feel well again and may help to maintain your weight. Why is Eating Well Important? n Reduces risk of infection n Helps in wound healing n Reduces risk of falls n May improve mood and wellbeing n Increases energy levels n Increases muscle strength n Protects your body from deficiencies e.g. if you are not having enough iron in your diet you might develop anaemia Please note: If you have diabetes please see page 7 for more specific advice. 2 Do you have a small appetite?

3 Tips for Improving your Diet n Aim to eat little and often throughout the day n Eat small nourishing snacks between meals (snack ideas on page 4) n Try not to skip meals, have a snack or nourishing drink if you cannot manage a main meal n Have nourishing drinks during the day. Avoid large quantities of fluids before meals, as this may fill you up n Try to go for full fat/full sugar versions of food/drink rather than the diet alternatives n Try to eat more on the days and times you feel well n When at home, choose meals that you enjoy, are easy to prepare and eat and have lots of calories in them (this will be highlighted in red on the food label) n Where appropriate, cook larger quantities of meals and freeze them for a later date Do you have a small appetite? 3

4 What Foods are Important? Foods that have lots of energy and protein in them are important as they act as a good source of fuel for your body and help you to fight infection. High Protein Foods include: n Meat n Fish n Eggs n Soya n Milk n Yoghurt n Cheese n Nuts n Beans n Lentils High Energy Foods include: n Biscuits n Crisps n Cakes n Chocolate n Puddings n Cream n Butter To help increase energy and protein intake, opt for the fullfat versions of these foods whilst you are unwell. 4 Do you have a small appetite?

5 Snack Ideas Sweet or savoury, the following snacks will provide you with energy whilst you are unwell. Savoury: n Cream of soups n Bombay mix n Individual cheeses n Crisps n Nuts n Dips and crisps n Quiche n Cocktail sausages n Cheese and biscuits n Instant noodles n Pork pies n Tinned soup n Tinned baked beans/spaghetti hoops Sweet: n Rice pudding n Cereal bars n Tea cakes n Malt loaf n Pastries n Biscuits n Cake n Trifle n Chocolate n Full fat yoghurt n Milk puddings n Dried fruit n Mousse n Custard n Ice cream Do you have a small appetite? 5

6 Nourishing Drinks As well as food, lots of drinks can provide calories, protein, vitamins and minerals. Examples of nutritious drinks are as follows: n Full cream milk n Milkshakes n Hot chocolate n Malted drinks n Milky coffee and tea n Smoothies n Sugary fizzy drinks e.g. lucozade, cola n Fruit juice n Soya drinks e.g. Provamel, Alpro Soya Whilst you are unwell, the dietitian or doctor looking after you may prescribe nutritional supplements for you (these may be milky/yoghurt/juice/jelly based); some of which provide minerals and vitamins which can contribute to overall health. 6 Do you have a small appetite?

7 Fortifying Foods If you are struggling to maintain your weight, a useful way of getting more energy and protein in to your body is by fortifying certain foods. Examples of foods that can be fortified are shown below: Fortified Milk: Add 4 heaped tablespoons of milk power to 1 pint of full fat milk. This can be used in tea, coffee, soups, milk puddings, porridge and custards. Fortified Mashed Potato: Add 1 heaped teaspoon of butter and 1 heaped tablespoon of cheese to 1 scoop of mashed potato. Hard boiled egg/flaked fish/corned beef/fried onions can also be used. Not only will this improve the flavour but will also provide your body with more energy and protein. Fortified Yoghurt/Custard/Milk Pudding: Add 1 heaped tablespoon of milk powder to 1 serving of yoghurt/custard/milk pudding. Jam, syrup or honey may also be added to further increase calories. Fortified Sandwiches: Add mayonnaise or salad cream to fillings such as egg, tuna, cheese or meat. If butter or margarine are spread thickly on bread/rolls this will increase the amount of energy your body is taking in. Fortified Soups: By adding cream, milk powder, crème fraiche, cheese, dumplings, pasta or croutons to soups this will increase the nutritional value of them. Do you have a small appetite? 7

8 What about Diabetes? If you have diabetes and a poor appetite it may not be helpful to follow the usual low fat, low sugar healthy eating guidelines at the moment. Instead, follow the advice provided in this leaflet. However, once your appetite has returned to normal it is important to follow these guidelines once again in order to keep your diabetes under control and look after your cardiovascular and overall health. Helpful Hints: n If you are unwell and/or not eating it is likely that your blood sugars may be different to normal. Your diabetes medication or insulin may need to be adjusted and you will have help to do this in hospital. When you are at home seek advice from your Diabetes Specialist Nurse or GP. n Do not stop taking your diabetes medication or insulin even if you stop eating. n If you are unwell and/or not eating it is likely that your blood sugars may be different to normal. Your diabetes medication or insulin may need to be adjusted and you will have help to do this in hospital. When you are at home seek advice from your Diabetes Specialist Nurse or GP. n If your blood glucose levels are consistently higher than 11mmol/l it will be more difficult to gain (or even maintain) your weight. Please get advice from your diabetes team on how to improve your blood glucose levels. n If your blood glucose levels suddenly increase and you have ketones in your urine or you think you may have an infection, refer to your Sick Day Rules n Stay well hydrated. Have plenty of unsweetened drinks to avoid dehydration, and eat little and often. n If you don t feel like eating, are feeling sick or can t keep any food down, replace meals with snacks or drinks containing carbohydrates. n Try to sip sugary drinks (such as fruit juice or non-diet cola or lemonade) or suck on glucose tablets or sweets like jelly beans. If you re vomiting, or unable to keep fluids down get advice from your Doctor as soon as possible. 8 Do you have a small appetite?

9 Returning Home Food Shopping and Cooking Food Shopping: If you are not feeling well enough to go shopping then often family, friends or neighbours are pleased to help out. Alternatively, if you have access to the internet you may be able to order your groceries online. Some areas also have a milkman who may deliver a wide range of items in addition to milk. Food Cooking: When you are not feeling quite yourself, cooking may feel like a burden. Local pubs and restaurants may have special offers on meals particularly for pensioners, also churches, mosques and places of worship often have luncheon clubs providing hot meals and company. Local libraries and social service departments will have information on clubs locally. Most supermarkets stock ready meals that you or your relatives can purchase for a quick and easy to prepare meal. Commercial companies such as Wiltshire Farm Foods, Oakhouse Foods and Home Foods can provide frozen ready meals delivered directly to your home via telephone, online or postal orders. In certain circumstances Meals on Wheels can be delivered to your home but would need to be authorised by your surgery. Store Cupboard Items The following list provides you with some useful foods to have in store which can provide a quick easy meal or snack. Milk: Long life or UHT full fat milk, dried milk powder, condensed milks, custard powder/cartons/tins. Meat and Fish: Tinned corned beef, ham, stew, meat balls, sardines, salmon and tuna. Cereals: Breakfast cereals, crackers, crisp breads, plain biscuits, pasta, rice and chapatti flour. Do you have a small appetite? 9

10 Fruit and Vegetables: Tinned fruit and vegetables, baked beans, instant potato and dried fruits. Drinks: Complan, Build Up, Ovaltine, Cocoa, fruit squash, coffee and tea. Freezer Items: Frozen fruit and vegetables, frozen ready meals, ice cream, meat and fish. Bread, rolls and pastry; home made items e.g. casseroles and soups. Remember to check the use by dates regularly. Sample Meal Ideas Breakfast Ideas n Creamy scrambled egg with buttered toast n Porridge/cereals with honey/sugar n Crumpets with butter and jam n Muesli with whole cream milk and natural yoghurt Lunch/Lighter Meal Ideas n Beans on buttered toast with grated cheese topping n A buttered jacket potato with tuna mayonnaise filling n Ham or cheese omelette, chips and salad with mayonnaise n A creamy soup with added grated cheese and croutons Main Meal Ideas n Shepherds pie with grated cheese topping and vegetables with added margarine or butter n Chicken curry or dahl with rice or chapatti spread with oil, butter or margarine 10 Do you have a small appetite?

11 n Cauliflower cheese made with fortified milk with grated cheese topping n Fish in cheese sauce with creamed potatoes and vegetables with added margarine or butter Pudding Ideas n Milk pudding e.g. rice/tapioca/semolina n Baked egg custard n Crumble with ice-cream n Trifle with cream n Jelly made with fortified milk Where now? For further information you may find the following resources useful: The British Dietetic Association (2012). Food Fact Sheet. Malnutrition Overcoming the problem Brotherton et.al (2010). Malnutrition Matters: Meeting Quality Standards in nutritional Care. A report on behalf of the BAPEN Quality Group Thomas et al (2007). Manual of Dietetic Practice Oxford: Blackwell Scientific Publishing Diabetes UK (2014). Wiltshire Farm Foods (2012). Oakhouse Foods (2013). NHS Constitution. Information on your rights and responsibilities. Available at Do you have a small appetite? 11

12 If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice. North Bristol NHS Trust. This edition published May Review due May NBT002833