Making the most of your food Advice for patients and carers

This leaflet provides advice for adults on increasing nutritional intake by making simple changes to meals, snacks and drinks.

Helpful tips

Softer, moist foods can be easier to manage, especially if you are feeling tired.

Try ‘ready-meals’ if you have difficulty cooking or preparing meals, either bought from the supermarket or from a meal-delivery service.

Allow plenty of time to eat your meals (so that you are not rushing).

Avoid having drinks just before meals as they can make you feel full. Have drinks after your meal or between meals instead.

Some fresh air and gentle exercise may help stimulate your appetite.

Try eating little and often. Aim for three small meals and two to three snacks between meals. 1

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Why have I received this handout?

You may have a poor appetite or have been eating less due to feeling unwell. If you are not getting enough nutrition to meet your body’s needs you will lose weight and could be at risk of malnutrition.

Malnutrition makes it more difficult for the body to fight illness and infection and can make us feel weak, tired and low in mood. To treat malnutrition we need to increase the energy (calories) and protein that we eat and drink.

What foods should I choose?

• Choose your favourite foods; eating foods you enjoy can help you eat more. Try to eat a variety of foods to make sure you get a range of nutrients.

• Avoid foods that are labelled as: diet, sugar-free, fat-free, low-fat or reduced-fat - use full-fat dairy products and butter or margarine.

• Frying food in butter or oil (rather than baking or grilling) will add extra energy.

• Aim to have two to three portions of high protein foods every day, such as meat, fish, eggs, nuts, beans, lentils and cheese.

• Aim to have one to two puddings each day. Try adding cream, custard, condensed milk or ice-cream or try milky puddings such as rice pudding. Creamy yoghurts, custard pots, mousses, crème caramels or individual trifles make a good snack.

• Try to include fruit and vegetables in your diet. To increase the energy, you can add butter to vegetables, or cream, sugar or custard to fruit. Try having cheese sauce, white sauce, mayonnaise or salad cream with meals.

• Cakes, biscuits, scones, pastries, crisps, chocolate and sweets, cheese, nuts and dried fruit are all good snacks to provide extra energy (calories). Try flapjacks, teacakes or malt loaf with butter, scones with jam and cream or chocolate or cream-filled biscuits.

• Spread peanut butter, chocolate spread, jam, honey or lemon curd generously on bread, toast, crackers or crumpets, in addition to butter or margarine.

Fortifying your food

Fortifying food means adding small amounts of other ordinary foods to your meals and snacks to increase the nutrition, especially calories and protein.

How to fortify some common foods

If you have: Fortify by adding:Cereal or porridge Fortified milk, cream, full-fat or Greek yoghurt,

honey, syrup, sugar, jam, dried fruitScrambled eggs Butter, fortified milk, grated cheeseSoups and stews Grated cheese, cream, dumplings or croutons Mashed potato Butter, olive oil, fortified milk, grated cheese,

skimmed milk powder or double creamCooked vegetables Grated cheese or creamy sauces, olive oil, butter,

mayonnaise or salad cream Salads Grated cheese, olive oil or salad dressing,

mayonnaise or salad creamCustard and milky puddings

Skimmed milk powder, double cream, condensed milk, honey, syrup, sugar, jam or dried fruit

Calories and protein provided by common foods

Food Amount Energy Protein Butter 10g ‘pat’ 75 kcal 0gCheese, grated 1 tablespoon 62 kcal 4gCondensed milk 1 tablespoon 66 kcal 1.5gDouble cream 1 tablespoon 75 kcal 0.5gOlive oil 1 teaspoon 45 kcal 0gSkimmed milk powder 1 tablespoon 44 kcal 4.5gSugar 1 teaspoon 20 kcal 0g

Homemade fortified drinks

If you or someone you care for has a small appetite, nourishing drinks can be helpful to provide extra energy (calories), protein and other nutrients. These recipes provide similar amounts of calories and protein to many ready-made ‘build-up’ drinks. It is important to try and have these nourishing drinks in addition to meals, not a meal replacement, as they will not meet complete nutritional needs on their own.

The fortified milkshake and fortified hot chocolate are the most nutritionally complete drinks, so are the best choice if you are not eating well.

Avoid filling up on low-calorie drinks such as tea, coffee, herbal teas, Bovril, broth-style soups or diet squash or diet fizzy drinks - try to have a nourishing drink instead if you can.

Fortified milk

Aim to have one pint of fortified milk each day in place of normal milk. You can use it in tea, coffee, on cereal, in cooking, or on its own. To make fortified milk:• Mix four tablespoons (50g) of skimmed milk powder into one pint

of full-fat milk. Stir well. One pint of fortified milk provides 540kcal, 37g protein

Recipes

Fortified hot chocolateCalories: 387 kcal | Protein: 18.6g | Cost: 45p (per serving)

Ingredients Method• 200ml full fat milk• 30g (2½ tbsp) skimmed milk

powder • 20g (4 tsp) hot chocolate

powder with added vitamins and minerals, eg Nesquik hot chocolate powder

• 15ml (1 tbsp) double cream • Marshmallows (optional)

• Add the skimmed milk powder to the full-fat milk and mix well to make fortified milk

• Warm the fortified milk • Add warmed fortified milk

gradually to the hot chocolate powder and stir well

• Stir in the double cream• Add marshmallows if desired

Fortified milkshakeCalories: 390 kcal | Protein: 18.4g | Cost: 40p (per serving)

Ingredients Method• 30g (2½ tbsp) skimmed milk

powder• 20g (4 tsp) milkshake powder

with added vitamins and minerals

• 200ml full fat milk• 15ml (1 tbsp) double cream

• Mix the skimmed milk powder and milkshake powder together

• Add full-fat milk gradually and stir well

• Stir in double cream

Fruit fizzCalories: 255 kcal | Protein: 2.6g | Cost: 25-40p (per serving)

Ingredients Method• 100ml fruit juice • 100ml lemonade - not ‘diet’ or

‘sugar-free’• 30ml high-juice squash - not

‘no added sugar’• 15g (1 tbsp) sugar • 50g (1 scoop) vanilla ice-cream

• Mix the fruit juice, lemonade and high-juice squash together in a glass

• Add the sugar and stir well• Add the ice cream and stir well

Key: tsp = teaspoontbsp = tablespoon

Fortified cup-a-soup (makes one serving)Calories: 282 kcal | Protein: 15g | Cost: 46p )per serving)

Ingredients Method• 1 ‘cream of’ cup-a-soup sachet

– best with creamy cup-a-soups such as chicken or mushroom

• 200ml full-fat milk• 20g (1½ tbsp) skimmed milk

powder

• Mix the milk powder into the milk and stir well

• Warm the milk• Add cup-a-soup sachet to a

mug or cup and gradually mix in the warm milk, stir well

For desserts, try the recipes below:

Sweet milk jelly (makes four servings)Calories: 337 kcal | Protein: 8g | Cost: 32p (per serving)

Ingredients Method• 1 packet (135g) jelly • 285ml (½ pint) boiling water• 285ml (½ pint) sweetened

condensed milk

• Separate jelly into cubes and place in a jug/bowl.

• Add the boiling water and stir until dissolved.

• Add the sweetened condensed milk, stir, then pour into mould/serving dish.

• Allow to cool, refrigerate to set.

Fortified instant whip (makes three servings)Calories: 354 kcal | Protein: 8.1g | Cost: 33p (per serving)

Ingredients Method• 200ml full fat milk• 100ml (6½ tbsp) double cream• 40g (3 tbsp) skimmed milk

powder • 1 packet (60g) of Instant Whip

dessert eg Angel Delight or supermarket own brand

• Mix the milk powder into the milk and stir well

• Add the double cream• Add the sachet of instant whip

and whisk well• Divide into three portions and

leave to thicken, no need to chill

Key: tsp = teaspoontbsp = tablespoon

If you are not able to follow this advice or you have been following it and you are still losing weight,

please contact your GP or nurse for further advice.

Although some of the foods and drinks in this leaflet may usually be considered unhealthy, they are recommended until your appetite and weight improve. These foods are ‘energy-dense’ and can help to reduce your risk of malnutrition.

Contact NHS Kernow

Sedgemoor CentrePriory RoadSt AustellPL25 5AS

Designed by NHS Kernow Clinical Commissioning GroupReview date: February 2022 | Reference: MO-MMFL/JR/0219

www.kernowccg.nhs.uk