Advice for patients on a high-protein and high-calorie diet

Transcription

1 Advice for patients on a high-protein and high-calorie diet UHB is a no smoking Trust To see all of our current patient information leaflets please visit

2 The importance of eating well During times of illness, and while recovering, it is important to eat a diet that is as nourishing as possible. Eating too little can affect your energy levels and your ability to heal. Good nutrition through periods of illness may speed up your recovery, and may also reduce the time you need to spend in hospital. A high-calorie diet will provide energy and help prevent weight loss and muscle wasting. Protein is a nutrient which helps growth and repair of tissues, as well as strengthening immunity. The body often uses more protein during periods of illness, for example after injury, surgery, infection or after some drug treatments such as chemotherapy. This booklet may help you if you have a poor appetite; noticed food tasting differently; have lost a significant amount of weight that was unplanned; or be at risk of losing weight. This booklet may not be suitable for individuals with Diabetes. Please ask your dietitian or GP for information on the diet that is suitable for your condition. How to follow a high-protein and high calorie diet Aim for three meals with three snacks, or try having five to six small meals if you struggle with larger meals Try eating small portions little and often, regularly throughout the day. Large portions may put you off eating altogether. You can always go back for a second helping Treat yourself to food that you enjoy Try to have nourishing drinks throughout the day Drink regular amounts of fluids, but avoid drinking large amounts right before a meal, as this may fill you up Everybody s appetite changes daily; make the most of good days and eat when your appetite is best, even if that is not at set meal times 2 PI18_1595_02 High Protein, High Calorie Dietary Advice

3 Keep snacks handy for when you feel like eating, as long as they do not interfere with main meals e.g. nuts, crisps, dried fruit, chocolate, cheese or yoghurts Low fat and reduced calorie varieties of foods should be avoided as the aim is to increase your calorie intake as much as possible Whilst you are in hospital, your relatives/friends may wish to bring food in for you. Whilst we encourage you to eat as well as possible, due to food safety regulations, we are unable to reheat food on the wards for you. However, cold snacks or shop bought items that can be eaten without heating are allowed. Starchy food Try to include starchy foods with each meal for example: Breakfast cereals Rice Pasta Potato Noodles Bread Couscous Tortilla Chapatti Crackers or crisp breads Green banana Paratha (flat bread) Quinoa Bulgur wheat Protein Try to include a high-protein food with each meal (two to three times per day). These can include: Meat (e.g. chicken, lamb, beef, pork, turkey, sliced meats, bacon, ham, corned beef) Fish (e.g. sardines, tuna, cod, salmon, mackerel, herring, trout, haddock, plaice, prawns, crab, mussels) Cheese (e.g. hard cheese, cream cheese, soft cheese, PI18_1595_02 High Protein, High Calorie Dietary Advice 3

4 cottage cheese) Eggs (e.g. fried, scrambled, boiled, poached, omelette) Lentils, beans, dhal, chickpeas, peas (in curries, soups, broths, casseroles, stews) Nuts and seeds (e.g. peanuts, cashews, almonds, sesame seeds, linseed) Soya, Quorn, tofu, tempeh, textured vegetable protein (TVP) Fruits and vegetables These provide essential vitamins, minerals, and fibre. Include small helpings with meals but try not to fill up on these as they are low in protein and calories. Fresh, frozen and tinned varieties can be used. Use the suggestions in this booklet to help you add extra calories and protein to fruit and vegetables. Your dietitian may also advise you to take a daily multivitamin and mineral supplement. We recommend that you try to include fruits and vegetables in your meals. Here are some examples; Bananas Apples Pears Berries Peaches Grapes Dried fruit Fruit juice Broccoli Carrots Peas Cabbage Cauliflower Tomatoes Swede Okra 4 PI18_1595_02 High Protein, High Calorie Dietary Advice

5 Nourishing drinks If you are struggling to eat enough food, fluids can be a useful source or energy and protein. Examples include: Milk or fortified milk Horlicks Hot chocolate Ovaltine Milkshakes Condensed or creamy soup The following drinks are available on the wards: Milk Meretine Energis Shake made with milk or water Meretine Energis Soup Squash Orange juice Tea Coffee Hot chocolate Some nourishing drinks are also available for purchase from supermarkets or pharmacies, such as: Meritene Energis Complan Nurishment PI18_1595_02 High Protein, High Calorie Dietary Advice 5

6 Fortifying your meals Meals and snacks can be made more nutritious without increasing the amount you need to eat, by fortifying them (increasing calorie content) or enriching them. This is done by adding foods high in calories and/or protein. Every mouthful should be as nourishing as possible. The following are examples of ways you can fortify you meals: Milk Choose full fat (or Gold top Jersey) milk rather than low fat varieties. Aim for one pint (568 ml) per day Fortify milk by whisking in skimmed milk powder to increase its protein and calorie content. Whisk in four heaped teaspoons of skimmed milk powder to ½ litre, (500 ml), or one pint of full fat milk. This milk can be used to make: Milky drinks (e.g. in tea, coffee, hot chocolate, malted drinks) Porridge and cereals Custard and milky puddings Savoury sauces to add to pasta, vegetables, and fish 6 PI18_1595_02 High Protein, High Calorie Dietary Advice

7 Margarine, butter and oil Avoid low fat, reduced and light spreads. Spread butter or margarine thickly on bread, toast, crackers, scones, crumpets or chapatti Mash plenty of butter, margarine, or oil into potatoes, or melt onto boiled and jacket potatoes Melt butter or margarine onto hot vegetables Stir butter, margarine, or oil into hot pasta or rice Add butter, margarine, or oil to scrambled eggs Roast potatoes and chips are high in calories or you may like other fried foods, such as fish, eggs and bacon Cream All types of cream are suitable. Add to porridge, soups, sauces and puddings Use as a topping for cereal and fruit Cream can be added to hot and cold drinks as a topping Cheese Use grated hard cheese, or a spoonful of cream cheese. Mix into scrambled eggs in addition to butter or margarine Mash into potatoes in addition to butter or margarine Use to make sauces for fish, pasta or vegetables Sprinkle grated cheese on top of soup, pasta and vegetables PI18_1595_02 High Protein, High Calorie Dietary Advice 7

8 Sugar Sugar, jam, honey, and syrup add useful calories to meals. Add plenty of jam, marmalade, honey or syrup to toast, scones, or crumpets Add to stewed fruit, smoothies, milky puddings or yoghurt Add to porridge or breakfast cereals If you have diabetes this advice on sugar may not be suitable for you so please check with your Dietitian. Beans and lentils To make soups or casseroles more nutritious, try adding tinned (ready to eat) beans such as butter beans or red kidney beans. These are especially useful if you are a vegetarian or vegan. Meal ideas Do not worry if you are unable to manage your normal meals. Here are some ideas for meals which are quick and easy to do, or can be bought ready made and are still nutritious: 8 PI18_1595_02 High Protein, High Calorie Dietary Advice

9 Main meals Cauliflower cheese, mashed potato or potato wedges and vegetables (add butter). Pasta dishes such as pasta bake, spaghetti bolognese, lasagne, macaroni cheese or cannelloni with a portion of garlic bread. Jacket potato with butter and filling. Fish and chips with mushy peas. Meat, fish or vegetable pie or burger with chips, vegetables and baked beans or coleslaw. Chilli con carne or Quorn with rice, topped with plain yoghurt and full fat grated cheese. Curry and rice with naan bread. Plain, cheese, or mushroom omelette with bread and butter. Sausages with mashed or roast potatoes, vegetables and gravy. Snacks Toast, crumpets, muffins, teacakes, pancakes, scones with butter and toppings of jam, peanut butter, marmalade or honey. Toast with toppings of beans, cheese, spaghetti, ravioli, sardines or tomatoes. Sandwiches, with tuna mayonnaise, cheese and tomato or ham and pickle. Creamy soup with a roll, toast, or buttered bread. Breakfast cereals with whole or fortified milk, sugar, honey or jam. Pizza, quiche, sausage roll, samosa, pakora or fried dumplings. Cheese chunks on crackers, crisps, bombay mix. Sponge cake, fruit cake, flapjack, cream cakes, biscuits or cookies. Chocolate, ice cream and jelly, mousse, yoghurt or fruit fool. PI18_1595_02 High Protein, High Calorie Dietary Advice 9

10 The following snacks are available on the ward (free of charge) on request: Cheese and biscuits Rice pudding Yoghurts Fruit Cake Biscuits If you miss a meal time (e.g. being off the ward for a scan or procedure) we have snack boxes available. These include a sandwich or wrap, a carton of fruit juice, a piece of fruit and a small snack. Please ask a member of staff and they can collect one for you. Other ways to help increase your appetite Take time to relax between meals or courses. Eat slowly and chew your food well. If possible, during meal times eat at a dining table with others. If food tastes differently to you, add herbs and spices to increase flavour. If you are feeling nauseous, keep away from cooking smells. Allow someone else to prepare your meals. Ready meals produce less cooking smells and can be just as nourishing. Dry foods, e.g. toast, crackers or plain biscuits, may help prevent nausea. Try to always have something at meal times, and avoid missing meals. 10 PI18_1595_02 High Protein, High Calorie Dietary Advice

11 Nutritional supplement products Your dietitian may suggest that you temporarily have a nutritional supplement drink on prescription, to top up what you are already eating. Advice will be given on the best type of nutritional supplement and how many you should aim to have each day. PI18_1595_02 High Protein, High Calorie Dietary Advice 11

12 Your dietitian may suggest trying: 12 PI18_1595_02 High Protein, High Calorie Dietary Advice

13 Supplement tips: Serve chilled or over ice cubes Add lemonade or tonic water to juice style drinks Add ice cream to milk based drinks Freeze and eat as an ice cream/sorbet/ice lolly Remove from the bottle and gently warm in a microwave (do not allow to boil) If, after following this advice you are continuing to lose weight, or if there is no improvement with your appetite or diet, please contact your GP for further advice or help. When your appetite returns, and your weight is right for you, please ask your dietitian, GP or practice nurse for information about healthy eating. PI18_1595_02 High Protein, High Calorie Dietary Advice 13

14 Please use the space below to write down any questions you may have and bring this with you to your next appointment. 14 PI18_1595_02 High Protein, High Calorie Dietary Advice

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16 The Trust provides free monthly health talks on a variety of medical conditions and treatments. For more information visit or call Nutrition and Dietetics Queen Elizabeth Hospital Birmingham Mindelsohn Way, Edgbaston, Birmingham B15 2GW Telephone: PI15/1595/01 Author: Nutrition and Dietetics Date: December 2018 Review date: December 2020