Download Identifying whether an individual requires

Making the most of food
Guidance Sheet 6
Identifying whether an individual requires nutritional support will normally be informed by using
the Malnutrition Universal Screening Tool (MUST). According to NICE clinical guideline (CG32):
“Nutrition support in adults”, people in care homes should be screened by appropriately
competent staff using this tool on admission and when there is clinical concern. If a resident is
losing weight NICE recommends evaluating the resident using MUST www.bapen.org.uk/pdfs/
must/must-full.pdf
If a resident has lost weight or has a poor appetite it is important to make the most of the foods
they are eating, this is also known as fortifying foods. The tips below will assist you making the
best food choices to help the resident gain weight or prevent further weight loss. Adapt eating
patterns and food choice to encourage increased nutritional intake from everyday food and
drink. Things to consider:
Completing a food and drink diary so that you can find a pattern (eg doesn’t eat so well in
the evening as becomes increasingly tired through the day)
Take into account personal tastes and preferences
Use full-fat milk and dairy products
Fortify foods with milk powder, Complan® or Meritene® powder
Consider problems handling food and if required provide assistance with eating or cutting
up food (eg arthritis, specialised cutlery or other equipment required)
Review if there are problems chewing, eg dentures: check that they fit properly and
consider if a visit to the dentist is necessary
If you notice problems swallowing refer resident to GP but consider softer texture foods in
the meantime
Do not overload the plate as this can be overwhelming, but make sure the resident knows
that they can ask for more
It is preferable for the resident to enjoy normal foods but in richer form.
Try to include the following each day:
Three small meals, as well as 2 to 3 snacks including milky drinks
At least one pint of full cream milk (blue top) or fortified milk (see over
for recipe) incorporated into food or as milky drinks
A serving of one of these protein rich foods 2 to 3 times per day: meat,
chicken, fish, eggs, cheese, yoghurt, nuts, beans or lentils
At least 8 to10 cups of fluid per day
At least one dessert or pudding per day
Ideas for between meals: nourishing snacks
Snacks should be offered in addition to meals not instead of meals
Cheese and crackers or digestive biscuits with butter or margarine
Nuts, dried fruit, crisps, chocolate, sweets
Cake, cheesecake, scones, fruit loaf with butter or cream
Savoury snacks (eg pork pie, sausage roll, Scotch egg, quiche)
Cold meats (eg salami, pepperoni, sausages)
Crumpets with butter and jam
Pastries (eg custard tart, jam tarts, Danish pastry)
Ice cream, full fat or creamy yoghurts, trifles
How to enrich your food further:
Fortified milk: To a pint of full cream milk add 2 to 4 tablespoons of dried milk powder. Use
this in place of ordinary milk or water to make up coffee, packet soup, sauces, jelly, milk
puddings, instant whips, custard, porridge and to pour over breakfast cereals. Resident
should aim to drink one pint a day.
To soups add grated cheese, cream, dried milk powder, baked beans, pasta, dumplings,
evaporated milk, vegetable oil, lentils.
To potatoes, pasta, rice and vegetables add grated cheese, cream, margarine or butter,
salad cream, milk based sauces, vegetable oil, fried onions.
To puddings add double cream, custard, ice cream, jam, honey, syrup, dried fruit, evaporated
or condensed milk.
To breakfast cereals add fortified milk, double cream, evaporated milk, yoghurt, syrup, honey,
sugar, fruit or dried fruit.
Avoid low fat, light or diet products as these contain fewer calories. The healthy eating guidelines
for the general population do not apply when you are unwell. If residents are worried about having
too much fat then try to include more foods which contain fats that are healthy for your heart (eg
rapeseed oil, olive oil, olive oil spreads,
avocado and nuts).
If the resident has diabetes, continue to avoid
sugary drinks and high sugar foods and try to
include more high fat and high protein foods.
If you have any doubts contact the GP or the
dietitian.
To contact us please email: [email protected]
Version 4_2015 _Review Date: December 2017