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Area Nutrition and Dietetic Service Food First – Making the most of your food Introduction If you have lost weight, have a poor appetite or have been missing meals it is important to make the most of the foods you are eating, along with trying to eat more. This is also known as food fortification. The following information will help you make sure your food is as nourishing as possible, help you gain weight or prevent further weight loss until you are feeling better. This advice may not be suitable for some medical conditions, for example food allergies or swallowing problems for which you may need individual advice. If you have been advised to thicken fluids please continue to do so. If you have diabetes or high cholesterol, this information will conflict with advice that may have previously been given. However, ensuring you are well nourished is more of a priority at present. If you continue to have problems eating please contact your GP, District Nurse, Practice Nurse or Dietitian. General advice and tips • • • • • • • • • • • • • Eat in a relaxed environment and take time to eat your meals. Try to get some fresh air before meals. Aim to take gentle exercise daily. If you’re having dental problems, or you have dentures that don’t fit, contact your dentist. If you are a smoker, avoid smoking before meals as this could affect your appetite. Eat smaller, more frequent meals and snacks; try to eat every two to three hours. Avoid low fat, reduced sugar and diet products as they will have fewer calories. Try not to drink fluids before or with meals as they can fill you up. Make the most of occasions when you feel hungry and choose the foods you fancy. Ask someone else to cook or consider using fresh or frozen meal delivery. These can be useful if your appetite is affected by cooking smells or standing for long periods of time is a problem. Make use of convenience foods, such as ready meals, pre-prepared sandwiches or tinned foods. Frying foods will increase their calorie content; however, some people may find fried foods off-putting when they are unwell. Alcohol in small amounts can stimulate your appetite (if permitted by your GP). Information Sheet 1. Produced by Prescribing Support Dietitians, October 2009. Review October 2010. Area Nutrition and Dietetic Service, NHS Dumfries and Galloway. Food fortification – The basics Simple changes to your meals and snacks will make a difference. For example: • • • • • • 1 teaspoon of butter or margarine adds 50calories 1 teaspoon of sugar adds 16calories 2 tablespoons of double cream adds 130calories 1 tablespoon mayonnaise adds 100calories 1 oz / matchbox sized piece cheese adds 120calories 4 level tablespoons dried milk powder adds 200calories Use full cream, enriched (see recipe below) or channel island milk. Aim to have 1 pint per day. Fats, such as cream, butter and cheese provide energy-use them generously. Sugars such as jam, honey and syrup can be added to food and drinks to increase their calorie content. Add butter or margarine, cheese or white sauce to vegetables. Aim to have at least one pudding every day. Enriched milk (530 calories, 35g protein) Mix 3 level tablespoons of dried milk powder into 1 pint of full cream milk. Breakfast • • • • • Cereals or porridge made with full cream, enriched or channel island milk. Extra calories can be added with cream, sugar and honey. Spread butter or margarine, jam, marmalade or honey generously on toast, bread, crumpets, teacakes, pancakes and croissants. Chocolate spread, lemon curd, peanut butter and cheese spread can also be used to add extra calories. Scrambled eggs on toast made with butter or margarine and cheese. Filled roll with fried egg, bacon or sausage. Thick and creamy yogurts. Light meals • • • • • • • • • Soup – choose creamy varieties or add cream, cheese or croutons. Toast with cheese, eggs, beans, sardines or ravioli. Omelette with cheese. Sandwiches or jacket potatoes. Fillings: - tuna, egg, cheese, coleslaw, cold meat, corned beef, coronation chicken, salmon. Add calories with butter, margarine, salad cream or mayonnaise. Tinned stew or macaroni cheese. French toast - add cheese and ham as a filling. Ready meals e.g. fish pie, cottage pie. Boil in bag fish. Packet pasta – just add milk, for example Pasta ‘n’ Sauce or try the supermarket own brand. Information Sheet 1. Produced by Prescribing Support Dietitians, October 2009. Review October 2010. Area Nutrition and Dietetic Service, NHS Dumfries and Galloway. Puddings • • • • • • Milk puddings such as rice pudding, custard, semolina or tapioca. Sponge, fruit crumble, or stewed fruit with cream, ice cream or custard. Fruit with ice cream, evaporated milk, condensed milk or jelly made with milk. Gateaux, cream meringue or cheesecake. Individual chocolate mousse, trifle, crème caramel or crème brulee. Yogurt or fromage frais. Snack ideas • • • • • • Crisps with dips or hummus Scone, pancake, crumpet, potato scone or malt loaf – add butter or margarine, jam, cream or cheese. Doughnut, flapjack, traybake or shortbread. Chocolate coated, cream or jam filled biscuit. Piece of cake or a muffin. Sausage roll, pork pie, Scotch egg, savoury egg. • • • • • • • Handful of nuts, e.g. Cashews, Peanuts, Pistachios. Dried fruit. Cheese and crackers. Pate on oatcakes Chocolate bar Individual desserts i.e. yogurts, trifle, custard, rice pudding A nourishing drink (see drink ideas below) Commercial supplements Complan or Build Up are enriched drinks sold in chemists and supermarkets. They are available in both sweet and savoury flavours and can be used between meals when appetite is low. Chemists and supermarkets also have their own brand versions. Nourishing drinks Milky drinks, e.g. coffee, hot chocolate, milkshakes, malted drinks, can be made with full fat or enriched milk and sugar to increase their calorie and protein content. Ready to drink flavoured milk drinks are also available, such as Nesquik, Yazoo, Mars or Aero. Nourishing drink recipes • • • For best results when making any of the following recipes, use a hand blender. Unless otherwise stated blend all ingredients together and serve chilled. Calorie and protein content of the drinks are dependant on milk used, for example, enriched milk contains more calories and protein than full cream milk. Milk shake (Makes 300mls, contains 400-450 calories and 9-14g protein) 190mls or 1/3 pint of full cream or enriched milk 2 tablespoons of milkshake syrup or powder 1 scoop ice cream Handful of tinned, fresh or frozen fruit (optional) Information Sheet 1. Produced by Prescribing Support Dietitians, October 2009. Review October 2010. Area Nutrition and Dietetic Service, NHS Dumfries and Galloway. Fruity float (Makes 300mls, contains 195 calories and 3g protein) 125mls fruit juice 125mls regular lemonade 1 teaspoon sugar 1 scoop of ice cream Fruit smoothie (Makes 400mls, contains 375-425 calories and 16-21g protein) 190mls or 1/3 pint of full cream or enriched milk 1/2 pot of thick and creamy yogurt Handful of tinned, fresh or frozen fruit (optional) 1 tablespoon of honey 1 scoop ice cream Iced coffee (Makes 200mls, contains 265-315 calories and 9-14g protein) 190mls or 1/3 pint of full cream or enriched milk 2 teaspoons of coffee powder / granules 2 teaspoons sugar 1 scoop of ice cream Ginger lime (Makes 300mls, contains 150 calories and 7g protein) 250mls of ginger beer 2 tablespoons of lime cordial 1 pot of natural yogurt Nourishing cup-a-soup (Makes 200mls, contains 220-275 calories and 8-13g protein) 190mls or 1/3 pint of full cream or enriched milk 1 sachet of cup-a-soup Blend cup-a-soup powder with heated milk and serve. Chocolate mallow (Makes 200mls, contains 390-440 calories and 8-14g protein) 190mls or 1/3 pint of full cream or enriched milk 1 tablespoon drinking chocolate 1 tablespoons rum * (*Optional - if permitted by your GP) 2 teaspoons sugar Whipped cream 4 marshmallows Blend the drinking chocolate, sugar and rum with heated milk, then top with marshmallows and whipped cream to serve. Malt dream (Makes 200mls, contains 275-325 calories and 9-14g protein) 190mls or 1/3 pint of full cream or enriched milk 1 tablespoon of malt powder, such as Horlicks or supermarket own brand. 1 teaspoon honey Whipped cream Blend malt powder and honey into heated milk, top with whipped cream and serve. Cinnamon spice (Makes 200mls, contains 170-220 calories and 6-11g protein) 190mls or 1/3 pint of full cream or enriched milk 1 tablespoon golden syrup Pinch of cinnamon Pinch of mixed spice Blend syrup, cinnamon and mixed spice into heated milk and serve. Information Sheet 1. Produced by Prescribing Support Dietitians, October 2009. Review October 2010. Area Nutrition and Dietetic Service, NHS Dumfries and Galloway.