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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