Patient Information Eating well with a small appetite and kidney disease The information contained within this diet sheet is intended to be used alongside the tailored dietary advice provided by your dietitian Author: Dietetics Produced and designed by the Communications Team Issue date Jan 2016 - Review date Jan 2019 - Expiry date Jan 2020 Version 2 Ref no. PILCOM1720
This diet sheet is for those with kidney disease who have a small appetite, need to gain weight or prevent further weight loss. It contains suggestions of how to boost your energy and protein intake without necessarily having to eat more food. Eating well is important to maintain your health. Food contains energy and protein, but also essential vitamins and minerals. Eating well can reduce your risk of infections, build and maintain muscles, aid wound healing and provide energy for everyday activities. Please remember that any other diets you may be following may still apply. Your dietitian will support and guide you to achieve this. Tips to help improve your appetite Eating little and often can help improve a reduced appetite. Try and include three small meals and 2-3 nourishing snacks per day. Serve a smaller portion of your meal to prevent feeling overwhelmed, you can always go back for more. Smoking, as well as being bad for your health can also suppress your appetite. If you smoke, try not to smoke in the half-hour before your meal. Try not to fi ll up on drinks shortly before or during meals. A small glass of alcohol 30 minutes before a meal may help to stimulate your appetite; however, check with your doctor/pharmacist fi rst to make sure this is suitable with any medications you might be taking. Any alcohol needs to be included within your fl uid restriction. Fresh air can often stimulate your appetite. If possible go for a brief stroll or go outside for a while before eating. Eating in a well-ventilated room can also help. If you re too tired to cook, use ready-made oven/microwave foods or freeze extra portions of meals when cooking and use another day. Try to choose the lower salt options where possible; if unsure speak to your dietitian. There are a variety of ways that you can purchase meals such as Meals-on-Wheels, ready meal delivery services (such as Wiltshire farm foods or Oakhouse foods), lunch clubs or day centres. Consider what would be convenient for you. 2
Tips for fortifying your foods Extra protein and calories can be added to normal foods to increase the nutritional content without increasing the portion size. This is known as food fortifi cation. This means that each mouthful you eat is more nourishing. Ideas of everyday foods you can add to foods or drinks to increase their calories or protein content For an extra 50-100kcal: Add 2 teaspoons of jam or honey to porridge or milk puddings Add thickly spread butter/margarine to sandwiches, toast, crackers, scones or chapati Add 2 teaspoons of sugar to tea/cereal/puddings Add a tablespoon of pickle/relish to sandwiches Add a heaped tablespoon of milk powder to cereal, milk puddings, mashed potatoes, sauces and soups For an extra 100-150kcal: Melt grated cheese (a small matchbox size) into soups, sauces and mashed potato Add a tablespoon of green pesto to pasta or mashed potato Add 1 scoop of ice cream to puddings/drinks Add 2 tablespoons of full fat crème fraiche/greek yoghurt to fruits/ puddings Stir in a tablespoon of oil/butter/margarine to soups, sauces, vegetables and mashed potatoes, cooked rice/pasta Use a tablespoon of oil/butter/margarine to fry foods such as pre-boiled potatoes or vegetables, meat, fi sh, eggs Add a tablespoon of double cream to drinks, milk puddings, porridge, soups, scrambled egg 3
For an extra 150-250kcal: Stir in a tablespoon of clotted cream to a dessert Mix a heaped tablespoon of full fat mayonnaise into sandwich fi llings Add a tablespoon of full fat cream cheese to potatoes, pasta or in your sandwich Nourishing snack ideas Little and often is the best way to try to increase your calories. Aim for 2-3 nourishing snacks a day. Ideas of nourishing snacks you can include between meals to increase your calorie and protein intake: Savoury snacks Breadstick with a dip Pork pie Scotch egg Sausage roll Chicken drumstick Cream crackers Crumpet Slice of toast English muffi n Croissant Maize, corn or rice based crisps, eg. cheese puffs, tortilla chips, Snack a Jacks, rice cakes Examples of toppings for toast, croissants, crackers, crumpets include butter, jam, marmalade, honey, tinned tuna, tinned salmon, chicken, corned beef, turkey, egg and some cheeses such as mozzarella, brie and stilton 4
Sweet snacks 2-3 biscuits, eg. shortbread, digestive, ginger, cream/jam fi lled biscuits Cake, eg. sponge cake, fl apjack, cream cake, Danish pastry, doughnuts, jam tarts, iced buns Small packet of sweets, eg. boiled, chewy, jelly, mints or marshmallows Scone Scotch pancake Full fat yoghurt Full fat mousse Crème caramel Cheesecake Trifle Custard Rice pudding Ice cream Examples of toppings for scones, teacakes, scotch pancakes include butter, cream, jam, marmalade, honey, syrup, lemon curd 5
Sample menu ideas Menu 1 Breakfast A small bowl of porridge made up with water Use 200ml full fat milk instead of water Lunch 2 slices of white bread with roast chicken Pear Be generous with the fi lling and add mayonnaise Add full fat yoghurt Dinner Shepherd s pie with boiled carrots Half a tin of peaches Grate cheese on top of the Shepherd s pie and add butter to boiled vegetables Add custard made with full fat milk Extra calories from fortifying the meals: approximately 500kcal and 21g protein 6
Menu 2 Breakfast 1 croissant Add butter and jam, spread thickly Lunch 2 slices of toast with butter Stewed apple Add 2 fried eggs Add scoop of ice cream Dinner Chicken curry with rice Low fat yoghurt Add double cream to the curry sauce and fry the chicken and vegetables in oil Replace with full fat yoghurt Extra calories from fortifying the meals: approximately 600kcal and 16g protein 7
Not to be photocopied Individual goals Contact details: If you require further information, please contact the Nutrition and Dietetic Department at Basildon University Hospital on 01268 593958. All dietitians employed at Basildon and Thurrock University Hospitals NHS Foundation Trust are state registered with the Health and Care Professionals Council. Basildon University Hospital Nethermayne Basildon Essex SS16 5NL 01268 524900 Minicom 01268 593190 Patient Advice and Liaison Service (PALS) 01268 394440 E pals@btuh.nhs.uk W www.basildonandthurrock.nhs.uk The Trust will not tolerate aggression, intimidation or violence directed towards its staff. This is a smokefree Trust. Smoking is not allowed in any of our hospital buildings or grounds. This information can be provided in a different language or format (for example, large print or audio version) on request.