Food Fortification and Managing a Small Appetite

Food Fortification and Managing a Small Appetite

Patient and Carer Information

Macmillan Allied Health Professionals Team

• Author ID:      VL/ RH
• Leaflet ref:      CM 239
• Version:         2
• Leaflet title:    Food fortification and managing a small appetite
• Last review:    June 2024
• Expiry Date:   June 2026

Poor appetite

People often lose their appetite and find it difficult to eat as much as usual when they become ill. 

There are lots of reasons why this happens, for example: loss of appetite, feeling full quickly, effects of treatment, worry or any combination of these.

If you are eating less it is important to eat and drink a nourishing diet to help prevent or reduce weight loss, fight infection and repair damaged tissue. 

Try not to get out of the habit of eating. You actually need to eat to stimulate your appetite. 

Make the most of the times you feel like eating.  Do not worry; if it is not ‘normal’ foods at ‘normal’ times – if you fancy cereal at midnight, enjoy it! 

Be positive about what you do eat – every extra mouthful helps.

A short walk before a meal or some fresh air may help to give you an appetite. 

One small glass of wine, beer, sherry or your favourite drink taken half an hour before a meal may boost your appetite. Check with your doctor first.

Experiment with different foods, you may find that you like things you do not usually eat. 

How to make the food you eat count

It is important to make every mouthful count when you have a small appetite, have weight loss or are unable to eat enough food. 

Think of a ‘little and often’ meal plan. Try to eat three small meals and three snacks a day - aim to eat something every two to three hours.

Here are some suggestions to help prevent weight loss, maintain weight or gain weight: 

• If you find there are certain foods you can easily eat, for example cereals, eat them as often as you like
• If cooking smells put you off eating, keep away from the kitchen while food is being cooked or try eating cold foods instead
• Keep tasty snacks beside you to nibble 
• Relax and allow yourself plenty of time to eat a meal
• Have drinks at least half an hour before or at the end of your meal
• Try to have a nourishing drink between meals, such as milk based ones
• Make eating as easy as possible - make use of ready to eat or convenience foods which are easy to prepare, such as microwaveable ready meals
• For a great source of vitamins and minerals try to include some fruit and vegetables in your diet. This could be either: fresh; frozen or tinned fruit and vegetables.

Food fortification – making food more nourishing

The calorie content of everyday foods can be increased without increasing the volume of food. By introducing the suggestions below into your meals and snacks you will boost your energy and protein intake.

• Add between five and eight tablespoons of skimmed milk powder (according to taste) to one litre of milk. This can be used in foods such as: custard, cereals, drinks, rice puddings and will increase the energy, protein, calcium and vitamins A and D content. This will add approximately:
  • 30kcals, 2 grams protein to tea or coffee (30mls).
  • 100kcals, 7 grams protein to breakfast cereals (100mls).
  • 14 grams of protein to milky drinks (200mls)
• Add extra full fat butter or margarine to bread, potatoes, vegetables and sauces. 
  • 90kcals (10-20grams)
• Add sugar, jams, honey or syrup to hot drinks, breakfast cereals and puddings. 
  • Adding three teaspoons of sugar = 60 – 80kcals
  • Thickly spreading jams, honey or syrups = 40-50kcals
• Add grated cheese to soups, scrambled eggs, mashed potatoes and vegetables. 
  • 165kcals, 10 grams of protein (40grams)
• Add tinned evaporated milk to fruit based desserts,  cereals and milky puddings.
  •  150kcals, 8 grams protein (100mls)
• Full fat houmous and mayonnaise can be added to potatoes, vegetables and sandwiches. 
  • For mayonnaise (30grams, two  tablespoons)
  • For houmous (30 grams, two tablespoons = 200kcals, 8 grams of protein)   

Quick and nourishing snack ideas

• Sandwiches with a variety of fillings such as: tuna mayonnaise, egg mayonnaise, salmon, cooked meats or cheese.
• Readymade desserts such as: full fat yoghurt, full fat fromage frais, crème caramel, mousse, cheesecake, trifle.
• Fruit either tinned in syrup or fresh - cream, custard, evaporated milk, full fat yoghurt or full fat ice cream can be added for extra energy.
• Small sausage rolls or pies.
• Toast or bread with peanut butter or jam.
• Breakfast cereals with full cream or fortified milk.
• Dried fruit or unsalted nuts.
• Crackers and cheese.
• Fruit based cakes, malt loaf, cereal bars.
• Soup made with fortified milk, added cheese or cream and bread.

Nourishing drinks

• Hot milky drinks such as malted milks or hot chocolate –replace water with milk in instant varieties.
• Milkshakes made with full fat milk, tinned fruit and full fat ice cream.
• Soup, especially condensed or cream varieties or with added fortified milk.
• Pure fruit juice and lemonade with a scoop of ice cream.

People with diabetes

Some of the ideas listed in this leaflet contain sugar and would not usually be recommended for people with diabetes to eat between meals. 

When your appetite is reduced they can be used as a temporary measure but we recommend extra monitoring of your diabetes control. You should contact your doctor, the diabetes specialist nurse or the dietitian for further advice.

Oral health information for adults with natural teeth

Some of the nourishing snacks and drinks listed in this leaflet are high in sugar and are not usually recommended for between meals due to increased risk of tooth decay. 

However, during periods of illness you may use the ideas in this leaflet. It is recommended that you clean your teeth more often. 

You should use family fluoride toothpaste for brushing. A fluoride mouthwash may be used between meals.

For more dental advice please contact your dentist, nurse or doctor.

Useful information

If you need help with food shopping, cooking or making meals contact your doctor, district nurse or social worker. They can discuss the possible options for either home care help, ‘meals-on-wheels’ or to attend a luncheon club.

There are some commercial delivery food companies that provide a variety of meals and cater for special dietary requirements.

British Dietetic Association (BDA) provides food fact sheets to the general public on diet and health and other relevant information relating to nutrition.

Website address: www.bda.uk.com

Macmillan Cancer Support provides a variety of information for patients and carers. 

Macmillan helpline: 0808 808 00 00 

Website address: www.macmillan.org.uk

Contact us

Please contact the Dietitian or the Macmillan Allied Health Professionals Team if you would like more information.

We are based at:

Wigan and Leigh Hospice

Kildare Street

Hindley

Wigan

WN2 3HZ

Telephone: 01942 525566 Monday to Friday 8am until 4pm.

Local Community Pharmacy

Your local community pharmacies offer a wide range of services, including information and general advice on symptom relief medicines, as well as a prescription collection and delivery service.

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