High Calorie, High Protein
Dietary Advice

If you are experiencing weight loss this may be due to a variety of causes. Weight loss is almost always associated with infection: it is important to treat any underlying infection. Regaining lost weight is a key part of recovery from the infection and helps you to respond to any drug treatment.

A reduction in the quantity of food eaten is the most common cause of weight loss. This is usually due to loss of appetite, nausea, fatigue and/or complex tablet regimens.

Weight loss is caused by the lack of two key food dietary elements: protein and calories. To help successful
weight gain it is therefore important to concentrate these in the foods that you manage to take. The healthy eating message of a ‘low fat, low sugar, high fibre’ diet is not necessarily relevant when you are trying to gain weight.

Ways to improve food intake:

* Eat more frequently: ‘little and often’ i.e. 5-6 small meals or snacks rather than 2-3 larger meals (often not finished!). Try to take something every few hours. Do not miss meals.
* Choose nutrient-dense foods (avoid diet/slimline/low sugar products; try to avoid very low fat foods).
* Choose nutritious fluids as drinking is often an easier way to gain calories/protein. Do not fill up on water, coffee, tea or diet drinks. Be aware that drinking before or with a meal can fill you up.
* Make eating easy; choose simple meals & snacks, ensure fridge/cupboard are well stocked; choose favourite foods. Start early in the day - having breakfast can help stimulate your appetite.
The roles of protein and calories:
* Protein is a ‘body-building’ nutrient that is important for muscle growth and replacing old or damaged body cells and tissues.
* Calories give us energy or ‘fuel’ and are needed for the body to carry out all its functions. Sufficient calories are needed to enable the body to use dietary protein effectively.

Good sources of protein (try to include one of the following as part of each meal):

* Meats and game
* Poultry –chicken / turkey / duck
* Fish –ensure it is well cooked. Try scrambled egg, omelette, hard boiled, egg mayonnaise
* Dairy foods –milk cheese yoghurt. (Try fortifying your milk to increase protein: add 2-3 tablespoons of skimmed milk powder to a pint of milk. Use this milk on cereals, in milkshakes, drinks, milk puddings, sauces and added to soups.
* Pulses –baked beans, kidney beans etc. lentils, peas, and chickpeas (including houmous) try adding to soups and casseroles.
* Nuts and seeds –useful to add cereals and dishes or taken as snacks.
* Vegetarian options –tofu, quorn, tempeh, and soya products.

Good sources of energy foods:

All food groups give some energy. Good sources of calories are ‘carbohydrates’: starchy (slow-acting) and sugary/refined (fast-acting) foods and ‘fats’.

Starchy foods:

* Bread, potatoes, pasta/noodles, rice, cous cous, breakfast cereals, porridge
* Sweet potato, yam, cassava, plantain, matooke (green banana), chapati, naan
* Crackers, bagels, scones, teacakes, muffins, crumpets, brioche, crisps, cakes, biscuits are useful snacks if main meals taken are very small.

Sugary foods:
Sugar is a concentrated form of carbohydrate and an easy way of adding energy to the diet. Be aware that good dental hygiene is important, especially if sweet foods/drinks are taken between meals. NB: this group of foods is not advisable if you have raised blood sugars.

* Sugar (brown/white), syrups, jam, honey, marmalade
* Sweets, chocolates, desserts, sweet cakes and biscuits
* Sugary drinks: fizzy, squashes/cordials, lucozade & isotonic/sports drinks

Good sources of fat:

Fats are the most concentrated source of calories, giving twice as many calories as a similar portion of carbohydrate or protein. A few people are intolerant to fat and find it aggravates diarrhoea therefore should not increase levels in the diet. For the majority it is the easiest nutrient to increase when appetite is poor and energy density is needed in the diet; it can then be used at a more moderate level once weight and appetite have improved. (Try to increase ‘unsaturated’ fats (plant-based) in preference to animal fats.)

* Vegetable based cooking oils (e.g. olive and sunflower oils)
* Butter, margarines and spreads Mayonnaise (pasteurised), salad cream, dressings
* Full fat dairy products: milk, cheeses, cream/sour cream/creme fraiche, yoghurts, fromage frais
* Nuts (including peanut butter); seeds (including sesame seeds and tahini)
* Oily fish (e.g. sardines, mackerel, pilchards, salmon): tinned in oil or fresh
* Dips(e.g. houmous, taramasalata, cream cheeses, avocado/guacamole, salsa & sour cream) with crisps/tortilla chips/pitta bread
* Croissants, pastries, chocolate

Fruits & vegetables:

A persistently poor dietary intake can lead to a lack of certain nutrients. While fruit and vegetables are an important source of vitamins and minerals these foods are also filling, low in calories, and provide little if any protein. Fruit and vegetable portions should not be excessive. The following suggests ways to use these foods in a more calorie-dense way. A multivitamin and mineral preparation can be prescribed from your clinic and may be advisable to correct any potential deficiencies.

Fruit:
* Serve fruit (fresh/tinned in syrup/frozen) with yoghurt, ice-cream, custard, cream or add to a milkshake.
* Dried fruit is higher in calories than fresh, but equally high in vitamins and minerals. Add dried apricots, prunes, apples, and pineapples to breakfast cereal or yoghurt. Eat with nuts as a snack. Add raisins or sultanas to curries, rice dishes or salads.
* Fruit juice is a more concentrated calorie source than fruit, often easier to consume if appetite is poor.
* Fruit puddings are useful: try fools, compotes, pies, crumbles, pastries, tinned in syrup.

Vegetables & salads:
* Add olive oil or cheese to roasted vegetables. Serve veg. with cheese sauce and breadcrumbs.
* Add olive paste, pesto, cheese sauces to mashed potatoes and pasta.
* Serve crudités with high calorie dips (see ‘fats’ section).
* Add avocado, sundried tomatoes, olives, nuts, cubes of cheese, croutons to salads and use dressings.

Drinks:

* Choose nutritious fluids in preference to low calorie drinks, water, coffee and tea which fill you up.
* If appetite is poor a large proportion of your calories can be acquired from high calorie fluids e.g. fruit juice, milk (fortified), milkshakes, drinking yoghurts, fizzy drinks, squashes/cordials, Ribena.

Calorie and protein supplements:

There are times when achieving an adequate intake is impossible without the help of specially formulated dietary products. High calorie and protein products are in liquid or powder form and can be used to supplement your diet as a simple source of nutrition. Ask your dietician for further information regarding these supplements or for further ideas/advice.