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Food tips for those with bad appetites

Tags: cancer , diet , nutrition

Food tips for those with bad appetites

People with cancer may find that they eat less than usual or have a poor appetite at certain times.

Nutritionist Sarah Schenker suggests some manageable and palatable ways to stabilise your eating pattern and boost your nutritional intake.

Tips for cancer patients with a poor appetite

Many cancer patients experience a reduced appetite at some stage during their illness, which can be due to anxiety or tiredness or may be a side effect of their treatment.

It is vital that you maintain an adequate nutritional intake to help you fight the cancer, so if you are having problems eating, seek advice from your doctor.

If you don't feel like eating much and/or lack the energy or will to prepare full meals, you can help ensure that you maintain an adequate nutritional intake by eating a well-balanced range of lighter meals and snacks and by fortifying some of the foods you eat.

Stabilising your eating pattern

If your food intake is irregular, aim to stabilise your eating pattern. Eating little and often is often more manageable than trying to tackle large meals when your appetite is poor. As long as appropriate foods are chosen, this can also result in a greater overall energy intake.

Aim for three small/light meals a day, interspersed with three small, energy-dense snacks (see the example menu at the end of this article). Occasional convenience foods and ready meals are fine if you find cooking tiring or difficult at this time.

Identify the time of day at which your appetite is best and try to maximise your food intake then. This might be breakfast time, so consider preparing a cooked breakfast instead of your usual bowl of cereal.

Increasing your energy intake

In addition to extra snacks, choose everyday foods with a higher calorie content. For example, opt for whole (full fat) milk and dairy products, rather than reduced-fat versions.

You can also fortify food with ingredients such as milk powder, butter, cream and vegetable-based oils to increase your energy intake in a palatable way. See the 'Fortifying food' chart for suggestions on ways to do this.

Fortifying food

Milk powder
Add 2-4 tablespoons to a pint of milk and use throughout day in tea, breakfast cereal, porridge, custard, puddings etc. Stir directly into soup.

Butter or margarine
Add liberally to potatoes, cooked vegetables and bread.

Grated cheese
Sprinkle onto soup or potatoes.

Cream (or evaporated milk)
Have with fruit.  Add to soup, smoothies, sauces or mashed potatoes.

Jam, syrup, honey
Add to breakfast cereals, porridge, milk puddings. Use more liberally in cooking, but avoid food becoming too oily.

Sugar or glucose powder
Add to sweet foods and drinks. Glucose is less sweet than sugar so more can be added, although it is more expensive.

Maintaining an adequate protein intake

Each day, eat at least two small portions of protein with a high biological value. These protein foods contain all the essential amino acids. If you find the texture of meat difficult, white fish and eggs may be better tolerated.

Dairy products such as milk, cheese and yoghurt, as well as soya-based alternatives, all make very useful contributions to protein requirements and you may find them easy to consume.

Protein foods with a high biological value:

  • Any meat, offal, poultry or fish - fresh, tinned or frozen.
  • Eggs.
  • Milk, cheese and yoghurt.
  • Textured vegetable protein, tofu, soya beans, soya bean flour, and soya milk, yoghurts and puddings.

Protein foods with a low biological value contain an incomplete range of essential amino acids, and therefore must be combined with other amino-acid-containing foods (eg baked beans on toast).

Protein foods with a low biological value:

  • Pulses - eg peas, beans and lentils.
  • Nuts.
  • Cereals - eg wheat, rice, barley, rye, bread, pasta, flour, breakfast cereal, biscuits.
  • Potatoes.

Drinking adequate fluids

Try to have nutritious fluids, such as juices, smoothies, drinking yoghurt and hot chocolate, rather than drinking large volumes of water, which can impair appetite and lacks calories.

Malted drinks such as Horlicks, Ovaltine or Milo can be comforting and are fortified with some vitamins and minerals.

Quick tips for boosting energy and nutrient intake

  • Take pills and supplements with whole milk or a probiotic drink instead of water.
  • Use whole milk in tea and coffee and add sugar (if taken) instead of sweeteners.
  • Add whole milk and sugar to breakfast cereals, or try sugar-coated cereals.
  • Make porridge with whole milk and a little cream.
  • Keep a small amount of butter out of the fridge so it is easy to spread on hot toast and other toasted foods. As it melts in, add a little more.
  • Have a good selection of different toppings to choose from to spread on toast, such as jam, honey, chocolate spread and peanut butter.
  • Try Scotch pancakes, crumpets or English muffins as an alternative to toast, as they are less filling if you have a reduced appetite.
  • Make soups with milk and water and stir in an extra tablespoon of milk powder or grated cheese.
  • Add butter and grated cheese to mashed potatoes.
  • Mash sardines with full-fat soft cheese to spread on toast.
  • Add mayonnaise to sandwich fillings such as tuna, chicken or grated cheese, or add soft cheese to slices of ham or smoked salmon.
  • Add smoked salmon pieces to scrambled eggs and grated cheese to omelettes.
  • Mix grated cheese into baked beans.
  • Have soft canned fruit instead of fresh fruit and add a scoop of ice cream.
  • Make jelly with milk instead of water, and try simple milk puddings such as rice pudding, blancmange or instant whip.
  • Add a handful of dried fruit to cereals and puddings.
  • Have milky drinks and biscuits at bedtime.
  • Have scheduled snacks between meals.Try some of the following:
  • cubes of Cheddar cheese with digestives;
    individual pots of custard, rice pudding or full-fat yoghurt;
    mini ice creams or choc ices;
    small bags of mixed nuts (if your dentition allows);
    half an avocado;
    mini breadsticks with dips such as hummus, guacamole or soft cheese;
    meat or fish pates on cream crackers.

Example menu

Achieving 1,800 kcal intake for those with very poor appetites

Take pills and/or supplements with a small probiotic drink. Sip a small carton of fruit juice throughout the day.

Breakfast
1½ tbsp cornflakes with 150ml whole milk and 1 tsp sugar
Cup of tea with whole milk and 1 tsp sugar

Mid-morning
Warmed Scotch pancake spread with butter
Cup of tea with whole milk and 1 tsp sugar

Lunch
Protein-fortified soup made with 200ml whole milk
Small pot of milk jelly

Mid-afternoon
Cup of tea with whole milk and 1 tsp sugar
1 digestive biscuit with a small cube of Cheddar cheese

Dinner
Small cheese omelette
1 scoop of ice cream

Bedtime
Malted milky drink

Useful websites

"Diet problems with cancer", Cancer Research UK

http://www.cancerhelp.org.uk/

"Eating problems", Macmillan Cancer Support

http://www.macmillan.org.uk/

Please note, these tips are provided for your information and should not be considered a substitute for any advice given to you by your GP or specialist.

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