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If you have lost or are losing weight due to cancer or cancer treatment, you may need to add more energy and protein to your diet.
If you have a good appetite, you shouldn’t have trouble eating the extra energy (calories) and protein that you may need if you are ill. However, if your appetite is not very good there are two ways to add extra energy and protein to your diet, without having to eat more food.
Your doctor or dietitian might initially encourage you to try to eat everyday foods that are high in energy and protein before they recommend or prescribe any supplements.
These can be added to everyday foods or taken as nourishing drinks, which are available as milkshakes, juices, soups or powders to make up yourself. There are also ready-made puddings or concentrated liquids that can be taken in smaller doses. Some supplements are high-protein powders that can be added to your normal food. We can show you simple ideas about how to do this|.
Many supplements are available to add extra energy and/or protein to your diet. Some can be used to replace meals, while others are used in addition to your normal diet. Although a few of these products are available directly from your chemist or the supermarket, your doctor, nurse or dietitian can also prescribe them for you. They can also give you advice about how and when to use them.
High-protein or high-energy supplements should only be used with advice from your doctor or dietitian. If you are diabetic, seek advice from your doctor, specialist nurse or dietitian before using food supplements.
Balanced and flavoured meal replacement drinks are also available as powders, which can be mixed with fortified milk| or water. Some can be prescribed by your doctor; others, for example Build-Up® or Complan®, can be bought from your chemist and some supermarkets.
These are available on prescription in a variety of flavours: sweet, savoury and neutral.
Once mixed, milk-based supplements and powders should be sipped slowly over a period of 20 minutes.
These ready-to-drink, flavoured supplements are available on prescription. High-energy and juice-tasting supplements have a high sugar content, so people who are diabetic should talk to their dietitian before using them. These drinks may not be suitable if you have a sore mouth or throat as they may sting.
People who have had radiotherapy for certain types of head and neck cancers| may be more at risk of tooth decay, and so should avoid having sugar too often. It’s a good idea to clean your teeth or use a mouthwash after any sugary snacks. Your doctor, nurse or dietitian can give you more advice about this.
Fat emulsion supplements such as Calogen®, can be taken separately in small doses, or added to some foods. Your doctor or dietitian will give you clear guidance on how and when you should use this type of supplement.
Unflavoured powders are also available on prescription from your doctor or dietitian.
These powders are virtually tasteless so you can add them to drinks, soups, sauces, gravies, casseroles, flan fillings, milk puddings and instant desserts. Your dietitian or doctor will be able to explain how much powder to use in different meals or drinks.
You can make fortified milk by adding 2-4 tablespoons of dried milk powder to a pint (570ml) of full-fat milk. Keep it in the fridge and use it in drinks and for cooking. Use fortified milk, or milk-based supplements, instead of water to make up soups, jellies, custard and puddings. Many of the makers of nutritional supplements can give you recipes that use their products.
Make porridge with full-fat milk or cream. Pour fortified milk or a milk-based supplement over cereal. Add honey, golden or maple syrup to porridge, stir in stewed or dried fruit or use 2-3 teaspoons of a high-energy supplement instead of sugar.
Add lentils, beans and noodles to casseroles and soups. Stir a tablespoon of cream into canned soups or add energy and protein supplements. Grate some cheese over the heated soup. Make up packet soups with fortified milk or a milk-based supplement.
Mashed potato can be enriched by adding butter or cream, a small amount of a high-energy supplement, and by sprinkling grated cheese on top.
Melt butter on top of hot vegetables, top with grated cheese or a chopped, hard-boiled egg. Alternatively, serve them with a sauce made with fortified milk or cream.
Always use plenty of butter or margarine. Spread fillings thickly. Add a dessert spoon of mayonnaise or salad cream to sandwich fillings such as hard-boiled egg or tuna.
Keep snacks like nuts, pasteurised cheese, fresh and dried fruit, biscuits, crackers, breadsticks and dips, yoghurts or fromage frais handy to nibble if you feel hungry between meals.
If you’re out of the house for some time during the day, for example attending radiotherapy appointments, consider taking some snacks or a supplement drink with you.
Add ice cream, cream or evaporated milk to cold puddings, and custard made with fortified milk to hot puddings. Make up instant desserts with fortified milk. Try adding sugar or syrup to puddings. You could also try some pudding recipes using different ready-made or powdered supplements. The manufacturers of nutritional products often have recipe booklets.
Our recipes section| has lots of ideas for adding extra energy or protein to your diet. Here’s an example:
1 sachet Build-up®
200ml/7floz full-fat milk
1 scoop ice cream
With thanks to the Royal Marsden Hospital for contributing this recipe.
Use fortified or full-fat milk instead of water when making coffee and bedtime drinks. Add three teaspoons of a high-energy powder to hot or cold drinks. Ready-made drinks can be drunk straight from the pack, gently heated or incorporated into recipes.
If you can’t face a meal, have a nourishing drink instead. You can also drink these between meals to help you put on weight. You might like to make your own drinks, such as fruit milkshakes or smoothies. You can make a smoothie by blending fresh banana, peaches, strawberries or other soft fruit (fresh or frozen) with fortified milk, fruit juice, ice cream or yoghurt in a liquidiser or blender.
To make a nutritious milkshake, mix fortified milk with either puréed fruit or a fruit yoghurt and add 2-3 teaspoons of a high-energy powder supplement. A scoop of ice cream will add extra energy.
Content last reviewed: 1 May 2012
Next planned review: 2014
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© Macmillan Cancer Support 2013
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