If you have a good appetite, you should not have trouble eating the extra calories and protein that you may need if you are ill. If you do not have a good appetite, there are ways to add extra energy and protein to your diet without having to eat more food.

Talk to your doctor, specialist nurse or a dietitian if you are still struggling. They may encourage you to eat everyday foods that are high in energy and protein. They can also recommend or prescribe manufactured food (nutritional) supplements, which can come in forms such as milkshakes and juices.

Your doctor at the hospital can refer you to a dietitian. In some hospitals, you can refer yourself. You can contact the hospital’s dietetic department for more information. If you are not in hospital, your GP can refer you to a community dietitian, who may be able to visit you at home. They may also be able to see you at your local GP surgery or health centre.

If you have any dietary limitations, for example lactose intolerance or diabetes, it is important to talk to a dietitian, GP or specialist doctor at the hospital for advice.

Fortified milk

Adding extra energy and protein to your diet without having to eat more is called fortifying your food. You can make fortified milk by adding 2 to 4 tablespoons of dried milk powder to a pint (570ml) of full-fat milk and mixing it together. Keep it in the fridge and use it in drinks, on cereals and for cooking. Use fortified milk or milk-based supplements instead of water to make soups, jellies, custards and puddings. Many producers of nutritional supplements can give you recipes that use their products. Read the packet or visit the website for details.

Cereals and porridge

Pour fortified milk or a milk-based supplement over your cereal. Make porridge with full-fat milk or cream. Add golden syrup, maple syrup, honey or sugar to your cereal or porridge. Try adding stewed or dried fruit too.

Casseroles and soups

Add lentils, beans or 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, or drizzle some olive oil over the top. Try making packet soups using fortified milk.

Mashed potato

Add butter or cream to mashed potato, and sprinkle grated cheese on top.

Vegetables

Melt butter on hot vegetables and top with grated cheese or a chopped, hard-boiled egg. Or add a sauce made with fortified milk or cream.

Sandwiches

Use plenty of butter or spread. Add a dessert spoon of mayonnaise or salad cream to thick sandwich fillings such as tuna, chicken, egg or cheese.

Below are some tips to add energy and protein to meals:

• When you are shopping, choose full-fat foods instead of ‘diet’ or ‘light’ foods.
• Fry your foods in oil, ghee or butter.
• Add extra butter, margarine or oil to bread, potatoes, pasta and cooked vegetables.
• Add extra cheese to sauces and extra paneer to curries.
• Add cream, sour cream, plain yoghurt, mascarpone or crème fraiche to sauces, soups and meat dishes.
• Add whole or blended beans, lentils or peas to curries and stews.
• Add evaporated milk, condensed milk or cream to desserts and hot drinks.
• Have cream or ice cream with desserts.
• Add peanut butter (or other nut spreads), chocolate spread, tahini, honey or jam to bread, toast, crackers and biscuits.

The best way to get more energy and protein into your diet is by eating a healthy, balanced diet. If you are still having eating problems or are continuing to lose weight, talk to your specialist doctor, nurse or GP. They can give you more advice.

There are many nutritional supplements available, which can add extra energy or protein (or both) to your diet. You can add them to your everyday foods, or they can be an addition to your normal diet. Sometimes they can be used to replace meals.

The types of nutritional supplements available include:

• milk-based supplements
• juice-tasting supplements
• soups
• powdered drinks
• ready-made puddings
• concentrated liquids.

They come in many different flavours. If you have a dairy (lactose) intolerance, ask your GP, specialist nurse or dietitian to prescribe dairy-free food supplements.

You can get some of these products from your chemist or supermarket, but your doctor, nurse or dietitian will need to prescribe some of them for you. High-protein or high-energy supplements should only be used with advice from your doctor or dietitian.

If you are diabetic, it is important to get advice from your GP, specialist nurse or dietitian before using nutritional supplements.

Powdered drinks

Some powdered drink supplements can be used to replace a meal. You can mix them with fortified milk or water. Some can be prescribed by your doctor. You can buy some products from your chemist and some supermarkets.

Milk-based supplements

These are available on prescription in a variety of flavours, including sweet, savoury and neutral. The supplements usually need to be used within 24 hours. If you can only manage small amounts at a time, you can pour some into a glass and keep the rest in the fridge. We have ideas on how to include these in your everyday diet above.

Juice-tasting supplements

These ready-made, flavoured supplements are available on prescription.

High-energy and juice-tasting supplements have a high sugar content. If you are diabetic, talk to your dietitian before using them. These drinks may not be suitable if you have a sore mouth or throat, as they may sting.

If you have had radiotherapy for certain types of head and neck cancer, you may be more at risk of tooth decay, so it is best to avoid having sugar too often.

It is a good idea to clean your teeth or use a mouthwash after any sugary snacks and make sure you have your teeth regularly checked by a dentist. Your GP, nurse or dietitian can give you more advice about this.

Fat-based liquids

You can take these supplements separately in small doses, or you can add them to some foods. Your doctor or dietitian will give you advice on how and when you should use this type of supplement.

Energy and protein powders

Unflavoured powders are also available on prescription from your GP or dietitian. These are almost tasteless, so you can add them to:

• drinks
• soups
• sauces
• gravies
• casseroles
• flan fillings
• milk puddings
• instant desserts.

Your GP or dietitian can explain how much powder to use in different meals or drinks.