Many hospice patients struggle with weight loss or low appetite. Here are ways to incorporate additional protein and calories into the diet.

Protein-Fortified Milk

Add 1 cup of instant powdered milk to 1quart of whole milk (instead of adding it to water). Mix well and chill. One cup of this mixture will provide about twice as much protein as one cup of regular milk. You can flavor it with vanilla, chocolate, molasses, almond extract and/or honey.

This mixture can be used to make cream soups, hot cereal, desserts (custard, tapioca and other puddings), bread, cocoa, cream sauces, meat loaf, mashed potatoes and any other foods to which milk is ordinarily added.

Cheese

Cheese is a very good source of protein and calories. One ounce (the average slice) supplies 7 grams protein and 100 calories.  Suggestions for using cheese:

  • Add melted cheese as a topping to vegetables, rice, potatoes or pasta.
  • Serve on sandwiches.
  • Serve alone or on crackers as a snack.
  • If patient is on a low sodium diet, ricotta and cream cheese are the best choices.

Prepared Supplements 

The following products may be kept on hand to use when nothing else seems appetizing or when you need to put together something nutritious quickly. 

  • Instant breakfast
  • Protein powders can be purchased in groceries, drug stores, and health food outlets.

These can be added to shakes and smoothies to provide increased protein without a lot of sugar.  Compare brands for carbohydrate content.

Snacks

Snacks are essential for those who can only eat a small amount of food at a time. Served with a beverage, they boost the amount of protein and calories eaten in a day. They should be easily prepared and readily available.

Here are a few suggestions categorized according to texture and temperature:

Crunchy: Vegetables with dip, fruit, crackers (plain or with sour cream dip), granola, cheese or peanut butter on crackers and nuts.

Salty: Popcorn, crackers, pretzels, chips, nuts and cheese.

Soft: Banana, applesauce, creamy cheeses, pudding, yogurt, custard, ice cream, gelatin and cottage cheese.

Sweet: Cookies, cake, pie, fresh fruit, ice cream, dry fruit cooked in water, flavored yogurt and gummy fruit snacks.

Hot: Soups, cocoa, cheese toast, cinnamon toast, English Muffin pizza and warmed muffin with tea or coffee.

Cold: Lemonade, fruit juice, milkshakes and smoothies, ice cream, yogurt, hard boiled egg, sherbet, chocolate milk, gelatin and cheese cake.


Increasing Calories


Butter:
Add to soup, mashed and baked potatoes, hot cereal, grits, rice, noodles and cooked vegetables.  Stir into sauces and gravies.

Whipped cream:  Use in cocoa, desserts, gelatin, pudding, fruits and pancakes.

Light cream: Use in soups, sauces, egg dishes, batters, puddings, and custards. Put on cereal, mix with pasta and rice, add to mashed potatoes, pour on chicken and fish while baking, substitute for milk in recipes, as well as add to tea and coffee. 

Sour cream: Add to soups, baked white and sweet potatoes, vegetables, sauces, salad dressing, stews, gelatin desserts, bread and muffin batters and dips.

Mayonnaise: Combine with meat, fish, or vegetable salads or use in sauces, gelatin, casseroles and dips.

Nut butters: Peanut, cashew, almond, sesame tahini and other seed/nut spreads boost both protein and calories while providing many important nutrients. Add to smoothies and shakes, spread on bread or crackers, make nut butter cookies and add to sauces and dips.

Dried fruits: Cook in water or fruit-flavored tea and serve with meals or as a snack. Add to muffins, cookies, breads, cakes, rice pudding or pilaf, cereals, stuffing, pies, cobblers and yogurt.

Full-fat yogurt: Add to smoothies and fruit salads. Use as a dip with crackers. 

Smoothies

Homemade smoothies are highly nutritious and easy to swallow. The flavors are infinitely variable with fresh and frozen fruits, protein powders, milk, yogurt, ice cream, soymilk, nut and seed butters, wheat germ, flax seed meal, juices and flavorings.

The addition of some type of leafy green such as spinach or kale can provide nutrients from green vegetables without strongly affecting taste. Greens primarily reduce the sweetness.

To preserve the quality of leftovers, they can be frozen in small containers. When thawed, the smoothie tastes identical to when it was freshly made.

To save preparation time and provide variety, a few batches could be made up in advance and frozen so that the patent may select different flavors throughout the day. People tend to consume more when they are provided with a wider variety of tasty choices.

Wheat Germ

Toasted wheat germ is available in supermarkets and is a nutritionally dense food, providing protein, fat, important vitamins and minerals. Add it to yogurt, pudding, cereal, casseroles, vegetables, baked goods, pancakes, fresh fruit or anywhere its nutty flavor is suitable.

Wheat germ also works well as breading for baked fish. You can substitute it for bread crumb toppings on casseroles.

Ways to Improve Appetite and Nutrition

  • Patients often complain that food has lost its flavor and aroma. Sometimes experimenting with different flavors can increase taste and appetite.
  • Some people may develop a dislike for certain strong-flavored meats such as pork or beef, but still accept fish and poultry.  Should distaste for these foods develop, protein intake may be maintained by using dairy products, eggs and vegetable sources of protein such as beans, peas, lentils, soy products and nut butters.
  • Cured meats (ham, sausage, corned beef and lunch meats) sometimes appeal to those with a decreased taste for salt.
  • The addition of fresh and canned fruits may make puddings, shakes and cottage cheese more appealing.
  • Small, frequent meals are recommended for persons experiencing loss of appetite and fullness shortly after eating. Avoid drinking with meals to maximize food consumption. Have beverages between meals.