Diabetes: eating well if you have a poor appetite

If you have diabetes and you are underweight or struggling with your appetite, it is important you eat the foods you like, rather than restricting your diet too much.
 
This may mean eating foods that are higher in fat and calories. 

Speak with your diabetes team to review your medications.

Talk to a dietitian to help you make any changes. 

Food is important to help you maintain your health. It contains essential vitamins, minerals and protein to help your body repair itself and recover from illness. 

Eating well also helps to maintain weight and fight infection.

This is particularly important when you feel unwell.  This is a time when you may not feel like eating, but you need to eat as well as you can.

Useful tips

• Try to eat three small meals and three snacks throughout the day.
• Keep snacks within easy reach.
• Eat at times when you feel hungry or when your appetite is better.
• If cooking is difficult, try using ready meals, frozen and tinned foods or ask a friend or relative to help.
• If shopping is difficult, consider Meals on Wheels or other meal delivery services such as Wiltshire Farm Foods.
• Try to eat with people and in relaxed and pleasant surroundings whenever possible.
• Go for a walk or open a window to take in some fresh air before eating.

Fluids

It is important to stay hydrated at all times, especially when you are unwell.

Try to do the following:

• sip fluids throughout the day 
• avoid drinking large volumes with meals
• try to drink at least 6 to 8 cups of fluids each day (1.5 to 2 litres).

You can also gain extra nutrition in drinks.  Try the following:

• milk
• milkshakes
• hot milky drinks such as hot chocolate, Horlicks or milky coffees.

Avoid low calorie and diet drinks as these are lower in energy.

Snacks

Snacks between meals are a good way to help you meet your daily nutritional needs when your appetite is poor.

Snacks can help you to gain weight.

Snacks can be eaten alongside nourishing drinks and enriched foods.

Aim to have 2 to 3 snacks between meals.

Tips for choosing snacks

Try to avoid ‘diet’ or ‘light’ products.  These are lower in energy than regular products.

Try to make a routine of having a small snack with your drinks.  For example, have milk with a biscuit or small handful of nuts.

Sweet snack options:

• croissant or pain au chocolate or almond croissant

• plain or fruit scone
• teacake or hot cross bun with butter
• slice of Victoria sponge or other cake
• biscuits.

For a soft diet:  sponge roll, rice pudding, tinned peaches and cream.

For a puree diet:  fromage frais, custard, ice cream or mousse, creme caramel, pureed stewed fruit (for example apple and cream).

Savoury snack options:

• slice of pizza
• Scotch egg 
• mini pork pie
• sausage roll
• Cornish pasty
• handful mixed nuts
• bag of crisps
• handful of Bombay mix.

• Some snack combination ideas

• Glass of enriched whole milk and a banana
  • 250ml whole milk with 2 tablespoons skimmed milk powder added
  • 1 regular banana
     
• Glass of whole milk and mixed nuts
  • 250ml whole milk with 2 tablespoons skimmed milk powder
  • 40g handful of mixed nuts
     
• 3 crackers with butter and cheese
  • 3 crackers
  • 1 tablespoon butter
  • 50g cheese (approximately 5 slices)
     
• Ham and cheese croissant
  • 1 large croissant
  • 30g cheese (approximately 3 slices)
  • 2 slices of ham
  • For vegetarians, remove the ham
     
• Avocado and cream cheese on toast
  • 1 slice of toast
  • 1 tablespoon cream cheese
  • Half an avocado
     
• Enriched rice pudding with honey or jam
  • 125g pot rice pudding
  • 2 tablespoons of cream
  • 1 tablespoon of honey or jam
     
• Cream cheese and ham on crackers or toast
  • 3 crackers or 1 slice of toast
  • 1 tablespoon cream cheese
  • 2 slices of ham
     
• Peaches with Greek yoghurt
  • 120g tinned peaches in juice
  • 150g Greek yogurt
  • 1 tablespoon honey
     
• Smooth peanut butter on toast or oatcakes
  • 1 tbsp butter or margarine
  • 2 tablespoons smooth peanut butter
  • 1 slice of toast or 4 oatcakes
     
• Bowl of cornflakes with enriched milk
  • 35g bowl cornflakes
  • 125ml whole milk with 1 tablespoon skimmed milk powder 
     
• Weetabix with enriched milk
  • 2 Weetabix biscuits
  • 125ml whole milk with 1 tablespoon skimmed milk powder 

The benefits of nourishing drinks

A nourishing drink can contain as many calories as an extra snack or small meal.  It can be a good way to help by increasing your daily energy, protein, vitamin and mineral intake.

This will help you if:

• you have lost weight due to illness
• you need ‘building up’ or extra nourishment
• you have a poor appetite and find it easier to tolerate liquids.

Nourishing drinks still count towards your overall fluid intake.  We advise you to prioritise them over lower calorie drinks.

Drinks such as water, squash, tea, instant coffee, broth soups and fizzy drinks contain fewer calories and much less protein than nourishing drinks.

Enriched milk

Try to consume a pint of milk every day. 

Whole (full cream or full fat) milk contains a range of nutrients. You can drink it by itself or use it to make milkshakes, hot chocolate, hot malt drinks, and milky coffees. You can also use it on cereal, to make porridge, custard, and milk puddings.

If you dislike cow’s milk you can try the following milks instead:

• rice
• almond
• goat.

To add extra nutrition, you can add skimmed milk powder to your milk before you use it. You can find skimmed milk powder in supermarkets and local shops (often near the longlife milk section). 

Try adding 8 heaped teaspoons (120g) of skimmed milk powder to a pint of milk. This gives you an extra 400 calories (approx) without changing the flavour of the milk too much. 

Homemade nourishing drinks recipes

• Hot malt drink

  • 25g (4 teaspoons) Ovaltine, Horlicks or other malted drink powder

  • 200ml whole milk
  • 1 tablespoon double cream
    
    Heat milk using microwave or hob, but avoid boiling.
    Spoon the powder into a mug and mix into a paste with a little milk.
    Slowly stir in remaining milk and cream, and serve.
     
• Simple milkshake
  • 15g (3 teaspoons) of milkshake powder 
  • 200ml whole milk
  • 1 tablespoon double cream
    
    Stir milkshake powder into cold milk, add the cream and serve.
     
• Fortified milkshake
  Choose 1 option from the 3 options listed below.
  ​​​​​​​
  • Add 1 to 2 tablespoons (15 to 30g) of skimmed milk powder. This adds an additional 50 to 100kcal and 5 to 11g protein
  • Add 1 scoop of ice cream to your milkshake during preparation and blend it in. This adds a further 115kcal
  • Add a portion of fruit, for example banana or berries.  This adds flavour and nutrients such as fibre.

Fortifying foods

Make small changes to the way you prepare your usual foods.  This can help you to gain extra energy and protein.

Try using the following products to fortify your foods.