So, You’ve Been Told to Eat More Calories…

Abbe Simon, CCC-SLP

It is not uncommon for one or more of our staff members to recommend increasing your daily calories in order to maximize your nutritional intake. It is not uncommon for us to hear responses such as, “But I’m not hungry”, “I eat big meals already [at dinner]” or “I don’t have time to eat more often.”

Many times, we learn that our patients have arrived at our Center without having eaten breakfast and rarely bring a snack with them despite the fact that they will not eat lunch until after 1:00. This is typical for those people who have a morning appointment that often makes the family feel rushed and out of time for the morning meal. Whether your nutritional intake is a regular diet, a modified softer diet, or tube feeding, breakfast should never be missed. Depriving your body of this initial caloric intake is denying your system the “fuel” it needs to run itself in the most efficient way. When this happens, the body can start to use its own fuel, i.e., muscles as an energy source and can burn up calories without taking any in. This can lead to loss of muscle mass and is not beneficial to your well being.

This article contains convenient ways for providing an efficient and easy means to achieve your nutritional needs throughout the day by starting out with a full stomach. It includes recommendations for those who may present with swallowing changes (dysphagia) and require soft foods and/or thickened liquids. We aim at providing efficient ways to consume a well balanced diet without having you become tired from preparing foods and/or from eating.

Early Morning and You’re On the Go:

As I mentioned above, too often we find patients complaining that they had no time to eat before leaving the house. Listed below are convenient foods to take on the go. It requires a little bit of organization of your time but is well worth it:

• A can of Ensure Plus or Boost Plus (can be taken orally or if you are taking nutrition via tube, you can bring 2 cans and feed during your appointment) Ensure and Boost can be purchased over the counter (in drug store or supermarket)
• Bran Muffin
• Carnation Instant Breakfast mixed with whole milk, lactaid or soy milk
• Fresh Samantha Juices (bought in stores)
• Banana
• Bagel with cream cheese. Choose soft bread without crust if you have difficulty chewing. For additional calories, add marmalade or jelly
• Regular yogurt (not lite or fat free) with fruit
• Health Shake prepared ahead of time and stored in refrigerator
• Store bought yogurt drinks- come in different flavors and have excellent source of calories
• Hot chocolate mixed with regular, lactaid or soy milk
• Sandwich made with soft bread, cheese, or meat (avoid lettuce and tomato if you have difficulty chewing)
• Puddings: chocolate, rice, ensure
• lightly toasted bread with 3-4 slices of cheese and bring along a can of Ensure, Boost or Carnation Instant Breakfast mixed with milk (as above).

If time allows you to eat at home, prepare oatmeal with milk- you can add honey, and/or raisins. Additional breakfast options include scrambled egg prepared with some milk, yogurt, cottage cheese, cold cereal (allowed to soak in milk for those who have chewing/swallowing difficulty), fruit, or muffin. Often times, it is recommended that small, more frequent meals be consumed. If this is the case, have one of the above, and then another about two-three hours later.

Midday Meal

Whether you are home, work, or at an appointment, with friends, or at a restaurant, it is easy to select meals that are healthy, easy to prepare, and easy to chew/swallow. Emphasis here is on food that can be taken with you.

• Yogurt with added fruit, wheat germ, granola
• Cottage cheese with fruit
• Soft bread/roll with cheese
• Soft sandwich (tuna fish, egg salad, chicken salad- all can be chopped and made with extra mayonnaise for easier swallowing)
• Pasta with sauce, melted cheese. Avoid spaghetti and al dente noodles if you have difficulty chewing
• Baked sweet potato brushed with olive oil and cinnamon
• Can of Ensure, Boost
• Health/Yogurt Shake

Dinner Time:

When we make suggestions to improve nutritional intake, many people often grimace and can’t imagine eating such “healthy” foods. Listed here are enticing ways to add flavor to your palate…

• Meat loaf – add bread crumbs, spices, BBQ sauce and frozen vegetables – adds wonderful flavor
• Ground meat prepared with tomato sauce, spices, beans softened during cooking. This can be placed over small noodles, mashed potatoes or rice. Avoid dry, flaky rice if you have difficulty swallowing.
• Mashed sweet potatoes seasoned with honey, cinnamon
• Over cooked fresh vegetables chopped up and left in refrigerator for chopped salad- add extra salad dressing if you have difficulty chewing or swallowing
• Soups made with meat, vegetables (pureed for those who have swallowing difficulty)
• Pureed squash – seasoned with cinnamon, butter, brown sugar

Snacks:

• Soft granola bars/Ensure bars
• Fruits, precut vegetables left in refrigerator- cucumbers, overcooked vegetables for those who have difficulty chewing.
• Chocolate or vanilla pudding
• Rice pudding
• Applesauce (a wonderful addition to any meal if food tends to “get stuck” in your mouth or throat)
• Yogurt/Health Shake- you can use a blender to prepare tasty meal: add fresh fruits and or vegetables, yogurt, or sorbet, milk, or juice, ice. To add sweetness, you can include a little honey or vanilla as well.
• For those individuals who having difficulty swallowing water, adding ice to the above shake provides a good source of hydration.

If you are experiencing decreased appetite and interest in eating, discuss this with you doctor during you next visit. Certain medication may be recommended to increase you appetite. Happy eating!