You have been given this information because you have a poor appetite or have lost weight.
In the past you may have been asked to avoid certain foods.
This might include those containing potassium or phosphate.
While you are eating less it may not be necessary to limit these foods. Your dietitian can advise you on this.
This page contains advice on:
- Tips to prevent malnutrition
- Fortifying your foods
- Meal suggestions
- High protein options
- Stimulating the appetite
- Nutritious fluids
- Setting goals
What? When? And How?
Try to make your goals SMART.
S - Specific
M - Measurable
A - Achievable
R - Realistic
T - To a time frame
I will aim to drink 1/2 pint of full fat milk daily.
This goal states exactly what you are going to do. It is realistic and gives a specific amount of time it will be achieved in.
Choose a goal that is achievable for you.
You might find that you feel too unwell to follow the advice in this booklet. If this is the case for you, you may benefit from a nutrition drink.
Your dietitian will advise you whether you need them and will write to your GP.
If you already have a nutrition supplement drink and struggle to manage them, try to the following:
- Keep them in the fridge
- Add them milk to use on cereal
- Make them into jellies, sorbets, slushies or ice cream
- Add them to yoghurt or custard
- If you find them too thick or sweet you can dilute juice based supplements with fizzy drinks and milky ones with
- You could make them into a smoothie or shake. Ask your dietitian for some recipes.
- Most supplements come in multiple flavours. Ask the pharmacist for a different flavour if you don’t like the one you have.
Over the counter supplements
You may have seen some of these drinks in the chemist (pharmacy) or supermarket. Some are not suitable for patients with a kidney condition.
Check with your dietitian before you drink any of these.
Malnutrition can happen when your body does not get enough nutrients from your diet. It is quite common in people with a kidney condition.
Having a problem with your kidney can cause poor appetite and nausea. It can also affect the way food tastes.
Malnutrition increases your risk of:
- Muscle loss (including muscles like the heart and lungs)
- Poor wound healing
- Hospital admission
Your stay in hospital may be longer and your treatment can be less effective.
Tips to prevent malnutrition
Here are some ideas you could try:
- Aim for little and often (e.g. 3 small meals and 3 snacks per day) if you can’t manage larger portions
- Choose foods that are fortified to increase their calories
- Have more high energy puddings and snacks
- Choose more protein rich foods
- Try to stimulate your appetite
- Choose high energy drinks
- Set yourself realistic goals
These suggestions will be explained in more detail on this page.
When you have a poor appetite it is important to choose drinks which provide more calories:
- Do not fill up on water, tea, or coffee, particularly before meals
- Try to have milky drinks once per day as they provide some protein and energy
Examples are: cocoa, hot chocolate, milkshake, smoothie, latte, cappuccino or drinking yoghurt
- *Add sugar instead of sweetener
- *Try fruit juices and full sugar squash
*If you have diabetes you might want to check with your diabetes specialist nurse first.
If taking a supplement drink, only have these between meals so that you are not too full for your meal.
Fortifying your foods
‘Fortifying’ means adding extra nutrients to a food.
Here are some ways to increase the calories in your food.
This is particularly important if you can only manage to eat small amounts.
Fats and oils
Fats and oils have the highest amount of calories. Having more of these will help you get enough calories without having to increase your portions.
Adding sugar, honey or syrup is another way to fortify your food. If you have diabetes you may be used to being strict with reducing sugar. While you are not eating well you can relax this a bit.
Avoid diet products
This means foods that are advertised as low fat or low sugar.
Ways to increase fats and sugars in your diet
- Add double cream, full fat yoghurt, full fat milk, honey, or fresh fruit to your cereal.
- Add butter and jam or marmalade liberally to your toast.
- Add butter or full fat milk to your omelette.
- Use full fat milk, extra cheese or cream to make white, cheese sauces or packet sauces.
- Add cream, fromage frais, or crème fraiche.
- Try hollandaise, mayonnaise, ketchup, salad cream, barbeque sauce or horseradish.
- Add butter, oil, cream or grated cheese to potatoes.
- Add butter, cream cheese or nut butter to bread.
- Try adding oil to rice (e.g. biryani or egg fried rice) or fried onions.
- Choose pasta with oily or creamy sauces such as pesto, macaroni cheese, carbonara or lasagne.
- Try dips like hummus or sour cream with crackers, pitta, or corn crisps.
Stimulating the appetite
You do not have to stick to your normal mealtime routine*
- Eat what you want, whenever you want
- Eat as much as you can when you feel hungry and make the most of ‘good days’
*check with your diabetes nurse if you are on insulin
Don’t skip meals
- If you can’t manage a meal, have a snack or try a milky drink instead
- Remember - not eating in itself can cause low appetite
Seek food that appeals to the senses
If the smell of some foods affects you then try to:
- Avoid the kitchen during cooking
- Avoid cooking things with strong smells (e.g. Brussel sprouts, fish)
- Choose cold foods
- Choose foods that are quick to prepare
If you’ve lost interest in eating; try to imagine foods with appealing sights and smells, then try a small portion.
Make food more attractive by adding a garnish.
Fresh air and the environment
- If you are able, fresh air and a small amount of exercise before a meal can help increase your appetite.
- Make meals sociable in a relaxed, pleasant environment.
A small amount of alcohol before a meal can increase your appetite (but check with your doctor first)
You may be worried that eating more fat and sugar will affect your health.
As malnutrition can cause other problems, it is important to tackle this first. Once you are eating well again you can go back to your normal healthy way of eating.
If you’d like to include some healthy fats in your diet, here are some options:
- Oils: olive oil or rapeseed oil (monounsaturated fats)
- Oily fish: mackerel, salmon, sardines, trout, fresh tuna
- Oily fruit and vegetables: *avocado or olives in oil
- *Nuts and seeds: pistachio, walnuts, chestnuts, almonds, hazelnuts, peanut, pecans and sunflower seeds
*check with your dietitian before eating lots of nuts or avocados as these are high in potassium.
High protein foods
Protein is important for keeping muscle strong and healing wounds. When you are poorly you can lose protein from your body, so it’s good to try to eat more of these foods. It can be found in:
- All types of meat, chicken and turkey, including cold meats or processed meats e.g. sausages, ham
- All types of fish including processed fish e.g. in breadcrumbs or tinned fish
- Any type of cheese and all milk
- Yoghurt and fromage frais - choose ones high in protein
- Dairy based puddings (e.g. rice pudding, custard and crème caramel)
- Certain types of bread (e.g. baguette, panini and ciabatta)
Sweet snacks and puddings
- Fruit crumbles
- Full fat yoghurt
- Tea cakes
- Spotted dick
- Sticky toffee
- Syrup/jam sponge
- Bread & butter pudding
- Angel delight
- Rice pot
- Prepare and store small portions of your favourite foods
- Plan what you will eat in advance
- Keep finger foods handy for snacking
- Ensure cupboards and fridges are well stocked
- If cooking is difficult try some supermarket readymeals or a delivery from Wiltshire Farm Foods, Oakhouse Foods or Parsley Box
- If shopping is difficult you could try online ordering
There are no set rules, you don’t have to eat breakfast at breakfast or dinner at dinner time. You may find some of these ideas appeal at different times of the day.
- Thickly spread butter and jam on bread rolls, crumpets, muffins or croissants
- Danish pastries
- American pancakes with syrup
- Cereal or porridge made with full cream milk
- Full fat yoghurt with fresh fruit and honey
- Baked beans on toast
- Cheese or cold meat roll
- Eggs (e.g. omelettes, boiled, poached, fried, scrambled or with soldiers)
- Cooked breakfast (e.g. sausage, bacon, baked beans)
- French toast (e.g. eggy bread)
Try using different breads:
- Or whatever you fancy!
With at least two fillings e.g. ham and cheese, salmon and cream cheese.
Why not try:
Fish: tuna, salmon, pilchards, sardines (tinned in oil), mackerel
Cheese: grated cheese or cream cheese
Paste: cold meats, hams, chicken or pesto
Meat: corned beef, cold meats, ham, chicken
Vegetarian: taramasalata, houmous, falafel, egg, nut butter
Sweet spread: jam, marmalade, honey, chocolate
If you get full quickly try:
- An open sandwich (e.g. one slice of bread with multiple fillings)
- Use butter or full fat margarine
- Try adding sauce (e.g. mayonnaise, salad cream, mustard, tomato ketchup) to add flavour and calories
Easy small meals
Eating several small meals and snacks can be easier than facing a large meal. Here are some suggestions that are
nutritious and quick to make:
- Scrambled egg on toast, with added cheese, bacon or herbs
- Baked beans on toast with lots of butter
- Cheese on toast (e.g. cream cheese topped with hard cheese), garlic bread with cheese
- Bacon or sausage bap
- Mini pizzas (you can even make your own using a crumpet, muffin or bagel as a base)
- Sausage rolls, pork pies, scotch egg, falafel
- Soups fortified with full fat milk, cheese and added croutons
- Flans, quiches, pies, pasties
- Savoury pancakes (e.g. ham, cheese, bacon, bolognaise)
- Tinned spaghetti, macaroni cheese
- Oily fish (e.g. tinned mackerel, sardines or salmon) on toast
- Fish fingers, fishcakes
- Cheese and biscuits
How to contact us
Department of Nutrition & Dietetics
Level 6, Gate 10, Brunel building
0117 414 5428
For more information, read our Nutrition & Dietetics: Kidney Disease and Food page.
If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.
© North Bristol NHS Trust. This edition published March 2022. Review due March 2024. NBT003379.