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Heart Healthy Diet for Poor Appetites

Food and drink options for people who have poor appetites during a period of ill health.

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Food as treatment

During periods of ill health it is common to have a poor appetite and eat less food. Over time this can lead to unplanned weight loss and slow down your recovery. You have been given this leaflet because you are not eating enough and you may have been losing weight. It is important in recovery to have enough energy, protein, fat, vitamins and minerals to help your body repair and avoid weight loss while your body is recovering.

This advice may only be necessary in the short term. Once you are eating well again or once you have reached your target weight, you can return to a healthy, balanced diet.

Tips to increase your intake:

  • Choose high energy foods: avoid low calorie or diet options
  • Eating 6 smaller meals or snacks may be easier than the traditional 3 meals a day
  • Don’t drink too close to a mealtime as this can fill you up
  • If you are struggling to prepare foods use convenience foods or ready meals.
  • Add extra calories to your food
  • Include nourishing drinks
  • If your food intake is limited a general multivitamin and mineral tablet can be taken
  • If you are feeling sick/nauseous choose cold foods and foods without a strong smell e.g. jelly and ice cream*, sandwiches, cheese and biscuits
  • In hospital choose energy dense (ED) meals, ask for biscuits on the tea round and extra puddings at mealtimes

Frequently asked questions before you start

Can I still use this advice if I have high cholesterol?

Increasing your weight does not necessarily require high amounts of sugar and saturated fat, which may increase risk to your heart health. Saturated fat is typically found in animal products such as butter, pies, cakes, fatty cuts of meat and cheese – we recommend that you reduce your intake of these foods. This leaflet promotes ‘healthier fats’ (called unsaturated fats) which are better for heart health and still provide useful calories (energy) to help stabilise your weight.

What if I have diabetes?

Eating enough energy, protein and micronutrients is essential for recovery. However, if you have diabetes it is important to keep your blood sugar levels stable. It may be that if you have a small appetite and your eating habits change, your medications need to be adjusted to prevent you having blood glucose readings that are too high or too low. Always inform your doctor or diabetic nurse if you are making changes to your diet at home. High sugar options are labelled with an asterisk (*).

I have been advised to have a low salt diet – what can I eat?

Salt increases your blood pressure which can put extra strain on your heart so it’s important to not eat more than the maximum recommended daily amount of 6g (a teaspoon). Some high energy foods naturally low in salt include: milk, yoghurts, smoothies, unsalted nuts and seeds, fruit juice and jelly. Read food labels when shopping and try and opt for foods with less than 0.3g salt per 100g and avoid foods with more than 1.5g salt per 100g.

Further advice on a low salt diet can be found on the British Heart Foundation website.

The following boxes offer ways to add extra calories and protein into your food

To soups, casseroles add
  • Beans
  • Lentils
  • Grated cheese
  • Milk powder
  • Croutons
  • Rice
  • Pasta
  • Dumplings
  • Barley/Couscous
  • Vegetable or olive oil
  • Single cream

To bread, toast, crackers, crumpets add
  • Thick spreading of vegetable or olive spread
  • Soft cheese
  • Jam*
  • Honey*
  • Chocolate spread*
  • Lemon curd*
  • Mashed banana
  • Nut butter
  • Mashed avocado
  • Hummus

To breakfast cereals add
  • Jam*
  • Honey* or syrup
  • Sugar*
  • Yoghurt (full fat)
  • Dried fruit* and nuts

To vegetables and salads add
  • Chopped hard boiled egg or tinned beans
  • Sauces or salad dressings
  • Grated cheese
  • Vegetable or olive spread
  • Salad cream
  • Dips

To sauces add
  • Cheese
  • Vegetable or olive spread
  • Yoghurt (full fat)
  • Milk powder
  • Vegetable or olive oil

To puddings also add
  • Custard*
  • Ice cream*
  • Sorbet*
  • Single cream
  • Jam, honey*, syrup*
  • Sugar*
  • Fruit, nuts
  • Evaporated milk*

To potato add
  • Single cream
  • Vegetable or olive spread
  • Milk powder
  • Grated cheese
  • Pesto
  • Olive or vegetable oil
  • Salad cream
  • Mayonnaise

To sandwiches add
  • Chutney
  • Cheese
  • Cream cheese
  • Nut butters
  • Jam*, marmalade*
  • Hummus
  • Pesto
  • Avocado
  • Mayonnaise
  • Salad cream

To pasta and rice add
  • Chutney
  • Cheese
  • Cream cheese
  • Nut butters
  • Jam*, marmalade*
  • Hummus
  • Pesto
  • Avocado
  • Mayonnaise
  • Salad cream

Examples of high calorie / protein snacks ideas

Savoury suggestions
  • Unsalted nuts and seeds
  • Cheese and biscuits
  • Crackers/crispbreads with dips and oils
  • Falafels and hummus/guacamole
  • Sandwich or toast with meat/fish/cheese/nut butter/jam/marmite
  • Meat free cocktail sausages/ scotch eggs/sausage rolls
  • Avocado on toast/snack breads
  • Baked/lentil crisps with dips
  • Savoury scone with vegetable/olive oil spread
  • Olives (in olive oil)
  • Oatcakes with dips
  • Mackerel or sardine fillets on toast
  • Mackerel or salmon pate on crackers/crispbreads

Sweet snacks
  • Scones with vegetable/olive oil spread and jam*
  • A small bar of dark chocolate/carob bar*
  • Rice pudding*
  • Custard*
  • Dessert mousse*
  • Thick and creamy yogurt*
  • Hot chocolate*
  • Hot malted drink*
  • Malt loaf with vegetable/olive oil spread
  • Fruit toast or teacake with vegetable/olive oil spread
  • Stewed Fruit* and yogurt
  • Dried fruit* (e.g. apricots/banana chips)
  • Crumpet/breakfast muffin with honey* or jam*

Nourishing drinks

It is important to drink enough fluid during the day. While fluids such as water and squash are hydrating they do not provide extra calories. Soups and milky drinks contain a good amount of energy as well as fluid. If you are on a fluid restriction, make sure to incorporate these drinks as part of your restriction.

Choose higher energy drinks where possible these include: whole milk, smoothies* or fruit juice, soups, milkshakes, milky coffees, hot chocolates, hot malt drinks and fizzy drinks*.

Homemade milkshakes and smoothies

If you are struggling with your intake, try making a tasty nourishing drink at home. See below for useful recipes.

Fortified milk recipe
  • 1 pint (570ml) full fat milk
  • 5 heaped tablespoons dried milk powder

Mix ingredients until smooth in consistency. Use in tea/coffee/on cereal, and to drink. Try adding yogurt, ice cream, puréed/frozen fruit* or milkshake syrup* for milkshake ideas.

Smoothie recipes

Strawberry delight:

  • 250ml milk
  • 300g greek yoghurt
  • 1 banana
  • 1 large handful of frozen strawberries
  • 1/4 avocado

Banana:

  • 250ml milk
  • 300g greek yoghurt
  • 1 banana
  • 1 handful of cashew nuts
  • 1 teaspoon honey*

Blend all ingredients together until thick and smooth consistency. Adjust to taste, add honey to sweeten.

Oils and salad dressings

Adding oil to salads and vegetables as a dressing, dipping in bread or flavouring pasta, and using oil generously during cooking are great ways to add energy to food. Examples of oils containing ’healthier fats’ include olive, extra virgin olive, walnut, sesame, flax, avocado, rapeseed (vegetable), and sunflower. Please note that coconut oil is very high in saturated fat, and, although not of animal origin, can negatively affect your overall heart health. Therefore we would not recommend cooking with it or including it in your diet.

Example Salad dressing recipes

Classic Vinaigrette

Whisk two tablespoons red wine vinegar, two teaspoons mustard, 1/2 teaspoon salt and pepper. Gradually whisk in 100ml of olive oil.

Honey and Mustard

One garlic clove, crushed, two teaspoon Dijon mustard, two teaspoons runny honey, three tablespoons white wine vinegar, 100ml of olive oil and 1/2 teaspoon of salt and pepper. Simply whisk all ingredients together.

Classic lemon and olive oil

One tablespoon lemon juice, three tablespoons olive oil, 1/2 teaspoon salt and pepper. Whisk together, taste and adjust seasoning.

Dips

Having a dip with a meal or snack can boost your enjoyment as well as your energy and protein intake. Some ideas include:

Dip recipes

Guacamole

Mash 1 ripe avocado in a bowl, add 1 diced tomato, mix in half a clove of garlic (crushed) and the juice of half a lime and 1/2 teaspoon of salt and pepper.

Creamy avocado dip

Mash 1 ripe avocado, stir in 2-3 tablespoons of natural yogurt.

Tzatziki

Grate 1/4 cucumber and mix well with 150ml natural yoghurt, 1 teaspoon of lemon juice, 1 tablespoon of olive oil, 1 teaspoon of dried / fresh mint and 1/2 teaspoon of salt and pepper.

Garlic Cream Cheese Dip

Mix 2 tablespoons of cream cheese, 2-3 teaspoons of whole milk,
1/2 teaspoon of garlic powder and 1/2 teaspoon pepper.

Hummus

To a food processor add 1 drained can of chickpeas, 1/2 garlic clove, 3 tablespoons of olive oil, the juice of 1/2 a lemon, 2 tablespoons of greek yoghurt, 1/4 teaspoon of cumin, 1/2 teaspoon of pepper, 2 tablespoons of tahini (optional) and 1 tablespoon of water. Blend until smooth. Add extra lemon juice/pepper/cumin to taste.

Pesto

To a food processor add 50g pine nuts, 80g basil, 50g grated parmesan cheese, 2 garlic cloves and 150 ml olive oil. Process until smooth and add black pepper to taste.

Information:

If you continue to lose weight despite this advice, please speak with your GP or dietitian for further input.

Sample meal plan

Breakfast

Porridge made with full fat milk and added fruit or nuts plus a full cream yoghurt

or
Scrambled/fried egg made with oil or vegetable spread on toast with fruit juice/smoothie*

Mid-morning snack

One portion of cheese and biscuits
or

Snack bread and hummus OR toast with nut butter with milky drink or smoothie*

Lunch

Sandwich with meat/fish/vegetarian meat alternative with vegetable spread

or
Toast with 2 poached eggs and avocado

or
Jacket potato with beans/cheese with rice pudding* / full fat yoghurt

Mid-afternoon snack

Milky drink or smoothie* with a portion of unsalted nuts/seeds

Evening meal

An omelette with vegetables (add margarine)

or
Meat/fish with pasta/rice/potatoes with vegetables/salad with dessert mousse*

Information:

While in hospital choose the energy-dense (ED) options for added calories. Ask for snacks regularly on the tea rounds and extra puddings at meal times.

Contacts

The Royal Sussex County Hospital

Eastern Road
Brighton
East Sussex
BN2 5BE

01273 696955 Ext. 64290

Renal telephone 01273 696955 Ext. 64327

Princess Royal Hospital

Lewes Road
Haywards Heath
West Sussex
RH16 4EX

01444 441881 Ext. 68313

Millview Hospital

Nevill Avenue
Hove
East Sussex
BN3 7HY

Telephone 0300 304 0080

Disclaimer

This leaflet is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

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