Increasing energy in a young person’s diet

An information leaflet for young people, parents and carers

If a young person is not eating as well as they would normally, is growing more slowly than expected, has lost weight, or has higher energy needs due to medical reasons, the following tips may help to increase the amount of energy in their diet.

Eat ‘little and often’

• If struggling to finish 3 larger meals and 2-3 snacks daily, swap to six small meals.
• Include snacks between meals and before bed. Having small, high-energy snacks at easy reach may help you to eat more often.
• Be positive about what is eaten – every extra mouthful helps.
• Limit mealtimes to between 20- 30 minutes; you don’t want meals to last too long.
• Eat regularly and avoid missing meals as eating stimulates the appetite.
• Make the most of the times that you/they feel like eating.
• Foods do not need to be given at their expected times, for example, a bowl of cereal in the evening is a good snack option.
• A short walk, or some fresh air, before a meal may help to build an appetite.
• Experiment with different foods.
• Ready meals/convenience foods are useful and can be just as nourishing.
• Avoid drinking large amounts with meals, as this can reduce appetite at mealtimes.
• Always try to have a pudding or a nourishing drink after meals (see ideas below).

Snack ideas

• Fruit (fresh, tinned and dried) with yogurt, cream, custard or ice cream.
• Sandwiches or toast with butter/margarine and high energy spreads or filling, examples include jam, marmalade, chocolate spread, biscuit spread, peanut or other nut butters, cream cheese, cheese or houmous.
• Pizza slices, sausage rolls, pork pie, scotch eggs, cocktail sausages or chicken bites.
• Biscuits, cakes, mini chocolate bars, flapjacks, cereal bars, buns, brioche or muffins.
• Crackers, bread sticks or plain biscuits with cheese, pate, nut butters, jam, tahini, cream cheese, cheese triangles, chocolate spread, butter/ margarine or hummus.
• Cheese cubes, cheese triangles, cream cheese.
• Bhajis, pakoras, spring rolls, halva, Bombay mix, falafel.
• Sliced avocado
• Chopped hard boiled eggs.
• Crumpets, scones, bagels, croissants and breakfast cereal.
• Ready-made desserts such as full fat yogurts, fromage frais, crème caramel, trifle, mousse, cheesecakes.
• Crisps, nuts, olives, savoury biscuits, roasted vegetable sticks and pittas with dips such as hummus, taramasalata, cheese dip.

How to add extra energy to savoury foods

If a young person is only eating small portions, the following may help to get more nutrition without necessarily having to eat more food.

• Choose full-fat foods where possible, avoid foods labelled ‘low fat’, ‘diet’ or ‘light’
• Oily fish (remove the bones) for example salmon, mackerel, sardines and avocado are naturally higher in calories so try to encourage these within the diet.
• Fruits and vegetables are excellent for vitamins and minerals; however, they are low in calories and can be filling. Make sure you combine them with a higher calorie option e.g., vegetables with cheese sauce or stir fried with oil.
• Add beans, pulses or ground nuts and seeds to soups and casseroles.
• Add cheese/cream cheese in mashed potato with milk, milk powder and butter/fullfat margarine/olive spread.
• Add mayonnaise/salad cream or pesto to sandwiches, or have two fillings, for example egg mayonnaise and bacon, or cheese and ham.
• Add grated cheese/cream cheese/double cream/butter in scrambled eggs.
• Have butter, cheese, gravy, tahini or white sauce on vegetables.
• Spread butter or margarine thickly on toast, bread, crumpets or crackers.
• Add cream, sour cream or crème fraiche to casseroles.
• Add skimmed milk powder to white sauces, soups.
• Add Pesto to vegetables, pasta and rice dishes.
• Add avocado to sandwiches or toast.
• Add coconut cream or coconut milk, ground almonds or tahini to soups or curries.

How to add extra energy to sweet foods

For example:

• Serve full-cream milk, cream, custard, ice-cream, evaporated milk, coconut milk or coconut cream with pies, sponge, porridge, fruit and other puddings.
• Add extra sugar, syrup or honey to desserts, porridge, cereals, fruit and custard.
• Add cream, full‑fat yoghurt, sugar, honey evaporated milk to breakfast cereals.
• Eat fruit with full ‑fat yoghurt, cream, ice-cream, or custard.
• Choose fruit in syrup.
• Spread peanut butter or chocolate spread on biscuits or on fruit.

For dental health

• Ensure sweet foods are given following a meal rather than between meals
• Avoid prolonged contact of sweet foods with the teeth
• Ensure teeth are cleaned well before going to bed

Quick and easy meal ideas

• Sandwiches (fresh or toasted) and wraps with high calorie fillings.
• Soup made with fortified milk (see fluid section below) and added cheese/ cream.
• Crumpets/ toast/ bagels/ tea cakes/ scones/ croissants with butter and jam or cheese.
• A bowl of cereal, for example porridge or smooth porridge made with fortified milk and honey, sugar, jam or dried fruit.
• Eggs – poached, scrambled, boiled, fried, or made into an omelette/ frittata, prepared with milk (or a fortified milk alternative) and cheese, cream and ham. Always ensure eggs are cooked well.
• Sausage/ bacon/ fish finger sandwich with butter/margarine and sauce (mayonnaise/ ketchup/ brown sauce).
• Baked potatoes/ sweet potatoes, with butter/ margarine and cheese.
• Pies, pizza, quiches, burger, fish fingers with oven chips.

Fluids

• Avoid a lot of sweet tasting drinks which may decrease appetite for foods. Too much milk can also affect food intake. About two-three cups (350-600ml) of whole milk or Jersey milk per day is sufficient.
• Arla Big Milk has added vitamin D, A, Calcium and Iron to improve micronutrient intake – This is a good option if struggling to find a multivitamin your child/young person will take daily.

How to make Fortified Milk:

• 1 glass = Add 2 heaped tablespoons of semi-skimmed milk powder and/or 1-2 tablespoons of double cream to 250mls of whole milk/Jersey milk or Arla Big Milk.
• 1 pint = Make fortified milk by adding 5 heaped tablespoons of semi-skimmed milk powder to 1 pint of whole milk.
• Use fortified milk to make milkshakes, hot milky drinks, milk puddings, custard, or use it with breakfast cereals.

For further details on your specific fluid requirements, please speak with your dietitian.

Ideas for nourishing drinks

Hot chocolate/malted drink:

• 200ml warm whole milk or dairy-free alternatives
• 1-4 teaspoons of hot chocolate or malted drink powder (quantity depends on taste preferences)
• 2 tablespoons of double cream or squirty cream
• Additionally, can also add marshmallows on top for extra energy and enjoyment.

Instant soup or pre-made soup:

• Make instant soup powder with hot milk, rather than boiling water. Add 1 tablespoon of semi-skimmed milk powder and/or 1 tablespoon of double cream.
• Fortify pre-made soup by adding 2-3 tablespoons of double cream when heating.
• Additionally, can add grated cheese or cream cheese on top or mix well when heating to melt the cheese completely.

Milkshakes:

• 200ml whole milk or dairy-free alternative
• 2-3 teaspoons of milkshake powder
• 2 heaped tablespoons of semi-skimmed milk powder or double cream
• Can try blending frozen fruit (e.g. banana or strawberries) with ice cream and whole milk.

Smoothies:

• 1-2 small handfuls of frozen or fresh fruit
• 2 tablespoons of full fat yogurt
• 200mls of milk or dairy-free alternative or fruit juice to a blender, blend until smooth.
• Additionally, can also add oats, nut butter or mixed seeds for extra energy

Shop-bought/Pre-made options:

• Fruit juice and fizzy drinks (avoid low calorie ones)
• Ready-made milkshakes or breakfast drinks
• Nourishing powdered drinks such as milkshake powders are readily available in a variety of flavours.

Nutritional supplement drinks may be available on prescription from the GP. The dietitian will recommend these if they think that they will be helpful.

Extra ideas

• Idea 1:
• Idea 2:
• Idea 3:

Contacts/ Further information

Your dietitian 01223 216655

Department of Nutrition and Dietetics

Box 119, Cambridge University Hospitals NHS Foundation Trust

Hills Road, Cambridge, CB2 0QQ