It is sometimes difficult to obtain adequate calories to maintain weight in life limiting illness. Poor appetite and medication side effects can lead to limited food intake and decreased quality of life. It will be important to provide meals and snacks that provide maximum nutrition. The following tips can help maximize calorie intake:

1. Do not skip meals
2. Add snacks between meals and at bedtime
3. Keep foods and snacks that are easy to prepare or pre-packaged on hand
4. Make meal time pleasant
5. Plan meal times around energy levels. Try to have the largest meals/snacks at times when you feel the best
6. Eat the highest calorie item on your plate first
7. Make everything you drink count. Use high calorie drinks over lower calorie options. For example, use juices, milk, and soda instead of water

Use the following high calorie foods to increase the overall calorie content of meals/snacks:

Food:

• Add Butter and Margarine to  Soups, Potatoes, Hot Cereals, Grits, Rice, Noodles, Cooked Vegetables, sandwiches, breads, pasta, cream Soups, Sauces, Gravies Combine with herbs and seasonings to spread on cooked meats, hamburgers, fish and egg dishes
• Use Whipped Cream to sweeten on hot chocolate, desserts, gelatin, puddings, fruits, pancakes, and waffles, fold unsweetened into mashed potatoes or vegetable purees
• Add Cream Soups to sauces, egg dishes, batters, puddings, put on hot or cold cereal, mix with noodles, pasta, rice, and mashed potatoes pour on chicken or fish while baking
• Cream Cheese Spread on breads, muffins, fruit slices, crackers, roll into balls and coat with nuts, granola or wheat germ
• Add Sour Cream to cream soups, baked potatoes and potato dishes, macaroni and cheese, vegetables, sauces, dressings
• Spread Salad Dressings and Mayonnaise on sandwiches and crackers
• Use in meat, fish, egg, or in vegetable salads Use as a dip for vegetables Honey, Jam,
• Add Sugar Add to bread, cereal, milk drinks and fruit/yogurt desserts Glaze for meats such as chicken
• Use Granola in cookie, muffin, and bread batters, sprinkle on vegetables, yogurt, ice cream, pudding, custard, and fruit
• Use Dried Fruits  as snacks with breakfast and in baked products EggsMix extra eggs into batter for French toast, pancakes, custards, pudding, quiches, casseroles, macaroni and cheese, chicken/tuna salad, beat into mashed potatoes, vegetable purees, and sauces (cook thoroughly after eggs are added)
• Powdered Milk: Add 2 – 4 Tbsp to 1 cup whole milk mix into puddings, potatoes, soups, ground meats, vegetables, cooked cereal, milkshakes, yogurt, and pancake batter
• Give Cheese as snacks or in sandwiches, add to casseroles, potatoes, vegetables, and soups
• Wheat germ: Add 1 to 2 Tbsp to cereals Mix into meat dishes, cookie batter, and casseroles
• Evaporated Milk: Use in place of whole milk in desserts, baked goods, meat dishes and cooked cereal
• Sweetened Condensed Milk: Add to pies, puddings and milkshakes Mix 1 to 2 Tbsp with peanut butter and spread on toast
• Sour Cream: Add to potatoes, casseroles, and dips Use in sauces and baked goods
• Peanut Butter: Serve on toast, bagels, crackers, bananas, apples, celery Instant Breakfast packets, Add to milkshakes or milk
• Gravies: Use liberally on mashed potatoes, rice, noodles, and meats

**Source: Chemocare.com and Children’s Hospital of Wisconsin**

Use the following tips to help add calories to favorite foods:

• Add extra oil when cooking meats, vegetables, stir-fry or soups.
• Have ¼ to ½ cup of nuts every day
• Use peanut butter on sandwiches, with fruit or on crackers
• Add olives to pasta, pizza and salad
• Top hummus on pita bread or crackers
• Add guacamole to Mexican foods or sandwiches
• Add avocado slices to your sandwich or salad
• Use olive oil-based vinaigrette dressings on salads, vegetables, and pasta
• Dip bread in olive oil and vinegar
• Eat fatty fish like salmon
• Sprinkle nuts or seeds into yogurt, cereal, oatmeal, and stir-fry
• Use nuts in muffin and bread recipes
• Add nonfat powdered milk to mashed potatoes, macaroni and cheese, and casseroles
• Try other nut butters like almond butter
• Add cheese to chili
• Make an egg omelet with olive oil, vegetables, and cheese
• Blend a fruit smoothie with ½ banana, frozen berries, milk and 1 Tbsp nonfat powdered milk
• Make trail mix with whole wheat cereal, nuts, raisins, and other dried fruits
• Use milk instead of water to make oatmeal or cream of wheat
• Sprinkle any kind of nut on ice cream
• Toss pasta with olive oil before adding sauce
• Drizzle olive oil onto popcorn
• Use heavy cream instead of non-fat dairy creamer
• Use real sugar, not sugar substitutes
• Use real butter

** Source: UCSF Medical Center**

High Calorie Snacks:

• Instant Breakfast Drink: 1 packet instant breakfast in 8 oz whole milk
• Instant Breakfast Shake: 1 packet instant breakfast, ½ c half & half, ¾ c ice cream, mixed in blender
• Cheese toast: 1 oz cheese on 1 slice toast
• Peanut Butter and Jelly Sandwich with Milk: 2 slices bread, 2 Tbsp peanut butter, 1 Tbsp jelly, 8 oz Whole milk
• Bagel with cream cheese, jelly and juice: Bagel, 1 oz cream cheese, 1 Tbsp jelly, 12 oz juice
• Egg and Cheese on English Muffin: 1 egg, 1 oz cheese, 1 english muffin
• Yogurt Smoothie: 8 oz yogurt, ½ c half & half, 1 c frozen strawberries, mix in blender
• Peanut Butter and Banana on toast: 2 Tbsp peanut butter, 1 banana, 1 slice toast
• Granola Bar and Yogurt: 8 oz fruit-flavored yogurt and 2 granola bars
• Tuna Salad on crackers: ½ c tuna salad, 5 crackers
• Protein Bars

**Source: Children’s Hospital of Wisconsin**

Questions? Please call your Hospice of Huntington Dietitians:
Kellie Glass RD, LD 606.615.2585 or Amy McFann RD, LD 304.690.5063