No appetite? How to get the nutrition you need

Eating well may help you feel better, and it may make it easier to tolerate your medical treatment. Use these tips to get the nutrition you need.

Sometimes a particular illness or its treatment can affect your appetite. Though you might not feel like eating, it's important to do what you can to keep your calorie, protein and fluid intake up while you're sick or undergoing treatment. Use these tips to help plan meals and snacks that will be more appealing to you and give you the nutrition you need to get better.

Keep in mind that in some cases, such as advanced cancer or very advanced heart disease, eating may not affect the outcome of your illness or treatment. In these settings, trying to follow specific dietary guidelines, such as eating a variety of fruits and vegetables or adhering to a low-sodium or low-fat diet, may not be practical. Sometimes caregivers or family members can unintentionally add stress to the situation by pushing or trying to force you to eat certain foods. Ask your doctor how carefully you need to follow specific dietary guidelines.

Mealtime

If you feel full after eating only a small amount, try eating small amounts more frequently when you do get the urge to eat. If you never seem to feel hungry, it's often helpful to eat according to a schedule rather than to rely on appetite.
Take advantage of the times when you feel your best. Eat more when you're hungry. Many people have their best appetite in the morning, when they're rested.
Limit fluids during meals, as liquids can fill you up and limit your intake of higher calorie foods. It may help to drink most of your liquids 30 to 60 minutes before or after meals.
Create a pleasant mealtime atmosphere. For example, use soft music, candles or nice place settings.
Vary the color and texture of foods to make the meal more appealing.
For adults, a small amount of wine or beer before meals — if allowed by your doctor — may stimulate your appetite.
Pay attention to smells, as certain scents may decrease your appetite or bring on nausea. Avoid smells that have this effect on you.

Snack time

Keep snacks readily available so that you can eat when you're up to it. Cheese, ice cream, canned fruit in heavy syrup, nuts, peanut butter with crackers, cottage cheese and chocolate milk are examples of high-calorie snacks requiring little or no preparation.
Bedtime may be a good time to snack because your appetite for the next meal won't be affected.

Anytime

Cold or room temperature foods may be more appealing, particularly if strong smells bother you. Cold sandwiches or main-dish salads, such as tuna, chicken, egg and ham salads, are good choices.
Experiment with foods. Once-favorite foods may no longer appeal to you, while foods you were never fond of may become more appealing.
Regular moderate exercise may help stimulate your appetite. Check with your doctor for exercise limits.
Nutritional supplement drinks — such as Boost or Boost Plus, Carnation Instant Breakfast, Ensure or Ensure Plus, and Scandishakes, among others — can provide a significant amount of calories and require little or no preparation. It may be easier for you to drink rather than to eat something.

Increasing calories

During illness, treatment or recovery, your need for calories may be greater than usual. The following suggestions can help increase the number of calories you consume:

Use butter or margarine generously on potatoes, bread, toast, hot cereal, rice, noodles, vegetables and in soups.
Spread peanut butter — which is also high in protein — on toast, bread, apple or banana slices, crackers or celery.
Add powdered creamer or dry milk powder to hot cocoa, milkshakes, hot cereal, gravy, sauces, meatloaf, cream soups or puddings.
Add breading to meat, chicken and fish rather than broiling or roasting them or baking them without breading.
Top hot cereal with brown sugar, honey, dried fruit or cream.
Top pie, cake, gelatin or pudding with ice cream, whipped cream or cream.
Use fruit canned in heavy syrup. It has more calories than does fresh or juice-packed fruit. If you prefer fresh fruit, add sugar and cream.
Drink beverages that contain calories. Good choices include fruit juice, lemonade, fruit-flavored drinks, malts, floats, soda pop, cocoa, milkshakes and eggnog. Nutritional supplement drinks are convenient options. Water, black coffee and tea have no calories, and bouillon and broth contain very few calories.

Though some of these suggestions add more fat and sugar to your diet, this shouldn't be a concern since you're only adding the extra calories until you can get your appetite back on track. Check with your doctor or a dietitian if you have concerns about changing the way you eat.

Increasing protein

Protein is important for growth, health and repair of your body. If you've been ill, you may need extra protein. Some suggestions include:

Add extra meat, poultry, fish or beans (pinto, navy, black, kidney) to casseroles, soups or stews.
Make your own high-protein milk: Add 1/4 cup powdered milk to 1 cup whole milk, or 1 cup powdered milk to 1 quart whole milk. Use it as a beverage, add it to malts or shakes, or use it in cooking.
Try a commercially prepared protein supplement, such as Beneprotein or ProMod.

If illness has made red meat — beef, pork or lamb — less appealing to you, try the following foods, which also are good sources of protein:

Cheese
Cottage cheese
Beans
Lentils
Eggs
Fish
Poultry
Nuts
Peanut butter
Milk
Milkshakes
Custard
Pudding
Yogurt

Fluids

Drinking adequate amounts of fluids is as important as getting enough calories and protein. Aim to get a minimum of 2 liters (about 64 ounces) of fluid a day, unless your doctor has directed you to limit your fluid intake. Try to choose drinks that contain calories.

Consider a multivitamin

If your loss of appetite is keeping you from eating well for more than a few days, you might consider taking a multivitamin to help you get the vitamins and minerals you need. Check the label and look for a multivitamin that doesn't give you more than 100 percent of the daily value (DV) of all the vitamins and minerals. Keep in mind, though, that if you're drinking liquid nutritional supplements, those will give you some of the vitamins and minerals you need, so you may not need an additional multivitamin. A nutritional supplement drink usually contains the equivalent of about one-fourth of a multivitamin.