Nutrition and Appetite

Nutrition and Appetite
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Nausea, with or without vomiting, is common among persons with illnesses like yours. There is a variety of medications available to treat nausea. Ask your nurse or doctor if there is a medication appropriate for you. There are some tips you can try on your own to help control nausea. These are listed below.

Try to eat dry and/or salty foods, such as pretzels, snack crackers, dry cereal, or dry toast, upon waking in the morning and every few hours thereafter during the day. These foods seem to coat the stomach and prevent excess "churning" of stomach acid, as well as provide a base on which to take other foods and beverages.

Avoid taking liquids on an empty stomach. Liquids can sometimes contribute to nausea, so try to take liquids about 1/2 to 1 hour after solids. You might also try taking liquids in frozen or solid form, such as ice chips, popsicles, fruit ice, or gelatin, for better tolerance.

Avoid greasy-fried or heavily spiced foods.

Try cold or room temperature foods, as hot foods tend to have stronger odors which can aggravate nausea.

Avoid large and/or infrequent meals. The smaller and more frequent your meals and snacks are, the more comfortable you will be. Choose foods that are high in calories and protein, as tolerated. Some examples can be found on the pages entitled "Calorie-Protein Boosters" and "Nutritious High Calorie Snacks".

DECREASED APPETITE

The loss of appetite, or desire to eat, is one of the most troublesome problems a patient and family face. It is a common problem, though we do not know exactly why it occurs. There are a few medications available which may stimulate individuals' appetites. Ask your nurse or doctor if such medication would be appropriate for you. There are some tips to try on your own to help to deal with your poor appetite and, thus, maintain your weight.

Eat smaller, more frequent meals and snack. Often large or even normal sized meals are so overwhelming that one is completely turned off by the food.

Use foods that are very high in calories and protein. See the pages entitled "Calorie-Protein Boosters" and "Nutritious High Calorie Snacks" for suggestions.

Try cold or room temperature foods, which may be more appealing than hot foods.

TASTE CHANGES

Tastes often changes with illnesses like yours. Sometimes this is due to medications or treatments and other times it may be because of the disease itself. Persons frequently their taste for meat, especially beef. Other common complaints include lack of intolerance to sweets, or a bitter or metallic taste in the mouth. The following is a list of ways to manage some of the more common complaints regarding taste.

	Try marinating meats in fruit juices, Italian dressing, beer, wine, or teriyaki sauce to mask an unpleasant taste.
	Try alternative sources of protein, such as fish, chicken, eggs, cheese, yogurt, milk, milkshakes, chicken salad, tuna salad, egg salad, ham salad, and dried beans.

Suck on candy or sip juice throughout the day to refresh the mouth.

A little bit of salt can tone down sweet flavors.

If you have a fungal infection in your mouth that is causing your taste changes (characterized by a white coating), ask your nurse or physician to examine your mouth and prescribe the appropriate medication.

EARLY SATIETY (feeling full)

Many persons complain of feeling full after just a few bites of food. Some even say they feel full all of the time. This is called "early satiety". There are medications available which may help with this problem. Ask your nurse if there is a medication that is appropriate for you. There are some ways to manage this problem that you can try on your own, as well.

Eat small amounts of food more frequently. This allows you to eat more calories and protein without feeling so uncomfortable.

You may find that high calorie liquids work better for you than solids. Some research suggests that liquids leave the stomach more quickly than solids.

Use foods that are very high in calories and protein. By doing this, it is possible to eat smaller quantities of food and still receive adequate nutrition. Examples can be found on the pages entitled "Calorie-Protein Boosters" and "Nutritious High Calorie Snacks".

HIGH CALORIE NUTRITIOUS SNACKS

You may not be able to eat regular meals. Several small snacks each day can be as nutritious as 3 meals per day. You may find that you are more comfortable if you snack several times each day instead of trying to eat fewer but larger meals.

Here is a list of ideas for nutritious snacks.

HARD COOKED OR DEVILED EGGS

CHEESE AND CRACKERS

PEANUT BUTTER AND CRACKERS

SMALL SANDWICHES (don't forget the butter, margarine or mayonnaise!)

CREAMED COTTAGE CHEESE

MILKSHAKES

YOGURT

PUDDING

CUSTARD

HOT OR COLD CEREAL WITH CREAM

CUP OF BROTH-BASED OR CREAM SOUP

CELERY STUFFED WITH CREAM CHEESE, PEANUT BUTTER OR CHEESE SPREAD

FRUIT WITH SUGAR AND CREAM + ICE CREAM

FRUITED GELATIN WITH WHIPPED CREAM

SHERBET

INSTANT BREAKFAST

GRANOLA BARS

CALORIE-PROTEIN BOOSTERS

It may be difficult to eat as much as you normally would, so it is important to try to pack as much nutrition into as small a volume possible. This can be done by adding high calorie and protein items to the foods you are able to eat.

Here are some examples.

Add nonfat dry milk powder to foods, such as those listed.
Try to add 2 Tablespoons per serving for 50 extra calories.

CREAM SOUP

CASSEROLES

PUDDING

CUSTARD (add prior to cooking)

HOT CEREALS

SHAKES

	SAUCES/GRAVIES
	WHOLE MILK

SCRAMBLED EGGS (add prior to cooking)

NOTE: To make 1 quart of high cal/high protein milk, add 1 c. of powdered milk to 1 qt. of whole milk - this can also be made with skim milk, 1 % milk 2% milk, or half and half.

Add butter, margarine, oils, salad dressing, mayonnaise, cream cheese, and/or sour cream to foods whenever possible. Each tablespoon adds about 130 extra calories and blends well in a variety of foods, such as those listed.

VEGETABLES

HOT CEREAL

POTATOES

CASSEROLES

CREAM SOUP

BREADS, ROLLS AND CRACKERS

EGGS

RICE AND PASTA

Sugars, such as white, brown, honey, and/or syrups can add calories to foods such as those listed.

HOT CEREAL

WINTER SQUASH

SWEET POTATOES

COLD CEREAL

COFFEE AND TEA

FRESH FRUIT WITH CREAM

BLOOD SUGAR

Blood sugar that is too low is called hypoglycemia. Blood sugar that is too high is called hyperglycemia. There are several reasons why a sick person may have an abnormal blood sugar: Diabetes may be difficult to control during a serious illness; some medicines may effect the blood sugar level; and certain types of disease may change the normal regulatory mechanisms that control blood sugar.

Your Nurse will notify and instruct you on the procedure to monitor blood sugar, if this has been deemed advisable. Your physician will determine if treatment is necessary.

In the event that blood sugar is being regulated, you should be aware of certain symptoms that may indicate a serious blood sugar abnormality:

TOO LOW - HYPOGLYCEMIA

Cold sweats, pallor

Nervousness, dizziness, tremors

Hunger, headache

Fatigue, weakness, drowsiness, confusion

Rapid heart rate, rapid respiration

Seizures, coma

ACTION: Give orange juice mixed with 2 teaspoons sugar as soon as symptoms are detected. Check blood sugar and notify your Nurse.

TOO HIGH - HYPERGLYCEMIA

Poor appetite, nausea, vomiting

Frequent urination

Flushed face, fruity breath

Fast, deep, labored respirations (resembling sighs)

Weakness, stupor, seizures, coma

ACTION: Check blood sugar and notify your Nurse. (Additional medication may be indicated).