If you are struggling with your appetite and food intake, try some of the suggestions below:-

• Try to eat small but frequent meals
• Avoid skipping meals and snacks, however small, every little helps
• Make the most of the times you want to eat and try to enjoy your food
• Avoid drinking with meals as this may fill you up and spoil your appetite
• Keep snacks by your bed
• If you don’t feel like solid food try a nourishing drink, e.g. full fat milk, Horlicks, smoothie, milkshake
• Prepare meals in advance when you have more energy and make extra for the freezer
• If the smell of food is unappetising, consider cold foods
• Accept offers from friends and family to help with cooking and shopping
• A short walk or fresh air before a meal, may increase your appetite
• Consider ready meals, these can be just as nutritious
• Use meals on wheels services or home delivery services offering pre prepared meals
• Include convenience foods (such as tinned, dried or frozen foods) in your weekly shop as these will last longer e.g. longer-life milk, savoury snacks, plain biscuits, rice puddings, corned beef, baked beans, soups, tinned puddings and custard.

If you are struggling with your appetite and losing weight unintentionally speak to your health care professional who can consider if you require a referral to a Dietitian.  In some cases, prescribed oral nutritional supplements may be required.  A Dietitian can assess and advise if these are required. Try to have 3 meals a day and snacks in between

• Ideas for snacks include: cheese and biscuits, scone, tea cake, yoghurt, biscuits, olives, cake, sausage roll, slice of pizza, cereal, mini dessert, spring roll or hummus and dip. Focus on foods you fancy
• Try to avoid filling yourself up with large servings of fruit, vegetables or salads as they do not provide much energy
• If you usually use low fat, low sugar ’diet’ foods and drinks, switch to the non-diet ones (e.g. whole milk)
• Add ingredients such as cream, cheese, butter, olive oil, cream cheese, milk powder and lentils to foods like soups, stews, curries, scrambled eggs, vegetables, potatoes.
• Add honey, syrup and jams to porridge, milky puddings, or toast
• Fortify your usual milk by whisking 4 tablespoons of skimmed milk powder into 1 pint of milk
• Focus on nourishing drinks. These can include: full fat or semi skimmed milk, malted drinks, such as Horlicks or Ovaltine made with milk, smoothies, fruit juice and full sugar fizzy drinks.  Milk is a good source of energy and protein
• Try to have a pudding after your main course or as an in-between meal snack, e.g. sponge and custard, cheesecake, ice cream and fruit, trifle or rice pudding
• You could try and make your own homemade milkshakes, using a mixture of cream, yoghurt, honey, blended fruit, ice cream and flavoured milkshakes powers
• Powdered nutritional supplements are available from chemists or supermarkets and may be useful, but can be expensive
• Please note, if you have diabetes, consult with your Dietitian/health care provider as some of the above suggestions may not be suitable

When your liver is not working properly, your body needs more protein than normal.  Protein is often known as the building blocks for building and repairing body tissues.  Eating too little protein, particularly for long periods of time, may lead to muscle weakness, frailty and slow recovery from illness or surgery   The goal is to eat approximately 1.2-1.5g protein per each kg body weight.

Good sources of protein include meat, fish, eggs, soy, tofu, beans, pulses, nuts and seeds and dairy foods such as milk, yoghurt and cheese.  As a guide aim to have at least 25g protein with each of your 3 meals a day.  Milky drinks, such as hot chocolate or ovaltine and milky puddings such as custard and rice pudding after or between meals will help boost your protein intake.  The table below includes some examples of protein rich foods and ways to achieve a good protein intake.

Combining a good intake of protein with exercise is ideal for maintaining and building muscle and making you feel stronger.

If you develop ascites, you can help reduce the build up of ascites by reducing the amount of salt in your diet.   About 70% of our salt intake comes from processed or every day foods, such as bread, crisps, breakfast cereals and ready meals.  Cooking from fresh where possible will help reduce your salt intake. 

Foods high in salt include:-

• Cured meats including: bacon, ham, sausages, salami
• Cheese – is a good source of protein, but avoid every day
• Smoked meats and fish
• Salted crisps, pretzels and nuts, olives
• Stock cubes, gravy, ketchup, soy sauce, Bovril, Marmite
• Tinned or packet soups and tinned vegetables
• Ready meals – check the packaging label for the lower salt options.

Try to reduce your intake of these foods or have smaller amounts.

Tips to reduce your salt intake:-

• Avoiding salt in cooking or at the table
• Gradually reduce your salt intake as your taste buds will adapt
• Choose unsalted snacks - crisps, nuts, popcorn
• Use herbs, spices, pepper, lemon for seasoning instead of salt.

It may be helpful to look at food labels as most food packaging has traffic light coding so you can tell whether a food has high, medium or low amounts of fat, saturated fat, sugars and salt .  Try to avoid foods that are coloured red for salt.  The salt content of some foods may surprise you.

If reducing your salt intake compromises your overall nutritional intake so you are losing weight unintentionally, this can be harmful.  A balance is required, discuss this with your Dietitian.

https://www.food.gov.uk/safety-hygiene/check-the-label

British Dietetic Association:  www.bda.uk.com/foodfacts

Food Standard Agency: www.food.gov.uk 

NHS: www.nhs.uk/live-well/eat-well