High Calorie, High Protein Eating When You Have Diabetes

A high calorie, high protein diet is sometimes needed to increase the amount of nourishment in your diet. This may be because you have lost weight, you are recovering from a procedure such as surgery or cannot manage to eat as much as you normally would.

In situations like those, it can be helpful to follow a high protein, high calorie diet because:

• it can help with wound healing and speed up recovery from surgery
• it can help you regain muscle that you may have lost
• it gives your body’s immune system energy to work and to help you fight infections
• it can make you stronger so that you are less likely to fall, or to have an injury if you suffer from a fall.

This leaflet may be different to the healthy eating advice you have been given in the past when you did not need extra nourishment. Your doctor, nurse or dietitian can tell you when you need to return to your usual diet.

It is possible to eat high calorie foods and still manage your diabetes, but eating differently may affect your blood sugars. If your blood sugars are much higher or lower than normal, or you need help with adjusting your diabetes medication, please speak to your health care worker.

You should continue to:

• limit sugary drinks
• eat regular meals
• include a portion of starchy food eg bread, potatoes, rice, pasta, porridge, breakfast cereal (not sugar coated), crackers or plain biscuits at each meal
• monitor your blood glucose levels if you normally do or you have been asked to.

Little and often

When you have a small appetite, you may only feel like eating small amounts at meal times. This means it is important to keep some snacks and drinks at hand to have between meals:

• try to have three small meals and three snacks per day, choosing nourishing foods and drinks
• have your main meal at the time of day when you feel most well
• use at least one pint of fortified milk each day (see below)
• try to have protein food, such as beans, dahl, lentils, nuts, eggs, cheese, meat, fish or vegetarian meat alternatives, such as tofu or Quorn, at least twice a day
• keep a store cupboard of easy to prepare foods, such as tinned beans and fish, long life or dried milk, dried mashed potatoes, packet or tinned soup, spaghetti, potatoes and ready-made custard.

Remember to make your diet as varied as possible. It is alright to eat more fat at the moment; this will give you more calories, which will help.

Practical tips

Milk

• You can increase the protein in milk by adding three to four tablespoons of dried milk powder to one pint of full fat milk or non-dairy milks. This is called fortified milk and can be used in drinks, on cereals, in puddings, soups or in sauces.

Drinks

• Try to have nourishing drinks between meals eg hot or cold fortified milk, milky coffee or cocoa drinks or sugar-free fizzy drinks topped with ice cream. Nutritional supplement drinks may be prescribed by your dietitian if you are unable to take enough diet.

Cereals

• Add fortified milk to cereal or porridge. Evaporated milk, double cream and full fat yoghurt could be added.

Vegetables

• When you serve vegetables, add butter, margarine or oil, chopped hard-boiled egg, grated cheese or cream cheese. Also try serving them with a savoury sauce eg cauliflower cheese.

Mashed potato

• Add double cream, crème fraiche, butter, margarine, oil, chopped hard-boiled egg, grated cheese, fortified milk, flaked fish or lentils.

Soups and sauces

• Try to add sauces to meals, which you have made with fortified milk. Also add extra butter, margarine, oil, double cream or evaporated milk.
• Make fortified soup with fortified milk. Add butter or margarine, cubed or minced meat, cooked beans or lentils, double cream, grated cheese (do not boil soup with double cream or it may curdle).

Eggs and tofu

• Omelettes, scrambled egg/tofu and egg custards are good sources of protein. Try adding cheese to savoury egg/tofu dishes and include in the morning for breakfast. Always make sure that eggs are cooked thoroughly.

Puddings

• Use fortified milk to make custard or milk puddings then add sweeteners or buy puddings and add cream.
• Try scones, tea-cakes, crumpets or tea-bread. Add butter or margarine (not reduced fat) or cream and jam.
• Have fruit pies, pastries or crumble (use sweetener to taste) with cream, evaporated milk or custard.
• Yoghurts or fromage frais.
• Fresh or tinned fruit (drain the juice or syrup) with cream or plain ice-cream.

Fats

• Spread margarine or butter thickly on bread and crackers.
• Stir extra margarine, oil and butter into hot pasta or rice.
• Roast potatoes and chips in the oven with extra oil or deep fry them.
• Add mayonnaise to salad or sandwiches eg tuna, egg, avocado.

Fruit and vegetables

• Fruit and vegetables are important for vitamins and minerals. Include small helpings with meals, but don’t fill up on these as they are low in protein and calories. A small glass (150ml) of fruit juice once a day can be included, for vitamin C.

Suggested meal ideas

Breakfast
Small (150ml) glass of unsweetened fruit juice
Cereal or porridge with fortified milk
Toast with butter, sunflower or olive oil margarine or peanut butter and/or jam or marmalade
Mushrooms, beans and egg or cheese on toast

Midday meal
Meat, fish, egg, cheese or beans with vegetables or salad and/or potatoes, rice, pasta or bread
Dessert if required

Evening meal
Creamy soup with roll and butter
Beans, cheese or egg on toast with grated cheese
Milk pudding, egg custard, vanilla ice cream or cheese and biscuits

Mid-morning/afternoon snacks
Milky drink
Plain biscuits
Cheese and crackers
Crisps or nuts
Milky pudding
Crumpet
Muffin
Sandwich
Pizza, quiche, samosa or bhaji

Useful websites/information

Diabetes UK
www.diabetes.org.uk
0345 123 2399
helpline@diabetes.org.uk

The Malnutrition Pathway
www.malutritionpathway.co.uk

About this leaflet

Author: Sandra Hood, Diabetes Specialist Dietitian
Written: April 2020
Approved: July 2020
Review date: July 2023
Edition: v1

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk