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Poor Appetite

Tips to Tackle Undernutrition

Undernutrition refers to an inadequate intake of calories, protein, vitamins and minerals to meet an individual’s needs to maintain good health.

Eating less than usual is an early sign of undernutrition, which is often associated with decline in physical function, poor quality of life and increased risk of death.

It is common for older adults and individuals with medical conditions such as cancer, chronic obstructive pulmonary disease (COPD), dementia and liver cirrhosis to experience poor appetite due to change in taste, reduced smell sensitivity and/or early satiety.

Satiety is the feeling of fullness and loss of appetite that happens after eating.

A useful tip to manage poor appetite is to offer individuals small portions of food and drinks every two to three hours. Apart from their favourite foods and drinks, it is equally important to include a variety of foods from these food groups in their diets:

  1. Whole grains (e.g. brown rice) and starchy vegetables (e.g. sweet potato)
  2. Lean meat, fish, legumes (e.g. beans, peas, lentils)
  3. Fruits
  4. Vegetables 

Here are some quick and easy tips to help address poor appetite, and manage your loved ones’ diets to ensure that their nutritional needs are met. 

nutrition tips for elderly

Breakfast

  • Oatmeal does not have to taste bland. Mix oats with flavoured milk (e.g. chocolate milk), a teaspoon or tablespoon of berries (e.g. goji berries, blueberries), and some nuts (e.g. almond slices, chopped walnuts).
  • French toasts with nut butter (e.g. almond butter, peanut butter). 

The goodness in this

  • Oats are a type of whole grain that contain prebiotics which can help in maintaining our gut health.
  • Berries provide antioxidants, fibre and natural sweetness. 
  • Almonds and walnuts provide unsaturated fats (good fats) and protein while adding extra crunch and flavour to the oats. 
  • Nut butters (without added sugar and additives) are a great source of vegetable protein. 

Morning Tea

  • A small glass of smoothie made with fruits and soy milk or full cream milk
  • Protein snacks such as red bean pancake, chicken pau, and soy beancurd dessert. 

The goodness in this

  • Smoothie is a nourishing beverage that combines vitamins, minerals and protein from fruits and milk.
  • Adequate protein helps to prevent sarcopenia, which is a condition characterised by loss of muscle, reduced muscle strength and increase in body fat.
  • For individuals who are underweight or have very poor appetite, they need to have food with higher calories and protein such as chicken pau, full cream milk. 

Lunch

  • Rice vermicelli in tomato egg drop soup. Fish or minced meat, garlic, onions, lemongrass and ikan bilis can be added to the soup for enhanced flavour.
  • High-fibre white sandwich with avocado spread and a small bowl of salad mixed with frozen vegetables (e.g. corn, peas, carrots) with protein food (e.g. egg, chicken, tuna).

The goodness in this

  • Rice vermicelli is a source of carbohydrate, which provides fuel for our brain and muscles.
  • Eggs provide extra protein without adding much food volume. 
  • Mixed salad with vegetables and protein can be a no-frill, nutritious and flavourful food item that you can make easily. 
  • High-fibre white bread is an alternative choice for people who do not like wholemeal/multigrain bread.

Afternoon Tea

  • Lemon tart, lemon custard or a soft cake plus a glass of lemonade or ginger tea or sour plum drink. 

The goodness in this

  • Acidic fruits like lemon and lime can help stimulate taste buds. 

Dinner

  • Fried rice with minced cauliflower, chopped carrots, ikan bilis, prawns, cashew nuts and pineapple. Spices (e.g. curry powder, turmeric powder), herbs (e.g. parsley), sauces (e.g. vinegar, fish sauce, ketchup) or cheese can be added for flavouring.  
  • A lighter option would be rice porridge with small cubes of sweet potato, shredded chicken or fish, and mushrooms.

The goodness in this

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  • Home-cooked fried rice with fruit, assorted vegetables and protein food (e.g. prawn, ikan bilis, cashew nuts) make a balanced meal.
  • Minced or chopped vegetables make it easier to chew and digest. 
  • Cheese provides extra calories and protein without adding much volume, making it easier for individuals with reduced appetite to manage. 
  • Spices, herbs and sauces serve to enhance taste of foods. 
  • Sweet potato and mushrooms are packed with fibre and antioxidants. Sweet potato is also rich in vitamin A while mushrooms are rich in vitamin Bs.

Supper

  • A small tub of yogurt with dried fruits
  • Red bean soup or Chinese black sesame paste

The goodness in this

  • Yogurt is a good source of probiotics and protein. 
  • Dried fruits offer more calories and fibre in a smaller volume. 
  • Bean-based desserts offer protein and fibre. 

There’s a lot of room for creativity when it comes to managing the diets of people with poor appetite. What we have proposed here are meal ideas, not actual meal plans. Personalised meal plans are usually designed by dieticians to meet individuals’ personal nutritional needs based on their medical conditions, lifestyle, weight and health goals. If you struggle in getting your loved ones to obtain adequate nutrients from food or wish to get advice on personalised meal plans, please consult a dietician. Poor appetite can be managed! 

Reference: 

Deutz, N. E. P., Bauer, J. M., Barazzoni, R., Biolo, G., Boirie, Y., Bosy-Westphal, A., … Calder, P. C. (2014). Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clinical Nutrition33(6), 929–936. 

About the Author:
This article is written by Ong Sik Yin for Jaga-Me. Sik Yin holds a Master’s degree in Nutrition and Dietetics from Flinders University. She is an Accredited Dietitian of Singapore (Singapore Nutrition and Dietetics Association) and an Accredited Practising Dietitian (Dietitians Association of Australia). She is an advocate of building a supportive ecosystem and conducive environment to promote health and wellness. She has over 10 years of experience providing nutritional advice and sharing her knowledge in hospital settings and public forums. 

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