Q & A - Answers to readers questions- high protein diet for illness and non dairy calcium sources

by Anne Myers-Wright RD/APD

Posted on Jan 23, 12:03 PM in and . No comments.

I have had quite a few questions after my last blog post and have picked out two to answer here. I hope that the answers help a few people, not just those who emailed in. I will cover a few today and, hopefully, answer the rest later. I do tend to write long answers! By the way, I did answer a couple “off line”, as confidentiality or an individual consultation was requested. So here we go:

Carrie has asked about trying to increase the protein in her Mum’s diet, as she is having chemotherapy and hasn’t much of an appetite.

Hi Carrie. I’m sorry to hear your Mum is struggling with her eating. It’s quite common for people to lose their appetite when having chemotherapy but at the same time, as you would no doubt know, a really important time to be eating well. I would first recommend that you try to see a Dietitian to get some advice specific to your Mum’s medical condition.

I can, however, give some general advice for now for increasing the protein in the diet.

I would first recommend that she tries small, frequent, snack type meals rather than 3 large meals a day. Having supplies of things she does like is important. I find the trick for increasing protein, when someone doesn’t have the best appetite, is building on what they do like. (This is one reason why seeing a Dietitian, who will get a good idea of what your Mum is eating and work with that, is a good idea.)

High protein foods include:

  • Meat, fish, chicken and vegetarian alternatives (tofu, quorn)
  • Eggs
  • Dairy products like milk, cheese and yoghurt (milk powder is good as a high protein addition too)
  • Beans, pulses and nuts

Anywhere you can add these to foods and drinks will help build up dietary protein – for example:

  • For toast or sandwiches – always add extra slices of meat or cheese (don’t have just a ham sandwich, have ham and cheese!)
  • Add nuts to cereals
  • Use peanut butter, fish, beans or cheese spreads on toast and in sandwiches -rather than jam/honey
  • Make porridge up on milk, not water
  • Add cheese to vegetables and salads, mashed potato and other mashed vegetables (you could also add milk powder to mashed veges as this also increases protein)
  • Add cheese and ham to scrambled eggs/omelettes and jacket potatoes
  • Add beans and pulses to salads and hot meals where possible – lentils are good in bolognaise.
  • Add milk powder to soups and savoury dishes.
  • Make sure she has yoghurt, custard or milky puddings with fruit
  • Drink milk and juice in preference to water, tea or coffee or try milk coffee

Good high protein snacks include:

  • Milkshakes
  • Fruit smoothies (made with milk)
  • Yoghurt
  • Cheese and biscuits (or just cheese pieces)
  • Nuts
  • Eggs – devilled, boiled

I notice you said your Mum really probably won’t be able to increase her protein much through eating more. If your Mum is really struggling and if she is better with drinks than food – then fortified milk drinks are a good and natural way to increase protein.

You can fortify milky drinks with milk powder (any supermarket brand).

Use fortified milk – add milk powder (1 pint full fat milk plus 2 tbsp milk powder) wherever possible (in cereal, cooking and for drinks)

Here is an example/recipe :

High Protein Milk Recipe

1000ml (1 litre) full cream milk OR 150ml (small glass) full cream milk
+ 1 cup milk powder + 2 tablespoons milk powder

Add milk powder to milk and whisk until dissolved
Pour milk into a jug. Stir milk powder in with a whisk until blended.
Keep this enriched milk in your fridge.
Use in place of milk in drinks, soups, porridge, desserts, baking, coffee

Classic Milkshake Recipe (350 Kcal, 13g protein)

  • 1 cup milk
  • 1 tablespoon milk powder
  • 2 scoops ice cream
  • Flavour using chocolate or strawberry syrup, instant coffee, vanilla essence, honey & malt.

Blend all ingredients until smooth, serve immediately.
For a creamier alternative, try substituting the ice cream for 1 tablespoon of cream
For alternative flavours, try using different flavoured ice creams or frozen .

I would definitely try to encourage your Mum to have two to three milk drinks each day – it’s important to encourage food as well though (and to see someone so you can get medically and individually tailored advice)

Emma has asked how she can make sure her non dairy loving 10 year old child gets enough calcium in his diet.

Hi Emma. It’s so important to try to ensure growing kids eat a healthy balanced diet which includes a good intake of calcium. It can be worrying when you feel that the fact that your child isn’t a fan of dairy foods might mean he is missing out. As you probably know, calcium is important for bone growth and development. It’s also important for strengthening teeth, regulating muscle function, for heart functioning and for nerve transmission. A ten year old will need an average 800 mg of Calcium per day. (the recommendation varies between countries)

Calcium Sources

Of course, dairy is a great source of dietary calcium but don’t worry, you can get quite a bit of good quality calcium in other foods.

Dietary sources of calcium include:

  • Leafy green vegetables – broccoli, collards (cabbage family), bok choy, Chinese cabbage and kale
  • Soy and tofu
  • Fish – sardines and salmon (with bones). Half a cup of canned salmon contains 402mg of calcium.
  • Dried fruit – such as figs
  • Nuts and seeds – brazil nuts, almonds, sunflower seeds, sesame seeds and sesame seed paste (tahini).
  • Calcium fortified foods – including breakfast cereals, fruit juices and bread. You will find some of these in the usual supermarkets.

Try adding some of these foods to your son’s diet and you should be ok with his calcium :)

Tags: Calcium, Chemotherapy, Dairy Intolerance, High Protein, Poor Appetite

About the author

Anne Myers-Wright

Anne Myers-Wright RD/APD

Anne is a Health Professions Council (HPC) registered dietitian (RD), an Accredited Practicing Dietitian (APD- Australia), a fellow of the Higher Education Academy (FHEA), a member of the British Dietetic Association, The Nutrition Society and of The Dietetics Association of Australia.


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