Nutritional
drinks - A guide for patients and their families
Nutrional Drinks - booklet coverContents
Introduction
There are now many special nutritional drinks and puddings
available to help when eating is difficult. With so much
choice it can be hard to decide what is right for you. This
booklet has been designed by The Christie dietitians to
show you:
- What nutritional drinks are available
- What nutritional drinks are the most suitable for you
- How all the products can be used
Who
is this booklet for?
This booklet is for people who find it a struggle to eat
ordinary foods and…
- are worried about not eating properly, for example,
because of swallowing difficulties
- have already lost weight because of their illness
and are worried about further weight loss
- are losing weight as a result of treatment
If you are having eating problems as a result of your
treatment such as loss of appetite, sore mouth or
diarrhoea, you will find useful advice in The Christie
booklet ‘Eating - Help Yourself’ available on the wards
and the Cancer Information Centre on the glass link
corridor
If you are an inpatient
You can discuss using nutritional drinks with the ward staff.
There are products available on the wards that you can try.
If you need further advice, ask the ward staff to refer you
to a dietitian.
If you are an outpatient
If you are an outpatient you can talk to your specialist nurse
or doctor. For further advice ask your Christie doctor or GP
to refer you to your local dietitian.
Remember, these products are meant to supplement your
diet and not replace all your ordinary food. It is best to try
to keep eating some ordinary foods, alongside the drinks,
if at all possible. See “Eating - Help Yourself” for ideas on
high protein, high calorie foods and snacks.
What
you need to know?
There is a wide range of these products in sweet or savoury
flavours. Some have a neutral taste and can be added to
other foods.
Some products are not suitable for people on special
diets. For example, many are unsuitable for diabetics. If
you are unsure, please ask your doctor or dietitian. Other
supplements contain gelatine, so may not be acceptable for
people on a Kosher or strict vegetarian diet.
There are recipe ideas for using supplements at the end of
the booklet.
New products and flavours are coming out all the
time. Ask your GP or dietitian.
Please note that companies may change the
ingredients or rename their products before this
booklet is reviewed.
What
Is available?
This booklet describes the different sorts of supplements that are available, and gives some recipe suggestions as to
how you can use them. Nutritional supplements come in
three groups:
- Nutritional drinks
- Energy and protein supplements
- Nourishing puddings
Nourishing
drinks
The following pages list the names of the drinks that are
available, that you can either buy (non-prescription) or are
available on prescription. The drinks are best sipped slowly
between your meals.
Try different sorts to find which ones you enjoy. They
can be served hot or cold, and can be adapted to suit
your taste by adding ice-cream, fresh fruit or other
flavourings. Use them to make sweet or savoury dishes
- some ideas are given at the back of this booklet.
Neutral drinks can be taken as they are, or flavoured
with soup mix or milk shake syrups - see recipes section for
ideas. You can also freeze them into ice-lollies or ice-cream.
The
advice in this booklet is not suitable for children
Nourishing drinks you can buy
These drinks (non-prescription) can be bought in chemists
and some supermarkets. They come in a powdered form
and should be made up as directed on the packet.
- Build-up Original: unflavoured
- Build-up Shake: vanilla, banana,strawberry, chocolate,
natural or lemon ‘n' lime (contains fibre).
- Build-up soup: chicken, potato and leek, tomato
and vegetable (contains fibre).
- Complan: original, strawberry, vanilla, chocolate or banana.
- Complan savoury: chicken or vegetable.
Nutritional drinks on prescription
Your hospital doctor or GP will assess whether you
need the drinks on prescription, and they will advise
you on the quantities to take. The majority of these
supplements are not suitable for strict vegetarians.
Ask your doctor or pharmacists about the
flavours available
High Energy Content*:
These are milk based drinks and come in a wide variety of flavours.
Ask your doctor or pharmacist about the range available
| |
Kosher approved |
Halal approved |
| Resource Engergy (Nestle) |
No |
No |
| Ensure Plus (Abbott) |
Yes (except raspberry, blackcurrant, strawberry, fruits of the forest) |
Yes (except raspberry) |
| Ensure TwoCal (Abbott) |
No |
Yes |
| Fortisip Compact (Nutricia) |
No |
No |
| Fortisip Bottle (Nutricia) |
No |
No |
| Fresubin Energy (Fresenius Kabi) |
Yes |
Yes |
| Fresubin 2 Kcal (Fresenius Kabi) |
Yes |
Yes |
High
energy content with fibre
Should be used with dietetic or medical supervision
| |
Kosher approved |
Halal approved |
| Ensure Plus Fibre (Abbott) |
Yes (except raspberry, strawberry, fruits of the forest) |
Yes (except raspberry) |
| Ensure Multi-fibre (Nutricia) |
No |
No |
| Fresubin Energy (Fresenius Kabi) |
Yes |
Yes |
| Fresubin 2 Kcal (Fresenius Kabi) |
Yes |
Yes |
| Resource 2.0 Febre (Nestle) |
No |
No |
High
energy content - Yoghurt style
These can be useful for people with taste change
| |
Kosher approved |
Halal approved |
| Ensure Plus Yoghurt Style (Abbott) |
No |
Yes (except orange burst) |
| Fortisip Yoghurt Style (Nutricia) |
No |
No |
Juice
style drinks
These drinks are not suitable for diabetics
| |
Kosher approved |
Halal approved |
| Resource Fruit (Nestle) |
No |
Yes (except orange burst) |
| Ensure Plus Juce (Abbott) |
Yes |
Yes (except orange, pineapple, lemon & lime) |
| Fortijuce (Nutricia) |
No |
No |
| Provide Xtra (Fresenius Kabi) (Suitable for vegetarians) |
Yes |
Yes |
Powdered energy drinks
They can be easily mixed into yoghurts, rice pudding, fruit juice or jelly to increase the protein
and calorie content.
| |
Kosher approved |
Halal approved |
| Calshake (Fresenius Kabi) |
No |
No |
| Enshake (Abbott) |
Yes |
Yes |
| Scandishake Mix (Nutricia) |
No |
No |
| Complan shake (Complan) |
No |
No |
Savoury supplement
These are
energy dense
nutritional
powders
which are
made up with
hot water to
make savoury
drinks.
| |
Kosher approved |
Halal approved |
| Vitasavoury (Vitaflo) |
No |
No |
| Ensure Plus Savoury
(Abbott) |
No |
No |
| Fortisip Savoury Multifibre
(Nutricia) (contains fibre) |
No |
No |
High Protein content
Should only be used with dietetic or medical supervision
| |
Kosher approved |
Halal approved |
| Resource Protein (Nestle) |
No |
No |
| Fortisip Extra (Nutricia) |
No |
No |
| Fresubin Protein Energy Drink (Fresenius Kabi) |
Yes |
Yes |
Energy and protein supplements
You should only use these energy and protein supplements
with the advice of a registered dietitian. They are
concentrated sources of energy and / or protein and
may be available on prescription from your GP. Powdered
supplements are useful to increase the nutritional value of
ordinary food.
Powdered supplements:
Some may not be
suitable for diabetics
- Energy: Maxijul (SHS), Caloreen (Nestle), Polycal (Nutricia), Vitajoule (Vitaflo).
These can be added to any liquid or moist food such as
porridge, yoghurt, soup or tea, to increase the calorie
content. They dissolve easily and are tasteless. Directions
for use are given on the packets.
- Protein: Protifar (Nutricia), Vitapro (Vitaflo), Promod
(Abbott), Procal (Vitaflo).
These can be added to liquid foods as above, to increase
the protein content. To be taken under dietetic or medical
supervision.
- Liquid supplements: Polycal (Nutricia), Maxijul liquid (SHS), Calogen (Nutricia),
Procal Shot (Vitaflo).
These are energy supplements which come as a flavoured
liquid. They can be taken neat, mixed into drinks or added
to food. Ask your dietitian for ideas and recipes.
Nourishing puddings
- Clinutren Dessert (Nestle): chocolate, vanilla, peach
and caramel.
- Forticreme Complete (Nutricia):vanilla, chocolate, coffee,
banana and forest fruits.
- Resource Energy Dessert (Nestle): caramel, chocolate or vanilla
- Fresubin Creme (Fresenius Kabi): vanilla, cappuccino or wild strawberry
- Fortisip Fruit Dessert (Nutricia): apple or strawberry
- Resource Dessert Fruit (Nestle): apple, apple-strawberry or apple-peach
- Ensure Plus Creme (Abbott) vanilla, neutral, chocolate or banana
Recipes
Savoury
FORTIFIED SOUP
- 3 tablespoons Natural Complan/Build-up or Scandishake
- 1 packet instant soup mix
- 200ml full cream milk
Mix the soup mix and Complan, Build Up or Scandishake. Add a little cold
milk to form a paste. Add remaining hot milk. Serve at once.
FORTIFIED SAUCE (e.g. cheese sauce, bechamel sauce etc)
Stir one sachet neutral Build-Up, Complan or Scandishake into a ready made sauce and heat or cook as normal.
Or mix together one sachet of neutral Build Upl Complan or Scandishake with a single servine of powdered sauce and prepare as per packet instructions.
Sweet Pudding
DESSERT PLUS
- 1 bottle of Fortisip, Ensure Plus or Fresubin Energy
- 1 packet instant pudding mix eg Angel Delight, instant
whip or supermarkets own brand.
- 6 tablespoons Build Up or Complan
Mix the high energy powder and the pudding mix together.
Add a little milk to make a paste. Add the nourishing drink
and whisk well. Leave to set.
This can also be frozen to make ice-cream or ice lollies.
ICE CREAM
- 50ml double cream
- 1 botttle of Resouce Energy, Ensure TwoCal or Fortisip
Stir supplement drink into whipped cream and place in freezer to set.
CUSTARD
- 20g custard powder
- 1 sachet vanilla Scandishake, Eshake or Calshake
- 1/2 pint (300ml) full cream milk
Mix custard powder and powdered supplement with a small amount of cold milk to form a paste. Pour the remaining milk into a saucepan and heat gently. Mix the heated milk with the custard mix and stir well. Return to saucepan and heat gently while stirring.
MILK PUDDING
- 2 bottles of vanilla flavour Ensure Plus, Fresubin Energy or Resource Energy
- 1 1/2 oz or 40g pudding rice
- 1 1/2 oz or 40g sugar
- Knob of butter
Mix ingredients together and pour into an oven proof bowl.
Bake at 180C (350F) Gas 4 for 20 mins. Then turn down and
continue to bake at 150C (330F) for 1½ hours.
JUICY JELLY
- 1 packet jelly
- 1 bottle Fortijuce, Resource Fruit or Provide Xtra
Make up the jelly as directed but replace 200ml of cold water with the supplement drink.
Breakfast
POWER OATS
- 3 tablespoons porridge oats or instant oat cereal
- 1/2 pint (300ml) full cream milk
- 3 tablespoons natural Build-up, Complan or Calshake
- Sugar, salt or honey to taste
Mix oats with milk and powdered supplement. Bring to boil
stirring continuously, then simmer for 5 mins and serve.
Add sugar, salt or honey to taste. Add more milk to thin the
consistency if required.
BREAKFAST BOOST
- 1 bottle Fortisip, Fresubin Energy or Ensure TwoCal
- 50g porridge oats
- 100ml water or full cream milk
Place porridge oats and water/milk in saucepan and cook as per instructions on packet. Slowly add supplement drink until desired consistency is reached.
Drinks
SUPER SHAKE
- 1 sachet Scandishake, Calshake or Enshake
- 200ml full cream milk
- 6 teaspoons Maxijul, Procal powder or Caloreen
- 1 scoop ice-cream
Mix ingredients together using a liquidiser or whisk and serve chilled.
STRAWBERRY DELIGHT
- 1 bottle of strawberry flavoured Ensure Plus, Resouce Energy or Fortisip
- 4 strawberries or small can of strawberries (juice optional)
- 1 block of vanilla ice cream
Pour ingredients into a liquidiser and liquidise until smooth. Serve chilled.
BANANA DREAM
- 1 bottle neutral or banana flavoured Fresubin 2kcal, Ensure Plus or Fortisip
- ½ - 1 banana peeled
- 1 block of vanilla ice cream
Pour the supplement into the liquidizer. Add the banana, broken
into pieces. Add the ice cream and liquidize until smooth.
SUPER SOOTHER
- 200ml full cream milk
- 1 tablespoon neutral Build Up, Complan or Scandishake
- 2 tablespoons Ovaltine, Horlicks or drinking chocolate
- Sugar to taste
Mix the Build Up, Complan or Scandishake with a little cold milk to form a paste. Heat the remaining milk in a saucepan. Add flavourinmg, sugar and hot milk to paste. Top with a marshmallow float or chocolate flake and cream.
CREAM SODA
- 1 sachet vanilla Scandishake, Enshake or Calshake
- 50ml single cream
- 150ml lemonade
- 1 scoop vanilla ice-cream (optional)
Place all ingredients in a jug and stir until smooth. Add ice cream if desired. Serve chilled.
FIZZ
- 1 bottle of Provide Xtra, Fortijuce, or Ensure Plus Juce
- 100ml lemonade or sparkling water
Mix ingredients in a glass and serve chilled.
APPLE N BLACK
- 1 bottle apple flavoured Fortijuce, Ensure Plus Juce or Resource Fruit
- 100ml diluted blackcurrant juice
Mix ingredients in a glass and serve with ice.
*Names, flavours and availablility of the supplement drinks and desserts may be subject to change
A selection of recipes have been chosen using different
products. Further recipes can be obtained from the company who make the supplement prescribed by your doctor
Abbott
Fresenius Kabi
Nestle
Complan
Nutricia
SHS
Vitaflo
Christie
Hospital booklets
Further information booklets include:
- Eating
Help Yourself: Gives general information about coping with
eating difficulties when having treatment.
- Advice
about soft and liquid foods: For people who can only manage
a soft or liquid diet because of swallowing difficulties. Offers
practical suggestions, recipes and nutritional information.
- Eating
well: for breast cancer: Advice
on diet for people having treatment for breast cancer who are worried
about weight gain - how to cope with feelings of hunger and weight.
- Low fibre diet: For people who have been advised to follow a low fibre diet due to their disease or treatment side-effects.
These booklets are free to patients attending The Christie. If you
would like a copy of any booklets, please ask the ward staff. If you
are an out-patient please ask your clinic nurse or visit the cancer
information centre on the glass link corridor.