I am 24 years old, 110 pounds and 5’ 10” male. I broke my hip this time last year when I was about 98 pounds. I am trying to gain healthy weight, but I am not feeling as strong as I was. I want to have more muscle definition. Any tips? –Andrew S.

Andrew, kudos on gaining 12 pounds this last year, but your body certainly seems to be undernourished based on your height and weight; as a healthy weight for your height would be above 132 pounds (60 kg). You need to focus on gaining weight for cushioning, fat-soluble vitamin storage, bone density, strength, immunity, and energy reserves for healing should you get sick or injured. Which is why, first and foremost, I recommend that you work with your doctor on this.

As a clinician, I am concerned by your degree of underweight and your major bone fracture. Hopefully you’ve already been evaluated by your physician to determine if there is an underlying health issue, as that wouldn’t be corrected by diet changes. I would strongly encourage you to see your doctor and work directly with them in conjunction with a Registered Dietitian for continued care in gaining weight appropriately. That said, I will offer you this advice:

Eat the most energy dense food available.            Salmon, tuna, ground meat, jerky, cheese, nuts, nut butter, avocado, olives, dried fruit, starchy vegetables (peas, winter squash, potatoes), tortillas, bagels, and granola are the highest in calories from their respective food groups. Replace watery produce or air-puffed starches with richer options.

Drink caloric beverages instead of water. Whole milk, nectars, and 100% juice are the best choices, followed by milkshakes, soft drinks/punch/lemonade, and creamed beverages like Thai tea, frappuccino and piña coladas. You can further increase the density of beverages by adding a couple spoonfuls of powdered milk or thawed juice concentrate to your glass. Replace your ice with frozen milk or juice as well, so you’re not inadvertently watering down your drinks.

Eat often, enjoying snacks and smaller meals. Really, eat whenever you can! Frequent consumption of calories enables your digestion to be continuously working on making nutrients available to your body. Mini-meals are also ideal if it’s difficult to eat a lot at one sitting. Not enough time for meals? Squeeze in some extra liquid nutrition right after you wake up or before you go to bed.

Utilize weight gain shakes from powdered mixes, ready-to-drink or homemade. There should be at least 300 calories per 8 fluid ounces. This is even more than the original version of meal replacement drinks like Ensure and Boost. For your own 400 calorie shake blend 6 fluid ounces whole milk with a cold small banana and a tablespoon each of peanut butter, chocolate syrup and protein isolate.

Finally, be patient, as it will take some time before you see muscle definition.

– Debbie J., MS, RD

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Debbie James is a registered dietitian. Any views or opinions presented in this article are solely those of the author and do not necessarily represent the opinions or recommendations of Fitness International, LLC.

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your primary care physician.