Regaining Weight in Older Adulthood | QA

by DebbieJ MS RDN | Nov 5, 2019 | All, Ask Our Dietitian, Home

Question:

My wife is 86. She has lost a lot of weight. How do I get her weight back? Are there any super foods in terms of calorie count? Are there any additives, like whey powder, that can help her gain weight? She always says she can’t eat another bite! I give her Nutrament and ice cream to get some calories in her, but this is liquid. She has been given an appetite enhancing pill (Dronabinol 2.5 mg) but it has not shown any effect.

– John

Answer:

Thanks for reaching out John. Glad that you are on top of her nutrition and have sought medical attention first. Certainly, there are very high calorie foods to incorporate I’ll address below. However, I must say in my experience with geriatric nutrition and long-term care residents, the body’s ability to process and assimilate the calories consumed is often the limiting factor. There may be impairments anywhere from gut digestion and absorption to cellular uptake and utilization.

You’re right to focus on solid foods as weight gain supplements should be given between meals not as a replacement. Nutrament by the way, is marketed as an energy drink for active persons and it’s half sugar1! [360 Cals, 10 g Fat, 47 g Sugar, 16 g Protein] If you’re trying to stay away from medical weight gain supplements, then a comparable 12 fl. oz. of Carnation Instant Breakfast High Protein2 would be more suitable (330 Cals, 9 g Fat, 18 g Sugar, 22 g Protein).

Cheese, avocado, fatty fish (salmon, trout, sardines, herring), full-fat yogurt, nut butters, olives and coconut (meat and milk, not the water) are the richest in calories. Incorporating eggs, beans, olive oil, potatoes and whole-grain starches will provide additional protein and energy. Meal and snack suggestions include: eggs benedict, pudding, nachos with guacamole, mashed potatoes, potatoes au gratin, pumpkin mousse, yogurt + fruit smoothies, shepherd’s pie, avocado on toast, peanut butter on crackers, bisques and chowders, olive tapenade with crostini, granola, and trail mix.

Several condiments can be used to supplement additional calories and protein, such as: syrups, gravies, cheese sauces, creams, spreads, butter, icing/frosting, honey, jelly/jam, pesto, tahini, hummus, and tamari. Use these to coat, cover, top and soak into the main foods (e.g. whipped cream and maple syrup on French toast). Additional food preparation tips are available from the Institute on Aging, the Dietitians of Canada, and the Cleveland Clinic.

Regarding medications2–4: Dronabinol has been available for three decades and is effective for stimulating appetite in the majority of elderly HIV and cancer patients who take it, although some don’t respond to it. The liquid solution form is showing promise over the capsule form for a quicker onset of action. For people experiencing loss of weight and lack of appetite in the absence of conditions like HIV or cancer, Megace is the drug typically prescribed, though it has limited effectiveness.

References:

“Nutrament Home Page.” Nutrament Home Page, Harvest Hill Beverage Company, 2019, www.nutrament.com/. Accessed 10.21.2019
“Carnation Breakfast Essentials® High Protein Ready-to-Drink.” Carnation Breakfast Essentials®, Société Des Produits Nestlé S.A., 2019, www.carnationbreakfastessentials.com/products/carnation-breakfast-essentials-high-protein-ready-drink. Accessed 10.21.2019
Wilson MM, Philpot C, Morley JE. Anorexia of aging in long term care: is dronabinol an effective appetite stimulant?–a pilot study. The Journal of Nutrition Health and Aging. 2007 Mar-Apr;11(2):195-8.
Badowski ME, Yanful PK. Dronabinol oral solution in the management of anorexia and weight loss in AIDS and cancer. Therapeutics and Clinical Risk Management. 2018;14:643–651. Published 2018 Apr 6.
Persons RK, Nichols W. Should we use appetite stimulants for malnourished elderly patients? The Journal of Family Practice. 2007 September;56(9):761-762 doi:10.2147/TCRM.S126849

– Debbie J., MS, RD

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 doctor.

Some questions have been edited for length and/or clarity.

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How to Gain Weight Healthily on a Vegetarian Diet | QA

by DebbieJ MS RDN | Oct 22, 2019 | All, Ask Our Dietitian, Home

Question:

I am trying to gain weight, and knowing what to eat and when to eat it is difficult for me as I am a vegetarian. I prefer to work out late at night around 9:00 PM. Do you have any tips on when to eat and what to eat?
– Hailey P.

Answer:

When to eat is a matter of your hunger and routine. Your late exercise schedule offers an opportunity there. If you don’t already consume a post-workout recovery shake, doing so can add a couple hundred calories before you end your day. Try an Orgain® Vegan Organic Nutrition Shake, an OWYN™ Vegan Plant-Based Protein shake, or a Garden of Life Organic Protein Plant-Based Drink. Foods and snacks are fine, but a liquid beverage is quick and delivers nutrients to support immediate muscle repair and synthesis.

High calorie vegan items include canned coconut milk, nut butters, tahini, sweet potatoes, avocados, oats, soybeans, dried fruit and most tortillas. Lacto/ovo vegetarian choices also include cheese, yogurt and eggs. Don’t forget about adding calories through condiments like pesto, hummus, vinaigrettes, marinara, and vegan mayo.

You’ll want to incorporate at least one high calorie food each snack and meal. There are so many high calorie dishes you can create on a plant-based diet! Breakfasts suggestions are banana-nut pancakes made with almond milk, chia seed pudding or avocado toast. Lunch and dinner options include butternut squash ravioli with pepitas, meatless chili with cornbread, and coconut curry with tofu, noodle and veggies.

– Debbie J., MS, RD

Disclaimer: Author is an Orgain® Brand Ambassador and has received product samples.

Some questions have been edited for length and/or clarity.

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How Can I Gain Weight? | Q+A

by Fitness Contributor | Feb 2, 2017 | All, Ask Our Dietitian, Home, Nutrition

Question:

How can I gain weight? I eat a huge breakfast +2 protein shakes every day and 6 meals daily. I’m 6 ft tall. I started at 142 lbs. I’m up to 154 and haven’t been able to add an ounce beyond that. Help, please.

-Anthony G.

Answer:

Good job on gaining some weight! Your weight for your height equates to a BMI of 21, which is within normal weight. If you were underweight, I’d recommend the following:

Focus on energy density, not just volume of food. Simply put, you need to make every bite count. So amp up calories in everything you eat and drink – entrees, snacks, beverages, and desserts.

Choosing the richest options could double your calories. For example, ¼ cup of nuts provides 160 calories compared to the 40 calories from microwave popcorn. A shake made with whole milk, protein powder, peanut butter, and frozen banana slices has 600 calories versus less than 300 calories from the same volume made with low-fat milk, protein powder, fruit and ice.

Meat lasagna made with regular ground beef, whole ricotta and whole mozzarella packs almost double the calories of one made with lean beef, low fat ricotta and part-skim mozzarella cheese.

Adding toppings whenever possible could increase calories significantly. A humble 80 calorie blueberry pancake becomes a powerhouse 150 calories with butter and maple syrup. Laying a slice of cheese on a chicken taco adds 100 calories to each. Spreading a half mashed avocado on a turkey sandwich adds 150 calories. A scoop of 150 calorie ice cream reaches 300 calories when you top it with caramel and nuts. You’ll notice that most of the additions are in the form of fat and sugar. This is no accident, as these happen to be the most energy rich.

Make every sip count by enriching your beverages. One way is to opt for the higher-calorie versions of each drink. Whole milk and nectars are richer versions of milk and juice, respectively. Go for chocolate milk for an even bigger energy load. Smoothies and frappuccinos are calorie-laden alternatives to soft drinks. Another way is to add concentrate to the liquid. For example, add 2 spoonful of dry milk or frozen concentrate to each glass of milk and juice, respectively.

If you were strictly speaking of adding lean tissue, see our article How can I gain weight in muscle, not fat?