Diet and Nutrition: A Guide to Weight Gain

Good nutrition is important for normal growth and development. When someone is underweight and not eating well, it can lead to malnutrition, which means that the body is getting too little nourishment or the wrong kind of nourishment. If that happens, patients might be weak and lacking in energy and are more likely to get sick. 

What you eat is just as important as how much. Small amounts of some foods are very nutritious. Below we’ve listed some cooking methods, mealtime suggestions, snack ideas and recipes to help patients gain weight sensibly. Many of the items can be ground up or pureed to better meet patients’ needs. Using whole milk or cream helps you add calories and achieve the right consistency. 

1. Make mealtime relaxed and happy. Avoid unpleasant conversation. Turn off the TV. Avoid distractions. 
2. Eat family meals together, so children or teens observe others eating. 
3. Have some quiet, relaxing time before eating. 
4. Never use force, punishment or bribery to get a child or teen to eat. This only causes tension and frustration. 
5. Praise your child or teen when they eat well. 
6. Avoid negative comments about food your child or teen doesn’t like. 
7. Stick to a daily eating pattern of three meals and two to three planned snacks. Avoid constant between-meal nibbling. Snacks can help stimulate the appetite and increase the amount eaten. 
8. Give liquids after meals so they don’t make your child or teen feel full before eating. 

• Pan fry or deep fry foods. Use canola or olive oil, when possible. 
• Use bread or cracker coating on meats. 
• Use sauces on cooked vegetables. Cream can also be used on cereal and in place of milk when recipes call for milk. 
• Add gravy and sauces to meat dishes and potatoes. 
• Cut finger food in different shapes to make them more appealing. 
• Use whole milk. 
• Use a lot of butter and margarine. Each teaspoon has 45 calories. Mix it into hot foods such as soups, potatoes, pastas, vegetables and cooked cereal. Serve hot bread because people often use more butter when it melts into the bread. 
• Use mayonnaise instead of salad dressing; it has almost twice the calories. Use it on salads, sandwiches and in other dishes. 
• Use liberal amounts of jelly, jam or preserves on bread. 
• Add brown sugar, peanut butter, honey (only if a child is more than one year old), dried fruit or cream to hot cereal. 
• Use canned fruit packed in heavy syrup. 
• Use a lot of peanut butter. Add it to puddings, ice cream, milk shakes and spread on celery, bananas or apples. 
• Use sour cream as a dip for fresh vegetables or as a topping on cooked vegetables or potatoes. 
• Serve fruits, yogurts, ice cream or pudding for dessert. 
• Add powdered milk to foods. Three tablespoons mixes well with cereals, scrambled eggs, omelets, soups, hamburger, ground meats, sandwich fillings, casserole dishes, potatoes, gravies and most homemade baked goods. 
• Use whipping cream, which has about 60 calories in a tablespoon, on pies, fruit, puddings, cocoa, Jello® and other desserts. 
• Add coconut milk to smoothies, hot cereals, hot chocolate, and in baking.

• Cheese or peanut butter with crackers 
• Fruit and cottage cheese 
• Milkshakes, malts and eggnog; for additional calories and protein, add a package of Carnation Instant Breakfast to any of these items 
• Ice cream with topping 
• Puddings or custard 
• Raisins and other dried fruits 
• Dips with fresh vegetables, crackers or chips 
• Higher calorie fruit juices like grape, prune, pineapple and nectars; limit fruit juice to 8-ounces daily 
• Eggs, either boiled or deviled 
• Fruit yogurt 
• Dry cereal 
• Juicesicles (frozen juice on a stick) 
• Bagel or English muffin with cream cheese 
• Granola bar 
• Carnation Instant Breakfast with whole milk or coconut milk
• Whole milk products instead of low fat or fat free
• Yogurt, custard style or high calorie or Greek yogurts
• Cottage cheese, 4% or whole milk
• Avocadoes; use as spread in sandwich

Fortified Milk 

1 cup nonfat dry powdered milk      

1 quart whole milk 

Mix well and chill before using. One cup provides 220 calories, 15 grams of protein. Use this in place of regular milk for drinking and cooking. 

Strawberry/Banana Yogurt Shake 

1/2 cup strawberries

1/2  cup fortified milk 

1/2  cup plain yogurt 1 tbsp. sugar 

1/2  banana 

Combine ingredients in blender for about 30 seconds until smooth. Pour into tall glass. Provides 330 calories. 

Chocolate Milk Shake 

1/4  cup chocolate syrup 

1/2  cup nonfat dry powdered milk 

1 1/2  cups ice cream 

1/2  cup fortified milk 

Combine ingredients in blender until smooth. Makes two cups. One cup provides 415 calories, 15 grams of protein. 

Sherbet Shake 

1 cup sherbet

3/4 cup fortified milk 

Blend ingredients in blender until smooth. Provides 400 calories, 14 grams of protein. 

Creamy Rice Pudding 

2 cups cooked rice

2 tsp. margarine 

2 cups fortified milk

1/2  tsp. cinnamon 

1/2  cup sugar 

Combine all ingredients in saucepan. Cook over medium heat, stirring frequently until thickened to desired consistency, 10-15 minutes. Serve warm or cold. Makes four servings. One serving (about 3/4 cup) provides 260 calories, 9 grams of protein. 

Commercially-prepared supplements are designed for people with special nutritional requirements. Many were developed exclusively for use in the hospital. Some are for use in tube feedings, and may be bitter tasting. Others, to be taken by mouth, are flavored like milk shakes. Still others may have little or no taste and can be added to other foods to increase their nutritional value. 

These liquid supplements should not be used without your doctor’s approval. If you have tried many of the suggestions listed in this booklet and are still looking for more ways to increase your child’s intake of calories and protein, ask your doctor or dietitian about liquid supplements. They will be able to tell you if such supplements would be appropriate for your child, recommend specific brands and suggest ways of using them effectively. 

If your child still does not gain weight, consult your doctor. Further evaluation and testing may be needed. 

Material adapted from Manual of Clinical Nutrition, TCCDA. Diet and Nutrition, U.S. Department of Health and Human Services.