Overview
Diabetes and eating well with a small appetite
This information is for people with diabetes who have a small appetite. It includes advice and ideas on how to eat a diet that:
- is high in energy (calories) and protein
- is well balanced
- helps to keep your blood sugar levels stable
We also suggest healthy heart options. These are healthier food choices if you need to make your diet more nourishing (fortify it) for a longer period.
We explain if any of the food options are not suitable for those with kidney disease. This guidance applies if your dietitian has recommended that you follow a low potassium or low phosphate diet. Potassium and phosphate are minerals found in various foods and drinks.
Reviewing your diabetes medicines
Some people with diabetes may get lower blood sugar (glucose) levels when they have a small appetite. This is more likely to happen if you take certain diabetes medicines, such as:
- insulin
- sulfonylureas, which are a group of medicines (including gliclazide) used to treat type 2 diabetes
Your blood sugar levels may also be lower or higher than usual if you feel unwell or have made changes to your diet.
It is important to contact a GP or your diabetes team for advice if you are concerned about your blood sugar levels. They may need to review the amounts (doses) or timing of your diabetes medicines.
If you have any more questions or concerns, please speak to your dietitian or the doctor or nurse caring for you.
How eating well can help you
If you have a small appetite, eating well can help you to:
- prevent or minimise weight loss
- regain weight that you have lost
- feel less tired and improve your strength
- fight an infection
- heal from wounds
- cope with your treatment better
- recover more quickly from periods of illness
How to have a higher calorie diet
Here are some ways to have a diet that is higher in calories and gives you more energy.
Eat little and often
Aim to have 3 small meals and 2 or 3 snacks or nourishing drinks every day.
Choose food and drinks high in calories and protein
Your meals, snacks and drinks should be high in calories and protein to give your body the nourishment (nutrients) that it needs every day.
We have included suggestions about how to increase the calories in your meals and make them more nourishing.
Drinks that are high in calories and protein include:
- a glass of milk
- hot drinks made with full-fat or fortified milk
If you buy drinks such as hot chocolate, you can compare the labels and choose reduced sugar options.
Include a medium portion of starchy foods with your main meals
Starchy foods give you energy and fibre. Examples include:
- bread
- potatoes or sweet potatoes
- rice
- pasta
- cereals
- chapattis (a type of flat, round South Asian bread made without yeast)
- couscous (a North African food made from crushed, steamed wheat)
- yams (the large, potato-like roots of a tropical plant)
- fufu, eba or gari (a type of West African cooked starchy vegetable food, which is often served with soup or stew)
- plantain (a type of green banana, which can be cooked and eaten as a vegetable)
Choose wholemeal or whole-wheat versions if they are available. These foods have more fibre and help to keep your blood sugar levels more stable.
To help with both your blood sugar levels and weight gain, avoid having starchy foods by themselves. Instead, try to eat starchy foods with protein-rich foods, fats or both.
Have at least 2 protein-rich foods every day
Foods high in protein include:
- meat, chicken, turkey or fish (the recommended portion size is the palm of your hand)
- 1 egg
- a small piece of cheese (the size of a matchbox)
- a standard pot of yoghurt or a vegetarian yoghurt
- 3 tablespoons of tofu, soya, Quorn®, or beans and lentils (a healthy heart option)
Include small portions of fruit and vegetables with meals
This is a healthy heart option, but be careful not to become full by eating fruit and vegetables. They are low in protein and calories. If you cannot eat everything on your plate, have the starchy and protein-rich foods first.
It is a good idea to eat fruit and vegetables with foods that have more protein and calories. For example, you could:
- have fruit with full-fat yoghurt as a snack or dessert
- prepare your vegetables with a bit of butter or olive oil on them
Have desserts to increase the calories in your diet
Puddings or desserts help to increase the calories in your diet. Good choices include:
- tinned or fresh fruit with cream
- full-fat natural or Greek yoghurt
- fromage frais (a soft, creamy cheese made with whole or skimmed milk and cream)
- cheese and crackers
- a slice of plain cake
Avoid drinking fluids before and during meals
Drinks can make you feel full. It is best to drink after your meals or at times that are not too near your main meals.
Include foods containing fats and oils
Foods containing fats and oils have more calories in each gram than protein and carbohydrate foods. They help you to put on weight. Examples include:
- margarine
- vegetable oils
- avocado (not suitable for a low potassium diet)
- nut butters (not suitable for a low potassium or low phosphate diet)
- oily fish
- plain biscuits, such as 2 or 3 digestive or rich tea biscuits
The plant and fish-based oils are healthier for your heart than animal fats.
Take a multivitamin and mineral supplement, if needed
You may need to take a multivitamin and mineral supplement every day if you can only manage small amounts of food. Talk to your dietitian or doctor about this if you are not sure.
How to increase the calories in your meals
If you can only eat small meals, you can make them more nourishing by adding high calorie ingredients to food and drinks. The following table gives you some ideas on how to do this.
| For extra calories, protein or both, add: | To: |
|---|---|
|
cheese, such as grated or full-fat cream cheese |
|
| skimmed milk powder (not suitable for a low potassium diet) |
|
|
extra fats, such as butter, margarine, rapeseed, olive and vegetable oils (a healthy heart option), mayonnaise, salad cream or salad dressings |
|
|
cream or full-fat natural or Greek yoghurt |
|
|
nuts (whole or ground) and nut spreads or butters (not suitable for a low potassium or low phosphate diet) |
|
Small meals and snacks
The following table gives examples of quick, nourishing small meals and snacks.
If you have been advised to follow a low potassium or low phosphate diet, some of the ideas may not be suitable for you. Please speak to your dietitian or wider healthcare team for personalised advice about your diet.
| Meal | Suggested small meal or snack |
|---|---|
| Breakfast |
|
|
Mid-morning snack |
|
|
Lunch |
|
|
Mid-afternoon snack |
|
| Dinner |
|
|
Dessert |
|
Following a low potassium or low phosphate diet
If you have kidney disease, your dietitian may have recommended that you follow a low potassium diet, a low phosphate diet or both.
Potassium and phosphate are minerals found in many foods and drinks. If your kidneys do not work properly, they may not remove extra potassium or phosphate from the body. This can affect your heart, nerves, muscles or bones.
If you are not eating well or have lost weight too quickly, the restrictions on potassium or phosphate in your diet can sometimes be relaxed. You can speak with your dietitian about this.
When your appetite has improved and you have regained weight, you need to return to your usual recommended diet.
Lowering the potassium in your diet
Here are some ideas to lower the potassium in your diet without reducing the calories and protein content.
Do
- Boil vegetables and potatoes, yams or plantains in plenty of water. This reduces the amount of potassium in them.
- Fry or roast vegetables and potatoes when you have boiled them. This adds calories from the fat.
- Choose small portions of fruits that are lower in potassium. Examples include apples, pears, small citrus fruits like satsumas and clementines, blueberries and drained tinned fruit.
- Choose small portions of vegetables that are lower in potassium. Examples include carrots, pumpkin, runner beans, peas, cabbage, cucumber, bean sprouts and lettuce.
Don't
- Do not use cooking water to make gravy or stock.
- Do not eat too many fruits and vegetables that are high in potassium. Examples include dried fruits, bananas, kiwis, mangoes, mushrooms, spinach, beetroot and avocado.
Lowering the phosphate in your diet
Here are some ideas to lower the phosphate in your diet without reducing the calories and protein content.
Do
- Choose cream cheese, crème fraîche (fresh cream), single or double cream and soured cream rather than cheese spreads (like Dairylea or Primula®), processed cheeses or condensed milk.
- Instead of offal, liver, ham or pâté, choose fresh, unprocessed meats. Examples include chicken, turkey, beef, duck, lamb, pork, veal or venison.
- Avoid fish paste, fish roes (eggs), monkfish, mussels, oyster, pilchard, sardines, scampi, sea bass, taramasalata (pink dip made from fish eggs) or whitebait. Instead, choose crab sticks, scallops, tinned crab, tuna or salmon, or winkles (sea snails).
Other ways to manage a small appetite
Here is more guidance about things that can help if you have a small appetite.
Tips if you have a small appetite
- If you find large portions of food overwhelming, try eating smaller portions on a smaller plate. You can always have second helpings if you want them.
- If you feel unwell or too tired for cooking, try frozen or chilled meals. Homemade or ready prepared meals can be good choices.
- Takeaway foods can be useful, especially if a home delivery service is available.
- Check if there are meals on wheels services in your area (when the council or other local organisations deliver meals to your home).
- Keep supplies of your favourite foods and snacks at home.
- If you know that you will be away from home for a few hours, carry some snacks with you. Plain biscuits, fruit, crackers, oatcakes or nuts are good options.
- If you find it particularly difficult to eat regular meals and snacks, you could have supplement drinks in the short term. These are nourishing and help to meet your energy needs. Your dietitian can give you more advice about this.
- If your appetite is poor, it is OK to have food and drinks that are higher in fat, carbohydrate and sugar. Talk to your dietitian if you have any concerns. When your appetite has improved and you have put on weight, you can return to a healthy, balanced diet.
More information and support
Diabetes UK
Diabetes UK is a charity for people living with diabetes in the UK. It gives information and support to help people with diabetes manage their condition effectively.
Phone: 0345 123 2399 (Monday to Friday, 9am to 6pm)
Email: helpline@diabetes.org.uk
Website: www.diabetes.org.uk
Kidney Care UK
Kidney Care UK is a charity that gives practical, financial and emotional support for people with kidney conditions and their families.
Phone: 01420 541 424
Email: info@kidneycareuk.org
Website: www.kidneycareuk.org
Resource number: 3967/VER4
Last reviewed: October 2023
Next review due: October 2026
A list of sources is available on request.
