Help with diet

[Breakfastbabe]

My husband has been told to cut out salt and reduce fluids to 1.5lt a day due to ascites, but increase protein and carbs and calories intake to around 3000 a day to maintain his weight. He is struggling with this as he has never had a big appetite and would happily exist on bread and sausage. He is type 2 diabetic but since he has cut out alcohol and eaten more cake and chocolate his diabetes has strangely stabilised to the point where his medication has been stopped.My question is, is anyone successfully on a low salt high calorie diet and if so, what would be a typical day's meals and snacks for you? There is a guide in the book we have been given for snacks but not actual meals. Thank you.

[Dexter786]

Aldi sell some lovel yogurt pouches that contain 25g of protein. You can eat them in the go and I’ve found they can help to increase your protein intake.

[Breakfastbabe in reply to Dexter786]

Thank you. He tried something from Lidl which he wasn't keen on but will have a look in Aldi.

[Ericabear]

I add ground roast peanut powder to yoghurts and breakfasts to try to increase the protein. Snack on nuts, dates, avocado and I do some little protein balls with, oats, sultanas, peanut butter and honey. Lentils and beans are great for soups or curries. See if you can get in with a dietician to help. Good luck.

[Breakfastbabe in reply to Ericabear]

Thank you. Not easy to see a dietician here but will take on board your lovely suggestions.

[Fides]

I struggled with getting enough protein in my diet, especially since at the time I was vegetarian, I grew up eating meat, but switched to eating vegetable, after developing Ascites, I eventually had to eat chicken, but it pretty much made me want to hurl.

I struggled to get enough calories, at one stage they had me needing 3500 calories per day.

Protein is important because everytime ascites is drained it drains protein and albumin out of the muscles.

I found it useful to use an excel spreadsheet to document what I was eating, when I was eating, recording the time, the number of meals, the protein, the salt etc. the dietician regularly asks you this information and I could never remember what, when and how much I had eaten, it also helped me regulate my diet.

I don't know whether you have been to a dietician yet, but for me it was part of the process and my excel spreadsheets were a great hit with the dietician.

So for protein I was prescribed Fortisips (Fortisips provide 300 calories per Fortisip and I forget how much protein, think it's 11-12g, and I also used Protein powder, I found this one on Amazon uk, not advocating this or Amazon, but it's what worked for me, and what was approved by my dietician.

(SERIOUS PROTEIN – Protein Powder – 4kg – Low Carb – Supports Lean Muscle Growth – Recovery Supplement - The Bulk Protein Company - 133 Servings (Chocolate)), it's important to check what is contained in the protein powder.

Dietician have some helpful pdfs that show the different ratios of protein for food, I find I am really bad when people give me a huge pile of pdfs, I never get round to reading all these things and even now post transplant I am still catching up on all the reading.

Here is an excerpt from one of the NHS documents that may help to give you some ideas

Food/ Drink Amount Protein Content (grams)

Meat

Chicken breast One fillet (~125g) 30

Turkey breast One fillet (~100g) 25

Lean beef mince ¼ of a 500g pack (125g) 26

Beef steak One steak (255g) 53

Beef burger One burger (100g) 21

Pork loin One (135g) 20

Lean pork mince ¼ of a 500g pack (125g) 23

Fish

Salmon One fillet (~96g) 21

Haddock One fillet (~140g) 27

Mackerel One fillet (81g) 19

Tinned Tuna chunks (in spring water) One tin (160g) 26

Tinned sardines One tin (90g) 19

King Prawns ½ of 150g pack (75g) 11

Dairy and eggs

Semi-skimmed milk One cup (200ml) 7

Skimmed milk powder 10g powder 3.6

Greek style natural fat free yoghurt ~⅓ of 500g pot (150g) 11

Greek yoghurt 0% fat Small pot (170g) 11

Skyr 0% fat ⅓ of 450g tub (150g) 16

High protein yoghurt One pot (200g) 20

Natural kefir yoghurt ½ of 350g tub (175g) 9

Cottage cheese (fat free) ⅓ of 300g pot (100g) 11

Egg (medium) One 7

Lower fat cheddar One slice (25g) 7

Reduced fat Dutch cheese (such as Gouda or

Edam)

One slice (20g) 6

Reduced fat feta cheese 1/6 of packet (30g) 5

Mozzarella ¼ of 125g pack (30g) 5

Plant-based proteins

Quorn® mince 1

/5 of a 500g pack

(100g)

13

Vegetarian sausages Two sausages 16

Kidney beans in water ½ can (120g) 9

Low sugar baked beans ½ can (~200g) 9.5

Chickpeas in water ½ can (120g) 8

Lentils ½ can (117g) 7

Tofu ½ of a 280g pack (70g) 9

Edamame beans (fresh) ½ pack (~88g) 12

Quinoa 30g uncooked 3.5

Unsalted almonds, walnuts, cashews A handful (30g) 6

Unsalted peanuts A handful (30g) 9

Peanut butter One tablespoon 4.2

Mixed sunflower and pumpkin seeds A handful (30g) 9

Soya drink One cup (200ml) 7

Soya yoghurt ~⅓ of a 500g pot

(150g)

6

Pea milk alternative One cup (200ml) 5

Moderator, am not sure whether I am allowed to link this information, I have the documents available and can send them to you, perhaps you could then post them on your site so I can then link them, this is a popular topic that many people ask?

[Breakfastbabe in reply to Fides]

Thank you for this really useful information. I think it would actually be easier if it was me as I would be really strict with myself but it is hard enough getting him to eat anything much so I kind of go with the flow and if he fancies a bakewell tart, well it's got nuts so there's a bit of protein, if he wants some ham well it's full of salt but hey ho there's a bit of protein in there. I think it would really help if we could get to see a dietician but the one we did see was really hard to understand unfortunately and it is difficult to get referred at our local hospital, especially when it is me doing the pushing and not him. Your list is really helpful though so thank you again.

[AyrshireK in reply to Breakfastbabe]

It does get to a point where anything you can get down you is perfect, my hubby is now unable to eat physical food at all - with Hepatic Encephalopathy he gets food in his mouth and chews it for ages but is unable to pass it over his throat and sadly if he does eat anything - even if it's been home made and blended to make it easy to swallow he ends up throwing it up.

He was on n/g feeding for three months at the start of this year but couldn't tolerate tube re-insertion after having had 3 traumatic tube removals so he can no longer manage n/g feed so he is now sustaining on 7 x Fresubin Supplementary drinks daily which are providing 2800 calories plus 140g protein per day as we await transplant.

He has diabetes (Type 3c) which was newly diagnosed at the end of last year and he has been put on insulin now as these supplements are super high in carbohydrates (45g a bottle) so his blood sugars have gone crazy.

I will ping you a pm with some information that may be useful to you as you hopefully await a dietician appointment.

Katie

[Breakfastbabe in reply to AyrshireK]

I am so sorry about your husband's state of health. It must be hard for you. Thank you for the information.

[Fides in reply to AyrshireK]

Yes at one point I couldn't tolerate the fortisips anymore and they convinced me to have the feeding tube inserted...that dietician was so hot and I was so gullible, what an evil woman...about the most invasive and disgusting procedure you can imagine, they pass a tube up your nose down the back of your throat and into your stomach, then feed you through it, can also be used to feed you medicine or to extract substances out, in my case they used it to draw bile out when I had a hernia.

Sometimes the tube gets blocked and they have to take it out and reinsert it again, but this reinsertion can cause heavy bleeding in your nose, the tube does not always go the right way causing a bleed and then they have to reinsert it in the other nostril, after repeatedly reinserting the tube and causing massive bleeding out of both nostrils I eventually refused to have this done. My sympathy for your husband.

[AyrshireK in reply to Fides]

My hubby had an n/g tube inserted during his transplant assessment in January and tolerated it for a solid 3 months but sadly during an H.E. moment he pulled it out, then on another occasion vomitted it up and then the last time his hot water bottle fell out of bed onto the tube and yanked it clean out of his nose. Sadly the nurse attempting the re-insertion the last time made an absolute blood bath of it and still managed to bunch it all up in the back of his throat meaning it had to come out again.

Then that was that hubby couldn't tolerate having it done again so now the only option left is the supplement drinks and he's on 7 per day and no additional food as he either just sits chewing it or vomits it straight back up and a bit of psychological fear has set in now that if he tries food it is just going to come back up so he daren't try.

He's tolerating but not enjoying the supplements but they are doing the job keeping his weight on as we await his transplant.

Katie

[Breakfastbabe in reply to AyrshireK]

I hope you get some good news soon. My husband has been told he is too old for a transplant and has too many problems with his circulation so even more reason to try and keep stable.

[Breakfastbabe in reply to Fides]

I am so sorry you had to go through all of that. I hope you can feel better soon.

[Fides in reply to Breakfastbabe]

Thank you for your comment, I had liver cirrhosis for 14 years at the end of that I developed Ascites for 6 months, and then my liver failed.

I feel blessed that I got to have the liver transplant because it is such a massive improvement on the ascites and it gave me a new lease on life.

[21Oaktreepinetree212]

Hi, breakfast, fibre weetabix, banana, blueberries. Coffee and honey,cheese later toastie ,biscuits,..lamb chops spuds,green veg herbs ..cake ice cream.. 😋 there's one day! Snack b4 bed

[Breakfastbabe in reply to 21Oaktreepinetree212]

Thank you. Does that keep the weight on for you?

[21Oaktreepinetree212 in reply to Breakfastbabe]

Yes it does. Try them lindemanns protein yogurts too..

[Breakfastbabe in reply to 21Oaktreepinetree212]

That's good thank you