Inflammatory Bowel Disease and High Calorie Supplements What are high calorie supplements? High calorie supplements provide calories, protein, vitamins and minerals in addition to what you normally eat. There are many commercial products available in grocery stores or pharmacies or you can make your own. They can help patients living with inflammatory bowl disease (IBD) increase their calorie and nutrient intake to maintain and improve their health.
Why do IBD patients need high calorie supplements? Many patients living with IBD suffer from a lack of nutrient intake. This may mean that they are either not eating enough calories, protein, or other nutrients or they are not absorbing some of what they have eaten. This is particularly true for patients who are experiencing symptoms of IBD, or are in a “flare up.” You may need to consider a high calorie supplement if you: • Are underweight • Have unintentional weight loss • Lack appetite • Avoid eating • Have food intolerances • Are in a “flare up”
Asking for help: Ask your dietitian if a high calorie supplement may be right for you.
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Types of Liquid High Calorie Supplements Brand
Nutrients
• • • •
250 kcal 9.4 g protein Source of 24 vitamins and minerals Includes Omega 3 and Omega 6 fatty acids Gluten and lactose free 355 kcal 13.5 g protein Source of 24 vitamins and minerals Excellent source of calcium and vitamin 225 kcal 12 g protein Source of 24 vitamins and minerals Gluten and Lactose Free
• • • • • • • • • • • • • •
Vanilla Chocolate Strawberry Butter Pecan Wild Berry Orange Cream Vanilla Chocolate Strawberry Butter Pecan Café au Lait Vanilla Chocolate Strawberry
Boost (240 mL Bottle)
• • • •
240 kcal 10 g of protein Source of 26 vitamins and minerals Lactose free
• • • •
Vanilla Chocolate Butter Pecan Strawberry
Boost Plus (240 mL Bottle)
• • • • •
• Vanilla • Strawberry • Chocolate
Boost High Protein (240 mL Bottle)
• • • •
360 kcal 14 g protein Source of 26 vitamins and minerals Lactose free Excellent source of calcium and vitamin D 240 kcal 15 g of protein Source of 22 vitamins and minerals Lactose free
• • • • •
260 kcal 14 g of protein Source of 21 vitamins and minerals Excellent source of Calcium Contains lactose
• Milk Chocholate • French Vanilla • No Sugar Added Milk Chocolate
Ensure (235 mL Bottle)
Ensure Plus (235 mL Bottle)
Ensure High Protein (235 mL Bottle)
Carnation Instant Breakfast (325 mL Bottle)
• • • •
Flavours
• • • • •
• Vanilla • Strawberry • Chocolate
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Other Commercial Supplements Brand
Nutrients
Flavours
Boost High Protein Powder
• 150 kcal per serving of mix • 5 g of protein per serving of mix • Source of 16 vitamins and minerals • Mix with milk
• Chocolate
Carnation Instant Breakfast Powder
• 130 kcal per 36 g packet • 5 g of protein per 36 g packet • Source of 21 vitamins and minerals • Mix with milk • Contains lactose
• • • • • • •
Ensure Pudding
• 170 kcal per 113 g container • Vanilla • 4 g of protein per 113 g container • Chocolate • Source of 24 vitamins and • Butterscotch minerals
Milk Chocolate French Vanilla Chocolate Malt Dark Chocolate Strawberry No Sugar Added Milk Chocolate No Sugar Added French Vanilla
Make Your Own High Calorie Supplement Version 1:
Version 2:
In a blender, blend:
In a blender, blend:
• 3/4 Cup Plain or Fruit Flavoured Yogurt • 1/4 Cup Skim Milk Powder • 1/2 Cup Apple Juice • 1 Tbsp Honey or Sugar
• • • •
1/2 Cup Whole Milk 1/2 Cup Canned Fruit 1 Cup Vanilla Ice Cream 2-3 Scoops Whey Protein Powder
These are not complete meal replacements, but they are a quick and tasty source of calories and nutrients. You can substitute lactose free or items that contain soya (soya milk, soya ice cream). You can add whey protein powder to shakes to increase the protein. Experiment with a variety of different fruits, juices or syrups!
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Top Tips for Increasing Calories in Your Diet Product
Kcal*
Practical Tips
Butter or Non-Hydrogenated Margarine
• 1 Tbsp ~ 100 kcal
• Melt onto hot items such as toast, pancakes, vegetables or popcorn. • Stir into items like soup, hot cereal, mashed potatoes and rice.
Regular Mayonnaise
• 1 Tbsp ~ 58 kcal
• Combine with different foods like pasta, vegetables and sandwiches. • Use in sauces and dips.
Regular Sour Cream
• 1 Tbsp ~ 26 kcal
• Serve over potatoes or perogies. • Use when baking muffins and breads.
Iced Cream or Whipped Cream
• 1/2 Cup ~ 145 kcal
• Use as a topping for puddings, pies, waffles, pancakes, fruit, hot chocolate or jello.
Dried Fruit, Nuts or Seeds
• 1/4 Cup ~ 209 kcal
• Eat as snacks. • Mix into cereals, puddings or salads.
Honey, Jam or Jelly
• 1 Tbsp ~ 65 kcal
• Spread over toast or crackers • Use in baking, such as cookies and cakes.
Table Cream
• 1 Tbsp ~ 31 kcal
• Add to hot beverages, milkshakes and other liquids.
*kcal can vary by product, please look at label information for actual product information
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References 1.
Abbott Nutrition Canada. (2010). Ensure products. Retrieved December 15, 2010 from http://www.abbottnutrition.ca/ adp_ani_an_dotca/url/content/en_CA/40.10:10/general_content/General_Content_0000174.htm
2.
Carnation. (n.d.) Instant breakfast products. Retrieved December 15, 2010 from http://carnationbreakfastessentials.com/ Products/Default.aspx
3.
Crohn’s and Colitis Foundation of Canada. (2010). Food for thought: Diet, nutrition and inflammatory bowel disease. Retrieved October 30, 2010 from http://www.ccfc.ca/English/info/brochures/FoodForThought.pdf
4.
Gassull, M. A. & Cabre, E. (2001). Nutrition in inflammatory bowel disease. Current Opinion in Clinical Nutrition and Metabolic Care, 4, 561-569.
5.
Hartman, C., Eliakim, R. & Shamir, R. (2009). Nutritional status and nutritional therapy in inflammatory bowel diseases. World Journal of Gastroenterology, 15(21), 2570-2578.
6.
Health Canada. (2009). Canadian nutrient file. Retrieved December 15, 2010 from http://webprod.hc-sc.gc.ca/cnf-fce/index-eng.jsp
7.
Lucendo, A. J. & De Rezende, L. C. (2009). Importance of nutrition in inflammatory bowel disease. World Journal of Gastroenterology, 15(17), 2081—2088.
8.
Nelms, M., Sucher, K. P., Lacey, K. & Long Roth, S. (2011). Nutrition therapy & pathophysiology (2nd ed.). Belmont, CA: Wadsworth Cengage Learning
9.
Nestle Healthcare Nutrition Inc. (2008). Boost products. Retrieved October 30, 2010 from http://www.boost.com/products/ ourproducts_boostdrink.aspx
10. Razack, R. & Seidner, D. L. (2007). Nutrition in inflammatory bowel disease. Current Opinion in Gastroenterology, 23, 400-405. 11. Sachar, D. B. & Walfish, A. E. (2007). Crohn’s disease. Retrieved October 30, 2010 from http://www.merck.com/mmpe/sec02/ ch018/ch018b.html 12. Sachar, D. B. & Walfish, A. E. (2007). Inflammatory bowel disease. Retrieved October 30, 2010 from http://www.merck.com/mmpe/sec02/ch018/ch018a.html 13. Sachar, D. B. & Walfish, A. E. (2007). Ulcerative colitis. Retrieved October 30, 2010 from http://www.merck.com/mmpe/sec02/ ch018/ch018c.html 14. Swinton, N. & MacDonald N. (n.d.). McGill cancer nutrition rehabilitation program: A nutrition guide for patients, families and friends. Retrieve December 15, 2010 from http://www.mcgill.ca/files/cnr/NutritionGuide.pdf
Handout designed by Leah Edmonds, College of Pharmacy & Nutrition, University of Saskatchewan. Funding for this project provided by the Interprofessional Health Collaborative of S askatchewan and the Saskatoon Health Region.
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