When the kidneys aren't filtering as well, waste products build up in the blood. In later stages of kidney disease, this buildup of waste can make you feel worse and significantly decrease your appetite. Even if you have a poor appetite, it's still important to eat enough, or you may become weaker, more fatigued, or even malnourished. Struggling to hit your nutrition goals due to low appetite? Read on for some strategies to try.
Tips to overcome low appetite
You don't have to try all of these tips at once, but pick an area or two to work on first. It's okay to increase your food intake over time, but always check with your medical team if you're having trouble eating enough for more than a few days.
Prioritize protein
Protein helps repair tissues and maintain muscle mass. You may not feel like eating, but it's still essential to hit your minimum protein goals. Try to include small amounts of protein at each meal. Eat the protein first at a meal or snack, or make sure you take a few bites of protein at each meal. As a reminder, good sources of protein are meats, fish, eggs, tofu, beans, dairy and whole grains like quinoa.
Eat small meals and snacks
Don't wait until you feel hungry to grab some food, since you might not feel hungry at regular intervals when you're not feeling well. Set a timer or alarm if you're not remembering to eat and don't feel hunger pains.
Instead of trying to eat three large meals, try to break your meals into four to six mini meals. While people typically eat meals about four to five hours apart, you might need to eat every 2 or 3 hours to make sure you eat enough.
Another strategy is to keep snacks near you while working or relaxing and try to take bites at regular intervals. Try a snack lunch or dinner with small amounts of foods you enjoy, and take bites while you watch a show or movie.
Try a snack plate with some of these foods:
- A few ounces of roast chicken or 2 hard-boiled eggs
- A slice of white toast with butter
- Lower sodium crackers with mashed avocado
- Apple slices with peanut butter
- Cucumber and carrot sticks with hummus
Fortify meals with healthy fats
Healthy fats include avocado, olive oil, canola oil, and safflower oil. Unsalted nuts and seeds also have healthy fats and may be an option for you in small servings, depending on your kidney diet restrictions.
Oil has about 40-50 calories per teaspoon, so adding a drizzle to vegetables, rice, or even an entree can boost your calorie intake without making you feel like you're eating a lot more. Eating ⅓ of a medium avocado would add about 80 calories to a meal. Avocados are a fruit, so they do contain potassium in addition to healthy fats. Be mindful of the portion size if you're watching your potassium intake.
Work with taste changes
Taste changes affect about 35% of people with end-stage kidney disease. Some people experience a metallic or bitter taste in their mouths, and others can't taste flavors as well.
If you're experiencing unpleasant tastes in your mouth, try these tips:
- Brush your teeth more often, and try using mouthwash to get rid of the taste
- Add a squeeze of citrus or a splash of vinegar to foods to neutralize any metallic or bitter flavors
- Suck on sugar-free mints or sour candies
Try new flavors
Sometimes foods are less appealing because you're using less salt due to a sodium restriction. Remember, if you're following a low-sodium diet, you don't have to eat only bland foods. Many of the salt-free seasoning blends are pretty tasty. Pick up a few from the grocery store to try because a new pop of flavor may help you take a few more bites.
To add flavor:
- Use a lower-sodium marinade, or make your own with citrus juice or vinegar, olive oil, and some herbs and spices
- Add a squeeze of lemon or lime to your protein or side dishes for fresher flavor
- Try a different cooking technique, like roasting vegetables in the oven until they're caramelized and crispier
Consider nutrition shakes and oral nutrition supplements
If you follow these tips and still aren't able to eat enough, you may need to supplement your diet with a nutritional shake, also known as an oral nutritional supplement. These nutrition drinks are a concentrated source of calories, protein, vitamins, and minerals, intended for people who have trouble eating enough to meet their protein and calorie needs.
Check with your medical team before starting a nutritional shake, as you may need to avoid shakes intended for the general population. Standard nutritional shakes may contain too much protein, sodium, phosphorus, and/or potassium for you. Your medical team may suggest a specific shake for you, and sometimes they're covered by insurance with a prescription.
Before starting dialysis, standard oral nutrition supplements include:
- Suplena
When on dialysis, standard nutrition shake options include:
- Nepro
- Novasource Renal
- Kate Farms Renal Support
Nutrition drinks taste best when cold. If you have trouble finishing one, try drinking a few ounces from a small shot or juice glass at different points of the day, such as with meals. Some of the brands come in multiple flavors, so don't give up if you don't enjoy the first one you try. You can also try blending a nutrition shake with a small amount of fruit, or add flavored syrups to change it up.
Bottom Line
Even if you have to follow diet restrictions and don't have a strong appetite, it's still important to eat enough to stay strong. Try some of these tips, but let your health care provider know if your appetite has dropped off and you or your family worry you're not eating enough. They may have additional ideas or refer you to a registered dietitian for personalized support.
