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.

Types of Liquid High Calorie Supplements

Brand	Nutrients	Flavours
Ensure (235 mL Bottle)	250 kcal 9.4 g protein Source of 24 vitamins and minerals Includes Omega 3 and Omega 6 fatty acids Gluten and lactose free	Vanilla Chocolate Strawberry Butter Pecan Wild Berry Orange Cream
Ensure Plus (235 mL Bottle)	355 kcal 13.5 g protein Source of 24 vitamins and minerals Excellent source of calcium and vitamins	Vanilla Chocolate Strawberry Butter Pecan Cafè au Lait
Ensure High Protein (235 mL Bottle)	225 kcal 12 g protein Source of 24 vitamins and minerals Gluten and lactose free	Vanilla Chocolate Strawberry
Boost (240 mL Bottle)	240 kcal 10 g protein Source of 26 vitamins and minerals Lactose free	Vanilla Chocolate Butter Pecan Strawberry
Boost Plus (240 mL Bottle)	360 kcal 14 g protein Source of 26 vitamins and minerals Lactose free Excellent source of calcium and vitamin D	Vanilla Chocolate Strawberry
Boost High Protein (240 mL Bottle)	240 kcal 15 g protein Source of 22 vitamins and minerals Lactose free	Vanilla Chocolate Strawberry
Carnation Instant Breakfast (325 mL Bottle)	260 kcal 14 g protein Source of 21 vitamins and minerals Excellent source of Calcium Contains lactose	Milk Chocholate French Vanilla No Sugar Added Milk Chocolate

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	Milk Chocolate French Vanilla Chocolate Malt Dark Chocolate Strawberry No Sugar Added Milk Chocolate No Sugar Added French Vanilla
Ensure Pudding	170 kcal per 113 g container 4 g of protein per 113 g container/li> Source of 24 vitamins and minerals	Vanilla Chocolate Butterscotch

Make Your Own High Calorie Supplement

	Technique	Ingredients
Version 1	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
Version 2	In a blender, blend:	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!

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

References

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
Carnation. (n.d.) Instant breakfast products. Retrieved December 15, 2010 from http://carnationbreakfastessentials.com/ Products/Default.aspx
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
Gassull, M. A. & Cabre, E. (2001). Nutrition in inflammatory bowel disease. Current Opinion in Clinical Nutrition and Metabolic Care, 4, 561-569.
Hartman, C., Eliakim, R. & Shamir, R. (2009). Nutritional status and nutritional therapy in inflammatory bowel diseases. World Journal of Gastroenterology, 15(21), 2570-2578.
Health Canada. (2009). Canadian nutrient file. Retrieved December 15, 2010 from http://webprod.hc-sc.gc.ca/cnf-fce/index-eng.jsp
Lucendo, A. J. & De Rezende, L. C. (2009). Importance of nutrition in inflammatory bowel disease. World Journal of Gastroenterology, 15(17), 2081—2088.
Nelms, M., Sucher, K. P., Lacey, K. & Long Roth, S. (2011). Nutrition therapy & pathophysiology (2nd ed.). Belmont, CA: Wadsworth Cengage Learning
Nestle Healthcare Nutrition Inc. (2008). Boost products. Retrieved October 30, 2010 from http://www.boost.com/products/ ourproducts_boostdrink.aspx
Razack, R. & Seidner, D. L. (2007). Nutrition in inflammatory bowel disease. Current Opinion in Gastroenterology, 23, 400-405.
Sachar, D. B. & Walfish, A. E. (2007). Crohn’s disease. Retrieved October 30, 2010 from http://www.merck.com/mmpe/sec02/ ch018/ch018b.html
Sachar, D. B. & Walfish, A. E. (2007). Inflammatory bowel disease. Retrieved October 30, 2010 from http://www.merck.com/mmpe/sec02/ch018/ch018a.html
Sachar, D. B. & Walfish, A. E. (2007). Ulcerative colitis. Retrieved October 30, 2010 from http://www.merck.com/mmpe/sec02/ ch018/ch018c.html
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.