Huntington's Disease Association
Fact Sheet 7
Huntington's
Disease and Diet
Why do I need to eat well?
People with Huntington's disease can find it difficult to maintain
their body weight, or they can be underweight. People who are very underweight are prone to infection, have slower wound healing
and progressive muscle wasting and lethargy. People with Huntington's disease usually need a much higher calorie intake than
normal.
I am hungry but find eating difficult
You do not have to eat large meals. Small frequent snacks, high in
calories (little and often) can be just as helpful.
Do not drink large amounts of fluids with meals as these will make
you feel full quickly but do try to drink plenty of fluids in between meals. Take your time over meals. Sit comfortably.
Add extra calories
MILK is a good source of protein. Try to drink at
least one pint of full cream milk a day. You can add calories easily to milk by adding 2oz skimmed milk powder to 1 pint of
full fat milk.
YOGHURT or similar desserts can be used on fruit
and puddings. Those with added cream or the thick'n'creamy ones are ideal. Avoid low fat or diet yoghurts.
DOUBLE CREAM added to cereals, fruits, puddings,
soups and mashed potato etc will increase calories.
CHEESE is a good source of both protein and
calories. Full fat cheeses such as cheddar and Lancashire are the best. It can be sprinkled on creamed potatoes, soft vegetables,
soups, fish in sauce, minced meats and baked beans. Add cheese to omelettes and scrambled eggs. Cheese in a sandwich, on biscuits
or on toast is an excellent snack.
MEAT AND FISH in any form is useful. Cook well
and serve with plenty of gravy or sauce. Tinned fish in oil or mayonnaise rather than brine or tomato sauce has more calories.
LENTILS AND BEANS are also a good protein source.
They can be added to soups, casseroles, and stews, or used just as a vegetable. Baked beans on toast is a useful snack.
NUTS (for those who are not experiencing swallowing
problems) can be added to salads, baked apples, cakes, biscuits, ice-cream and crumble toppings. They are good foods to nibble
between meals. Try having a peanut butter sandwich or peanut butter on toast for a snack.
Foods you may find difficult to swallow
Raw or hard cooked vegetables, salads, peas, sweetcorn, broad
beans, tomato skins; hard fruits such as apples, pears, grapes, pineapples, fruit skins or fruit peel., crusty bread, pre-sliced
bread, granary bread, high fibre white bread, bread crusts, toast, crackers and crisp breads; sponge cakes; crisps; hard chips;
flaky and puff pastry; hard pastry crusts; nuts and food containing nuts; dried fruit and foods containing dried fruit; shredded
wheat.
Put more energy in it!!
SUGAR - use lots. Put it in hot and cold drinks,
on softened cereals and in desserts.
HONEY, JAM, MARMALADE, GOLDEN SYRUP, TREACLE
can be spread generously onto bread, biscuits and scones, if you can swallow these. Stir them into milk puddings and softened
breakfast cereals. Add honey to Greek yoghurt for an excellent snack.
CHOCOLATE - can be melted in the microwave
added to custard, puddings or milky drinks.
TROUBLE SHOOTING
Dry mouth
If you find you have a dry mouth you may find the following suggestions
helpful:
* small sips of drinks frequently - a small flask with a lid and straw
like a cycling flask can be carried around easily.
* fruit drops may help to get the saliva flowing - some people have
commented that acid drops help.
* sucking ice cubes is useful unless you are likely to swallow or
choke on them. You can make these with lemonade or fruit juice as well as plain water.
* Sorbet
Ask your Doctor about the possibility of prescribing one of the artificial
saliva preparations available.
Care of the mouth
To keep your mouth in a healthy condition:
* use mouthwashes regularly. Ask your nurse or Doctor about the best
one for you to use.
* if your lips are dry, apply a lipsalve eg. Vaseline.
* clean your teeth frequently. Use dental floss.
* visit your dentist for regular check-ups.
* a cube of cheese after each meal will neutralise the acid that causes
tooth decay.
* if you wear dentures, keep them clean and make sure they fit correctly.
Ask your dentist for advice. Dentures are one of the first things to become loose when people lose weight.
* sometimes foods may not taste the same or seem to have no
taste - good mouth care can minimise this.
Keeping food down
* sit upright to eat your meals. Try not to lie flat immediately after
a meal.
* eat your meals in a well ventilated room and wear comfortable clothing.
* try to ensure there is a calm, relaxed environment.
* minimise what is going on around you so you can concentrate on eating.
* discuss with your doctor or a dietician any problems regarding
eating you may be having.
Changing your diet to suit your need
At times it may be necessary to avoid foods that you know cause you
problems, actually identifying these can sometimes resolve the problem.
Sometimes you may need to change the consistency of the food
i.e. eat softer or pureed food.
If you find you are having difficulty swallowing thin liquids, try
thickening them slightly, this often helps and prevents coughing.
There are many thickening agents on the market, your GP can
prescribe one for you.
How to get the texture right if you need soft or pureed food
There are three different ways to try:
Using a liquidizer
A liquidizer is the quickest and most efficient way giving the best
results.
The following tips may help you:
Try not to liquidize all of the meal together, liquidize the meat
and vegetables separately. You can add sauces to give flavour.
Meat and Fish
Remove all skin, bone and gristle from cooked
meat and fish, cut into small pieces add stock or gravy or sauce to get the right consistency.
Vegetables
Cook them to soften before liquidizing again
add stock, gravy or sauce to get the right consistency. Cooking them by steaming will maintain their nutrients.
Fruit
It is easier to blend fruit that is soft, or thawed
if frozen. Tinned fruit in syrup is a good choice. Stewed fruit can also be liquidized.
Using a Hand Blender
These are cheaper than liquidizers but take longer and some foods
may not cooperate.
Using a sieve and spoon
After cooking some food can be forced through a sieve this may need
to be done more than once.
Whichever method you use it is important to remember:
* meals need to look attractive
* all utensils should be kept clean
* meals may need warming during serving if feeding takes time.
* remember a calm relaxed environment will help!
* nutritional supplements which can help to add calories to your diet
are available from your GP.
* a dietician can advise you on your individual needs. Referral can
be arranged by your GP.
* a referral by your GP to a speech therapist can be helpful in resolving
some of your swallowing problems.
Some ideas for soft and pureed diet
DRINKS
FORTIFIED MILK
1 pint of milk (full fat)
glucose
powder
Put the powder into a jug. Add the milk gradually, stirring all the time until all the powder has dissolved. Store
in the fridge.
HONEY CUP
1/2 pint fortified milk
2 tsp honey
Warm
the milk. Put the honey into a cup. Pour the warm milk into the cup, stirring well.
MILK SHAKE
1/2 pint fortified milk.
1 scoop
ice cream.
Milk Shake flavouring.
Stir all the ingredients together in a tall glass
YOGHURT FLIP
1/2 pint fortified milk.
1
carton of ordinary fruit yoghurt.
sugar to taste.
Whisk all the ingredients together in a tall glass, serve chilled.
MINT CHOCOLATE COOLER
1/2 pint fortified milk.
2-4
heaped tsp drinking chocolate.
peppermint flavouring.
grated chocolate.
Mix the drinking chocolate and the peppermint
flavouring with a little milk. Add the remainder of the milk, stirring well. Pour into a glass and decorate with grated chocolate.
CITRUS SURPRISE
1/2 pint fortified milk
lime
cordial
orange and lemon slices for decoration
Add milk to the lime cordial according to taste. Serve chilled in a tall
glass decorated with orange and lemon slices.
WHISKY AND HONEY WARMER
3/4 cup of warm milk
2
level teaspoons clear honey
1 tablespoon whisky or brandy
Warm the milk, stir in honey, pour into a cup.
HOT MILK MOCHA
1/2 pint of milk
2 tablespoons
drinking chocolate
1 level teaspoon instant coffee
1 tablespoon double cream.
Boil milk and pour into mugs, add chocolate
and coffee, stir well, swirl in fresh cream and serve.
There are a wide range of high calorie, high protein drinks in many
sweet and savoury flavours available from your GP or contact your Dietician.
Meal ideas for those who have difficulty
swallowing
Breakfast
porridge.
Instant hot oat cereal e.g. Readybrek
Weetabix
fruit
juice
pureed fruit
plain or flavoured yoghurts
Main Meals
soup
casseroles, hotpots etc,
fish with sauces
pasta dishes
cauliflower
cheese
cheesy potato bake
lentil bake
Puddings
pureed fruit, milk puddings eg rice puddings, semolina, custard, blancmange
jelly, including milk jelly smooth yoghurts and fromage frais. ice cream and sorbet, instant desserts e.g. Angel Delight,
Birds Instant Whip, egg custards and creme caramel
NB: TRY TO HAVE A GLASS OF FRESH ORANGE OR GRAPEFRUIT JUICE
OR BLACKCURRANT CORDIAL EVERY DAY TO PROVIDE YOU WITH SOME VITAMIN C.
A Dietician can give you detailed individual advice about your needs,
A referral can be made via your GP.
The Huntington's Disease Association has a team of Regional Care Advisers
who can offer help on a wide range of problems. For details of the Regional Care Adviser in your area please contact Head
Office on 0171 223 7000.
