What is a high energy, high protein diet or HEHP?
It is a type of diet designed to minimise weight loss, help with gain weight in underweight individuals, maintain muscle mass and/or minimise the risk of malnutrition. Energy refers to the kilojoules or calories in our food and drink. Some foods have more energy than others. The amount of energy available depends on the nutrients it comes from – either fat, protein or carbohydrates.
Protein is essential for growth, maintenance and repair of tissues in the body including our muscles. It can also be used as an energy source. Food that are high in protein include meat, fish, chicken, eggs, dairy/alternatives (cheese, milk, yoghurt), beans/legumes, nuts/seeds and tofu/tempeh.
HEHP diets aim to deliver as many kilojoules and nutrients as possible in minimum volumes. It is highly beneficial for those suffering from early satiety, fatigue and/or a low appetite whereby they do not need to consume large meals.
Why HEHP is important in aged care and older populations
HEHP diets are commonly used within the aged care setting due to the high prevalence of malnutrition, unintended weight loss, wounds, pressure injuries and/or loss of appetite. HEHP diets are designed generally to be used in the short term and therefore will not give rise to chronic conditions. However, when used long term, malnutrition can be more important to prevent than a chronic disease, which is likely to have already developed.
For the elderly living at home, daily tasks such as cooking, shopping and eating are often not prioritised and/or can become difficult, leading to an increased risk of malnutrition. If your loved ones are showing signs of muscle/fat wasting, a HEHP diet may be considered.
HEHP strategies
Small frequent meals – try having 6 small meals per day or eating every two to three hours
Eat the protein part of your meal first to ensure the most important part is eaten before you feel too full
Fortify your foods by adding extra energy and protein to make the most of each mouthful – see ideas below
Replace tea, coffee or water with milk/alternative or juice-based drinks. When appetite is poor it is often easier to drink your nutrition
Eat according to your tastes/preferences at any time of the day. There are no rules around when to eat certain foods, for example, having an omelette for dinner
Enjoy meals with family or friends
Tips to get the most out of your meal
Cereal/porridge | Choose full cream milk/alternatives Enrich your milk by adding milk powder Add cream, honey, nuts/seeds, dried fruit |
Pancakes/waffles | Add ice cream, yoghurt Add honey, maple syrup |
Eggs (cooked to preference) | Add cheese, chopped bacon Add milk powder |
Sandwiches/wraps | Choose nourishing fillings (tuna & mayonnaise, chicken & cheese, egg, tofu & salad) Add a thick spread of butter/margarine, avocado |
Soup | Choose creamed, meat or bean varieties Add cheese, sour cream, Greek yoghurt, milk powder |
Salad | Include egg, meat, falafel, cheese or tuna/salmon Add oily or creamy dressings e.g. French, Caesar Add quinoa, chickpeas, brown rice or pasta Add avocado, nuts/seeds, olives |
Roast meats, vegetable bakes | Add white sauces, gravies Prepare with extra oil Melt cheese on vegetables |
Yoghurt/custard with tinned fruit | Choose full cream varieties Try higher protein options e.g. YoPro or Chobani Fit |
Desserts e.g. creamed rice, ice cream, cakes | Add flavouring of choice e.g. milo, chocolate/strawberry/caramel syrup, crushed nuts Top cakes with cream, ice cream or custard |
Milk drink | Choose full cream milk/alternatives Add milk powder Add extra scoops of milo or chocolate powder |
HEHP ideas this Easter
BREAKFAST: Pancakes with maple syrup and ice-cream
MORNING TEA: Easter Devilled Eggs or boiled eggs (paint these for some Easter fun) or a chocolate Easter Egg Hunt
LUNCH: Roast with Gravy, Cheesy Potato Bake & Roast Vegetables
AFTERNOON TEA: Cheese Platter: variety of cheese, crackers, dried fruit
DINNER: Easter Pie with Silver beet and Ricotta or an Chicken & Mushroom Casserole
DESSERT: Chocolate brownies with custard or ice-cream
SUPPER: Hot Cross Bun with Butter and a Cup of Milo
Summary
On the surface, HEHP diets can be seen as ‘unhealthy’ and are often criticised by those who do not understand malnutrition, aged care and hospitals thoroughly. HEHP diets are generally not recommended for healthy individuals, however, when there is a high risk of malnutrition, HEHP can be the best option. A food first approach is the best first step. Oral nutrition supplements (ONS) may be considered after a food first approach has been trialed if the individual is continuing to lose weight.
It’s always best to see an Accredited Practising Dietitian (APD) for personalised support. With our 16 qualified Dietitians across Australia, OSCAR Care Group are able to provide expert Dietetic advice in line with the latest evidence-based practice. Either on a regular basis within your Aged care facility or for elderly people living at home through our Clinic. We're here to help you.
Interested in a HEHP Recipe book?
OSCAR Care Group will be releasing a HEHP Recipe Book soon, click here to express your interest and be notified upon it's release.