Advice
Eating well, whatever happens.
Losing weight without trying, eating less, feeling weaker: these changes deserve your attention. This page helps you understand malnutrition, spot it in yourself or a loved one, and take your oral nutritional supplements properly.
Depending on your situation.
A one-minute test, and advice for the times when your needs increase.
Are you eating as you used to?
The one-minute test, to find out whether you should talk to your doctor.
Calculate your Delidose
Count the chevrons on your supplements. If you are malnourished, the basic guide is 3 chevrons a day.
Malnutrition and cancer
Keep up your strength during treatment, even when your appetite and sense of taste change.
Keeping your muscles as you age
Slow down muscle loss with protein at every meal and a little movement.
Before and after an operation
Be in good shape for surgery and heal more easily, thanks to what you eat.
Pressure sores and wound healing
Dressings protect, nutrition repairs. A simple guide for each stage.
Living with your supplements
Taking them properly, storing them, not getting tired of them and travelling with them.
Drinking well when swallowing is hard
Drinking enough every day without drinks going down the wrong way, with a printable diary.
Helping a loved one to eat and drink
The right steps at mealtimes, with a reminder sheet to put up in the kitchen.
Advice
Understanding malnutrition
Malnutrition happens when your body takes in less energy and fewer nutrients than it uses. It can affect anyone who is ill or elderly, and there is nothing shameful about it.
An imbalance between intake and needs
Your body needs energy to breathe, move and function. This energy comes from the carbohydrates, fats and protein in your meals. When your intake stays below these needs, your body starts drawing on its reserves. The result is unintended weight loss, muscle loss and, often, tiredness.
Three possible mechanisms
Either you eat too little: lack of appetite, swallowing difficulties, a neurological disease such as Alzheimer’s or Parkinson’s. Or you eat enough, but your gut absorbs nutrients poorly, for example after part of the intestine has been removed, after an infection that damages the intestinal wall, or because of an intolerance. Or your needs increase, during cancer, an infection, cystic fibrosis or extensive burns.
The role of age
Age is a risk factor, especially after 70. Metabolism changes, and muscles work less and waste away more easily. Taste changes, appetite falls, and chewing or swallowing can become difficult. Tell your doctor about any loss of appetite or any discomfort during meals.
After a hospital stay or an operation
A stay in hospital, an illness or an operation disrupts the body and your eating habits. Stress and surgery increase the body’s needs. Mealtimes change, appetite drops and you eat less. These factors can trigger or worsen malnutrition: tell your doctor about them.
Mood and medicines
An emotional shock, bereavement, loneliness, stress or depression can take away your appetite or make you skip meals. You can talk to your doctor about this without embarrassment. Some medicines also reduce appetite, interfere with the absorption of nutrients or cause vomiting. Not all of them have these effects: your doctor knows your treatment and can advise you.
Cancer, diabetes and excess weight
During cancer, the body uses more energy to fight the disease, and treatments and anxiety increase the risk further. Diabetes can also go hand in hand with malnutrition: a restrictive diet and insulin that is insufficient or not working well encourage muscle loss. So you can be overweight and malnourished at the same time. For people with diabetes, there are sugar-free supplements that are a source of fibre, designed to limit blood sugar spikes.
Advice
Spotting the signs
The first signs often go unnoticed. Knowing how to recognise them, in yourself or a loved one, means you can act in time.
Situations to watch out for
Some situations carry a higher risk: old age, coming home from hospital, cancer, loss of appetite, swallowing difficulties or pressure sores. Others are less well known: dental problems, a viral infection, bereavement or depression, taking many medicines, pain, severe constipation. Isolation, financial hardship and loss of independence also play a part.
Weight and clothes
Clothes become too loose, the belt goes in a notch. The scales show a little less at each weigh-in. Rapid, unintended weight loss should ring alarm bells. Weigh yourself regularly to keep track.
Tiredness and strength
Tiredness sets in, for you or your loved one. Getting up from a chair, walking or climbing stairs takes more effort. This loss of strength can be a sign of muscle loss.
Changes at the table
Plates are no longer finished, portions get smaller. The desire to eat fades, meals lose their pleasure, and food may even become off-putting. Eating can also become painful.
What to do if in doubt
Talk to your loved one about it simply. Encourage them to see their doctor, who can examine them and decide whether or not it is malnutrition. A dietitian, a nurse or your pharmacist can also listen and point you in the right direction. If malnutrition is confirmed, the doctor will suggest suitable care.
A situation that can improve
There is nothing shameful about malnutrition, and solutions exist. With the right follow-up, nutritional status can improve. Start by seeing your doctor.
Advice
Enriching your diet
Nutritional needs do not go down with age. As a first step, a few simple adjustments add more energy and protein to everyday meals.
Enriching everyday dishes
If your loved one is losing weight without trying, start by enriching what they already eat. Add fat and protein: cream, cheese, butter, eggs. An older person should keep eating as much as before.
Protein at every meal
Protein builds and maintains muscle. It also helps wounds heal and helps the body fight infection, thanks to antibodies. Include some at every meal: meat, fish, eggs, dairy products or pulses.
Snacks between meals
When meals are not enough, add snacks to the day’s three meals. A yoghurt, some dried fruit or a handful of nuts provide extra energy and protein.
A varied diet
Vary your foods: fresh seasonal fruit and vegetables, meat, fish or pulses, dairy products for calcium, wholegrain cereals. Fats have their place, whether animal, like butter, or vegetable, like oils, nuts and seeds. Cut down on added sugars and processed foods, which are nutritionally poor. Take your loved one’s tastes and habits into account.
Vitamin D and getting outdoors
Vitamin D helps calcium bind to the bones. Going out for walks often, with you if possible, helps the body make it from sunlight and keeps your loved one fit. Otherwise, the doctor can prescribe a vitamin D supplement.
If these measures are not enough
If your loved one does not regain weight or strength despite these measures, tell their doctor. The doctor may suggest oral nutritional supplements, richer in protein and energy, to be taken in addition to meals.
Advice
Getting your appetite back
Lack of appetite and loss of taste are common causes of malnutrition. An enjoyable meal, enough fluids and a little activity go some way towards helping.
Make food look appealing
A well-presented dish is more tempting. Lay the table, choose a nice plate and proper cutlery. Meals delivered to the home are better served on a plate or in a bowl than in their tray.
Awakening smell and taste
Cooking or reheating dishes at home releases smells that stimulate the appetite. Choose fresh, seasonal produce, and season with spices and herbs. Change the menu from one meal to the next: variety keeps up the desire to eat.
A shared meal, without rushing
Invite your loved one to help, for example by peeling the vegetables, and chat during the meal. Check that they are sitting comfortably and wearing their dentures and hearing aids. Put cutlery, water and salt within reach, and open a pot or yoghurt in advance. Let them eat at their own pace, one course at a time.
Drinking enough
As we get older, we feel less thirsty, which increases the risk of dehydration. Aim for about 1.5 litres a day, more in hot weather or if you have a fever, even if you are not thirsty. Choose water, still or sparkling, herbal teas or broths, with no added sugar; alcohol does not hydrate. Foods full of water, such as cucumber, courgette or an orange, also count.
Making drinking easier
Leave a glass or a light jug in plain sight. Fear of having to get up at night sometimes holds people back from drinking in the evening: if so, encourage your loved one to drink more during the day. A straw helps if their hands shake. If swallowing is difficult or painful, the doctor may recommend gelled water or powders that thicken drinks, sold in pharmacies.
Staying active
Walking every day or doing a little gardening keeps muscles working. These activities help preserve independence and reduce the risk of falls. The brain also needs stimulation: encourage mental activities and regular contact with other people.
Advice
Oral nutritional supplements
Known as ONS, oral nutritional supplements are classed as food for special medical purposes. They are taken on medical advice, in addition to your meals.
A supplement, not a substitute
An ONS complements your meals without replacing them. It provides protein, calories and sometimes fibre, in the form of a drink, a creamy dessert, a soup, a purée or a biscuit. Your doctor decides how many you need, most often one to three a day. The effects usually take a few weeks: stay in touch with your doctor to monitor your weight and adjust your supplements.
Flavours and textures
ONS come in sweet or savoury, milky or fruity, flavoured or neutral versions, in many flavours. Drinks need no chewing, creamy desserts are eaten with a spoon, filled biscuits can be crunched or dunked, and soups and purées bring something savoury. If you cough after drinking or food often goes down the wrong way, tell your doctor, who may recommend thicker textures, such as thickened drinks, creamy desserts or purées.
When and how to take them
You can take a supplement all at once or at several times during the day, following the directions for use of each product. What matters is reaching the prescribed amount every day. Ideally, take them as snacks between meals, around 10:00 or 16:00, or add them to breakfast, as a dessert or before going to bed. Taking one when you get up or at bedtime shortens the overnight fast: going more than 12 hours without eating makes malnutrition worse.
Making them part of your meals
At breakfast, pour a plain milk drink over your cereal, serve a glass of Delical Fruit Drink with your bread and butter or add Delical Le Brassé to the menu. Between meals, a creamy dessert such as Delical La Floridine, a biscuit or Delical Le Brassé with a few pieces of fruit makes an easy snack. In the evening, a supplement can become a small bedtime ritual. These are only suggestions: always follow your doctor’s advice.
Chilled or warm, and storage
Drinks and Delical Le Brassé taste better well chilled: put them in the fridge the day before and shake the bottle before drinking. Some flavours can also be drunk warm: plain, vanilla, chocolate, coffee, hazelnut. Pour the drink into a cup and heat it without boiling, 45 seconds to 1 minute in a 700 W microwave. Once opened, a product keeps in the fridge for 24 hours at most.
During cancer treatment
Some side effects of treatment guide the choice of supplement. Changes in taste or smell: neutral, milky flavours; dry mouth: tangy flavours, which stimulate saliva; irritated mouth or digestive tract: soft, smooth textures. Nausea: thick, smooth textures, eaten chilled; swallowing difficulties: thick textures, like a creamy dessert. Constipation: supplements that are a source of fibre; diarrhoea: products low in lactose.
Advice
If you don’t like your supplement
It is normal not to like every flavour or every texture. A few tips can help you take your supplement, and your pharmacist can suggest other options.
Note down your impressions
The first few days are for tasting several products and flavours. Keep a short daily record: products taken or left, liked or not. Take these notes to your pharmacist on your next visit: they will be able to advise you better.
Start from what you like
Start from what you enjoy every day: plain or fruit yoghurt, vanilla, chocolate or caramel custard, coffee éclair, strawberry tart. If you prefer savoury food, a soup or purée made with your favourite vegetables may suit you better. Your pharmacist can let you try other flavours. They can order the one you prefer if it is not in stock.
Change texture or flavour
If you mostly take drinks, try a creamy dessert, Delical Le Brassé or a fruit dessert. If you are tired of sweet things, turn to vegetable soups and purées. Take inspiration from the textures you usually enjoy: liquid and chilled, creamy, smooth or crunchy.
Combine with other foods
A plain supplement can be mixed into a soup, a purée or a smoothie, and can be used in cooking. A flavoured supplement goes well with fruit, can be blended with a yoghurt or sprinkled with flaked almonds or crushed biscuit. A plain milk drink can be drunk hot or cold with chicory, cocoa, instant coffee, sweet chestnut spread, honey or a syrup. Try different temperatures too: some people like their supplement well chilled, others at room temperature.
A few simple recipes
Delical Fruit Drink, topped up with sparkling water, becomes a refreshing drink; blended with ice cubes, a sorbet to offer when nausea strikes; left in the freezer for two hours, a granita. A plain milk drink turns into instant mash with an instant mashed potato mix, or into a flan with a flan mix. For a crumble, mix 50 g of Delical Instant Cereal, 50 g of flour, 50 g of butter and 80 g of sugar, spread on a baking tray and bake for 5 minutes at 180 °C. Your supplements can also go into savoury or sweet recipes, such as a gratin, a quiche or a clafoutis.
Your pharmacist’s role
If nothing works despite these attempts, tell your doctor and your pharmacist. Your preferences and difficulties help them adjust their advice. Together, you can look for an option that takes account of both your tastes and your needs.
Need advice?
You don’t have to search alone. Talk to your doctor, your dietitian or your pharmacist: they will help you choose the products that suit you.
Sources
- Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition. A consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1-9. doi:10.1016/j.clnu.2018.08.002
- Volkert D, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38(1):10-47. doi:10.1016/j.clnu.2018.05.024
- Volkert D, et al. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr. 2022;41(4):958-989. doi:10.1016/j.clnu.2022.01.024
Updated: November 2026.
Reviewed by Steeve Roland, physiotherapist, over 20 years in clinical nutrition, founder of BSNUTRITION · Updated on
Publisher: BS NUTRITION SA, Rue de l’Industrie 20, 1400 Nivelles, Belgium. Legal notice