Introduction
If you have lost a lot of weight due to illness, your doctor or dietitian may advise you to increase your intake of energy and protein. They may try to persuade you that your vegetarian diet is unsuitable. Do stick to your principles. This Information Sheet is to enable you to choose vegetarian foods which will help you to gain weight and recover from illness.
The energy density of foods is important when trying to gain weight. Energy density refers to the amount of energy or calories compared to the weight of the food. Vegetable foods tend to be less energy dense and so it is particularly important for vegetarians to be aware of suitable foods.
When you are poorly, modern healthy eating advice to reduce fat, reduce sugar and increase fibre, is peripheral to your immediate needs. If you know you must increase your energy and protein intake, you can do so by increasing your fat and sugar intake, and also try to avoid large amounts of fibre.
If You Are Underweight But Healthy
If you are not ill but feel you are underweight and need to gain then not all the advice on this sheet is suitable for you. You should try and increase your food intake without consuming too much fat and sugar although a little with the right type of food is fine. For example, you can use olive oil on baked or boiled potatoes and sugar in a nutritious wholemeal fruit cake.
Regular meals, especially breakfast, are important if you find it difficult to gain weight. Taking your time with meals and making sure you are relaxed is also important to ensure that your digestive system functions properly. A glass of wine with an evening meal is beneficial to relax you as well as stimulating your digestive juices.
Some people are just naturally thin no matter how much they eat and the envy of those who gain weight easily. As long as you are in good health and do not drop below the recommended range of weights for your height you should not worry. Exercise can help build up your muscles and make you feel better about your body shape.
Lack of Appetite
If your appetite is poor, you must not forget to eat. Try to have small but frequent meals, and if you can manage, snacks in between. You may like to try nutritious drinks between meals.
If you feel nauseous, try to avoid strong cooking smells and have a short walk or perhaps just sit in the fresh air before a meal.
Protein
Protein is essential to the body, for repair, to enable the immune system to function and for recovery from illness. If you are recovering from illness, it is important to include adequate protein in your diet. Good vegetarian sources of protein include: cereals, nuts & seeds, soya products (soya milk, tofu, tempeh etc) and pulses. Milk, yoghurt, cheese, and free range eggs are also excellent protein sources for the non-vegan.
You must ensure that you include a protein source at each meal. Try to choose the energy dense sources of protein that are relatively soft and which do not contain to much fibre, for example, the soya or dairy sources of protein.
Try nut butters. There are many more available other than peanut butter, try others such as hazel nut or cashew nut butter.
Soya products are excellent and easily digested sources of protein. Choose the nutritional supplemented soya milks with added calcium and sugar.
If you use dairy products, make good use of soft milky puddings, such as custard and rice pudding. Vegans can also get a variety of soya pudding, including soya rice pudding. If you like, add jam, honey, ground nuts or cream to your pudding. Porridge with a couple of tablespoons of added vegetable oil, perhaps with some nuts and/or dried fruit, can be very nutritious.
If you prefer to have white bread, white pasta and refined rice, then do so. But remember that the wholemeal varieties are very good sources of the B vitamins.
Make good use of cereal products (wheat, barley, rye, oats etc.), although avoid too much fibre. Complement cereals with other sources of proteins, such as nuts, seeds, pulses, milk and cheese.
Seeds, such as sesame seeds (tahini) or sunflower seeds, when ground as a paste, can also provide an energy dense source of protein in the diet. Tahini is particularly good when combined with a mashed pulse, such as chick peas to make hummus.
Pulses are more easily digested, if well cooked and mashed. Try mashed lentils or pureed black eye beans.
Energy
In order to gain weight it is essential to increase the energy content of your diet. Also, in order for your body to make proper use of protein, you must ensure sufficient energy. The most concentrated form of energy in the diet is from fat. If you can tolerate fat then try and increase the fat content of your diet.
Alcohol is also a concentrated form of energy and can be taken in moderation, perhaps before meals, as it may help improve your appetite. Only take alcohol with your doctors permission.
If you can tolerate oils, try adding some vegetable oil or vegetable margarine to your food, particularly to mashed pulses, salads and potatoes. If you like fried foods, then have fried foods.
Use cream if you can tolerate fats. A good vegan alternative to cream is cashew nut cream, made from ground cashew nuts and water.
Do not restrict your sugar intake, although always have sweet foods after the savoury part of your meal. Glucose is a less sweet and more concentrated form of sugar. Glucose can be added to foods and drinks, such as porridge and cocoa drinks to increase your energy intake. Check with your dietitian about using glucose. She may suggest that your doctor prescribes you a special type of non-sweet, high calorie supplement, which can be added to foods and drinks.
If you like to have soup, make sure the soup is as nutritious as possible. Add pureed lentils, vegetable oil, butter, whole milk, cream or cheese.
Make good use of the wide range of vegetable pates and spreads available.
General Advice

· You may prefer to take puddings half an hour to one hour after your first course, this will enable time for the first course to settle.
· You may find ice-cream, soya or dairy, refreshing after meals.
· Make good use of a food blender, if you have one, to blend fruit, vegetable and pulses.
· Have meals with a good sauce, made with pureed fried onions, perhaps with tomatoes or mushrooms. To increase the energy density of sauces use butter or vegan margarine and add soya milk, silken tofu, cow's milk or cream.
· Do make sure you include a source of vitamin C in your diet, perhaps fresh fruit juice, black-currant cordial or rosehip syrup.
· Try and eat some fresh fruit and vegetables or salad each day, especially green vegetables, to ensure you get your full compliment of vitamins and minerals. If you cannot tolerate whole fruit or crunchy vegetables, take them as fruit juice or a pureed soup made with fresh vegetables.
· High energy drinks, can be made using whole cow's milk, sweetened soya milk or silken tofu, with glucose, honey or sugar and a flavouring of your choice such as chocolate or vanilla.
· You can buy products from the chemists, to have as meal replacements, when your appetite is particularly poor. Do check on their suitability for vegetarians.
· Ask your doctor or dietitian about including a vitamin or mineral supplement in your diet. If you choose to take a supplement, inform your doctor and dietitian. Multi-vitamin and mineral tablets should not do you any harm, as long as you stick to the recommended dose.

If You Still Need Extra Protein & Energy
Your doctor can prescribe for you special supplements which can help you to gain weight. You would usually be referred to a dietitian, who can nutritional assess you and recommend the correct type of supplement.
If you are concerned about the suitability of a any product, for vegetarians or vegans, which have been prescribed for you, contact The Vegetarian Society. Also contact us if you are having problems with health professionals who may be sceptical about your vegetarian or vegan diet.