Nourishing Diet Level 6 – Soft and Bite-sized

Part of: South Tyneside and Sunderland Healthcare Group Introduction: How can I make my food softer? If you are having problems swallowing, or you are unable to • Adding thickened sauces e.g. , stock, white/cheese chew your food, you may find you need a soft and bite sized sauce, milk or cream. diet. • Mashing e.g. potatoes, vegetables or soft . • Mincing e.g. cooked meat or poultry. This booklet will help you choose foods of a suitable texture and help ensure that you obtain all the nourishment you need. A Balanced Diet – To ensure that you receive all of the nutrients you need it is important to eat a variety of foods each day. Try to Soft and bite-sized - Foods should be soft, tender and moist, eat something from each of the following food groups daily but not sticky and are best served with a smooth sauce, gravy or • Protein foods – soft tender or finely minced meat or flaked (thickened to the required consistency e.g. to the stage fish without fat, bones, skin or gristle. Pieces approximately of thickened fluid required). Food should be easily mashed using 1.5cm with no hard lumps served in a thick smooth sauce or a fork at the point of service/consumption, with the exception gravy. Boiled, poached or scrambled eggs. of pasta which should be mashed using a potato masher. Food • Starchy foods – Weetabix soaked in milk, porridge, creamed should require some chewing and contain no mixed textures or mashed potato, very small soft chips with gravy or tinned and no thin loose fluid. pasta in a thick sauce. • and vegetables – very soft, mashed boiled vegetables Food pieces should be no larger than 1.5cm2 (carrots, parsnip, turnip, cauliflower, mushy peas, tinned plum tomatoes with no juice, courgette, beetroot), well Contact name: ……………………………………. stewed, soft or mashed fruit with skins and seeds removed (melon, banana, , pears, apricots, peaches, plums.) Contact Number: …………………………………. • Milk and dairy foods – thickened milkshakes, yoghurts, fromagefrais, cream cheese, butter, thick milky . The following foods should be avoided to prevent choking: Main meals • Starchy foods – such as peanut butter, toffee, chocolate. • Cottage or Shepherd’s pie with well cooked, soft vegetables. • Coarse, dry, hard foods – such as nuts, seeds, coconut, dried • Minced meat in a thick smooth sauce or gravy and mashed or fruit, celery, muesli and crisps. creamed potatoes and well cooked, soft vegetables. • Crunchy or crumbly foods – such as biscuits, toast, pie crusts • Chicken or fish supreme. and . • Fish pie (with mashed potato topping) and well cooked, soft • Stringy fibrous foods – such as pineapple, shells of beans, vegetables. peas, sweet corn, lettuce and vegetable or fruit skins (broad • Corned beef hash or skinless , mashed potato and beans, grapes, tomatoes.) gravy. • Mixed consistency foods – such as cereals that do not blend • Ready prepared meals e.g. ravioli, macaroni cheese, spaghetti with milk like muesli, mince with thin gravy, minestrone bolognese with plenty of sauce (avoid those with crispy soup. toppings.) • Jacket potatoes (without skin) with butter and houmous/ Ideas for a soft, bite-sized diet tuna mayo/minced beef/egg mayo/grated cheese/baked Breakfast beans. • Weetabix (soaked in milk.) • Porridge/ Ready Brek. and snacks • Yoghurt, crème fraiche or fromage-frais with stewed or • Milk puddings (e.g. rice pudding, sago, semolina, custard.) mashed fruit. • Sponge puddings or soft plain cake with cream/ custard or ice • Boiled, poached or scrambled eggs well covered with tinned cream*. spaghetti or baked beans and grated cheese. • Instant , whips, blancmange. • Omelette with cheese and tinned tomatoes (with no juice). • Thick smooth yoghurt, fromage frais, mousse or fruit fool. • Milkshakes (thickened if advised by your speech and • Ice-cream*, sorbet, frozen yoghurt or banana split. language therapist.) • Egg custard, crème caramel or sweet pie fillings. • Plain shop bought chopped with butter/ margarine • Mashed or stewed fruit with cream, custard, crème fraiche or and syrup/jelly type jam or yoghurt/ cream/evaporated milk yoghurt. and mashed or stewed fruit. *If you are on thickened fluids avoid ice-cream as it will melt in the mouth and become too thin. How to enrich everyday food and drink Store cupboard foods Sometimes, following a soft diet means that you end up eating If you have difficulty preparing meals or do not feel like less than usual. It is very important that what you do eat is cooking, you may find it useful to have some of the following as nourishing as possible. Extra nourishment can be added to products in your fridge, freezer or cupboard. They can easily be everyday foods – try some of these simple ideas: mashed to the correct texture:

Milk Add 3-4 heaped teaspoons of dried milk powder to Tins Stew, minced beef, macaroni cheese, vegetables, each pint of full cream milk (aim to drink 1 pint per spaghetti, pasta shapes, curry, bolognese, milk day). Keep this in the fridge and use in hot and cold puddings and custard, soft fruit (not pineapple drinks, on cereals and in desserts and sauces. or grapefruit), boneless tinned fish. Cheese Grate into soups or scrambled eggs, and on to potatoes, vegetables or baked beans. Frozen meals Hot-pots, fish pies, fish/pasta in sauce, cottage pie, chicken supreme. Fats Add butter and margarine to mashed potatoes and vegetables. Packets Instant mashed potato, instant mixes, Cream Add to potatoes, porridge, cereal, milk puddings, dried milk powder, UHT milk, pasta in sauce, boil milky drinks, sauces or soups. in the bag meals. and Add sugar, seedless jam, honey, syrup or lemon curd preserves to drinks, cereals and desserts.

Helpful hints • Ensure that all foods are well cooked. • Remove skins, bones, seeds or pips. • Always serve with lots of thickened sauce or gravy. • Allow plenty of time to eat your meals and take small sips of drinks if this helps. Recipe Ideas Chicken/ Fish Supreme Cooked chicken, finely cubed 1lb (500g) cauliflower Or 1 ½ dessertspoons cornflour Piece of white fish ¾ pint (400ml) milk 1 tin condensed mushroom or chicken soup 4oz (120g) grated cheese 1oz (30g) butter • Pre-heat the oven to 375˚F / gas mark 5 / 200˚C. Salt and pepper, to taste • Place the chicken/ fish in a casserole dish and pour over the condensed soup. • Remove leaves from cauliflower and break into small bite- • Place in the hot oven for 30 minutes. sized florets. Boil in water until soft. • Serve with mashed potato and vegetables or pasta. • Mix the cornflour with a little of the milk in a large jug, to make a paste. • Pour the remainder of the milk into a saucepan and bring to the boil. • Remove from the heat and pour onto the cornflour, stirring all the time. • Return the milk and cornflour to the pan and simmer for 3-4 minutes until thickened (stir continuously.) • Remove from heat and stir in cheese and butter. • Drain water from cauliflower and add cheese sauce. • Divide into 4 servings and freeze the remaining portions when cooled. Notes Notes South Tyneside District Hospital Harton Lane South Shields Tyne & Wear NE34 0PL For information about our Trust: Tel: 0191 404 1000 www.stft.nhs.uk www.facebook.com/STNHSFT/ @STFTrust

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Production date: Nov 2018 Author: Nutrition Code: 1118/530 Review date: April 2021