IN THE KITCHEN WITH PIP DUNCAN

The regular or normal eating plan for most people includes foods with a variety of textures and consistencies. However, some people may have difficulty swallowing, dental problems or ill-fitting dentures.

Modified texture diets are prescribed, often by the speech therapist, for people with specific requirements. The diet should be carefully followed as people could be at risk of aspiration (breathing fluid into the lungs) when the swallowing function is compromised. It is important to check for signs of inadequate nutrition in people having a puréed diet as some vitamins and minerals are compromised when food is processed.

Treatment goals:

- To achieve and maintain optimum nutritional status.
- To achieve and maintain acceptable body weight.
- To present food as attractively as possible.
- To provide a variety of tastes, colours, shapes and types of food.
- To avoid constipation by including appropriate dietary fibre.

The goals are developed following assessment of height and weight to establish goal weight range; recording and assessing food and fluid intake, deciding the most appropriate modification and then monitoring the modification and reassessing when necessary.

Three types of modified texture diets are soft, minced and moist, and smooth puréed diets.

A soft diet is recommended for people with oral problems such as poor dentition, ill-fitting dentures or chewing difficulties. Foods which are naturally soft can be used or foods which are cooked and cut to alter their texture. Foods to include; soft foods, braises and stews, moist tender meats, most fruits, cooked vegetables, soft baked products, desserts with custards or sauce, milk puddings, the addition of extra gravies and sauces.

Minced and moist is recommended for people with chewing problems, poor dentition, ill-fitting dentures, and/or difficulty creating a food bolus to swallow. There may be some tongue implication or poor saliva production. Foods are soft and form easily into a ball. Foods to include – minced meat with extra gravy, soft or fork mashed vegetables, soft raw fruits, stewed or canned fruits, moist desserts with extra custard or sauce, milk puddings.

Smooth puréed diets are required by people with significant swallowing difficulties. People following full puréed diets are compromised in terms of their intake of heat-labile and water-soluble nutrients, especially vitamins C and B. Foods in this diet are smooth and lump-free, although a grainy consistency may be acceptable.

Foods to include; puréed meat, fish or chicken with extra gravy or sauce, mashed potatoes, vegetable purée, extra gravy or sauce, smooth milk puddings or fruit puddings, savoury or sweet egg custards, fruit purée and yoghurt.

Reference: Professional Foodservice, Duncan and Jensen
Pip Duncan, education and marketing manager, vegetables.co.nz, 0272714527