Nourishing Diet Level 4 - Pureed Diet

Transcription

1 Nourishing Diet Level 4 - Pureed Diet Part of: South Tyneside and Sunderland Healthcare Group

2 Introduction: If you are having problems swallowing, or you are unable to chew your food, you may find you need a puree diet. This booklet will help you choose foods of a suitable texture and help ensure that you obtain all the nourishment you need. Pureed food is thick, holds its shape when on a plate or when scooped. It can be eaten with a fork as it should not drop through the prongs. It can be piped, layered or moulded but cannot be poured and should not spread out if spilled. It should be smooth with a uniform consistency throughout with no bits (lumps, fibres, bits of shell/skin/husk, particles of gristle/ bones etc.) and requires no chewing. There should be no loose fluid that has separated off and it shouldn t be sticky or rubbery. Contact name:. Contact number:. How can I make my food suitable? Food can be pureed using a blender, liquidiser, food processor, or a masher and a sieve together. To make this easier: Cut food into small chunks before processing. Puree dry foods (e.g. meat) with extra liquid e.g. gravy, cream, milk or stock. Puree small quantities at a time to avoid lumps. Remove tough skins and large seeds before blending. Add thickening powder to some foods when blending to give a better pureed consistency that does not separate out. 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 eat something from each of the following food groups daily:- Protein foods pureed meat, fish, poultry, eggs, beans, peas and lentils (must be sieved - see page 2.) Starchy foods thick smooth porridge or cereals fully softened with milk fully absorbed, mashed potato soaked in gravy or white sauce which is fully absorbed, pureed rice or pasta. Fruit and vegetables pureed fruit and vegetables, fruit juice or vitamin enriched fruit squash (thickened to the required consistency.) Milk and dairy foods milk, yoghurt, cheese, butter, cream, evaporated milk, cream cheese, fromage frais. The following foods should be avoided to prevent choking: Sticky foods such as peanut butter, toffee. Coarse, dry, hard foods such as nuts, seeds, coconut, dried fruit, celery, muesli and crisps. Crunchy or crumbly foods such as biscuits, toast, pie crusts and crumbles. Stringy/pithy foods such as fruit skins, shells of beans, peas and sweetcorn it is important to sieve these foods after blending to remove the skins.

3 Ideas for a pureed diet Breakfast Porridge or Ready Brek fully soaked in full cream milk that has been fully absorbed add sugar to taste. Weetabix fully soaked and absorbed in full cream milk. Blended cheese omelette. Milkshakes. Thick mousse. Pureed fruit. May also need to be thickened and any loose fluid drained. Blended banana with sugar and cream. (add thickening powder as necessary to maintain the texture.) Main meals Pureed meat/ fish/ poultry with mashed potato and pureed vegetables. Blended ready meals (cook first, as per packet instructions) e.g. shepherd s pie. curry, beef casserole, fisherman s pie, lasagne, macaroni cheese. Puree soup with no lumps. Puddings and snacks Pureed milk puddings (e.g. rice pudding, semolina, custard.) Sponge puddings blended with cream or custard. Instant desserts, whips, blancmange, mousse, Angel Delight. Egg custard, crème caramel or sweet, smooth pie fillings. Fruit blended with cream, custard, or crème fraiche. Blended banana with sugar and cream. (add thickening powder as necessary to maintain the texture.) How to enrich everyday food and drink Sometimes, following a pureed diet means that you end up eating less than usual. It is very important that what you do eat is as nourishing as possible. Extra nourishment can be added to everyday foods try some of these simple ideas: Milk Cheese Fats Cream Sugar and preserves Add 3-4 heaped tbsp. of dried milk powder to each pint of full cream milk (aim to drink 1 pint/day). Keep this in the fridge and use for hot and cold drinks, on cereals and in desserts and sauces. Blend grated or soft cheese into potatoes, vegetables, main meals. Blend butter and margarine into mashed potatoes and vegetables. Add to potatoes, porridge, cereal, milk puddings, milky drinks, thickened sauces or soups. Add sugar or lemon curd to drinks, cereals and desserts. How to make food more appetising Try to puree foods separately and incorporate colour to make your meals interesting and appetising. Serve with brightly coloured vegetables such as pureed carrots of green beans with paler foods such as creamed potato and chicken. Add colour with finely chopped herbs (e.g. parsley) or spices (e.g. paprika.) Serve pureed food using an ice-cream scoop, food or jelly moulds or try piping it through different nozzles.

4 Using a blender Fruit Blend soft, frozen fruit that has been thawed, or very ripe fresh fruit e.g. strawberries, peaches, bananas. Try adding fruit juice, custard, yoghurt or ice cream. Sieve the puree to remove the pips or skin. Vegetables Cook vegetables to soften them before blending. Blend cooked, frozen or tinned vegetables. Vegetables with skins e.g. beans and peas must be sieved after being pureed. Meat, poultry and fish - Cook meat or fish before blending. Remove skins, bones, gristle and tough parts. Add gravy, sauces, stock, milk, condensed soup or evaporated milk to get a thick, smooth puree. Try the following sauces: Beef gravy, soup, fruit juice, horseradish. Chicken gravy, cream, onion or white sauce. Ham pineapple or fruit juices, cheese sauce. Pork gravy, soup, apple juice, apple sauce. Potatoes Some types can be pureed without adding extra fluid but, if extra liquid is needed, add warm milk, butter, or sour cream or try instant mashed potato e.g. Smash. Pasta and rice Puree using warm milk and butter, white or cheese sauces. Desserts Many are already smooth and don t need to be pureed, e.g. custard, semolina. Puree or blend any which contain lumps e.g. fruit yoghurts, rice pudding. Some foods may need to be thickened after being pureed. Try adding instant or mashed potato, cornflour, breadcrumbs, grated cheese, custard powder, ground rice, rusk or Weetabix. Recipe Ideas Spicy Minced Puree (approx. 8 servings) 8oz (250g minced beef) 1oz (30g) margarine/oil/butter 1 oz (30g) flour ½ pt. (300ml) gravy or stock 1 dessertspoon tomato puree ¼ - ½ tsp. mild chilli powder Salt and pepper to taste 2-4 oz (60 120g) mashed potato, to thicken to the desired consistency. Fry the minced beef in oil until brown. Add the flour and mix well. Add stock/ gravy, tomato puree, chilli powder and seasoning. Bring to the boil, reduce heat and simmer for minutes. Remove from the heat and blend until smooth. Thicken one serving with enough of the mashed potato to achieve a thick puree then serve with pureed vegetables. Divide the rest of the mixture into equal portions and cool completely before freezing (remember to add mashed potato to each serving once reheated. Lamb Puree with Mint Follow the recipe for Spicy Minced Puree but replace the beef with lamb. Add 1-2 tsp. of mint sauce or jelly instead of the tomato puree and chilli powder.

5 Pork and Apple Puree As for Spicy Minced Puree but use pork instead. In place of tomato puree and chilli powder add ½ stock cube, crumbled into the meat mixture. Blend the meat with 2 tsp. of apple sauce, 3-5 fl.oz (90 150ml) gravy and 3-4 oz (90 120g) mashed potato then serve with pureed vegetables. Yoghurt Fruit Cup Blend/puree a small carton of natural or fruit yoghurt with half a glass of fruit juice. Thicken as necessary then serve chilled. Examples: Natural yoghurt with Five Alive fruit drink. Mandarin yoghurt with orange juice. Banana Whip (2 servings) 2 bananas 2 tablespoons natural yoghurt 2oz (60g) cottage cheese 1 tsp. honey 1 tsp. lemon juice Peel and roughly chop the bananas. Place all ingredients in a blender and blitz until smooth. Sweeten to taste and thicken if necessary. Divide into 2 servings. Can be refrigerated for 24 hours but do not freeze. Suggested meal plan Breakfast - Pureed porridge or well-soaked cereal with fortified milk and sugar/ honey. Mid-morning - yoghurt/fromage frais/crème caramel/ Lunch - Pureed soup (may need to be thickened.) Pureed meat, poultry or fish. Mashed potato with butter/margarine or grated cheese. Pureed vegetables with butter/margarine. Milk pudding or stewed fruit and custard. Mid-afternoon as for morning. Evening meal as for lunch or pureed macaroni cheese, curry, shepherd s pie, lasagne. Angel Delight, chocolate mousse. Bedtime hot milky drink Horlicks, hot chocolate, hot toddy. *certain foods and drinks will need to be thickened to achieve a smooth, thick puree texture.

6 Notes Notes

7 South Tyneside District Hospital Harton Lane South Shields Tyne & Wear NE34 0PL Tel: For information about our Trust: We are committed to raising the standard of written information for patients, their carers, people who use the NHS and the general public. This information can be made available in another format or language on request. For further copies of this leaflet please contact on the telephone number above. Production date: Nov 2018 Author: Nutrition Code: 1118/530 Review date: April 2021