Fork Mashable diet (Texture E) This booklet gives practical advice to help you follow a fork mashable diet (Texture E). Included in this booklet is a table of different foods/drinks that are advisable for a fork mashable diet. There is also a table of foods that you should avoid. If you have any further questions, please contact the Nutrition and Dietetics Department or the Speech and Language Therapy Department. Contact details are at the end of this leaflet. 1 of 16
Contents 3 What is a fork mashable diet? 3 Why do I need a fork mashable diet? 3 How do I prepare a fork mashable diet? 4 How to eat well on a fork mashable diet 5 Fluid intake 5 What can I eat on a fork mashable diet? 10 Ideas for a fork mashable diet 12 Increasing the nutrition in your food 13 Additional advice 14 Notes 16 Contact us 2 of 16
What is a fork mashable diet? A fork mashable diet consists of food that can be mashed with a fork, and is soft, tender and moist. It requires a little chewing, but no dry, crunchy or tough foods which are harder to chew. Why do I need a fork mashable diet? Sometimes a fork mashable diet may be easier to eat. This may be due to: swallowing problems difficulty chewing sore/dry mouth or throat. You may need this diet for a short time only or it may be required for longer. You may be given individual advice from your speech and language therapist if you have been advised to follow a fork mashable diet. How do I prepare a fork mashable diet? Foods must be soft enough to be mashed with a fork. They may require some chewing but should not be hard, crumbly or crisp. Adding sauces or gravy can help make your food moist and easier to swallow. These are useful equipment that make your foods softer and easier to manage: Slow cooker Pressure cooker Casserole dishes Potato masher Fork Grater Sieve 3 of 16
These are suitable sauces to improve the texture and flavour of meals: Thick gravy White sauce Mayonnaise/ salad cream/ sour cream Hummus Guacamole Tomato ketchup/ brown sauce. How to eat well on a fork mashable diet You should aim to have three meals a day - breakfast, lunch and an evening meal. If your appetite is poor or you are losing weight, you should try to have snacks and/or nourishing drinks between meals. To ensure a balanced diet, it is important to include foods from each of the following groups: Starchy foods e.g. potatoes, cereal - three portions a day Protein foods e.g. meat, fish, eggs - two to three portions a day Fruit and vegetables - five portions a day Dairy foods e.g. milk, cheese, yoghurt - three portions a day Foods containing fat and sugar the quantity will depend on whether you are underweight or overweight and if you have diabetes. If you have any questions about these recommendations please speak with a dietitian. 4 of 16
Fluid intake If you have been advised to thicken your drinks it is important to follow the recommendations from your speech and language therapist. To avoid dehydration, you should aim to drink six to eight glasses (1.5 to 2 litres) of fluid a day. Tip: The best type of fluid to drink is water. Sometimes adding a flavouring e.g. squash or lemon or lime helps to encourage drinking more. What can I eat on a fork mashable diet? The following pages list the different foods/drinks that are advisable for a fork mashable diet. There is also a list of foods that you should avoid. If you have any questions about these recommendations please speak with your speech and language therapist or dietitian. Starchy foods provide energy and fibre Food Recommendations Avoid Breakfast cereals Cereals that soak up milk to be fully softened and of one consistency e.g. Weetabix, Oatibix. Porridge with milk. Muesli/granola Clusters Cereal with dried fruit and nuts Cereal bars Cereals which do not soak up milk, e.g. Cornflakes. Potatoes Well cooked potatoes Jacket potato 5 of 16
Pasta and rice Mashed potato Soft potato salad Pasta and rice dishes that are well cooked and moist, e.g. risotto, pasta with sauce, rice pudding skin Chips/wedges Al dente pasta Grains which stay separate, e.g. rice with no sauce, couscous, quinoa Dairy foods provide protein and calcium Food Recommendations Avoid Milk (NB please follow recommendations from your speech and language therapist if your fluids need to be thickened) Yoghurt/ fromage frais Cheese Use milk as a drink, on cereals or in puddings and milkshakes Smooth yoghurt/ fromage frais Greek yoghurt (no nuts) Soft cheese types e.g. cream cheese, ricotta, cottage cheese, Dairylea, crème fraiche, feta Use grated cheeses to enrich foods, such as on vegetables or in sauces. Yoghurts containing fruit/cereal/nuts/ other hard pieces Hard cheeses or cheeses with dried fruit and nuts 6 of 16
Meat, fish and alternatives provide protein Food Recommendations Avoid Meat soft, tender meat with pieces no larger than 15mm Fish Eggs Beans, pulses, lentils and nuts Meat dishes with sauces Casseroles, stews or minced meat Fish that is poached, steamed, boiled or baked with milk and butter Dishes with sauces e.g. tinned fish, such as salmon, tuna or pilchards All types (e.g. scrambled, poached, fried, plain or cheese omelette) Well cooked and/or tinned beans, pulses and lentils Smooth nut butters Hummus Dry, chewy meat, with fat, gristle, bones or skin Fried and roasted meats Battered meat / meat in pastry (e.g. sausage rolls) Grilled meat Fish with bones Battered or breaded fish Prawns, seafood, e.g. squid, scallops, mussels Omelettes with hard fillings e.g. mushrooms, peppers, bacon, asparagus Nuts, crunchy nut butters Beans with skins e.g. string beans, green beans, red kidney beans 7 of 16
Fruit and vegetables provide vitamins, minerals and fibre Food Recommendations Avoid Vegetables Well cooked vegetables - if fresh, peel and cook until they are soft enough to be mashed with a fork Frozen or soft tinned vegetables e.g. mushy peas Mashed vegetables (e.g. carrots, swede, pumpkin) Fruit Soft fruits like bananas and berries Try tinned, stewed or defrosted frozen fruit and fruit compote Fruit juice/smoothies NB very juicy fruits should be mashed in small pieces with juice drained away. Raw vegetables Vegetables with skins, e.g. cucumber, tomatoes Sweetcorn & peas Stringy vegetables - e.g. celery and lettuce Hard fruits and fruits with skins e.g. apples, grapes Fruits with seeds and pips Dried fruits Stringy fruit e.g. pineapple 8 of 16
High fat and sugar foods provide energy Food Recommendations Avoid Desserts/ snacks Chocolate spread, syrup, treacle, cake moistened with cream/custard, Smooth nut butters Desserts e.g. trifle, mousse, custard, rice pudding Softened plain biscuits (dunked in a hot drink) Jelly and ice-cream (NB if your fluids need to be thickened, please ask your speech and language therapist as jelly and ice-cream melt to a fluid when in the mouth) Desserts with hard textures e.g. boiled sweets, toffees, marshmallows, biscuits and chocolate with fruits and nuts Fruit crumble or pie, flaky pastries, popcorn, crisps 9 of 16
Ideas for a fork mashable diet Breakfast Fruit juice Cereal such as porridge, Ready Brek or Weetabix with hot milk Scrambled eggs, soft boiled, poached or omelette (without hard fillings) Stewed fruit served with yoghurt or fromage frais Yoghurt with fruit compote and honey Cheese (grated or soft) /chopped tinned tomatoes/mashed baked beans Main meals Minced meat in gravy/bolognaise sauce Moussaka (casserole dish made with vegetables and minced meat) Shepherd s/cottage pie Poached/flaked fish in sauce or fisherman s pie (no prawns/peas) Corned beef hash Casserole or stewed meat Risotto (rice dish) Kedgeree (dish with rice, fish and hard-boiled eggs) Well-cooked pasta dishes like macaroni cheese, lasagne, cannelloni or ravioli (including tinned pastas) Cauliflower cheese Cheese and potato bake (no pastry) Dahl curry (vegan curry) Soup (no hard chunks of vegetables) Jacket potato without the skin, filled with tuna/ cottage cheese/ baked beans Omelette (no hard fillings) 10 of 16
Vegetables Softly boiled vegetables with the skins removed e.g. carrots, parsnips, beetroot Soft tinned vegetables e.g. tinned carrots, mushy peas Mashed vegetables Snacks Milky drinks, including hot chocolate, cocoa, Horlicks/Ovaltine, milkshakes (NB please follow recommendations from your speech & language therapist if your fluids need to be thickened) Biscuits dunked in hot drinks to soften Crème caramel or fruit fool Dips such as taramasalata, guacamole, hummus Yoghurts (smooth, no bits) Soft cheeses, such as Philadelphia, Laughing Cow, Dairylea Moist cake mixed with custard or cream Desserts Milky puddings like rice pudding, sago, semolina, tapioca (add jam or honey to these if desired) Egg custard Trifle Sponge/moist cake with custard Milk/fruit jelly Ice cream, frozen yoghurt or sorbet Yoghurt, fromage frais, fruit fool, mousse or Angel Delight Crème caramel Soft tinned/stewed/defrosted frozen fruit or fruit compote with cream/custard Soya yoghurt/desserts 11 of 16
Increasing the nutrition in your food If you are concerned about your weight because you have either lost weight or are struggling to maintain your weight, you may wish to enrich your foods. When your appetite is reduced, it is easier to have smaller meals/puddings and regular snacks in between meals to better meet your nutritional needs. It is important to include a source of protein and carbohydrate (energy) in each of your meals. Avoid filling up on lots of fruit, vegetables and water at the expense of more nourishing foods and drinks. If you are concerned about your fruit and vegetables intake, speak to your dietitian. Adding the following foods to your savoury and sweet dishes will help to make your food more nourishing: Savoury dish Add milk, cheese/parsley sauce, cream, butter or margarine, mayonnaise. For every ¾ pint (400ml) of sauce add: 1 tablespoon of milk powder Or 1 2oz (30 60g) cheese Or 2 4 tablespoons (30 60ml) of double cream. Sweet dish Add milk, custard, butter or margarine, chocolate/butterscotch sauce, evaporated milk, cream, yoghurt and condensed milk. You can also fortify milk by adding four tablespoons of milk powder to one pint of full cream/fat milk. Whisk this with a fork or blender and use in place of ordinary milk, as well as in drinks, milky puddings, soups and sauces. 12 of 16
Additional advice Provided by: Contact details: Date: 13 of 16
Notes 14 of 16
Notes 15 of 16
Contact us If you have any questions or concerns, please contact the Nutrition and Dietetics Department on 020 7188 2010 or 020 7188 4128 (Monday to Friday, 9am to 5pm) or the Speech and Language Therapy Department on 020 7188 2522. If we are unable to take your call, please leave us a message and we will call you back during working hours. For more information leaflets on conditions, procedures, treatments and services offered at our hospitals, please visit www.guysandstthomas.nhs.uk/leaflets Pharmacy Medicines Helpline If you have any questions or concerns about your medicines, please speak to the staff caring for you or call our helpline. t: 020 7188 8748 9am to 5pm, Monday to Friday Your comments and concerns For advice, support or to raise a concern, contact our Patient Advice and Liaison Service (PALS). To make a complaint, contact the complaints department. t: 020 7188 8801 (PALS) e: pals@gstt.nhs.uk t: 020 7188 3514 (complaints) e: complaints2@gstt.nhs.uk 16 of 16 Leaflet number: 3565/VER2 Date published: November 2017 Review date: November 2020 2017 Guy s and St Thomas NHS Foundation Trust A list of sources is available on request