Department of Nutrition and Dietetics Department of Speech and Language Therapy Texture E Diet (Soft, moist diet) Patient Name: Assessed/ Recommended by: Name: Profession: Telephone: Date issued: This leaflet has been produced with the help of patients This leaflet is available in other languages and formats, eg CD, just ask. 1
Why do I need a different diet texture? Difficulty in swallowing, also known as dysphagia, is a condition which makes it difficult for some people to eat and drink. The muscles in your mouth and throat may be weakened or tired and as a result you may not be able to move food and liquid around your mouth and swallow it as you normally would. As a result, the food may go down into your lungs and cause infection. Texture changes can make it easier and safer for you to swallow. You have been assessed and it has been recommended you have a Texture E diet. This leaflet is a guide to help you prepare your food to the appropriate consistency. What is texture E? Texture E is a food consistency, which is soft and moist and can be broken down into pieces with a fork. It can be made up of solids and thick gravy or sauces. How do I prepare my foods for a Texture E diet? Foods can be prepared as normal but they must be soft and moist. They do not have to be liquidised, sieved or pureed. What about my medication? The texture of your medication may also need to be changed. Some medications are available in syrup as well as tablet form. Some can be crushed and mixed with food to make them easier to swallow. It is essential that you ask your GP or pharmacist before changing how you take your medications. 2
What about cleaning my teeth? It is important to brush your teeth, tongue and gums at least twice a day; especially after meals. Swallowing saliva containing bacteria from the mouth can lead to chest infections. You are advised to use a low foaming toothpaste (e.g. Sensodyne or Biotene) as this does not stimulate excess saliva or leave the mouth dry. Put a pea-sized amount onto the bristles and brush your teeth in the normal way. There is no need to rinse; remove any leftover toothpaste with the toothbrush. General advice for eating and drinking Make sure you are sitting comfortably in an upright position. If sitting upright is difficult, prop yourself with cushions rather than lying back. Make sure your feet are on a flat surface to give a good base support. Take small mouthfuls. Clear each mouthful before you take the next Take your time while eating and don t rush Avoid washing food down with a drink. Instead make the food more moist and swallow more often until it clears. Try to avoid eating when feeling very tired. If you tire quickly whilst eating you may find it easier to eat smaller amounts more frequently. It may help to remain sitting upright for at least an hour after eating Things to look out for when eating and drinking: o Frequent coughing or choking at mealtimes / when drinking o Frequent chest infections o Difficulty breathing o Discomfort when eating or drinking o Food getting stuck in the throat Contact your doctor if you have any of the above difficulties 3
A Nutritious Texture E Diet It is important to include a variety of food choices in your diet every day. Included in this section are some examples of food which you can enjoy, although there are many others. Please see page 6 for guidance on high risk foods we suggest you avoid. Meat, fish, eggs, pulses and other non-dairy sources of protein Include 2-3 portions per day. For example, 1 portion = 1 fillet of fish, 1 chicken fillet, 1 pork chop, 2 eggs, 4 tablespoons of cooked beans or pulses (prepared to Texture E diet), 120g (4oz) soya, tofu or Quorn. o Meat or Quorn/soya: Ensure that meats are tender and chopped up small. Add a savoury liquid such as a cream or barbeque sauce or gravy. You may find minced meats easier to chew and swallow. Pre-prepared dishes such as casseroles, corned beef hash and cottage pies are also suitable. You may want to try adding chutney, ketchup, mild mustard or curry to these foods to increase the variety of flavours. o Fish: Fresh, frozen or tinned fish can all be used. Poached or steamed fish is suitable as is canned fish with no bones. Moisten with a savoury liquid such as parsley or cheese sauce. o Eggs: baked and scrambled can be used. o Pulses: cooked pulses i.e. mushy peas, beans and lentils (shells removed) are suitable Milk and Dairy Foods Include 2 3 portions per day. For example, 1 portion = 1 pot yoghurt or fromage frais, 200ml milk, 150ml custard, 1 matchbox size piece of hard cheese (grated), 1 large pot (200g) cottage cheese. o Cheese: add grated cheese to sauces and mashed potato to make them more nourishing and tasty o Milk: use to make milky puddings. Use full fat milk if you are struggling to maintain your weight. o Milky puddings: home-made, tinned or packet puddings such as custard and semolina. Try Angel Delight, Instant Whip, blancmange, mousse, crème caramel, ice-cream and milk-jelly. o Yoghurt and fromage frais: thick, set variety without bits. 4
Bread, cereals and potatoes Include 7-8 portions per day. For example, 1 portion = 2 heaped tablespoon cooked rice or pasta, 2 egg sized potatoes, 3 tablespoons flaked cereal o Potatoes: these can be mashed, boiled, or baked/jacket potato without the skin. o Pasta or rice: pasta or rice dishes such as macaroni cheese or lasagne with extra sauce. o Breakfast cereal: ready to eat breakfast cereals e.g. Weetabix (softened in milk), porridge, Readybrek are suitable. Make sure any excess milk is drained. o Bread: Soft bread and bread rolls are appropriate (no crusts and cut into small pieces). Fruit and vegetables Include 5 portions per day e.g. 1 portion = 1 banana, 2 plums, 2 tablespoon of vegetables o Vegetables: cook fresh, tinned or frozen vegetables until tender, with a savoury sauce such as gravy, stock, milk or cream. Try adding butter for extra energy. o Fruit: Stewed fruit. Soft fruit e.g. bananas, melon, ripe pears, peaches, nectarines, seedless grapes and plums (no skins). Tinned fruit e.g. pears, peaches, apricots, fruit cocktail, strawberries, mandarin oranges (no skins and chopped). Add custard, cream or evaporated milk for extra protein. 5
High risk food to avoid Don t eat: Stringy fibrous texture- e.g. pineapple, runner beans, oranges, celery and lettuce. Vegetable and fruit skins; e.g. broad beans, peas, baked beans, grapes. Mixed consistency foods- e.g. ice cream and jelly, cereals that do not blend with milk, rice pudding, cornflakes with milk, soup with bits, fruit yoghurts. Crunchy food- e.g. toast, crisps, biscuits, batter, breadcrumbs. Crumbly food- pie crusts, crumble, crackers. Hard foods; e.g. boiled and chewy sweets, toffees, nuts and seeds. Food with husks; e.g. sweetcorn, granary and other multiple grain breads. Crusty Bread and baguettes. Consider your food choices. If you are losing weight, then avoid food and drinks labelled low fat or low sugar as you need more calories. However, if you are gaining too much weight, opt for the reduced fat and low sugar varieties. 6
Meal Ideas Breakfast Porridge or softened breakfast cereal with milk. Add sugar/honey/syrup. Soft scrambled egg, poached egg. Soft bread/bread rolls (no crusts), butter or margarine, seedless jam, shredless marmalade. Tea, coffee or fruit juice (thickened as necessary). Mid morning snack Tea, coffee, suitable soup, squash or juice, milky drink (thickened as necessary). Snacks e.g. milk jelly, bread and jam, chocolate mousse, full fat yoghurt/fromage frais. Lunch Tender, diced meat in gravy or sauce. Stew, casserole, cottage pie, corned beef hash, lasagne, bolognaise. Fish in sauce. Soft cooked vegetables. Mashed potato, pasta or moist boiled rice. Milk pudding, egg custard without pastry, soft sponge and custard. Tea, coffee squash or juice (thickened as necessary). Mid afternoon as mid morning Evening Meal Soup (thickened as necessary). Sandwiches (no crusts). Scrambled/poached egg/omelette with potatoes or soft bread. Stewed fruit and custard. Tea, coffee, squash or juice (thickened as necessary). If you are struggling to eat well, aim to have 3 small meals, 3 snacks, and nourishing drinks every day. Contact your Dietitian. 7