Department of Nutrition and Dietetics HOW TO CHOOSE A SOFT DIET Name Date.. Dietitian Contact No.
Introduction If you are finding it difficult to chew or swallow food you might benefit from having a soft moist diet. Some people may have been advised to have a soft diet by the Speech and Language Therapist. You can still eat your favourite foods, but may need to mash them, or add a sauce or gravy. Soft foods can be broken into pieces with a fork. It is best to avoid foods which might cause you to choke. It is important that you still have a varied diet to prevent it from becoming boring and to keep yourself feeling well. You should try to include food daily from each section of the table on page 3-4. If you have a small appetite or are losing weight you should make your foods more nourishing so that your body gets all of the goodness that it needs (see Page 3). Foods that may cause you to choke and are best avoided: Stringy vegetables eg celery, green beans, savoy cabbage. Skins from fruit and vegetables and pips. Small bones in fish. Tough or crunchy skins e.g. crackling Gristle from cheap mince Hard foods e.g. nuts, seeds, boiled and chewy sweets, batter, chips, currants. Crunchy foods eg toast, crisps, croutons, bread sticks, Twiglets, Bombay mix. Dry, crumbly foods, eg bread crusts, pie crusts, dry biscuits. Husks, sweetcorn, granary breads. 2
The table below lists ideas for suitable foods to include as part of your soft diet: Aim to choose one food from each section in your daily diet Foods Cereal foods Bread Rice and pasta Potatoes Suitable Soft Foods Biscuits, plain without added fruit. Flaked and puffed cereals. Porridge, Ready Brek, Weetabix, cornflakes. Yorkshire puddings, pancakes. Bread softened in soup, sandwich with a moist filling (crusts removed). Well cooked rice and pasta. Macaroni cheese, tinned spaghetti Mashed potatoes, jacket potatoes (no skin), instant mash Suitable Fluids to add, to make foods even softer Soften with hot drinks, milk, evaporated milk, condensed milk, cream. Mayonnaise/salad cream. Cheese or tomato based sauces. Butter, margarine, gravy, cream, milk Meat and poultry Fish Eggs Cooked tender meats (inc beef, pork, lamb, chicken). Stews, casseroles, curries, sausages in gravy, meat balls, faggots, ravioli, tinned meat, pastes, smooth pates, Shepherds pie, corned beef. Poached, boil-in-bag, tinned in sauce, fish paste, crab sticks. Poached, scrambled, omelette. Egg custard. Gravy, soups, stock, cream, butter, margarine. White sauce, cheese sauce, tomato based sauces, milk, butter, margarine. Milk based foods Cheese Milky puddings, eg rice pudding, sago, tapioca, semolina, yoghurt, fromage frais, instant whip, blancmange, chocolate mousse, trifle with soft sponge. Cooked and grated and added to potato, soups and sauces. Cheese spread, plain cottage cheese. Cream, evaporated/condensed milk, fortified milk, ice cream/ sorbet. Chocolate sauce. 3
Foods Suitable Soft Foods Suitable Fluids to Add, to make foods even softer Vegetables Pulses Fruit Cooked soft vegetables eg swede, turnip, carrots, parsnips, mashed with a fork. Tinned tomatoes, creamed soups, bubble and squeak. Baked beans, lentils, peas, mushy peas, pease pudding, vegetable pate, hummous. Stewed fruit (fresh, frozen or dried), tinned fruit, bananas, ripe peaches/nectarines, kiwis, strawberries Milk, fortified milk, white sauce, cheese sauce, gravy, butter/margarine, water drained from cooked vegetables. Soups, stock, cooking oil eg sunflower, corn, olive oil. Fruit juice, syrup, yoghurt, evaporated milk, cream, custard, ice cream, dessert syrup and sauces. Puddings Sponge pudding, fruit crumble, pie or cobbler, egg custard, crème caramel, instant whips, blancmange, mousses, trifles, milk puddings, creamy yogurts. Soften with custard, cream, ice cream, dessert syrups Drinks Fruit juice aim for 1 glass/day. Milky drinks eg milkshakes, hot chocolate, milky coffee. Oxo, bovril, cup-a-soups. Over the counter eg Build Up, Complan, Recovery 4
If you have a small appetite or are losing weight If you have a small appetite or are losing weight try some of these ideas to increase the calories and make your foods more nourishing: Try to have small frequent meals/snacks. Aim for 6-8 each day. A milkshake, milky drink, full fat yoghurt or mousse would make an ideal snack. Fortify your milk by adding 4 tablespoons of milk powder to 1 pint of full cream milk. Use this in all drinks, puddings, cereals, mashed potato and sauces. Aim to have 1 pint of this fortified milk each day. Milk powder such as Marvel, 5 Pints etc. Use nutritious drinks such as Complan/Build Up/Recovery between meals or as meal replacements if you do not feel up to eating. These products are available from the Chemist and some supermarkets. Try adding 1 tablespoon of natural Complan/Build Up to soups, sauces and puddings. Make food look appetising arrange attractively on the plate. Use salt, pepper, herbs, ground spices and ketchup and sauces to improve flavour. Avoid diet or low calorie alternatives. Add extra calories and nourishment to your meals by adding extra fat and/or sugar. Using Fats/Oils for Extra Calories Choose full fat dairy products. Use double cream in soups, sauces, puddings and potatoes. Single or double cream, evaporated milk, Greek yoghurt, crème fraiche can be added to cold foods and drinks. Add butter/margarine/oil to vegetables and potatoes. Add grated cheese to soups, sauces, vegetables and potatoes. Mayonnaise can be added to fish and egg dishes, vegetables and potatoes. NB If you have been advised to watch your intake of fats discuss with your dietitian or doctor. Using Sugar for Extra Calories Use extra sugar, syrup, condensed milk, honey or seedless jams in puddings, porridge or drinks. Glucose can be used in the same way, but is less sweet (available from the chemist). Have soft sweets and chocolates as snacks. NB If you have diabetes or should avoid extra sugar please discuss with your dietitian or doctor. 5
Nutritional Supplements on Prescription You may have been advised to drink prescribable nutritional supplement drinks such as Fresubin Energy, Fortisip use these as recommended by your dietitian. IF YOU HAVE TRIED THESE SUGGESTIONS AND ARE STILL LOSING WEIGHT PLEASE CONTACT YOUR DIETITIAN OR DOCTOR FOR FURTHER ADVICE Fluid It is important that you make sure you drink plenty of fluid in order to prevent dehydration and/or constipation. Aim for 2-3 pints (8-10 cups) each day. Try to include nourishing fluids like milky drinks, fruit juice, vitamin C enriched squashes as well as tea and coffee. Saving Time To save time on preparation and cooking time you might find it useful to have a store cupboard of convenience foods, or keep ready meals in the freezer. Suitable products to include are: Tinned meat or fish Tinned or packet soup Pasta and pasta sauces Tinned pasta meals eg ravioli, macaroni Instant mashed potato Convenience meals eg frozen fish pie, lasagne Porridge oats/ready Brek/Oat So Simple Tinned fruit Tinned rice/milk pudding Instant/ready made custard Evaporated milk/tinned cream Instant desserts, eg instant whips/angel delight, mousses/yoghurts, fruit fools (keep these products refrigerated) Ice cream You might find it helpful to prepare foods in bulk and store them in the freezer. Make sure you defrost these foods thoroughly at room temperature and re-heat until piping hot. Note If you have your meals delivered it may help to contact the supplier and explain that you need a soft diet, they should then be able to send you suitable meals. 6
Meal Plan Meal Time Suggestions for soft foods Breakfast Cereal or porridge with fortified milk or cream Bread with extra butter/margarine and jam Fruit juice Egg eg poached or scrambled and tinned tomatoes Mid-morning Milky drink or nutritional supplement drink eg Complan/ Build Up Biscuits (soften with hot drink), moist sponge cake Sweets/chocolates Lunch Fortified soup and roll Jacket potatoes with lots of butter, grated cheese/ tuna mayonnaise, baked beans Sandwiches with soft filling Mid-afternoon Milky drink or nutritional supplement drink eg Complan/ Build Up Yoghurt, tinned fruit, banana Evening Meal Fish in parsley sauce, mashed carrots and potatoes/ Cottage pie and soft vegetables/ Chicken and vegetable casserole, mashed potatoes/ Macaroni cheese Milky pudding Ice cream or custard and stewed fruit Bedtime Hot milky drink and biscuits Notes: 7
Other contacts: Patient Experience Service Tel: 0800 917 6039 Produced by Registered Dietitians of Portsmouth Hospitals NHS Trust Reviewed: December 2009 Review: December 2012 Ref: C2/09 8