Texture modified diet - minced and moist - dysphagia
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
Aim
To provide a diet of soft-textured foods that can be easily chewed and formed into a bolus.
Characteristics
Texture B – minced and moist. Foods in this category may be naturally soft (e.g. cottage cheese), or cooked or minced to alter texture. Patients use the tongue, rather than teeth, to break the small lumps in this texture. Food should be soft and moist and easily formed into a ball. Food may be presented as a thick puree with obvious lumps in it; lumps should be soft and rounded (no hard or sharp lumps). Target maximum particle size for adults is 0.5cm. This diet texture can be applied to any portion size and most therapeutic diets.
Indications
- may be ordered for patients with swallowing difficulties
- poor dentition or no dentures
- painful mouth
Nutritional adequacy
Nutritionally adequate, but may be low in dietary fibre. Patients ordered this diet should be monitored regularly to ensure adequate dietary intake.
Precautions
All foods to be minced or mashed. Puree vegetables may be used to increase variety if minced vegetables cannot be safely prepared, but should be kept to a minimum.
Paediatrics
Suitable for use in paediatrics when combined with an age-appropriate diet.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | Coarsely minced, tender meats or fish with sauce Casserole dishes, processed or mashed to reduce particle size Very soft egg dishes (e.g. scrambled eggs, soft frittata) Well-cooked legumes, partially mashed or processed (e.g. baked beans) Soft tofu, in small pieces or crumbled | Sliced roasted meats or grills Meat with gristle Crumbed or fried fish Dishes with pastry (e.g. spinach pie, quiche, pizza) Casseroles with large pieces (e.g. curried prawns) or fibrous vegetable pieces (e.g. peas, onion) Dishes with crisp topping |
| Sauces, gravies | All | - |
| Starchy vegetables / pasta / rice | Mashed potato Small moist pieces of pasta or well-cooked rice with plenty of sauce | Roasted or baked vegetables (including cut up) Jacket or boiled new potatoes Rice (if dry); rice that does not hold together Crisp or dry pasta (e.g. edge of lasagne) |
| Vegetables | Tender cooked vegetables, easily mashed with a fork (e.g. carrots, sweet potato), or pureed | Cooked vegetable pieces >0.5cm Raw vegetables Other vegetables such as whole peas, corn kernels, celery and broccoli stalks |
| Soups | All soups, pureed or with soft pieces less than 0.5cm | Soup with large pieces of meat or vegetables (e.g. corn) or rice |
| Sandwiches | None | - |
| Salads, dressings | None | - |
| Breads, cereals | Breakfast cereal with small moist lumps (e.g. rolled oats, semolina, wheat flake biscuits Unprocessed bran may be stirred into moist cereal to increase fibre | All bread Hard cereals that do not soften easily (e.g. toasted mueslis) Cereals with dried fruit or seeds (e.g. Sultana Bran®, Just Right®) |
| Spreads | Jams without seeds or peel, honey, peanut butter, Vegemite™ | Jams with seeds, marmalade |
| Hot breakfast choices | Scrambled or poached eggs (chopped), Baked beans (partially mashed or processed), Canned spaghetti (cut up), creamed corn | All others (e.g. fried egg, bacon, sausages) |
| Fruit | Mashed soft fresh fruits (e.g. bananas, mango, Finely diced or pureed canned or stewed fruit | Other fresh fruit Dried fruit Fruit pieces >0.5cm Canned pineapple |
| Yoghurt | All yoghurt and yoghurt-like desserts (e.g. Fruche®) including soft fruit <0.5cm | - |
| Desserts | Smooth desserts (e.g. custards, mousses, blancmange, cut up trifle, creamy rice, puddings) Soft fruit-based desserts without hard pieces Ice-cream Gelled cake* | Jellied fruit Cakes, unless served with custard Bread puddings |
| Milk and cheese | All milk, milkshakes, smoothies Very soft cheese with small lumps (e.g. cottage cheese, ricotta) | Hard cheese Crisp cooked cheese topping on hot dishes Soft sticky cheese (e.g. camembert) |
| Beverages | All | - |
| Biscuits | None | All |
| Miscellaneous | Liquid or pudding nutrition supplements Very soft smooth chocolate Cream, pepper, salt, sugar, sweetener | Nuts, seeds and coconut Hard lollies |
*Cake that has been soaked in jelly or gel so that the entire food portion becomes soggy
References
- Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
- Dietitians Association of Australia and The Speech Pathology Association of Australia Ltd. Texture-modified foods and thickened fluids as used for individuals with dysphagia: Australian standardised labels and definition. Nutrition & Dietetics 2007; 64 Suppl 2:S53-76.