Fact sheetDiet specifications

Published on 1 Feb 2015


Texture modified diet - smooth puree - 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 that is smooth and lump free, which requires no chewing.

Characteristics

Texture C – smooth pureed. Food in this category is smooth and lump free, but may at times have a grainy quality. It is similar in consistency to a commercial pudding. Food could be moulded, layered or piped. Food should be cohesive enough to hold its shape on a spoon. When placed side by side on a plate, the consistencies should maintain their position without bleeding into one another. This diet texture can be applied to any portion size and most therapeutic diets.

Indications

  • may be ordered for patients with swallowing problems
  • 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 beverages, sauces and gravies must be thickened to the appropriate level for individuals also prescribed thickened fluids.

Paediatrics

Suitable for use in paediatrics when combined with an age-appropriate diet.

Specific menu planning guidelines

Allowed Not allowed
Hot main dishes

Pureed meats or fish, with a sauce or gravy to achieve a thick moist texture

Soufflés and mousses (e.g. salmon mousse)

Pureed legumes with no husk in final puree

Soft silken tofu

Minced or partially pureed dishes

Sauces, gravies Smooth pureed sauces without lumps (e.g. smooth cheese or white sauce, gravy) Any with seeds or lumps (e.g. onion or fresh tomato sauce)
Starchy vegetables / pasta / rice

Very smooth mashed potato

Pureed pasta or noodles with sauce

Pureed rice with sauce

All others including coarsely mashed potato

Vegetables

Pureed vegetables

Added milk and margarine may be used to increase energy density

Coarsely mashed vegetables

Pureed vegetables containing lumps

Particles of vegetable fibre or hard skin

Soups Pureed to remove all lumps Soup with any vegetable fibre or lumps
Sandwiches

None

-
Salads, dressings

None

-
Breads, cereals

Smooth lump-free breakfast cereal (e.g. pureed rolled oats, semolina)

All breads

Cereals that do not soften easily, or with fruit or seeds (e.g. muesli)

Spreads Jams without seeds or peel; honey Jams with seeds, marmalade, peanut butter
Hot breakfast choices Pureed scrambled egg, pureed baked beans or pureed canned spaghetti All others that have not been pureed
Fruit

Pureed fresh, canned or stewed fruit

Very well-mashed banana

All others, including pureed fruit with any visible lumps

Yoghurt Lump-free yoghurt and yoghurt-like desserts (e.g. Frûche®) Fruit yoghurts with visible fruit pieces or seeds
Desserts

Smooth desserts (e.g. custards, mousses, blancmange, smooth puddings)

Soft meringue

Ice-cream with smooth toppings or syrup

Gelled cake*

Any desserts with fruit pieces, seeds, nuts, crumble, pastry or non-pureed garnishes

Milk and cheese

All milk, milkshakes, smoothies

Smooth cheese paste (e.g. smooth ricotta)

All solid and semi-solid cheeses (including cottage cheese)

Beverages Tea, coffee, cordial, soft drink, milk, fruit juice without pulp Fruit juice with visible pulp
Biscuits None -
Miscellaneous

Liquid or pudding nutrition supplements

Cream, pepper, salt, sugar, sweetener

Lollies, jelly, coconut, nuts, seeds and grains

* Cake that has been soaked in jelly or gel so that the entire food portion becomes soggy

References

  1. Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
  2. 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.
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