Eating well on a fork mashable diet (previously known as soft options of normal diet)

Transcription

1 Reference: Briony Thomas (2007) Manual Of Dietetic Practice (4th ed.) Blackwell Publishing. Department Of Health (2001) National Health Service Recipe Book. HMSO p26. British Dietetic Association and Royal College of Speech and Language Therapist (2011). Dysphagia Diet Food Texture Descriptors. Nutrition and Dietetic Service Gateshead Health NHS Foundation Trust Nutrition and Dietetic Service Queen Elizabeth Hospital Sheriff Hill Gateshead Tyne and Wear NE9 6SX Tel: (0191) Eating well on a fork mashable diet (previously known as soft options of normal diet) Your dietitian is: Speech and Language Department Hancock Building Queen Elizabeth Hospital Sherriff Hill Gateshead Tyne and Wear NE9 6SX Tel: (0191) Your speech and language therapist is Updated June 2011 Review date: June

2 You have been advised to try the soft option because you have difficulty with swallowing and eating. Fork mashable diet Food should be broken up with the flat edge of a fork. It requires some chewing, but normal muscle strength and teeth are not necessary. How can I make my food softer? There are a variety of ways to make your foods softer and easier to manage, including: Adding sauces Mashing Mincing gravy, stock, white/cheese sauce, milk or cream (examples include fish in butter or parsley sauce, cauliflower cheese, mince in gravy) potatoes, vegetables and soft fruits cooked meat and poultry Suggested meal plan Breakfast Mid Morning Snack Lunch Mid Afternoon Snack Foods to avoid These food items should be avoided to prevent choking: Stringy fibrous textures such as pineapple, runner beans, celery and lettuce. Vegetable and fruit skins such as broad beans, grapes and tomatoes. Mixed consistency foods eg cereals that do not blend with milk like muesli, mince with thin gravy, minestrone soup. Crunchy or crumbly foods such as toast, pie crusts, dry biscuits, crumbles and crisps. Biscuits, boiled or chewy sweets and toffees, nuts and seeds. Food with husks, such as peas, beans, wholegrain cereals and breads. Tea Supper Notes 2 11

3 Ideas for extra flavour (savoury) Herbs and spices. How can I make sure that I m getting enough to eat? If you have unintentionally lost weight or you are not able to eat your usual amount of food: Smooth mustard. Smooth chutney. Bottled sauces: Tomato Worcestershire Brown/BBQ Salad Cream Mayonnaise Avoid low calorie, low sugar or low fat foods unless otherwise advised. Choose full fat products where possible including full cream milk, full fat yoghurts, butter or margarine instead of low fat spread. Eat regular meals with nourishing snacks in between (see light meal/pudding ideas). What if my appetite is very poor? Ideas for extra flavour and calories (sweet) White, chocolate or fruit sauce/puree. Syrup, treacle, honey. Jam, lemon curd. Cream, condensed milk, evaporated milk, crème-fraiche, custard, ice cream. Yoghurt, fromage-frais. If you have a small appetite and cannot manage large portions, there are a many ways that foods can be enriched to make them as nourishing as possible, using normal everyday foods. For example: Milk Cream Adding four tablespoons of dried milk powder to one pint of milk (full cream if possible). Keep this in the fridge and use in drinks, on cereals and in puddings, sauces, custard or other desserts. Add to potatoes, porridge, cereal, milk puddings, milky drinks, soups or sauces. Fats Add margarine or butter to vegetables, potatoes, rice or pasta. Cheese Grate into soups, omelette, scrambled egg and mashed potatoes, on to mashed baked beans/tinned spaghetti and vegetables, or even add to main dishes like Bolognaise. Sugar Add to drinks, cereals and use in puddings. 10 3

4 Weight loss Weigh yourself regularly. Your weight will give you some idea as to whether you are eating enough. If you are losing weight, ask your GP to refer you to a dietitian. Constipation Useful store-cupboard ingredients If you do not feel like cooking or have difficulty preparing meals, there are many convenient alternatives available. You may however need to alter the texture of some of these in order to make them easier to eat by blending or sieving or pureeing. Constipation can become a problem if on a modified diet. To avoid this try the following: Drink at least six to eight cups of fluid each day such as water, tea, coffee, milk, fruit juice or squash. Include vegetables, pulses (beans, peas, lentils) in soups and casseroles. Include stewed, tinned or fresh fruit daily. Try prunes or prune juice one to two times daily. Helpful hints Ensure that all foods are well cooked. Moisten foods with sauces and gravies. Check all foods for bones and skin. Chew foods well before swallowing. Take small sips of drinks with meals if this helps. Allow plenty of time to eat your meals. Tins Frozen Meals Packets Stew Minced beef Curry Bolognese Spaghetti Pasta shapes Macaroni cheese Tinned vegetables Hot-pots Fish pies Fish/pasta in sauce Frozen vegetables Pasta in sauce Boil in the bag meals Instant mashed potato 4 9

5 Fluids It is important to make sure you drink enough fluid each day to keep you well hydrated. Six to eight glasses is the recommended amount. In order to ensure you receive as much nourishment as possible from your drinks if your appetite is poor, Try some of the following: Tea, coffee, drinking chocolate, Ovaltine, Horlicks made with milk. Milkshakes with ice cream or fruit added (blended until smooth using a food processor, liquidiser or hand blender). Cup-A-Soup made with milk or cream. Fruit juice or full sugar squash. Complan and Build-Up drinks are useful between meals if appetite is particularly poor. These can be bought from most chemists and some supermarkets, and come in a range of savoury and sweet flavours. It is very important to remember to thicken your drinks if you have been advised to do so by your speech and language therapist. Breakfast ideas Porridge, wheat biscuits or instant oat cereal made with milk or cream. Add sugar, honey or syrup to taste. Scrambled, poached, boiled eggs. Omelette with cheese and tinned tomatoes. Sausages without skins. Soft bread (no grains or crusts) well covered with tinned spaghetti or baked beans with grated cheese. Soft bread (as above) with jelly type jam (avoiding seeded j am), shred less marmalade, chocolate spread, honey or lemon curd. Cooked eggs well covered with tinned spaghetti or baked beans with grated cheese. Yoghurt or fromage-frais with stewed or soft fruit (eg mashed bananas or stewed apple). Pancakes with butter/margarine and syrup/jelly type jam or soft/stewed fruit and yoghurt/cream/evaporated milk. Light meal ideas Packet/Condensed soups made with milk or tinned soups (avoiding those with croutons or hard lumps). Scrambled/boiled eggs and soft grain less bread (no crusts). Poached egg or cheese omelette with baked beans/tinned tomatoes or mashed potatoes. Tinned pasta (eg ravioli, spaghetti Bolognese) or well cooked pasta in sauce sprinkled with grated cheese (for extra calories). Cauliflower cheese/macaroni cheese. Creamed potatoes with grated cheese and baked beans. 8 5

6 Soft bread sandwiches without the crusts with the following filling: - Cream cheese. - Potted meat/fish paste. - Hummus. - Tuna mayonnaise. - Well mashed egg and mayonnaise. - Smooth peanut butter ands seedless jam. - Mashed banana (with honey/syrup/jam for extra flavour and calories). Jacket potato (without skin) with butter/margarine and the following fillings: - Grated cheese or cheeses sauce. - Butter and margarine. - Condensed soups. - Baked beans/tinned spaghetti. - Tuna mayonnaise. - bolognaise. Wheat biscuits or porridge with the following toppings: - Mashed banana. - Pureed fruits. - Jam, honey, syrup, chocolate sauce. - Grounded almonds and honey. Main meal ideas Cottage or shepherds pie and well cooked soft vegetables. Mincemeat in gravy with mashed or creamed potato and mashed vegetables. Casserole, stew, or curry (ensuring any meat is tender and broken into pieces and that vegetables are well cooked and soft). 6 Fish pie (with mashed potato topping) or fish in sauce (eg cheese, parsley or butter) with vegetables. Remember to check for bones. Ready made meals such as ravioli, macaroni cheese, spaghetti bolognese or other pasta dishes made with plenty of sauce (avoiding those with crispy toppings). Corned beef hash/sausages without skins, mushy peas and mashed potato. Well cooked meat and vegetables in sauce (eg Ragu, Dolmio, Chicken Tonight, condensed soup, Uncle Bens - taking care to avoid those with crunchy vegetables) with either mashed potatoes, well cooked rice or pasta. Pudding and dessert ideas If you cannot manage a pudding straight after your main course, try waiting an hour or so, and have a pudding as a snack between meals. Suitable suggestions for puddings and snacks include: Milk puddings (eg rice pudding, sago, semolina, custard). Sponge puddings, soft plain cake or pancakes with stewed fruit or sauce and cream/evaporated milk/custard/ice cream. Trifle or other individual ready made desserts. Jelly made with milk or evaporated milk and served with ice cream, custard and/or cream, like a trifle. Instant desserts, whips, or blancmange. Fruit fool, smooth fruit yoghurt, fromage-frais or mousse. Soft fruit chopped into small pieces ( apricots, pear bananas) or stewed apple or drained tinned fruit with evaporated milk, cream, ice cream, custard, crème-fraiche or yoghurt. Ice cream, sorbet, frozen yoghurt, banana split. 7