You have been advised to follow a Level 5 Minced and Moist diet because you have difficulty swallowing. Minced and moist foods will be easier for you to manage.
What is a minced and moist diet?
You can change everyday foods by finely mincing or mashing. If the food cannot be finely minced, then you should purée it. Ensure no hard pieces, crust or skin has formed during cooking or standing.
- Can be eaten with a fork or spoon
- Could be eaten with chopsticks in some cases if the individual has very good hand control
- Can be scooped and shaped (e.g., into a ball shape) on a plate
- Soft and moist with no separate thin liquid, any fluid should be very thick
- Lumps are easy to squash with tongue
- Biting is not required and only minimal chewing
Small lumps visible within foods only and should fit through the prongs of a fork.
Adults 4mm lump size
Paediatrics 2mm lump size
How do I prepare minced and moist food?
Prepare food using a blender, food processor or it can be mashed with a fork.
It is important that food tastes, looks and smells good.
- Puree or mash foods and put them on the plate separately. This helps keep flavour and colour of each item. Do not mix all foods from the meal together.
- Ensure that all foods are well cooked and moist
- Remove skins/seeds and cut into chunks before mashing
- Always blend dry food with extra liquids e.g., gravy, milk, or stock (try not to use water as this reduces the goodness in the food).
Fluid in/on food must match the recommended thickness, as recommended by a Speech and Language Therapist.
A thickener, flour or cornflour may be added to maintain thickness. Special food moulds and piping bags can be used to make the food look more like the original ingredient.
Is the texture right?
- Food is soft, tender, and moist. Needs very little chewing.
- It usually requires a very thick, smooth sauce, gravy, or custard
- No hard, tough, chewy, fibrous, stringy, dry, crispy, crunchy, or crumbly bits
- No pips, seeds, pith, skins, outer shells, husks, bone, or gristle
- No round or long-shaped foods e.g., sausages, grapes, sweets
- No hard chunks e.g., pieces of apple
- No sticky foods e.g., cheese chunks, marshmallows
- No ‘floppy’ foods e.g., lettuce, cucumber, uncooked baby spinach leaves
Food fortification for poor appetite or weight loss
If you have a small appetite or have recently experienced unintentional weight loss it is important to make your food as nourishing as possible. You can do this by adding full fat products to your meals, snacks, puddings, and drinks. This is called food fortification.
| Milk | Add four tablespoons of powdered milk to one pint of full cream milk. Use in drinks, cereal, puddings, sauces, and custard. |
| Cream | Add double cream to mashed potatoes, porridge, cereal, milky puddings, soups, and sauces. |
| Fats | Add margarine or butter to vegetables, potatoes, or pastas. Add mayonnaise or salad cream to potatoes, eggs, cheese, and fish. |
| Cheese | Grate into soups, scrambled eggs, and mashed potatoes. |
| Sugar | Stir into hot drinks, milkshakes, milky puddings, porridge, sprinkle on fruit, and other desserts. |
| Jam / Honey | Add to porridge, puddings, yoghurts etc. |
Please be aware that food fortification may make foods a thinner consistency. Ensure any fluids are thickened to the correct consistency, as directed by a Speech and Language Therapist
| Food type | Recommendations |
| Meat, chicken and fish and meat alternatives | Meat must be finely minced with no hard bits. Serve in a very thick, smooth sauce or gravy. Fish -served finely mashed (bones and skin removed) and in a very thick, smooth sauce. Casserole/stew/curry must be a very thick sauce and have meat and vegetable chunks blended to small soft lumps. Sausage meat should be skinless and minced. If meat cannot be finely minced, please purée. |
| Fruit and Vegetables | Fruit and vegetables should be served mashed. Drain away any juice that has separated. Cook until soft, add thick sauce and then mash with a fork. Fresh fruit should be ripe and peeled with pips removed before mashing or grating. Stewed, baked and soft tinned fruits are also suitable for mashing. (Drain away any juice). Skins on mushy peas or mashed beans may be difficult — please blend if this is an issue. |
| Soup | Homemade or canned soup must be very thick, ideally pureed |
| Cereals | Cereals should be very thick and fully softened with all milk fully absorbed. Any milk/fluid must not separate off (i.e., no loose fluids/no mixed thick and thin textures. |
| Desserts | Texture of very thick yogurt or stewed apple Mashed soft sponge cake with smooth filling and mixed in with very thick, smooth custard. Overall texture must be very thick. |
| Rice, pasta, noodles | Cook until soft, cut up and mash with a sauce. No loose, hard pieces of rice or pasta. Rice should not separate into individual grains. |
| Eggs. And Cheese | Poached or scrambled eggs mashed Grated cheese, cauliflower cheese, macaroni cheese, cottage cheese, cream cheese mashed with a fork. |
Meal ideas –
Breakfast
- Porridge, wheat biscuits or instant oat cereal made with full cream milk or double cream. Add sugar, honey, syrup, mashed banana, pureed fruit, jam, chocolate sauce or ground almonds. Please ensure all milk or cream is soaked into the cereal. There should be no loose fluids.
- Omelette with cheese/mashed tinned tomato—drain loose fluids
- Sausage without skins mashed
- Poached or scrambled eggs, with tinned spaghetti cut up finely or mashed baked beans and grated cheese
- Thick yoghurt, crème fraiche or fromage frais with pureed or mashed fruit (mashed banana, ripe pear, stewed apples).
- Pancakes (e.g., scotch, or American style), very soft chopped finely or mashed pancake with butter, syrup, jam, or chocolate spread.
- Bread and milk simmered together until all fluids soaked in with added cream, sugar, or honey to taste.
Lunch
- Packet soups made with milk or blend tinned soup to ensure lumps are small, very soft and moist. Please ensure the soup is a thick broth consistency that can be spooned rather than drank from a cup. Bread can be blended in.
- Cauliflower cheese or macaroni cheese mashed or blended to have moist soft lumps or until smooth.
- Poached egg or cheese omelette mashed with baked beans or chopped tomatoes (bean skins may need to be blended)
- Mashed Jacket potato (skins removed) with pot meat/fish paste, hummus, mashed tuna mayo, minced bolognaise, mashed egg mayo, thick cheese sauce, grated cheese, cottage cheese or mashed baked beans (bean skins may need to be blended).
- Pasta, (tinned or homemade) e.g., ravioli, spaghetti, spaghetti Bolognese—mash into soft moist pieces or blend. Add extra cheese for more calories.
- Minced skinless sausage with mushy peas and mashed potato
References:
The International Dysphagia Diet Standardization Initiative 2016 (http://iddsi.org/framework/)
Contact Us
Nutrition and Dietetics
Nutrition and Dietetic Service
Queen Elizabeth Hospital
Sheriff Hill, Gateshead, NE9 6SX
Speech and Therapy
Speech and Language Therapy Service
Queen Elizabeth Hospital
Sheriff Hill, Gateshead, NE9 6SX