LEICESTERSHIRE NUTRITION & DIETETIC SERVICE
ADULT SPEECH AND LANGUAGE THERAPY SERVICE
PRE-MASHED DIET ADVICE
(TEXTURE D)
Name……………………………………………………………………………………………
Dietitian …………………………………………………………… Tel: …………………..
Speech and Language Therapist…………………….………… Tel: …………………
Hospital / Clinic …………………………………………………………………………….
Date ………………………………………………..
Pre-Mashed Diet Advice – June 2016
MAIN POINTS
1. You will need to puree / blend or well mash your food
2. It can have some texture but ‘bits’ should be no bigger than 2mm
3. You should try to have lots of different foods in your diet
4. Some foods don’t puree well
INTRODUCTION
If you are having difficulty with chewing or swallowing your food, or
coughing during or after eating, you may need a pre-mashed diet.
It is important that you keep eating lots of different types of food to make
sure you get all the vitamins and minerals that your body needs to stay
healthy.
This advice leaflet will give you ideas on what to eat to keep your meals at
the correct consistency, as well as advice on how to get the most out of
your meal times.
Many people find it difficult to keep their weight steady while eating a pre
mashed diet. This information sheet will give you ideas on how to make
your meals as nourishing as possible, to stop you losing weight and help
you gain weight if you need to.
WHAT IS A PRE-MASHED DIET?
A pre-mashed diet consists of foods which are very soft and moist that have
been well mashed before serving (e.g. with a fork) to leave some variation
in texture but no big lumps or ‘bits’ and needs little chewing. If meat cannot
be finely minced (pieces approximately 2mms in size), it should be pureed.
Mix in extra thick sauce, e.g. cheese sauce, or gravy to make the right
consistency. It should hold its shape on a plate. Any sauce / gravy should
be the same thickness as the food.
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FOODS TO AVOID / TAKE CARE WITH
Most foods will be fine to use once they have been put through a liquidiser.
However the following is a list of foods that do not puree well;
1. Bread
2. Peas, green beans, baked beans, kidney beans, sweet corn. These
will all need to be sieved after puréeing as the skins do not liquidise
down well.
3. Very dry foods e.g. hard cheese, meat without sauce or gravy,
biscuits
4. Raw vegetables such as celery and salad
Ice cream and jelly may NOT be recommended if you are also having
thickened fluids – check with your Speech and Language Therapist
PRACTICAL TIPS
We all have to eat and for most of us it is an enjoyable experience, often
involving family and friends.
Eating a pre mashed diet will mean a change from your normal routine, but
by following these ideas you can still enjoy your food.
1.
Have a wide range of foods. This will provide you with lots of
different nutrients to keep you healthy and also stop you getting
bored.
2.
Make the food look appetising. Purée / mash each food separately
so it keeps its own colour and flavour.
3.
Once you have pureed hot food, warm it up again in a pan or
microwave, as pureeing will make it cooler. It will also warm up
cold foods so if you are making milkshakes etc, chill the food or
drink in the fridge before serving.
4.
Mix with a fork before serving to make sure liquid is not separating
out and to achieve one texture.
5.
Eat in a quiet relaxed atmosphere and take your time.
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6.
Make sure you swallow each mouthful before you take the next
mouthful. If you feel that some food is still at the back of your
throat, swallow again before continuing to eat.
7.
If you are eating out, let the restaurant know beforehand that you
need a special diet and what your requirements are. Most places
will be happy to cater for you. If you know you take longer to eat
think about ordering a main course and ask for that while everyone
else is eating their starter. You may then be ready for dessert at
the same time as everyone else.
8.
If possible, weigh yourself once a week. If you are losing weight or
your appetite is poor, please make sure you are following the ideas
on page 7.
Your Dietitian or Speech and Language Therapist will be happy to help you,
so please contact them if you are worried or have any questions about your
diet.
PREPARING AND SERVING YOUR FOOD
Equipment you will need
A hand blender can be used to puree small quantities of food, otherwise a
food processor or liquidiser would be useful. Some foods may not require
pureeing or processing beforehand e.g. thick, smooth soup, whereas well
cooked vegetables may be mashed with a fork / masher.
Presentation
Make your meals look appealing by using foods that are different colours.
Foods that are light in colour, such as chicken or fish, are better served with
brightly coloured vegetables such as carrots or broccoli.
Thickening foods
Once you have pureed your food you may need to thicken it. You can use
things such as mashed potato (must be really smooth, no lumps), corn
flour, custard powder, ground rice, jelly crystals / gelatine, grated cheese,
instant sauce, tomato juice or gravy granules, as well as the thickening
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agent you may be using for your drinks (if recommended by a Speech and
Language Therapist).
Flavours
Herbs, spices or lemon juice can help improve the flavour of foods.
Tips
You may find it easier to prepare food in bulk then store in your freezer.
Make sure that the food is defrosted thoroughly at room temperature before
reheating.
BALANCED DIET
You should try to have foods from each different food group everyday:
Protein foods: try to have one of these twice per day
•
pureed or finely minced meat or well mashed fish in sauce,
•
Pureed lentils, beans, pulses
•
scrambled egg
•
cheese in sauce
Starchy foods: have a food from this group at least 3 times per day
•
‘Ready Brek’, porridge or ‘Weetabix’ with warm milk
•
mashed potato (no lumps) or pasta, rice with a sauce
(jacket / baked potato (no skin) is a better texture i.e. easier to
swallow than boiled & mashed potato for people with a tumour in
the oesophagus as it is less tacky).
•
rice pudding, semolina or custard
Vegetables: which will cook until soft and can be lightly pureed or well
mashed e.g
•
carrots
•
turnips
•
cauliflower
•
broccoli
•
parsnip
•
swede
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Fruit: try to have 2 portions a day of stewed, mashed or pureed fruit e.g.
•
mango
•
banana
•
apple (without the skin)
•
tinned peaches or pears
or fruit which can be pureed and sieved if necessary or put in a drink e.g.
banana or strawberry milkshake.
Dairy products: try to have the equivalent of at least 1 pint of milk per day
1 smooth yogurt (no bits) = ⅓ of a pint
30g/1oz cheese = ⅓ of a pint
Use full cream varieties and wherever possible make custard, semolina or
rice pudding with full cream milk.
Fatty & sugary foods: add more of these foods if you need to gain weight
e.g. butter, margarine, oil, cream or grated cheese, sugar, honey or syrup.
Make sure you puree everything you need to.
PROBLEMS YOU MAY HAVE
Poor appetite/weight loss
If you have a small appetite or find that you are losing weight you should
make your foods more nourishing. There are some ideas below on how to
do this.
Practical hints:
1.
Try to have small meals/snacks often i.e. 6-8 per day.
2(a). If you are not able to manage a full meal try instead to have a
milkshake, soup or pudding to which you have added e.g. ‘Complan’.
(These are available from the chemist or supermarket.)
2(b). If you are struggling to cook or shop on a regular basis, make use of
convenience foods which require very little preparation (see store
cupboard ideas on page 17).
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3.
Take only sips of drinks with a meal as these can be quite filling.
Have additional drinks between meals/snacks.
4.
Extra nourishment can be added to your food in different ways, e.g.
• use full cream milk to make milk puddings, milky drinks and
sauces
• add 4 tablespoons of milk powder (e.g. ‘Marvel’) to 1 pint of full
cream milk. Use this in hot drinks, puddings, mashed potato (no
lumps) and sauces
• add grated cheese to vegetables, potato, soups and sauces
• add extra butter / margarine / oil to sauces, potatoes, vegetables
and pasta
• use double cream in soups, sauces, potatoes and puddings, e.g.
custard
• add extra sugar, syrup, jam or honey into puddings, drinks or
cereals
• ensure meals are pureed with nourishing fluids e.g. gravy or
sauces, not just water
5.
If you continue to lose weight then please ring your Dietitian for some
more advice.
Note:
Remember to thicken all drinks and foods if advised by a
Speech & Language Therapist.
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PREMASHED MEAL IDEAS
BREAKFAST
•
•
•
‘Ready Brek’, porridge or ‘Weetabix’ (well soaked) with full cream
milk and sugar
Pureed fruit and full fat smooth yogurt e.g. Greek yogurt
Scrambled egg cooked with milk – very creamy, soft and smooth,
no big lumps
BETWEEN MEAL SNACKS
•
•
•
Milky drink such as ‘Ovaltine’, ‘Horlicks’ or ‘Complan’ nb may need
to be thickened, check with your Speech & language Therapist
Pureed stewed fruit
Full fat smooth yogurt, custard pot or soft pudding (see pudding list
on next page)
SNACK AND MAIN MEAL IDEAS
•
•
Cream of tomato soup (smooth, no bits)
Other smooth soups that have been pureed or sieved
Note: soups need to be of a thick consistency or thickened, if
necessary, as per the Speech and Language Therapist’s
recommendations
•
•
•
•
•
•
Scrambled egg cooked with full cream milk – very creamy, soft,
smooth, no lumps
Hard boiled egg, mashed and mixed with salad cream /
mayonnaise to a soft, moist paste
Smooth pâté
Cauliflower / broccoli cheese, well cooked and pureed / well
mashed
Cream cheese mixed with tomato puree
Minced meat, cooked with root vegetables (no onion, tomato skins
or peas) and pureed
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•
•
•
Sieved tinned fish mixed with mayonnaise (e.g. tuna, salmon)
Boil-in-bag fish with sauce which has been pureed or well mashed
Cream cheese mixed with tomato puree, served with mashed
potato (no lumps) or pureed pasta
The above could be served with
• Creamed / mashed or instant mashed potatoes (no lumps)
• Well-cooked pureed pasta
• Well cooked rice pureed with sauce or with your main dish e.g.
curry
And pureed / mashed soft vegetables with butter, gravy or sauce
For more ideas see recipe ideas at end of leaflet.
PUDDINGS
•
•
•
•
•
•
•
•
•
•
•
•
•
Yogurt, smooth with no ‘bits’
Fromage frais, smooth with no ‘bits’
Mousse e.g. chocolate
Blancmange
Instant Whip
Stewed or tinned fruit which has been pureed and sieved
Mashed banana, mixed with cream, evaporated milk or custard
Custard (thick)
Sponge pudding with pureed fruit, mashed well with custard
Crème caramel
Ground rice pudding, smooth and not runny
Fruit smoothies (these may need to be sieved)
Milkshakes
Make all desserts, where applicable, with full cream milk
SUGGESTED MEAL PLAN
Breakfast
Instant porridge or ‘Ready Brek’ made with full cream milk and sugar.
Mid-morning
Milky drink such as ‘Ovaltine’, ‘Horlicks’ or ‘Complan’.
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Midday meal
Pureed mince and gravy, mashed potatoes, pureed/ well mashed
vegetables, custard or smooth yogurt.
Mid-afternoon
Pureed stewed fruit and thick cream or custard.
Evening Meal
Pureed / well mashed cauliflower cheese, mashed potatoes, mousse.
Bedtime
Smooth yogurt, custard, fromage frais or milky drink.
PRE-MASHED DIET RECIPES
MAIN MEALS
Cauliflower Cheese 4 servings
500g (1lb) cauliflower
1½ dessert spoons (1½ x 10 ml spns) cornflour
450 ml (¾ pt) full cream milk
120g (4oz) grated cheese
30g (1oz) butter
Salt and pepper to taste
1.
2.
3.
4.
5.
6.
Remove leaves from cauliflower. Divide into florets and boil in
water until tender.
Mix the cornflour with a little of the milk in a large jug. Pour the
remainder of the milk into a saucepan.
Boil the milk; remove from the heat and pour, stirring all the time,
into the blended cornflour.
Return the milk and cornflour to the pan and simmer for 3-4
minutes, stirring continuously, until thickened.
Remove from heat and stir in the cheese and butter.
Drain the water from the cauliflower. Place the florets and cheese
in the liquidiser.
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7.
8.
Divide into 4 servings.
Serve 1 portion and freeze the remaining portions, when cooled,
for use later.
Macaroni Cheese 1 serving
Small tin (210g / 7 oz) pasta in cheese sauce e.g. macaroni
1 dessert spoon (1 x 10ml spn) cornflour
1.
2.
Place contents of the tin into the liquidiser with cornflour.
Liquidise until some texture remains but no big lumps then heat
gently in a saucepan until thickened, stirring constantly, and serve.
You may require slightly more or less cornflour depending upon the make of
pasta cheese.
Cod Mornay 2 servings
* 90g / 3oz poached fish, without bones
* 150-210ml (5-7 fl oz) ordinary savoury sauce e.g. standard white or
cheese
60g / 2oz approx. mashed potato per portion
* Suitable alternative – frozen fish in sauce
1. Puree fish and sauce lightly together. Divide into 2 equal portions.
Add all the mashed potato to one portion and serve.
2. Freeze the remaining portion for use later.
Mediterranean Minced Beef 8 servings
250g / 8oz minced beef
30g /1oz margarine
30g /1oz flour
300ml /1½pt water or beef stock
1 x 10ml spn / 1 dessert spoon tomato puree
¼ - ½ x 5ml spn / ¼ - ½ tsp mild chilli powder (optional)
Salt and pepper to taste
60g / 2oz mashed potato approx. per 45g portion of mince
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1.
2.
3.
4.
5.
Fry the minced beef in the margarine in a deep saucepan until brown.
Add flour and stir well until mixed in.
Slowly add water or stock, stirring continuously.
Add tomato puree, chilli powder and seasoning.
Bring to the boil, reduce heat and simmer for 15-20 minutes, stirring
occasionally.
6. Remove from heat, transfer to a food processor and process until no
large ‘bits’ remain.
7. Take 45g (1½oz) portion of minced beef and mix with 60g (2oz)
mashed potato and serve with pureed / well mashed vegetables.
[NB: You can increase the quantities of each depending on your
appetite e.g. 90g (3oz) beef with 120g (4oz) potato].
8. Divide the rest of the meat mixture into equal portions and cool
completely before freezing for use later.
Minted Lamb
As Mediterranean Minced Beef but using lamb instead of beef and
replacing the tomato puree and chilli powder with 1-2 x 10mlspn / 1-2
dessert spoon of mint jelly at stage 4.
Pork with Apple 1-2 servings
(As Mediterranean Minced Beef)
Omit the tomato puree and chilli powder. Instead add ½ stock cube,
crumbled into the meat mixture at stage 4.
1. Follow to stage 6.
2. Then take 90g / 3oz cooked minced pork, pureed
2 x 5ml sp / 2 tsps apple sauce
90-150 ml / 3-5 fl oz gravy
90g / 3oz mashed potato
3. Mix all ingredients until thick but no big lumps or ‘bits’.
4. Serve with pureed / well mashed vegetables.
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Pureed Vegetables 1 serving ?needed for texture D
60g / 2oz cooked vegetables e.g. carrots, swede, cabbage (either fresh or
frozen)
30-60g / 1-2 oz mashed potato or made-up instant potato
1. Take cooked vegetables and liquidise with a little stock or water, if
necessary, until smooth paste like consistency is reached.
2. Sieve if necessary and mix with mashed potato to ensure a thick
consistency.
Note: Peas, sweet corn and beans (e.g. broad, butter, red kidney) must be
sieved after liquidising as skins can make the food difficult to swallow.
SOUPS
Spicy Tomato Soup
Fry some chopped onion in a little oil with garlic paste, salt, chilli powder
and ½ teaspoon of sugar. Add either tinned tomato soup or a tin of
chopped tomatoes with desired amount of water and boil vigorously to
reduce. Mash the tomatoes and liquidise before serving. Add cream if you
need the energy.
Potato & Tomato Soup 1 serving
60g / 2oz made up instant potato
60ml / 2 fl oz cream of tomato soup
Knob of butter, salt and pepper to taste.
1.
2.
3.
Make up the instant potato following the instructions on the packet.
Blend by hand or in a liquidiser until smooth.
Heat the soup and butter in a saucepan until it begins to boil.
Remove from heat.
4.
Mix potato and soup together to a smooth consistency. Add salt
and pepper to taste and serve.
Note: Any remaining cream of tomato soup from the tin can be frozen in
60ml / 2fl oz portions for use later, if desired.
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Tinned Soup 1 serving
120ml / 4fl oz of your favourite tinned soup
15g / ½ oz corn flour
1.
Liquidise soup and sieve to remove any lumps.
2.
Blend corn flour in a little water until smooth and stir into the soup.
Heat through until thickened, stirring constantly and serve.
Note: Any remaining cream of tomato soup from the tin can be frozen in
portions for use later, if desired.
DESSERTS
Stewed Fruit
e.g. Stew apples/pears/rhubarb/mango and liquidise. Serve with thick
custard, extra thick double cream.
Apple Dessert 1-2 servings
200ml / 1/3 pt apple puree
2 teaspoon / 2 x 5ml spns of caster sugar
2 rounded teaspoons / 2 x 5 ml spns corn flour, mixed in a little water to a
paste.
Heat puree until just bubbling, add sugar and cornflour and stir rapidly until
thickened.
Serve hot or cold.
Banana Whip 2 servings
2 bananas
2 tablespoons / 2 x 15ml spns natural yogurt
60g / 2oz cottage cheese
1 tsp / 1 x 5ml spn honey/syrup
1 tsp / 1 x 5ml spn lemon juice
1.
2.
Peel and roughly chop the bananas.
Place the bananas, yogurt, cottage cheese, honey and lemon juice
in the liquidiser. Liquidise until smooth.
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3.
Divide into 2 servings, serve one and refrigerate the second
serving for up to 24 hours. DO NOT FREEZE.
Note: Try fromage frais in place of the yogurt. Sweeten to taste with
sugar.
Apricot Dessert 1-2 servings
454g tin of apricots in syrup
3 rounded teaspoons / 3x 5ml spns cornflour, mixed in a little water to a
paste.
1.
2.
3.
Drain the syrup from the fruit.
Liquidise the fruit with 60ml / 2fl oz of the fruit syrup and sieve, if
necessary, to make a puree.
Heat the apricot puree until just bubbling, add cornflour and stir
rapidly until thickened. Serve hot or cold.
Fruit Bake 3-4 servings
500g / 1lb cooking apples, peeled, cored and sliced.
30g / 1oz dates, stoned and chopped
30g / 1oz caster sugar
3x15 ml spoons of water / 3 tablespoons
30g / 1oz suet
60g / 2 oz fresh wholemeal breadcrumbs
30g / 1oz soft brown sugar
300ml / ½ pint custard.
1.
2.
3.
4.
5.
6.
Grease an oven proof dish.
Layer apples, dates and caster sugar in dish and add the water.
Mix together the suet, breadcrumbs, brown sugar and sprinkle on
top of the fruit.
Bake at 180ºC, 350ºF or Gas mark 4 for 30-40 minutes until golden
brown.
Liquidise hot fruit bake with custard.
Divide into 3-4 portions. Serve one and refrigerate the rest. NOT
SUITABLE FOR FREEZING.
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Note: You can use other tinned or fresh fruit, such as peaches or pears in
this recipe.
Tinned Milk Pudding 2-3 servings
N.B. Tinned semolina milk pudding may be eaten cold without thickening or
liquidising.
210g / 7oz tinned milk pudding (e.g. rice, tapioca, sago, macaroni)
1 dessertspoon / 1 x 10ml spn cornflour
1 dessertspoon / 1 x 10ml spn original or flavoured “Complan” powder.
1.
Liquidise the milk pudding with the cornflour and the “Complan”
powder.
2.
Gently heat in a saucepan until thickened, stirring constantly.
3.
Divide into 2-3 equal portions. Freeze into 2-3 equal portions.
Note: You may need slightly more or slightly less cornflour depending on
the make of the milk pudding.
Consider adding spice such as nutmeg to tinned rice pudding for added
flavour.
Custard 4-6 servings
100g / 3½ oz custard powder
60g / 2oz granulated sugar
600ml / 1pt milk
1.
Blend the custard powder and sugar with a little cold milk until
smooth.
2.
Heat the remaining milk and when nearly boiling stir into the
custard powder mixture. Return to saucepan and heat through
until thickened, stirring constantly.
Use by itself as a custard or mixed with liquidised and sieved fruit of your
choice to make fruit fools.
You could also use tinned or packet custard.
Note: If necessary add milk powder, cheese, cream, butter, syrup, sugar
into recipes (see page 7).
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STORE CUPBOARD IDEAS
Suitable convenience foods to keep in your store cupboard are:
•
•
•
•
•
•
•
•
•
•
•
•
•
Tinned minced meat, corned beef
Tinned fish
Tinned or packet soup (without bits)
Tinned cream / evaporated milk
‘Ready Brek’ / porridge oats
Custard / instant whip / milk puddings
Tinned fruit (to make milkshakes)
Instant mashed potato
Pasta / pasta sauces
Tinned vegetables
Gravy granules
Milk powder
Complan
Note: The above ideas can also act as a suitable alternative to some of
the items listed in the recipes section and can save on preparation and
cooking time.
Make sure that you puree anything that you need to.
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WEIGHT CHART
Some people find it useful to write down their weight.
If you would like to keep a record of your weight you can do that here.
There is no need to weigh yourself more than once a week. Try to weigh
yourself on the same scales at the same time of day each week.
Date
Weight
Developed and Produced by Nutrition and Dietetic Service, University Hospitals of Leicester NHS Trust
Updated by Leicestershire Nutrition and Dietetic Service and Adult Speech and Language Therapy Service
Crown Copyright – Nutrition and Dietetic Service, University Hospitals of Leicester NHS Trust
April 2013
Access our website on www.lnds.nhs.uk
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