LEICESTERSHIRE NUTRITION & DIETETIC SERVICE
ADULT SPEECH AND LANGUAGE THERAPY SERVICE
THICK PUREED DIET ADVICE
(TEXTURE C)
Name……………………………………………………………………………………………
Dietitian …………………………………………………………… Tel: …………………..
Speech and Language Therapist…………………….………… Tel: …………………
Hospital / Clinic …………………………………………………………………………….
Date ………………………………………………..
Pureed Diet Advice – June 2016
MAIN POINTS
1. You will need to liquidise and sieve or blend your food
2. It needs to be smooth
3. You should try to have lots of different foods in your diet
4. Some foods don’t puree well ( see page 3)
INTRODUCTION
If you are having difficulty with chewing or swallowing your food, or
coughing during or after eating, you may need a pureed 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 a
smooth 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
pureed 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 PUREED DIET?
A pureed diet consists of foods which are very soft and moist that has been
pureed in a liquidiser or food processor and passed through a sieve, to
leave a single consistency with no lumps or ‘bits’. The mixture should be
soft and moist enough to just about ‘drop’ off a spoon. Mix in extra thick
sauce, e.g. cheese sauce, or gravy to make the right consistency. Each
food should be pureed separately to maintain different flavours. 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
and sieved.
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 pureed 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 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.
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5.
Eat in a quiet relaxed atmosphere and take your time.
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 give them a ring if you are worried or have any
questions about your diet.
PREPARING AND SERVING YOUR FOOD
Equipment you will need
All food needs to be sieved but some may not require pureeing or
processing beforehand e.g. thick, smooth soup. A hand blender can be
used for small quantities of food; otherwise a food processor or liquidiser
would be useful.
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.
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Thickening foods
Once you have pureed your food you may need to thicken it, if this has
been recommended by the Speech and Language Therapist. You can use
things such as mashed potato (must be really smooth, no lumps) ,
cornflour, custard powder, ground rice, jelly crystals / gelatine , grated
cheese, instant sauce, tomato juice or gravy granules, as well as the
thickening agent you may be using for your drinks (if recommended by your
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 meat or fish in sauce
•
pureed beans, lentils or pulses
•
cheese in sauce
Starchy foods: have a food from this group at least 3 times per day
•
‘Ready Brek’, instant porridge e.g. Oat so Simple 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 patients with a tumour in
the oesophagus as less tacky).
•
ground rice pudding, semolina or custard
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Vegetables: which will cook until soft and can be pureed, e.g.
•
carrots
•
turnips
•
cauliflower
•
broccoli
•
parsnip
•
swede
Fruit: try to have 2 portions of fruit a day which can be stewed or tinned
and pureed e.g.
•
mango
•
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
ground rice with full cream milk.
Fatty & sugary foods: add more of these foods if you need to gain weight
e.g. butter, oil, cream, margarine, grated cheese, sugar, honey or syrup.
Make sure you puree and sieve everything you need to.
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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:
Useful tips:
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).
3.
Take only sips of drinks with a meal, as these can be quite filling.
Remember to 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
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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.
PUREED MEAL IDEAS
BREAKFAST
•
•
‘Ready Brek’, porridge or ‘Weetabix’ (well soaked and sieved) with
full cream milk and sugar
Pureed fruit and full fat smooth yogurt
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
•
•
•
Hard-boiled egg, mashed and mixed with salad cream /
mayonnaise to a soft, moist paste
Smooth pâté
Cauliflower / broccoli cheese, well cooked and pureed
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•
•
•
•
Cream cheese mixed with tomato puree
Minced meat, cooked with root vegetables (no onion, tomato skins
or peas), pureed and sieved
Sieved tinned fish mixed with mayonnaise (e.g. tuna, salmon)
Boil-in-bag fish with sauce which has been sieved and blended
The above could be served with
• creamed 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 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 with no nuts 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 sieving)
Milkshakes
Make all desserts where applicable, with full cream milk
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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’.
Midday meal
Pureed mince and gravy, mashed potatoes, pureed vegetables, custard or
smooth yogurt.
Mid-afternoon
Pureed stewed fruit and thick cream or custard.
Evening Meal
Pureed cauliflower cheese, mashed potatoes, mousse.
Bedtime
Smooth yogurt , custard, fromage frais or milky drink.
PUREE FOOD DIETARY ADVICE
MAIN MEALS IDEAS
Cauliflower Cheese 4 servings
500g (1lb) cauliflower
1½ dessert spoons (1½ x 10 ml spoon) corn flour
450 ml (¾ pt) milk
120g (4oz) grated cheese
30g (1oz) butter
Salt and pepper to taste
1.
Remove leaves from cauliflower. Divide into florets and boil in
salted water until tender.
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2.
3.
4.
5.
6.
7.
8.
Mix the corn flour 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 corn flour.
Return the milk and corn flour 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 until smooth.
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 sp) corn flour
1.
2.
Place contents of the tin into the liquidiser with corn flour.
Liquidise until completely smooth then heat gently in a saucepan
until thickened, stirring constantly, and serve.
You may require slightly more or less corn flour 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 mashed potato per portion
* suitable alternative – frozen fish in sauce
1. Liquidise together. Divide into 2 equal portions. Add all the mashed
potato to one portion and serve.
2. Freeze the remaining portion for use later.
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Mediterranean Minced Beef 8 servings
250g / 8oz minced beef
30g /1oz margarine
30g /1oz flour
300ml /1½pt water or beef stock
1 dessert spoon (1 x 10ml spoon) tomato puree
¼ - ½ x 5ml spoon / ¼ - ½ tsp (1 x 5ml) mild chilli powder
Salt and pepper to taste
60g / 2oz mashed potato
1.
2.
3.
4.
5.
Fry the minced beef in the margarine in a deep pan 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
smooth.
7. Take 45g (1½oz) portion of liquidised minced beef and mix with 60g
(2oz) mashed potato and serve with pureed vegetables. [NB: You
can increase the quantities of each depending on your appetite e.g.
90g (3oz) pureed 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 10ml spoon / 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.
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2. Then take 90g / 3oz cooked minced pork, liquidised
2 x 5ml spoon / 2 tsps. apple sauce
90-150 ml / 3-5 fl oz gravy
90g / 3oz mashed potato
3. Mix all ingredients until smooth.
4. Serve with pureed vegetables.
Pureed Vegetables 1 serving
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 smooth
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.
Make up the instant potato following the instructions on the packet.
Blend by hand or in a liquidiser until smooth.
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3.
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.
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.
DESSERTS
Rice Pudding
Add spice such as nutmeg to tinned rice pudding and liquidise.
Stewed Fruit
e.g. Stew apples/rhubarb/mango and liquidise. Serve with thick custard,
extra thick double cream.
Apple Dessert 1-2 servings
200ml / 1/3 pint apple puree
2 teaspoon / 2 x 5ml spoons of caster sugar
2 rounded teaspoons / 2 x 5 ml spoons 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.
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Banana Whip 2 servings
2 bananas
2 tablespoons / 2 x 15ml spoons natural yogurt
60g / 2oz cottage cheese
1 tsp / 1 x 5ml spoon honey
1 tsp / 1 x 5ml spoon 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.
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 spoons corn flour, 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 smooth puree.
Heat the apricot puree until just bubbling, add corn flour 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.
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1.
2.
3.
4.
5.
6.
Note:
recipe.
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.
You can use other tinned fruit, such as peaches or pears in this
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 spoon cornflour
1 dessertspoon / 1 x 10ml spoon original or flavoured “Complan” powder.
1.
Liquid 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
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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.
STORE CUPBOARD IDEAS
Suitable convenience foods to keep in your store cupboard are:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
tinned mince 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
Build Up
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 and sieve 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
June 2016
Access our website on www.lnds.nhs.uk
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