Dietary Advice For a Moist and Minced Diet

How do I make every bite count?

During your consultation you were asked about your appetite and if you had lost any weight recently.  You may have had your weight and height recorded.

This information has identified you as being at risk of malnutrition.  You have also been advised to alter the texture of your diet following a swallow assessment.

It is important to maintain your weight and prevent any or further weight loss to reduce the risk of further health problems and to keep you as well as possible.

To do this, it is important to eat nourishing foods; high in energy and protein and in line with the recommendations for texture and consistency.

This leaflet gives you ideas about small changes that can be made which will help you achieve a more nourishing diet. This will help prevent further weight loss. 

The following suggestions may help and should be followed until your healthcare professional is happy with your weight or there is a change in the recommended texture of your diet and fluids.

This leaflet considers the texture of your food only.  If you have been advised to alter the consistency of your fluids, then you should follow the recommendations of the Speech and Language Therapist.

When following a minced and moist diet you should choose:

• foods that can easily minced or mashed with a fork.

• foods that can be eaten with a fork, spoon or chopsticks   

in some cases, if you have good hand control.

• foods that can be scooped and shaped (e.g. into a ball) on a plate.

• soft and moist food with no separate thin liquid.

• foods that may be presented as a thick puree with obvious lumps in it.

• food that is moist and should easily form into a ball in the mouth.

• foods which can have small lumps visible that pass through the tines of a fork.  The lumps should be easy to squash with the tongue.

• vegetables cooked until tender and then mashed. Avoid raw vegetables, salads, seeds, nuts and dried fruit and vegetables with skins on, for example, sweetcorn and beans (if necessary). Pieces should be no greater than 0.5cm.

• mashed or pureed fruit such as banana, or finely sliced or diced soft pieces of canned or cooked fruit such as pears or peaches.  Pieces should be no greater than 0.5cm.  Avoid fibrous or stringy fruit such as pineapple or dried fruit.

Be careful of food with bones in, for example, fish and stews.

Foods that should be avoided include:

• hard or dry foods such as crackers, dry biscuits or pastries.
• all breads and sandwiches
• large pieces of fruit, fibrous fruit or fruit that is too hard to be mashed with a fork or dried fruit.
• choose foods without skins, for example, skin on meats such as sausages or chicken, or on fruit.

Quick meal ideas

• breakfast cereals with small moist lumps, such as, wheat biscuits or porridge made with enriched milk.
• small moist pieces of soft pasta in a creamy or tomato based sauce, for example, macaroni cheese, spaghetti bolognaise or ravioli. Some dishes may require mashing or blending.
• inside of a jacket potato (no skin) mixed with butter and fillings, such as, grated cheese or tuna mayo.
• scrambled egg.
• any minced meats, for example, mince casserole or stew with added gravy and no skin.
• corned beef hash.
• fish mashed in a savoury sauce, for example, white, parsley and cheese sauces.
• smooth or strained soups, such as, condensed or creamy.  If using packet soups make using hot enriched milk.

Dessert and nourishing snack ideas

• hot milk puddings: homemade custard, semolina, sago, rice, tapioca, all made with or with added enriched milk, evaporated milk or cream.  You can also add seedless jams, sugar or syrup.
• cold desserts such as instant whips, blancmange, egg custard, mousse, crème caramel, ice-cream and jelly (including milk jellies).
• tinned or stewed fruits mashed in syrup.
• sponge cakes mashed in custard.
• french style set yogurts, fromage frais or thick and creamy yogurts – you may need to remove any large pieces of fruit.
• stewed apple with sugar served with cream, ice-cream or yoghurt.
• mousse or jelly blancmange.
• ice cream or sorbets.

How do I eat a nourishing diet?

You should try to:

• choose foods with a soft texture.
• eat 3 small meals each day as well as a mid-morning, mid-afternoon and supper time snack or eat small amounts every 2 to 3 hours. 
• include nourishing drinks (to be thickened if needed).
• fortify full-cream milk with dried milk powder (3 to 4 tablespoons to a pint).  Use at least 1 pint of this a day in foods and drinks (to be thickened, if needed).
• use plenty of sauces such as gravy or creamy and / or cheesy sauces or custards made with full cream milk or cream.
• avoid “low fat” or “diet” products. 
• have a milk-based pudding after each meal.
• choose 2 good sources of protein each day such as meat, fish, chicken, eggs, cheese, yogurt or beans and pulses.
• add flavour using herbs or spices.  Taste the food and add seasoning.
• drink 6 to 8 glasses of fluid each day (tea, coffee, fruit juice, milky drinks, to be thickened, if needed). Sip on these throughout the day and take drinks after your meals, to avoid filling up on them.
• eat mousse or jelly blancmange.
• have ice cream or sorbets.  You can also add sweet sauces, for example, chocolate, vanilla or lemon.
• eat mashed banana with enriched milk, cream or ice-cream.

Sample menu

Breakfast

Wheat biscuit or pillow (e.g. Weetabix® or Readybrek®) made with full cream milk and with added honey or syrup.

Mid-morning snack

(See suggestions in leaflet)

Thick and creamy smooth yogurt.

Lunch

Middle of jacket potato with butter and cheese served with mashed beans.

Mashed banana with added double cream, chocolate spread or smooth peanut butter.

Mid-afternoon snack

(See suggestions in leaflet)

Smooth mousse.

Evening meal

Minced chicken casserole, minced carrots and creamed potatoes.

Mashed or pureed tinned fruit with custard.

Supper

Hot chocolate.

Contact numbers

If you need further help or advice please contact:

North Tees and Hartlepool NHS Foundation Trust

Specialist Services Admin Hub

Telephone: 01429 522471

Opening hours: 8.30am to 4.30pm (Monday to Friday, excluding Bank Holidays)

Wiltshire Farm Foods

147 Stockton Street

Middlesbrough

TS2 1BU

Telephone:  01642 643999

Opening hours: 9:00am to 5:00pm (Monday to Friday)

Information and references used in the development of this leaflet:

1. Food Standards Agency (2002) McCance and Widdowson’s The Composition of Foods, Sixth Summary Edition. Cambridge: Royal Society of Chemistry
2. Gandy, J. (2014). The Manual of Dietetic Practice (5th Ed). Wiley Blackwell Ltd.
3. Complete IDDSI Framework Detailed definitions 2.0 | 2019 (http://ftp.iddsi.org/Documents/Complete_IDDSI_Framework_Final_31July2019.pdf)

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