Information for patients
This leaflet can be made available in other formats including large print, CD and Braille and in languages other than English, upon request.
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 by a Speech and Language Therapist.
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:
- Food that is soft and moist and needs very little chewing.
- Foods which have small bite-sized pieces. (4mm by 4mm).
- Foods that can be eaten with a spoon or fork.
- Lumps that are easy to squash with the tongue or can easily be minced or mashed with a fork.
- Foods that do not require biting or very little chewing is required.
- Foods that hold their shape.
- Foods that can be scooped and shaped into a ball.
- Sauces should be extremely thick, smooth and non-pouring.
- If texture cannot be finely minced it should be pureed vegetables.
- Vegetables should be finely minced, chopped or mashed and cooked until soft. Pieces should be no greater than 4mm.
- Remove pips and skin from fruit and mash. Tinned fruit should have any excess thin juice drained. Pieces should be no greater than 4mm.
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 dried fruit that is too hard to be mashed with a fork.
- Choose foods without skins, for example, avoid skin on meats such as sausages or chicken, or on fruit with skins.
- Seeds and nuts.
Quick meal ideas
- Breakfast cereals with small moist lumps, such as, wheat biscuits or porridge made with enriched milk.
- Small 4mm sized, 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. These are not recommended if you have been advised to have thickened fluids by your Speech and Language Therapist.
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.
- If you are able to 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.
Wheat biscuit or pillow (e.g. Weetabix® or Readybrek®) made with full cream milk and with added honey or syrup.
(See suggestions in leaflet)
Thick and creamy smooth yogurt.
Middle of jacket potato with butter and cheese served with mashed beans.
Mashed banana with added double cream, chocolate spread or smooth peanut butter.
(See suggestions in leaflet)
Minced chicken casserole, minced carrots and creamed potatoes.
Mashed or pureed tinned fruit with custard.
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)
Telephone: 01642 643999
Opening hours: 9:00am to 5:00pm (Monday to Friday)
Information and references used in the development of this leaflet:
- Food Standards Agency (2002) McCance and Widdowson’s The Composition of Foods, Sixth Summary Edition. Cambridge: Royal Society of Chemistry
- Gandy, J. (2014). The Manual of Dietetic Practice (5th Ed). Wiley Blackwell Ltd.
- Complete IDDSI Framework Detailed definitions 2.0 | 2019 (http://ftp.iddsi.org/Documents/Complete_IDDSI_Framework_Final_31July2019.pdf)
Comments, concerns, compliments or complaints
Patient Experience Team (PET)
We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:
Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]
Out of hours
Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617
Data protection and use of patient information
The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.
Telephone: 01642 383551
Email: [email protected]Privacy Notices
This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:
Email: [email protected]
Leaflet reference: PIL1191
Date for review: February 2027