The minced and moist diet, categorized as IDDSI Level 5, is designed for individuals with chewing difficulties (oral dysphagia). This article provides a detailed overview of the diet, including preparation techniques and recipe ideas, drawing upon the International Dysphagia Diet Standardisation Initiative (IDDSI) guidelines.
Understanding the Minced and Moist Diet
The minced and moist diet is often recommended by speech-language pathologists or other healthcare professionals to individuals experiencing oral dysphagia. Oral dysphagia can arise from various factors such as dental issues, poorly fitting dentures, or impaired tongue movement, which hinders proper chewing. Common medical conditions that may contribute to dysphagia include stroke, Alzheimer’s dementia, Parkinson’s disease, ALS, and oral cancer.
The Role of IDDSI
The International Dysphagia Diet Standardisation Initiative (IDDSI) was established in 2013 by a global team of professionals. IDDSI aims to standardize dysphagia diets worldwide, ensuring consistent dietary guidelines across different settings like homes, hospitals, rehabilitation centers, and nursing homes.
Minced and moist foods are classified as IDDSI Level 5, situated between Level 3 (Liquidized) and Level 7 (Regular/Easy-to-Chew) on the IDDSI scale. For adults, minced foods should be cut into pieces no larger than 4 mm, which is small enough to fit between the tines of a fork.
Identifying Properly Prepared Minced & Moist Food
To ensure food is appropriately minced and moist, adhere to the following guidelines:
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- Size: Ensure food particles are no larger than 4mm.
- Moisture: Food should be moist, not dry.
- Texture: Food should not be sticky or firm.
IDDSI Spoon Tilt Test: This test helps to confirm the consistency of the food. Scoop up a sample of the food to evaluate its texture and moisture.
The IDDSI handout on Level 5 Minced & Moist includes a chart that lists foods to avoid because they are hard to mince or hard to swallow even when minced.
Techniques for Preparing Minced & Moist Food
While pureed food may be more commonly prepared, mincing is straightforward with the right tools and techniques.
Tools for Mincing
- Sharp Knife: Essential for manual mincing of ingredients like garlic, onion, and other vegetables.
- Food Processor: A food processor with a standard chopping blade is highly effective for mincing a variety of foods. Look for models with a strong motor and sharp blades. Some processors also include a dicing attachment.
- Blender: Suitable for certain foods, though it may produce a more pureed consistency.
- Other Tools: Consider using an onion chopper, potato masher, potato ricer, or food mill depending on the food type.
Mincing Process
- Preparation: Cut the food into chunks before processing.
- Food Processor: Use the "pulse" feature to mince the food in short bursts until the desired particle size is achieved.
- Moisture: Add liquid or moisture during or after mincing to prevent dryness. Be cautious when adding liquid to a food processor, as it may result in a puree.
Meat Preparation
Ground meat (beef, chicken, or turkey) can be purchased pre-ground. If cooking meat in a skillet, use a spatula to break it into small pieces. Some individuals believe freshly minced meat tastes better than pre-ground meat.
- Raw Meat: Mince raw meat straight from the refrigerator or partially freeze it for easier handling.
- Manual Mincing: Partially freezing the meat makes it easier to cut into small pieces by hand.
Minced & Moist Recipe Ideas
Virtually any meal can be adapted to a minced consistency. Here are some recipe ideas:
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Pasta with Red Sauce
Enjoy a classic Italian dish with properly prepared pasta and marinara sauce.
- Wash hands before preparation.
- Break dry pasta into thirds and place in a food processor.
- Boil pasta in a large amount of water until very soft. Drain and rinse with cold water. Stir oil into the cooked pasta. Hold at 140°F or higher (CCP).
- Measure 1.5 cups of marinara sauce.
- Test before serving per IDDSI Testing Methods for Minced & Moist, Level 5 (MM5), using the Fork Pressure Test, Spoon Tilt Test, and ensuring no separate thin liquid.
- The amount of moisture in the food can vary.
- Recipe standardized and tested at 150°F.
- Refer to local food regulations for time and temperature values for prepared items.
Other Meal Ideas
- Pancakes: Mince pancakes using a food processor or onion chopper.
- Tacos with Beans: Cook ground beef or turkey with taco seasoning, mince well with shredded cheese, and combine with refried beans, salsa verde, and sour cream.
- Sloppy Joes: Cook ground beef or turkey with Sloppy Joe sauce, mince well, and serve on a minced hamburger roll.
- Chicken Salad: Cook and cool chicken, mince the meat, and mix with minced pickled onion and mayonnaise. Optionally, mince soft bread with an onion chopper or food processor and moisten with a thin sauce of mayonnaise and lime juice.
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