For individuals experiencing difficulty chewing and swallowing, often due to conditions like dysphagia, adapting one's diet is essential. This article presents a collection of recipes and considerations for creating soft and bite-sized meals that are both nutritious and enjoyable. It is vitally important to consult with Speech-Language Pathologists (SLPs) and Registered Dietitians (RDs) to determine the appropriate diet consistency and nutritional needs.
Considerations for Planning Soft Food Meals
When planning meals for those with chewing and swallowing difficulties, several factors should be taken into account:
- Texture: Foods should be soft, moist, and cohesive, avoiding anything hard, crumbly, or sticky.
- Size: Bite-sized pieces are crucial to prevent choking.
- Nutrition: Ensuring adequate calorie and nutrient intake is vital, especially when weight loss is a concern.
- Flavor: Pureed or soft diets should not sacrifice flavor. Experiment with herbs, spices, and flavorful sauces to enhance the taste.
Featured Recipes and Ideas
The recipes below have been developed, or options given, for those who are having trouble chewing and swallowing. Please also explore the other recipes on food to glow as quite a number are tagged as ‘soft food’ and may be suitable, depending on your needs. I am adding new recipes every week so it may be worth checking in occasionally. Or better yet, subscribing. Some foods and mentioned products contain UK affiliate links to useful products that I recommend for soft food diet needs. These are chosen for their ability to process or cook food in the most effective way (i.e. higher wattage for more power to blend smoothly). Clicking on and buying any product costs you nothing extra but helps offset the costs of running Food To Glow and keeping it ad-free.
Nutritious Weight Gain Drink
Oftentimes weight and muscle loss is an issue with those needing an altered textures diet. Many of the commercial drinks contain high amounts of sugars, which some may wish to avoid. This is a no-sugar, anti-inflammatory drink recipe with plenty of calories and (potential) muscle-building nutrients. I’ve given suggestions for flavouring it, but use anything that appeals to you. If you want it sweet, may I suggest that you use a small amount of honey or maple syrup, and make up the rest of the sweetness in pure organic stevia? You will only need a tiny tiny amount of the latter as in its pure form it is very concentrated in sweetness.
Blend the above until completely smooth for drinking.
Read also: Nourishing Meals for Esophageal Health
- 1 capsule mixed digestive enzymes - chemotherapy and radiotherapy can change the way we break down fats, carbohydrates and proteins.
- High quality probiotic supplement - check with your doctor that this is suitable for you during treatment. Healthy gut bacteria are greatly diminished by cancer treatments and this will affect how well we absorb nutrients from food.
Directions: Add the ingredients and any sweetener to a blender and process until smooth and creamy.
Vegetable and Bread Cube Bake
This is a great dish for not only those with difficulty chewing and swallowing, but also for anyone who just wants a bit of comfort food - with a healthy streak. If you are trying to gain weight please use full fat versions of the dairy products mentioned, and perhaps add in more cheese too.
Spray or paint a one-litre baking dish (approximately 27×18) with a little oil. Preheat the oven to 180C. Heat the oil in a large frying pan. Gently sauté the onions until soft, then add the remaining vegetables and the dried herbs. Cook on a medium heat for about five minutes, until all are starting to soften. Add a dash of stock or water to help the vegetables soften (although the mushroom and kale may release enough liquid). Decant the cooked vegetables in to the baking dish. In a medium mixing bowl whisk together the milk, crème fraiche, chives and the eggs, adding about 1 tsp of salt and a large pinch of pepper. Pour this mixture over the vegetable topped bread cubes. Gently press the mixture into the bread and allow to soak up for about five minutes. Sprinkle over the cheese and bake in the preheated oven for about 25-30 minutes. Allow to cool slightly before serving warm with a simple green salad or some cooked peas. Pass the ketchup!
Need more calories? Add another tablespoon of oil, and use full-fat dairy.
Turkey Meatloaf
I’ve made this protein-packed recipe lower-fat but if you need to keep your weight up sauté the vegetables in 3 tablespoons of oil, or serve with buttery mash.
Read also: Oral Surgery Diet Tips
In a frying pan, over a medium-hot heat, sauté the onions in the oil for about five minutes. Add the garlic and carrots to the pan and cook for a further eight minutes, or until the carrots begin to soften. Add the next five ingredients and set aside to cool for a few minutes. Put the turkey mince and porridge oats into a large bowl and mix together. Add in the cooled vegetable mixture, beaten eggs, stock and parsley. Mix well; it will look quite sloppy. Pat the meatloaf mixture into an oiled rectangular baking tin (approximately 28 x 18 cm) and cover with the ketchup or barbecue sauce. You can also form the mixture into a rectangular shape - about 10 cm/4 in high- on a well-oiled baking sheet. I tend to put it in the fridge for half an hour to firm up, but this is not necessary if you are putting the mix into a baking tin. Bake at 170 C for 50 minutes to one hour, or until a meat thermometer registers 70C.
Frittata
The basic frittata recipe consists of eggs, onions, potatoes and olive oil. These can be jazzed up according to whatever else you have in the cupboard or fridge. Leftover boiled potatoes are perfect for this recipe.
In the frying pan or cast iron skillet*, heat the oil over a medium to low heat. Add onions and saute for a few minutes, then push aside and gently fry the sliced potatoes for a few minutes. Spoon in your preferred seeds, if using. Reorganise the onion and potatoes (i.e. even them out a bit). Add the chopped spinach to the pan and beat the turmeric into the eggs. Pour the seasoned eggs into the pan, making sure they are well-distributed. Let mixture semi-set over a low heat. I usually cover the pan for most of the time. Finish off under a hot grill or, if you are brave invert the frying pan onto a plate and slide the undercooked side back into the pan to finish. The undermost side will probably by quite golden brown with ‘caught’ oniony bits. This is the way it should be - you haven’t burned it! If you have trouble chewing flip the frittata over before it gets brown and continue cooking until just cooked through. Let it cool to almost room temperature (it doesn’t taste nearly as nice straight from the pan.). This also tastes fab cold and is perfect for picnics.
Aubergine Melanzane
This is a low-fat version of an Italian favourite, but you can easily make it higher fat and higher calorie. Use either a quality bought sauce (I like Seeds of Change basil and tomato, or roasted pepper and tomato - the large bottle) or bubble up the easy sauce suggested below. Either way, it is delicious and very simple to make; it also freezes well (just give it 15 minutes more time).
Slick two baking trays with olive oil. Slice the aubergines 1 cm thick and lay on the oiled trays. Brush the aubergines with a little more oil. Bake the aubergine at 200 C for about 20 minutes, or until very soft and looking golden brown. Remove the aubergines from the oven. For those with difficulty chewing perhaps remove the skin before slicing. Lower the oven temperature to 180 C. In a 8 by 12-inch pan (approximate size) place the largest slices in a single layer. Top each with some sauce, a thin layer of spinach and some torn basil. Continue layering up until all aubergines are used. Top with last of the sauce, lay on the mozzarella or dollop on ricotta, sprinkle over the Parmesan and breadcrumbs.
Read also: Gentle Foods for After Wisdom Teeth Surgery
Easy Tomato Sauce
Heat the oil in a medium heavy-bottomed pan (not aluminium). Add the onion and sauté gently until onion is soft; add the garlic, thyme, carrot, bay and celery and continue cooking for 15 minutes, until the carrot is quite soft. Add the tomatoes with their juice and bring to the boil, stirring often. Lower the heat and simmer for at least 30 minutes, until as thick as porridge; season with salt, and maybe a pinch of sugar. Cool slightly, remove the bay leaves and whiz with a hand blender .You can keep this sauce in the fridge for one week or freeze in an appropriate container for 3 months.
Lentils with Salsa and Fish
This is a smart, restaurant-style dish that is guaranteed to elicit a few aahs ‘round the table. It is, however, very easy and relatively quick. Make it quicker by preparing the lentils the day before and reheating them gently with a splash of hot stock while you get on with the salsa and fish. Don’t be tempted to use any other type of lentils as the texture and unique taste are integral to the success of this dish.
A note on the choice of fish: cod is the most obvious choice for this dish but as stocks are low perhaps take the opportunity to experiment with other firm white fish, such as hake. Ask your fishmonger for a good substitute for cod, telling him or her that you want something that will remain intact after steaming.
Simmer the lentils, uncovered, with the bay leaf and onion in 500 ml of cold water for 20 minutes, or until the lentils are tender (have a nibble; they should taste ‘done’ but will look quite firm). Drain, plucking out the bay leaf and onion. Return the lentils to the pan and season. Coat the lentils with the olive oil; cover and keep warm. While the lentils are simmering, prepare the salsa. Some people pop everything into a food processor and blitz for a smooth sauce. Others mash everything with a pestle and mortar for a more rustic dressing. Either is fine, although the latter is spectacularly messy if you are not practised. I tend to chop everything up on a board, scrape it into a mini food chopper and give it a quick pulse for a chunky, yet amalgamated texture. Sort the fish just before serving. If you have a food steamer just place the fish on the perforated tray and steam for five minutes, or as recommended by the manufacturer. For those of you like me who have a less modern approach there are two recommended methods. If you have a pressure cooker use the trivet and basket that comes with it (but not locking the lid) and steam the fish for five minutes over simmering water. Alternatively pour hot water in a large frying pan, place an upended heat-proof flat-bottomed ramekin (or similar) in the centre and top with a plate that accommodates the fish and fits, with a bit of steaming room, in the pan. Cover and steam for five minutes. If all that sounds a tremendous faff, poach in acidulated water (ie, add the juice of one lemon to enough lightly salted boiling water to just cover the fish) - turn off the heat when the water returns to the boil and leave for five minutes. Regardless of the fish method used, place a generous spoonful of lentils on each plate, top with a piece of fish and drizzle over some salsa. Serve with lemon wedges.
Pimiento Cheese
This type of sandwich spread is common in the US deep south and it is called pimienta cheese. Nearly everyone over there just buys it ready made from the shops, but it is so easy to whiz up that it’s a shame that more people over there don’t make it. It’s certainly not for slimmers but if you need to keep the weight on, or if you are looking for something to liven up a prescribed low-fibre or easy-to-swallow diet, this tasty spread smeared on white bread might just fit the bill.
Whizz everything up in a food processor and allow to ‘come together’ for 20 minutes before eating. This is perfect on its own if you want quickly made, easily eaten calories with taste. Otherwise, it is a great accompaniment to slow-cooked, falling-apart meats.
Creamy Polenta
A wonderful recipe for those bored with the normal soft diet fare of mashed potatoes and rice.
Bring the milk to the boil and then add in the garlic, bay leaf, salt and pepper and nutmeg. Simmer for five minutes. Use a slotted spoon to remove the bay leaf and garlic. Slowly whisk in the polenta (pour it in in a steady stream, whisk all the time). Cook the polenta on a low heat for 10 minutes, stirring so that it doesn’t stick (which it really wants to do!). Add in the cream and cheese, cooking for a further 2-3 minutes.
Sardine Pâté
I didn’t think I liked tinned sardines until I made up this quick pate for one of my nutrition classes. In truth I was going to make something else but didn’t have enough of one of the ingredients so raided my husband’s tinned sardine stash instead. It was in place of frozen artichoke hearts: quite a leap of faith/common sense. I reluctantly had a wee taste and was extremely surprised that I liked it - a lot. I hope you do too. If your food processor isn’t that great, try and get boneless tinned sardines. Otherwise do get the ones with bones in as they are one of our only dietary sources of essential Vitamin D.
Blend in a food processor until very smooth. Have with bread, or even wrapped in soft lettuce leaves with some thin strips of cucumber.
Smoked Fish Custard
Blend the smoked fish in a food processor, add one-third of the beaten egg mixture and one-third of the cream, blending until smooth. Put the ramekins into a roasting tray; pour some boiling water into the tray so that it comes up about two-thirds the way, and bake in an oven preheated to 200C/400F for 30 minutes. To serve, turn upside down on plate and garnish with soft lettuce (like salade mache) and a lemon wedge.
Miso Glazed Fish
This is simplicity itself and oh so tasty. You may need to get the miso - which is a thick paste made of fermented rice or barley plus soybeans - at the health food store. Much tastier than it sounds, I promise. Once opened it keeps really well in the fridge and can be used to perk up all kinds of things such as noodles and spread over halved and baked aubergine (flash under a grill, then eat the flesh only; see below). I’ve not stipulated the fish type as different types of fish are used in different countries. In the UK try haddock, gurnard, hake or coley rather than endangered cod. Regardless of where you are what you are wanting is a firm white fish.
Mix together the glaze ingredients until the brown sugar has completely dissolved. Preheat your grill/broiler and place the fish on a baking tray, then pop under the heat until the tops are starting to brown and the glaze caramelizes - watch it to make sure it doesn’t burn - about three minutes. Take the fish from the grill/broiler, brush with the remaining glaze. Now either turn the heat to 180C/375C, or lightly cover the fish with foil (not touching the fish) and put on a lower rack, and cook until the fish is cooked through but still moist - about five minutes.
This glaze is also superb on baked aubergine/eggplant: slice an aubergine in half lengthways slash a diamond pattern into the flesh (not cutting the skin), oil and bake in a medium-hot oven for 20 minutes. Remove from the oven and spread over the miso glaze; place under a hot grill/broiler until bubbly.
Pears Baked
This is a quick and extremely yummy pudding for the whole family. Drain the pears and lay in a pie dish or other ovenproof dish (e.g. Bake in a 200C/400F oven for 25-30 minutes.
Risotto
A ‘wet’ risotto made with finely chopped onions with soft, cooked butternut squash or sweet potato cubes, sage and finely grated cheese.
Understanding IDDSI Levels
The International Dysphagia Diet Standardization Initiative (IDDSI) framework provides a common language and testing methods for dysphagia diets. Level 6, Soft & Bite-Sized, is appropriate for individuals who have good tongue control and force and can manage chewing.
Level 6: Soft & Bite-Sized Testing and Description
Level 6: Soft & Bite-Sized is appropriate for individuals who have good tongue control and force and can manage chewing. At this level, the size of each bite is predetermined, and can be appropriate for individuals with some pain or difficulty chewing, or those who may not choose appropriate bite sizes without help.
Food pieces can be no larger than 15mm square for adults or 8mm square for children. Foods must have no separate thin liquid, but should be soft and moist. The pressure from a fork or spoon must be able to mash the pieces easily; this is called the Fork Pressure or Spoon Pressure Test. In these tests, the utensil must be able to easily cut through or break apart the food using only the side of the utensil. When mashing the sample to test, only use as much pressure as causes your thumbnail or fingernail to blanche white. After mashing, the food must not return to its original shape.
IDDSI Level Examples
- Level 4: Puree & Extremely Thick: Rosemary Mashed Potatoes (use an electric mixer to beat until smooth and creamy).
- Level 5: Minced & Moist: Picadillo Ground Beef with Tomatoes (olives and raisins may need to be avoided). Apple Butternut Squash Pancakes (depending on how finely grated the squash is).
- Level 6: Soft & Bite-Sized: Gifilte Fish with Beet-Horseradish Cream (add extra cream to prevent a crumbly texture), Goat Cheese and Fig Jam Knife-And-Fork Burger (add extra jam for moisture, as needed), Thanksgiving Meatballs (cranberries added), Maple Green Beans (roast until tender).
Additional Tips and Considerations
- Fork Pressure Test: Ensure foods are easily mashed and stay cohesive by pressing them with a fork.
- Moisture is Key: Add sauces, gravies, or extra moisture to prevent dryness.
- Avoid Problematic Foods: Raw fruits and vegetables, nuts, seeds, and tough meats may be difficult to manage.
- Consult Professionals: Always follow the recommendations of your SLP and medical team regarding diet consistency.