Download Dysphagia Texture B

Department of Nutrition and Dietetics
Department of Speech and Language Therapy
Texture B Diet
(Liquidised)
Patient Name:
________________________________________________________
Assessed/ Recommended by:
Name: ___________________________ Profession:_____________________
Telephone: ______________________ Date issued:____________________
This leaflet has been produced with the help of patients
This leaflet is available in other languages and formats, eg CD, just ask
Why do I need a different texture diet?
Difficulty in swallowing, also known as dysphagia, makes it difficult for
some people to eat and drink.
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The muscles in your mouth and throat are weakened and as a result
you may not be able to move food and liquid around your mouth and
swallow it as you normally would. As a result, the food may go down
into your lungs and cause infection.
Changing the texture of your food can make it easier and safer for
you to swallow.
You have been assessed and it has been recommended that you
have a Texture B diet. This leaflet is a guide to help you prepare
your food to the appropriate consistency.
What is texture B?
Texture B is a pureed food consistency, which requires no chewing.
It should be a smooth, soft and thick consistency and should contain
no lumps or bits. It cannot be eaten with a fork and should drop rather
than pour from a spoon, similar to whipped cream or thick custard. A
thickener may be added to foods if they are too runny when pureed.
How do I prepare my foods for a Texture B diet?
Foods can be pureed using a hand or electric blender, liquidiser or
food processor.
It is important that the food is very smooth; we recommend you use a
sieve to make sure all lumps, skin and pips are removed.
You may need to add liquid to some foods to make them easier to
blend. Avoid using water as this will make food less nourishing and
tasty. Other things to use could include milk, cream, juice, gravy or
sauces.
Foods can taste and look more appealing if they are pureed
separately (e.g. meat, potato, carrots) rather than all together in the
same dish.
Freeze ‘extra’ meals:
• Allow to cool, cover, label and freeze quickly
• Allow to thaw completely before re-heating
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• Re-heat foods until piping hot and allow to cool to the heat you
most prefer.
The flavour of food can be diluted when you add extra sauce or
gravy; try adding more seasoning, such as salt, pepper, herbs and
spices, once food has been blended / liquidised.
To thicken foods
Try adding corn flour, instant mash, instant sauce mix, packet soups
or custard powder to thicken foods.
What about my medication?
The texture of your medications may also need to be altered. Some
medications are available in syrup as well as tablet form. Some can
be crushed and mixed with food to make them easier to swallow. It is
essential that you ask your GP or pharmacist before changing how
you take your medications.
What about cleaning my teeth?
It is important to brush your teeth, tongue and gums at least
twice a day; especially after meals. Swallowing saliva
containing bacteria from the mouth can lead to chest
infections. You are advised to use a low foaming
toothpaste (e.g. Sensodyne or Biotene) as this does not
stimulate excess saliva or leave the mouth dry. Put a
pea-sized amount onto the bristles and brush your
teeth in the normal way. There is no need to rinse;
remove any residue with the toothbrush.
General advice for eating and drinking
• Make sure you are seated comfortably in an upright position. If
sitting upright is difficult, prop yourself with cushions rather than
lying back. Make sure your feet are on a flat surface to give a good
base support.
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Only take small mouthfuls.
Make sure each mouthful is cleared before you take the next.
Take your time while eating and don’t rush.
Do not wash food down with a drink. Instead make the food more
moist and swallow more often until it clears
• Try to avoid eating when feeling very tired. If you tire quickly whilst
eating you may find it easier to eat smaller amounts more often.
• It may help to stay sitting upright for at least an hour after eating
Things to look out for when eating and drinking:
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Frequent coughing or choking at mealtimes or when drinking
Frequent chest infections
Difficulty breathing
Discomfort when eating or drinking
Food getting stuck in the throat
Contact your doctor if you have any of the above difficulties
A Nutritious Texture B Diet
It is important to include a variety of food in your diet every day; you
can still do this when you are following a different texture diet.
Included in this section are some examples of food which you can still
enjoy, although there are many others. Also included is information
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on how to make your diet higher in energy and protein if you are
finding it difficult to eat, and / or are losing weight.
Please see page 7 for guidance on high risk foods you should not
eat.
Meat, fish, eggs, pulses and other non-dairy sources of protein
Include 2-3 portions per day. For example, 1 portion = 1 fillet of fish, 1
chicken fillet, 1 pork chop, 2 eggs, 4 tablespoons of cooked beans or
pulses, 120g (4oz) soya, tofu or Quorn.
Tips
o Meat or Quorn/soya: Cook and remove fat, skin, bones and
gristle before liquidising until smooth. You may find it
necessary to sieve the meat if any lumps remain. Add a
savoury liquid such as a cream or barbeque sauce or gravy.
You may find minced meats easier to liquidise. Pre-prepared
dishes such as casseroles, corned beef hash and cottage pie
can also be pureed. You may want to try adding pureed
chutney, tomato puree, ketchup, mild mustard or curry to these
foods to increase the variety of flavours.
o Fish: Fresh, frozen or tinned fish can all be liquidised. Cook and
remove skin and bones from fresh/frozen fish before blending.
Moisten with a savoury liquid such as parsley or cheese sauce
as your puree.
o Eggs: baked and scrambled can be blended.
o Pulses: puree lentils and split peas in thick soups and dhal.
Remove skins.
Milk and Dairy Foods
Include 2 – 3 portions per day. For example, 1 portion = 1 pot yoghurt
or fromage frais, 200ml milk, 150ml custard, 1 matchbox size piece of
hard cheese used in a cheese sauce, 1 large pot (200mg) cottage
cheese (pureed).
Tips
o Cheese: use cheese to make a cheese sauce. Avoid grating
cheese directly onto hot foods e.g. mashed potato, as cheese
can become stringy.
o Milk: use to make milky puddings. Use full fat milk if you are
struggling to maintain your weight.
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o Milky puddings: home-made, tinned or packet puddings such as
custard and semolina. Rice, sago and tapioca will need to be
liquidised. Try Angel Delight, Instant Whip, blancmange,
mousse, crème caramel, ice-cream and milk-jelly.
o Yoghurt and fromage frais: thick, set variety without bits. Strain
to remove fruit pieces if necessary.
Bread, cereal and potato
Include 7- 8 portions per day. For example, 1 portion = 2 heaped tbsp
cooked rice or pasta, 2 egg sized potatoes, 3 tablespoons flaked
cereal
Tips
o Potatoes: puree well with milk, cream, cheese or butter; sieve if
they are still too lumpy. Instant mashed potato is a useful
alternative.
o Pasta or rice: puree pasta or rice dishes such as macaroni
cheese or lasagne with extra sauce.
o Breakfast cereal: sieved porridge or instant hot oat cereal.
Make sure any excess milk is drained
o Bread and pastry should be avoided.
Fruit and vegetables
Include 5 portions per day e.g. 1 portion = 1 banana, 2 pear halves, 2
tbsp of vegetables
Tips
o Vegetables: cook fresh, tinned or frozen vegetables until
tender, then puree with a savoury sauce such as gravy, stock,
milk or cream. Try adding butter for extra energy.
o Fruit: Choose ripe fresh, tinned or frozen fruit. Blend tinned,
stewed or thawed frozen fruit with fruit juice or syrup. Remove
skins and pips from soft ripe fruit before pureeing and add a
squeeze of lemon juice to prevent browning. Add custard,
cream or evaporated milk for extra energy and protein.
Avoid high risk foods
These foods should be avoided unless they can be pureed and
sieved to a texture B consistency.
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Don’t eat:
• Stringy fibrous texture- e.g. pineapple, runner beans,
oranges, celery and lettuce
• Vegetable and fruit skins; e.g. broad beans, peas, baked
beans, grapes
• Mixed consistency foods- e.g. ice cream and jelly, cereals that do
not blend with milk, rice pudding, cornflakes with milk, soup with
bits, fruit yoghurts
• Crunchy food- e.g. toast, crisps, biscuits, batter, breadcrumbs
• Crumbly food- pie crusts, crumble, crackers
• Hard foods; e.g. boiled and chewy sweets, toffees, nuts and seeds
• Food with husks; e.g. porridge, sweetcorn, granary and multiple
grain breads
• Others- chocolate, roast potatoes, salad, rice that is not pureed
• Food that is sticky when in the mouth; e.g. peanut butter
• Bread – all types should be avoided – see previous heading
Bread, cereal and potato
• Cheese – Avoid all cheese types unless making a cheese sauce.
The cheese sauce should be smooth in consistency. Avoid cheese
that becomes ‘stringy’ when melted.
Consider your food choices. If you are losing weight, then do not eat
food and drinks labelled “low fat” or “low sugar” as you need more
calories. But if you are gaining too much weight, you should choose
the reduced fat and low sugar varieties.
Meal Ideas
Breakfast
• Instant hot oat cereal or sieved porridge
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• Pureed fruit with yoghurt or fromage frais
• Fruit smoothie with yoghurt, fruit, milk and honey. Strained to
remove bits
Snacks and nourishing drinks
• Pureed and sieved thick soup such as chicken, leek and potato,
vegetable
• Milky coffee, hot chocolate, milkshake, Horlicks, Ovaltine and
other malted drinks
• If you have been advised to have thickened fluids you will need
to thicken drinks and soups (see “Thickened Fluids” document).
Main meals
• Pureed meat dishes such as cottage pie, shepherd’s pie,
casserole, stew, corned beef hash with additional sauce or
gravy
• Pureed fish or fisherman’s pie with a savoury sauce such as
parsley, cheese or white sauce
• Pureed pasta dishes like lasagne, macaroni cheese, spaghetti
bolognaise with additional sauces as required
• Overcooked rice, pureed with curry of sweet and sour sauce
• Liquidised cream potatoes or cheese and potato pie
• Well cooked and blended vegetables. Pureed cauliflower
cheese.
Desserts
• Pureed and sieved fruit with custard or cream
• Yoghurt or fromage frais without bits
• Mousse or instant whip
• Sieved rice pudding, tapioca, crème caramel
• Egg custard (no pastry)
These are also suitable snacks for between meals
If you are struggling to eat well, aim to have 3 small meals, 3 snacks,
and nourishing drinks every day. Contact your Dietitian.
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