Modified Texture Diet: IDDSI level 5&6 (IDDSI levels minced/moist - level 5, or soft and bite size - level 6)

Contact Dietitian: ……….…………………………………………………

Tel No: 01223 216655

If your mouth or throat becomes sore during the course of treatment, or chewing or swallowing is more difficult, a texture modified diet may be easier to manage. The following advice and meal plan provides some tips on textures you may find easier to eat, and gives some ideas for meals and snacks.

• Taking foods ‘little and often’ may be more manageable - aim for small frequent meals and snacks every two to three hours.
• Try using sauces, gravy, butter, cream or custard to soften foods. For example, have fish in sauce, fruit with cream, sponge with custard or cream.
• Soften foods by chopping, mincing or mashing.
• Small sips of drink with a meal can help to moisten your food.
• Meats should be well cooked and tender - try stewing, casseroling etc.
• Warm foods may be more soothing. Allow a piping hot meal or drink to cool before eating or drinking.
• Try to avoid foods that require a lot of chewing and are difficult to swallow. For example, tough gristly meat, raw vegetables and nuts.
• You may need to take nutritious drinks between your meals to supplement your intake. Your dietitian will advise you about this.

Main courses

Menu ideas for meals and snacks

• Shepherd’s pie, cottage pie, corned beef hash, meat loaf, moussaka or lasagne
• Minced meats and gravy or sauce e.g. Bolognese
• Sausages (may be easier to manage if skinless), or sausage meat
• Tender meat or chicken in stews, hotpots, curries or casseroles
• Potted meat and pates
• Chicken in a cream sauce
• Flaked fish (without bones) in white, cheese, mornay or parsley sauce
• Fish pie, fish cakes, fish mousse (e.g. salmon) or light pate
• Tinned fish e.g. tuna, salmon, sardines or pilchards – mixed with salad cream, mayonnaise or cheese sauce
• Prawns in sauce
• Chicken, egg or tuna mayonnaise salad
• Risotto
• Well-cooked pasta (including ravioli, tortellini, cannelloni) with sauces, such as cheese, tomato, carbonara
• Macaroni cheese
• Noodles
• Tinned spaghetti hoops with grated cheese
• Lentils or chick peas made into dahl
• Vegetarian/vegan soya or Quorn™ mince e.g. vegetarian/vegan cottage pie, shepherd’s pie, lasagne,
• Vegetarian/vegan risotto, curry, stew or soft nut roast
• Dips, such as hummus, guacamole, cream cheese, taramasalata
• Ratatouille
• Savoury bread and butter pudding
• Cauliflower/broccoli cheese
• Scrambled tofu

Add extra protein to vegetarian and vegan dishes with beans, pulses, ground nuts and seeds, and cheese or eggs

Eggs*

• Serve scrambled, poached, boiled or as an omelette (add cheese if desired)
• Courgette fritters (can be baked like a tray bake or fried)
• Egg mayonnaise
• Savoury pancakes with a soft filling
• Egg dishes for example: savoury egg custard, soufflés, baked eggs
• Whisk into milk puddings prior to cooking

* Ensure that eggs are well cooked

Potatoes and Vegetables

• Well cooked carrots, turnip, swede, cauliflower, sweet potato, butternut squash, courgette, broccoli and marrow are easily mashable, or can be grated before cooking
• Try adding grated cheese, add extra butter/margarine or serve with a white/cheese sauce or gravy
• Add milk, butter and grated cheese to mashed potatoes
• Mash the inside of a jacket potato with butter and add a suitable topping
• Instant mashed potato is a quick alternative

Desserts

• Sponge pudding/bread and butter or sticky toffee pudding with custard/cream/ice cream
• Milk puddings e.g. rice pudding or semolina. Milk puddings can be made with fortified milk (four tablespoons of dried milk powder with one pint of full cream milk)
• Instant Whip/Angel Delight (or supermarket own brands), mousse, fruit fool, jelly, crème caramel, blancmange, trifle, panna cotta (no bits), egg custard or rum baba
• Pancakes with cream/ice cream
• Yoghurt, fromage frais or milk jelly
• Ice cream, sorbet or frozen yoghurt
• Tinned/stewed/mashed fruit with cream, custard, ice cream or yoghurt

Snacks

• Dairylea triangles, Primula cheese spread
• Biscuits dipped in warm drinks to soften
• Mashed banana
• Yoghurt, custard or rice pudding pots
• Moist muffins or cupcakes

Cheese, yoghurt, crème fraiche, ice cream, custard, milk and cream can all be replaced with dairy free alternatives. They do tend to be lower in calories and protein, so make sure you add extra.

For those who may be experiencing weight loss, full fat and sugar products such as full cream milk and creamy yoghurts should be used. You may also like to refer to the sore mouth and food fortification advice sheets available.

Meal Plan

Breakfast:

• Porridge, Ready Brek®, Weetabix®, cornflakes with fortified milk and sugar or honey
• Scrambled eggs made with milk and butter, margarine or grated cheese
• Soft fruit for example banana, stewed apple, pear or melon
• Glass of fruit juice or smoothie

Mid-morning:

• Milky drink (ideally make with fortified milk)
• Snack or dessert (see list)

Lunch:

• Tender meat in gravy, shepherd’s pie or chicken stew
• Fish e.g. fish in parsley sauce, fish pie
• Pasta with sauce e.g. macaroni cheese
• Mashed potato with added butter, cream, or cheese
• Well cooked vegetables e.g. carrots, cauliflower with butter, cheese, or a sauce

If you feel full up after your main course, you may prefer to leave your dessert until later.

• Milk pudding, for example: rice pudding or semolina
• Sponge pudding and cream, ice cream or custard

Mid-afternoon:

• As for mid-morning

Evening Meal:

• Jacket potato with butter and soft filling e.g. tuna with mayonnaise, or tinned spaghetti
• Soup with added pasta, cream, cheese or soft meat
• Soft bread and butter or margarine with cream cheese, pate or meat paste
• Omelette with cheese
• Yoghurt, ice cream, trifle or mousse

Supper:

• Warm milky drink e.g. hot chocolate, Horlicks or Ovaltine
• Biscuits (soften by dunking in a warm drink) or soft cake with ice cream, cream or custard
• Cereal with fortified milk and sugar or honey

Meal Delivery Services

These companies can deliver soft meals to your home:

Meals on Wheels:

Cambridge and surrounding areas:

Website: CAMMS Meals on Wheels (opens in a new tab)

Telephone: 01223 314288

Hertfordshire:

Website: Hertfordshire Independent Living Service (opens in a new tab)

Telephone: 03302 000103

Norfolk:

Please visit Supplying-norfolk-county-council/meals-on-wheels (opens in a new tab) or call 0344 800 8020 to find an approved provider in your area.

Suffolk:

Website: 01473 749927 Aspect Living Suffolk (opens in a new tab)Gov.uk/meals-home (opens in a new tab)

For other areas, you can search for your nearest meals on wheels service using the following website: gov.uk/meals-home (opens in a new tab)

Website:Oakhouse Foods (opens in a new tab) Telephone: 0333 370 6700

Website:Simply Puree (opens in a new tab) Telephone: 0191 456 0456

Website:Wiltshire Farm Foods (opens in a new tab) Telephone: 0800 077 3100

Useful Contacts

• The Stroke Association (opens in a new tab) 0303 3033 100
• Motor Neurone Disease Association (opens in a new tab) 0808 802 6262
• Parkinson’s Disease Society (opens in a new tab) 0808 800 0303
• MS Society of Great Britain (opens in a new tab) 0808 800 8000
• Macmillan Cancer Support (opens in a new tab) 0808 239 06 25