Patients and clients may experience a number of physical, mental, and dental conditions that will require specially prepared meals. There are many different types of issues that may interfere with someone's ability to consume foods. For example, some people may be able to use a straw, others may forget to chew and swallow properly, and still others may cough frequently throughout a meal, interfering with swallowing. Each requires slightly different textural alterations.
If you know or work with clients or patients whose diets require texturally altered foods, this article will provide you with some good tips to ensure that they are receiving a complete and nutritionally balanced diet.
Maintaining patient interest and pride while serving them texturally altered foods is paramount. Therefore, you should try to serve altered 'regular' foods rather than relegating patients with textural alterations to a monotonous diet of applesauce, mashed potatoes, and broth. Keep texturally altered foods as close to the 'regular' menu as possible. If everyone else is having carrots with parsley as a side dish, texturally altered menus should have them as well. Choosing a variety of foods will provide adequate nutrients as well as prevent boredom for the patients.
Many foods can be puréed without losing the flavor. However, you'll need to use some imagination in serving them so they look attractive. After all, no one wants three or four bowls of 'mush' served to them, no matter how pleasant the color or aroma. For example, vegan meatballs and spaghetti can be chopped and served over puréed spinach. They may also be puréed and served over garlic bread. Even if the bread cannot be eaten, it will add an attractive look and aroma. In addition, apple pie—crust and all—can be puréed and then served with a scoop of non-dairy ice cream as a dessert.
Many vegan foods work well for texturally altered diets. No texture changes are needed for applesauce, mashed potatoes, vegan refried beans (thinned with a bit of tomato juice, if needed), or hummus. Other vegan foods are easily altered for chopped or puréed diets. For example, most vegan soups, cooked beans, butternut or banana squash, cooked root vegetables (such as beets, rutabagas, and carrots), or potatoes (including white, yellow, sweet, and purple) can be run through a blender or food mill to create a hearty, correctly-textured base for a chopped or puréed meal.
Lentil loaf, vegetarian pâté, and pasta casseroles may be soft enough for chopped diets, and these can be puréed for people who require even softer textures. In our kitchen, we prepare these entrées as we would for customers who don't have chewing or swallowing issues. Then, we chop, mince, grind, or purée the entrée to suit clients' needs. For tasty desserts, we crumble cake or soft cookies over sorbet; vegan pudding (made with soy or rice milk); baked apples; or chopped or puréed peaches, apricots, or plums.
Commercial baby food is not appropriate for any population except infants. The texture is generally too thin to counter many swallowing issues, and the food is not sufficiently nutrient-dense enough for anyone over the age of two years. The amount of baby food that an adult would need to consume for adequate nutrition would probably be far greater than one could comfortably eat during a meal. In addition, commercial baby food may be excessively salty and can be expensive.
However, baby foods can be used as a base for texturally altered menu items or for sauces. For instance, baby food beets or carrots can be used as a colorful sauce for a main dish. Baby food peaches, apricots, or applesauce can be used as a topping for desserts, such as sorbets.
Many people with dental, chewing, swallowing, or other issues just can't take in a sufficient amount of food. The whole process of eating simply may be so difficult or tiring for them that they will not consume enough calories every day. If a person can eat or drink only small amounts, there are ways to 'pack' the calorie and protein content of the food eaten:
A popular commercial thickener, Thick-It™, is made from modified cornstarch and maltodextrin. This is considered to be vegan. You can visit the Thick-It website at <www.thickitretail.com> for ideas about food presentation. The Thick-It company also sells ready- to-use puréed foods; however, most are not vegetarian or vegan.
Puréed foods can be thickened with mashed potatoes or commercial thickeners and then piped in a pastry bag to simulate sliced carrots, green beans, or potato pearls. Puréed foods can also be thickened and baked or steamed in small food molds to create attractive shapes. If cooking creates a product that is too dry, serve with sauces or gravies to create a thinner texture.
Additionally, hydration is an important part of a healthy intake. If possible, 6 to 8 cups of liquid (approximately 1 quart) are needed on a daily basis. Some patients with swallowing problems may not be able to do this easily. If thin liquids are an issue, fluids can be thickened with a commercial thickener or can be partially frozen to form slush. Even if it is not attractive to the preparer, a patient may accept thickened coffee or tea to enjoy the taste.
For this article, we have created five different texture levels from puréed (level 1) up through modified regular food (level 5). The menus begin on page 23. The menus vary in texture, and the best one for each patient should be selected by a health care professional.
Nancy Berkoff is The Vegetarian Resource Group's Food Service Advisor. She is the author of Vegan in Volume, Vegan Meals for One or Two, Vegan Menu for People with Diabetes, Vegan Seafood: Beyond the Fish Shtick for Vegetarians, and numerous other cookbooks.
The contents of this website and our other publications, including Vegetarian Journal, are not intended to provide personal medical advice. Medical advice should be obtained from a qualified health professional. We often depend on product and ingredient information from company statements. It is impossible to be 100% sure about a statement, info can change, people have different views, and mistakes can be made. Please use your own best judgment about whether a product is suitable for you. To be sure, do further research or confirmation on your own.
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