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Increasing Enjoyment of Modified Texture Diets

Photo: Teplansky Photography

Eating is a multisensory experience. Texture, aroma and flavor — as well as what the food looks like on the plate — can all impact how something tastes and influence how much someone eats. Those on a modified-texture diet due to dysphagia, or difficulty swallowing, should still be able to enjoy meals with their friends and family.  

A 2012 survey from the American Academy of Otolaryngology-Head and Neck Surgery Foundation estimated that one in 25 U.S. adults is impacted by dysphagia. With dysphagia, it takes more effort for food or fluid to move from the mouth to the stomach. It may be a temporary or chronic condition, and it also can be an indication of a serious illness.

Individuals with dysphagia may be able to tolerate some solids, while others require primarily soft or even entirely pureed food. Though these modifications can make it possible to safely meet nutritional requirements, they can also have a negative impact on the dining experience, appetite and overall health. Having to eat a pureed diet, for example, can make people feel uncomfortable having meals with others, especially if those meals aren’t visually appealing, which can lead to decreased intake and dining isolation.

Modified texture diets don’t have to be boring, though! Health care practitioners and foodservice companies are putting more effort into improving the pureed experience with molds, creative recipes and a focus on flavor. A lot of these techniques even can be utilized at home.

Jenny Overly, a registered dietitian and Director of Nutrition, Health and Wellness for food and dining management company Unidine, works with RDNs in senior living, where many residents are affected by dysphagia. As part of its Puree with a Purpose program, the company creates visually appealing pureed meals using tools like food molds, and trains chefs on methods to enhance nutrition, flavor and overall dining experience.  

She explains that because so much of our enjoyment of food is visual, the impact of more appealing pureed food has been meaningful in helping residents meet their nutritional needs and enjoy meals in a social setting. “What we see,” says Overly, “is that people start to eat more — and eat more real food — and become more comfortable. It’s exciting for us as dietitians to have actual food in our toolbox.”

Chris Greves, Unidine’s Director of Culinary for Senior Living Training and Development of Culinary Teams, says people preparing dysphagia meals at home should “think about flavor and about what you’re using to get the texture you want.” His tips include:  

Equipment Essentials:

  • Blender
  • Food processor
  • Small blender for smaller portions
  • Ricer
  • Piping bags
  • Food molds

Tips and Tricks:

  • To safely puree something like a chicken breast into a uniform texture, chop the cooked meat into pieces before throwing in the blender.
  • To preserve flavor, use broth or milk. Water that seeps into food, especially meat, can dilute the taste.
  • Use herbs and spices to season food.
  • Though gel and powder thickeners have their place, Greves recommends food-based approaches like adding crustless white bread to puree mixtures.

Whether you’re just getting acquainted with modified texture diets or simply learning to expand your repertoire, don’t be afraid to try new things. 

Jessica Cording, MS, RD, CDN, is a dietitian and writer based in New York City, where she works with a variety of private and corporate clients and is on staff at the Hospital For Special Surgery. She writes for various media outlets and blogs at Keeping It Real Food. You can follow her on Twitter and Instagram.

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