We provide a general overview regarding basic mechanical soft diet information & guidelines. For more information, click here to see our Food Substitutes For Mechanical Soft Diets overview. And click here to see our overview for how to help feed and provide medications for an individual following a mechanical soft diet.
• A mechanical soft diet is typically prescribed for someone who has dysphagia (dis-faze-shuh). Dysphagia means difficulty chewing and swallowing. A mechanical soft diet involves modifying the consistency and texture of foods, which allows for proper nutrition and reduces the risk of choking and food getting caught in the throat or lungs—which can be serious or fatal. (You can learn more by clicking here to access the dysphagia diet web site.)
• It is important to consult a health care professional about mechanical soft specifics on an individual-by-individual basis. The health care professional’s advice is to be followed above all else.
• The mechanical soft diet gets its name from the fact that kitchen equipment—like a blender, food processor, meat grinder, masher, grater, and knife—is used to make foods easier to chew and swallow. Sometimes a liquid (water, broth, milk, fruit juice, etc.) is mixed in to add moisture and smooth out the consistency of food. Thinner isn’t always better, however.
• A mechanical soft diet avoids foods that are coarse, seeded, hard, dense, sticky, dry, too spicy, tough, stringy and/or complex. Rice, peas, cheese, corn, bread and bread-like products, as just a few examples, can be sticky—and lumpy—even when processed in a blender or food processor with added liquid.
• In addition to the importance of consistency and texture of foods/liquids, nutritional balance and flavorful, attractive meals are also priorities—and possible to achieve—for someone following a mechanical soft diet. The mechanical soft diet should typically include spices, herbs and flavor enhancers to increase the appeal of food.
• In addition to food, liquids (including foods with liquid added as part of moisturizing and smoothing out the consistency) may also need to be refined in some way to achieve the right thickness. Once again: thinner isn’t always better.
• There are 3 levels to the mechanical soft diet for food consistency, texture and smoothness. There are 4 thickness consistencies as far as liquids. The health care professional will indicate which level and thickness are appropriate for each individual.
You need certain equipment to prepare a mechanical soft diet. This guarantees a way to refine—blend, mash, grind, grate or cut and sometimes add liquid—food so it is easier to chew and swallow. You sometimes might first mash, grind, grate, or cut before blending.
Blender or Food Processor
Useful for achieving a smooth consistency. It isn’t advisable to blend hard foods such as uncooked carrots (or other uncooked, hard vegetables) or big chunks of food, such as a whole chicken breast. The blender/food processor will be much more effective with small pieces of cooked and soft foods. Moistening foods with some liquid is often necessary. The Black & Decker 10-cup food processor is used very successfully by a number of provider residential settings.
Works wonders from a smoothness standpoint for all sorts of soft and cooked fruits and vegetables. Adding liquid (milk, sauce, gravy, juice) to your mashed foods will help to smooth out the texture, especially when you use the masher effectively.
True to its name, will grind up denser, cooked meats such as chicken and beef (but no bones or skin!). Grind is often a setting found on many food processors. Adding liquid (milk, sauce, gravy, juice) to your ground up meats will help to smooth out the texture.
Yields particularly tiny pieces of food, working best with somewhat hard foods like raw fruits and vegetables, and even denser, cooked meats such as chicken and beef. If you want to serve fresh carrots, as an example, a grater will supply a finely chopped fresh carrot. Adding a bit of broth will help make it easier to swallow the fresh, grated carrot. A grater isn’t going to work well with soft or mushy foods because there isn’t much for the grater to grab on to.
Depending on the texture you’re aiming for, you can use a knife to finely chop foods (mince), so you end up with a consistency that is easier to chew and swallow.
3 LEVELS FOR FOOD
An individual following a higher numbered diet level can generally tolerate a lower numbered diet level. For example, it is generally safe for an individual eating a Level 2 diet to eat a Level 1 diet. However, the health care professional should make these decisions and his or her guidelines should be followed closely.
Level 1, Puree
This diet consists of foods that are a smooth and consistent texture. There shouldn’t be any chunks, pieces or mixed textures. The food should be pudding-like and should not be difficult to chew or move with the tongue.
There are some foods that may have a pudding-like consistency without additional refining. A few examples might include actual pudding, non-chunky applesauce, and yogurt without fruit pieces. For the majority of foods that aren’t normally a pudding-like texture (meats, vegetables, fruits, pasta, bread, etc.), you can often achieve a Level 1 consistency by using a blender or food processor and adding in some liquid; this is actually what puree (pure-aye) means.
While there are a wide variety of foods that can be incorporated into a Level 1 diet, not all foods will puree to a smooth, non-sticky consistency. Corn, peas, cheese, some pastas and breads, and rice are some foods that can pose challenges for a Level 1 diet for this very reason.
The Level 1 diet will almost exclusively use a blender or food processor to achieve a puree consistency. The stems and seeds of vegetables and fruits should be removed and the health care professional should provide guidance on the inclusion of edible skin/peels before pureeing.
Further below, we provide more information about safety considerations, foods to include and avoid, adding liquids, flavoring considerations, and all-important nutritional balance.
This diet consists of foods that are moist, soft-textured and easily chewed and swallowed. Meats are ground or finely cut to equal a size no bigger than about ¼ inch. Some mixed textures such as those found in a casserole might be appropriate. Soft pancakes well moistened with lite maple syrup, soft fruits/vegetables from the can in lite syrup or water, soft cookies dipped in milk, soft/ground meats in small bites, egg noodles, and scrambled eggs are examples of food often appropriate for a Level 2 diet.
An appropriate beverage may be used to help wash down certain bite-sized foods.
You may use a blender, food processor, masher, grinder, grater and knife to achieve a Level 2 consistency.
Further below, we provide more information about safety considerations, foods to include and avoid, adding liquids, flavoring considerations, and
This diet consists of moist, bite-sized foods of more normal consistency and broader variety and texture, but still avoiding: hard, sticky, crunchy, dry, coarse, seeded, tough, stringy and chunky.
An appropriate beverage may be used to help wash down certain bite-sized foods.
You may use a blender, food processor, masher, grinder, grater and knife to achieve a Level 3 consistency.
Further below, we provide more information about safety considerations, foods to include and avoid, adding liquids, flavoring considerations, and nutritional balance.
4 THICKNESSES FOR LIQUIDS
There are thickening agents that can be used to achieve an appropriate consistency prescribed by the health care professional. By thickening fluids, you can help reduce the risk of liquid going into the windpipe or trachea. Thicker liquids move slower to give better control of the liquids in the mouth, so swallowing can occur safely.
There are no restrictions. No thickener needed.
Liquids must be thickened to a nectar consistency, which is similar to the consistency of buttermilk. Nectar Thick liquids can be sipped through a straw or from a cup.
Liquids must be thickened to the consistency of honey. Honey Thick liquids are sipped from a spoon or a cup.
Pudding or Spoon Thick
Liquids must be taken with a spoon. Pudding Thick liquids must hold their shape on the spoon.
USE EXTREME CAUTION
• When in doubt about the consistency or appropriateness of any food or beverage, don’t serve it.
• Some foods should be cooked before refining with equipment and the possibility of added liquid (smooth out consistency). Included are meats, all kinds of noodles and pasta, rice, potatoes, beans not from a can, and some fresh and frozen vegetables. This is for safety, taste and ease of refining reasons. And quite simply: Most of us wouldn’t eat noodles out of a box or an uncooked potato, and neither should the individual following a mechanical soft diet.
• Once foods have been refined, some can dry out if left uneaten for even a few minutes. Typically these are foods that have been blended or mashed and mixed with a liquid to smooth out consistency and add flavor. What this means is that you may have to add more liquid and stir vigorously or blend again—even doing this several times during the meal. Always make sure that what you are serving is a smooth, appropriate consistency with the right amount of moistness and at the right temperature level.
Just because you started with the right consistency, doesn’t mean you have the right consistency as time marches on during a meal that can be a slow process when an individual has dysphagia. Included in this note of caution are: bread, bread-like products and starchy/sticky foods, noodles/pasta, cheese, cereals and beans.
• Individuals with dysphagia need time to eat; it can be a slow process.
Patience ensures safety and that enough calories are being consumed.
• Nutrition is key. Be mindful regarding including enough fiber and being diligent about sodium, calories, fat content and other nutritional components. Opt for high fiber, low-sodium and low-fat ingredients whenever possible. Consult the health care professional regarding calorie intake requirements, since some individuals will need to lose weight and some will need to gain weight.
• Foods that are generally served separately should be refined (blended, mashed, liquid added, etc.) separately. One big mushy plate of blended mashed potatoes, ground meat, peas and chicken broth isn’t appealing. Separating these foods and flavoring each encourages eating a balanced, hearty meal. An exception to this is if the recipe has already combined the ingredients and flavors, such as for lasagna. A good rule of thumb is: If it doesn’t appeal to you, it won’t taste good to the person on a mechanical soft diet.
• Warm up foods that are typically served warm. Most people don’t eat cold spaghetti; neither should the person following a mechanical soft diet. Be sure to not serve anything too hot, however.
• Don’t use water as the only liquid to mix in when refining foods. Water doesn’t contain important nutrients and it lacks flavor. Appropriately-flavored foods are important to enhance the appeal of food for an individual following a mechanical soft diet. See the section further below titled Moisturizing & Flavoring.
• Be positive and encouraging.
FOODS OFTEN INCLUDED
There are a wide variety of foods that are suitable for all 3 levels of a mechanical soft diet given the appropriate refining with equipment and moisturizing liquids. The health care professional will be involved in providing specific guidelines, so be sure to check.
The following list is a general one and assumes that appropriate refining (use of equipment and sometimes a liquid to smooth out consistency and add flavor) is taking place as needed for the individual’s specific consistency and texture needs as defined by Level 1, 2 or 3 and liquid thickness requirement. Also assumed is that refining continues throughout the meal to ensure a proper consistency at all times, not just at the start of the meal (so additional liquid and use of equipment may be needed, sometimes several times during the meal for a particular food or foods).
Having an appropriate beverage on hand to help wash down small pieces of food that can be on the dry side (such as bread and bread-like products) can be very helpful.
Pay close attention to nutrition facts and choose high fiber, low-sodium and low-fat versions when possible for foods used in the mechanical soft diet. Some individuals following a mechanical soft diet may need to watch their calorie intake because they need to increase their weight instead of decreasing their weight.
Click here to access our Food Substitutions For Mechanical Soft Diets overview.
Soft fresh fruits without stem and seeds but with edible skin/peel as allowed by health care professional
Soft, cooked vegetables
Canned fruits and vegetables
Tuna fish and other delicate, flaky fish (no bones!)
Mashed or refried beans
Baked potato (no skin)
Pasta—egg noodles are among the least dense of pastas
Macaroni & cheese
Spaghetti-Os from the can (no meatballs or franks)
Salsa (not too spicy or chunky)
Cream soups or clear broth (broth from can or make from bouillon cubes)
Soups without large chunks of meat/vegetables
Cottage cheese (small curd)
Other soft cheeses
Some soft breads without crust (consider adding some seedless jam or jelly) (often best softened with liquid)
Scrambled and hard and soft-boiled eggs
Waffles and pancakes (often best softened with liquid)
Ready-to-eat cereals (no dried fruits, nuts or candies) (often best softened with liquid)
Muffins (no large chunks of fruit or nuts) (often best softened with liquid)
Jams and jellies (without seeds)
Applesauce (no chunks)
Yogurt (no chunks or fruit)
Ice cream and sherbet (no candy or fruit chunks)
Frosted birthday cake with no fruit or hard candies (often best softened with liquid)
Beverages (may want to include 100% fruit juices in order to supply nutrients)
FOODS THAT MAY REQUIRE MORE REFINING OR A SUBSTITUTION
The following are examples of foods that may require additional, careful thought regarding how best to achieve and maintain the right consistency and texture for the person following a mechanical soft diet. Or, the food must be substituted. Click here to access our Food Substitutions For Mechanical Soft Diets overview.
1. Which Level—1, 2 or 3 for this individual? Which thickness for this individual?
2. Which equipment will help accomplish the desired consistency?
3. Which liquid to add, if any, for smoothness, nutrition and flavor?
4. Is it possible to achieve the appropriate consistency and texture with this food?
5. Does it stay the appropriate consistency and texture throughout the meal or is it necessary to refine again (and again) before continuing to serve?
• Complex foods with different ingredients in combination such as in casseroles, wraps, tacos, burritos, sandwiches, etc. (often helpful to refine foods separately and omit those not appropriate for specific diet level—1, 2 or 3)
• Bread, toast and bread-like products (choose soft and no seeds/no crust)
• Cheese (often helpful to substitute) (can harden as the meal goes on)
• Pasta with chunky sauce (substitute with non-chunky sauce)
• Dense, thick pastas (substitute with whole wheat egg noodles)
• Rice (often helpful to substitute)
• Corn (often helpful to substitute)
• Peas (often helpful to substitute)
• Whole beans (mash, use refried and/or puree with liquid)
• Raw fruits (depending on the fruit, may choose to substitute)
• Raw vegetables (depending on the vegetable, may choose to substitute)
• Lettuce (often helpful to substitute)
• Fatty deli meats such as salami and pepperoni (must substitute)
• Dense meats such as poultry, pork, beef and some seafood and fish
• Hot dogs/sausage with skin/casing (must substitute with skinless)
• Popcorn (must substitute another snack)
• Dried fruits & nuts (must substitute)
• Peanut butter (must substitute)
• Cookies (choose soft with no candy or nuts)
• Hard or chewy candy (must substitute)
MOISTURIZING & FLAVORING
Adding liquid and some carefully selected ingredients to refine foods for a mechanical soft diet accomplishes two equally important goals.
1. The food is moisturized, which helps create a smooth consistency that makes it easier to swallow and is in line with the health care professional’s guideline regarding thickness of liquids for the individual.
2. The food becomes more flavorful, so that it is more appetizing and enjoyable.
The list below includes liquids that can be used to both moisturize and flavor foods for a person following a mechanical soft diet. It is important to pay attention to taste; just pouring in a bunch of chicken broth all the time isn’t an appetizing solution even though it makes the food moist. Remember: Thinner isn’t always better, and if it doesn’t taste good to you, it probably won’t taste good to the person eating the refined food.
Using warm liquids to break down starchy, dense and bread-like products can be very helpful. You can heat liquids in the microwave oven before using equipment (such as a blender or food processor) to refine foods according to the diet level, Level 1, 2 or 3.
Pay close attention to nutrition facts and choose low-sodium and low-fat versions when possible for any foods/liquids used in the mechanical soft diet. Be especially mindful about adding sodium, fat and calories—poor nutrition sometimes lurks in what you add to foods. Consult the health care professional regarding calorie intake requirements, since some individuals will need to lose weight and some will need to gain weight.
Chicken or Beef or Vegetable Broth; low-sodium
You can use broth from a can or make it from bouillon cubes. We (My25!) also have a recipe for a no-sodium vegetable broth that can be made from scratch. Broth is best when heated. You can make up a batch of broth and freeze it in ice cube trays to defrost, warm and use as needed, since this is a useful and flavorful moisturizer that will be used frequently.
Canned Soups; low-sodium
Soups that don’t have large vegetable or meat chunks (cream of mushroom, cream of chicken and cream of tomato might be appropriate choices for a number of individuals, as an example) can add good flavor to vegetables and meats. Canned soups taste best when directions on the can are followed (if directions indicate adding water, add water) and when heated.
Available in jars or dried in a packet (add water), gravy adds a creaminess to the consistency of meats, potatoes, and pasta, while adding lip-smacking taste. Best when heated.
Salad Dressings; low-sodium, low-fat
Salad dressings are available in a variety of flavors and are versatile enough that they can be used to add moisture and flavor to meats, pasta or vegetables. Avoid seeds and overly tangy.
Soy Sauce or Teriyaki Sauce or BBQ Sauce; low-sodium
Added to meats, vegetables and pastas, soy sauce adds a new, flavorful twist to a meal.
Squeeze of a Lemon, Lime or Orange
A hint of citrus can add a big taste punch, while adding enough liquid to fish, ground poultry or fruits and vegetables to make them delicious. Just be careful that you don’t make the food taste too sour with too much of a squeeze! And make sure none of the seeds end up in your food.
Fruit Juices; 100%
A little bit of V-8, tomato, orange, pineapple, or apple juice can add zest to pasta, poultry, other meats, vegetables and fruits.
Juice From Canned Fruits & Vegetables
A little bit of the liquid from canned fruits and vegetables can be added to a variety of foods to add flavor and moistness.
Milk, in the right combination, makes foods—such as macaroni and cheese and mashed potatoes—deliciously creamy and easier to swallow.
A variety of zero-calorie Crystal Light beverage options can elevate the taste of vegetables, cereals, pastas and even chicken and pork.
While water won’t add flavor, it will help to moisten foods and also cut down on any overpowering flavor you might have added (such as too much lemon juice)
Other Flavoring Ingredients
Remember that a mechanical soft diet doesn’t necessarily restrict a diet beyond texture (but steer clear of overly spicy foods). This means that you often have a lot of choice when it comes to ingredients that add flavor.
Thoroughly mix in spices and other flavor enhancers to make meats, pasta, potatoes, vegetables, and fruits more appetizing. A pinch, dash or smidgen does the trick—in other words, a little goes a long way. Be mindful about adding sodium, fat and calorie ingredients— poor nutrition sometimes lurks in what you add to foods.
Salt and pepper
Soft cheeses that melt into the food
Jam (without seeds) or jelly; low-sugar
Maple syrup; lite or watered down
Honey; a little bit or watered down
Hummus; may need to be watered down with the squeeze of a lemon