Advice after your nerve block for surgery
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What is ‘Easy to Chew’ diet?
You may be advised to have a Level 7 Easy to Chew diet if you have problems with your dentition, swallowing or oesophagus (‘food-pipe’). Easy to Chew food may be used if you have strong enough chewing ability to break down soft/tender foods into pieces without help. This texture may be right for you if you usually choose to eat soft food and have weaker chewing muscles for hard/firm textures but can chew soft/tender food without tiring too easily.
Easy to Chew
- Normal everyday foods of soft/tender texture
- Do not use foods that are: hard, tough, chewy, fibrous, have stringy textures, pips/seeds, bones or gristle
- You should be able to ‘bite off’ pieces of soft and tender food and choose bite-sizes that are safe to chew and swallow
- You should be able to chew pieces of soft and tender food, so they are safe to swallow without tiring easily
- Your tongue should be able to move food for chewing and apply pressure until the food is soft and moist enough to be easily swallowed
How to prepare an Easy to Chew meal
Meat is cooked until tender. If you cannot serve soft and tender, serve as minced and moist.
Fish is cooked until soft enough to break apart easily with the side of a fork/spoon.
Fruits are soft enough to break apart into smaller pieces with the side of a fork or spoon with skins removed. If advised to have thickened fluids avoid fruit with high water content, where the juice separates from the solid in the mouth during chewing, e.g. watermelon, melons, oranges.
Vegetables are steamed or boiled until tender. Stir fried vegetables may be too firm for this level.
Cereal is served after being soaked in milk to enable it to soften. Drain any excess liquid before serving.
Sandwiches with soft fillings are ok unless you have been advised against bread/sandwiches by your Speech & Language Therapist, if this is the case do not eat these. See ‘meal suggestions’ for further advice.
No: hard, tough, chewy, stringy, dry, crispy or crunchy bits
No: Pips, seeds, skins or husks
No: Floppy foods, e.g. lettuce, spinach cucumber
Not everything needs to be prepared from scratch - many different convenience foods can be used.
You can purchase ready-made Level 7 Easy to Chew meals from suitable companies, e.g. Wiltshire Farm Foods have an ‘Extra Tender’ range. https://
Maximum Nutrition to help maintain weight
If you have problems chewing or swallowing, or are unable to eat ordinary solid food for any other reason, it can be difficult to achieve a balanced diet. However, your body still needs just as much nourishment. It is important to maximise your nutrient intake, especially protein and energy.
How to make everyday foods more nutritious
Fortified Milk
- Add 2-4 tablespoons of dried milk powder to a pint of full fat milk*.
- Keep in the fridge and use in drinks and cooking.
- Use milk or evaporated milk in place of water in soups, jellies, puddings and bed-time drinks.
Breakfast Cereals
- Use fortified milk– (recipe above)
- Sprinkle an extra spoonful of sugar* on top
- Add cream/ double cream*, evaporated milk, syrup or honey to porridge
Cereals need to be soaked in milk until soft. If you are on thickened fluids avoid mixed consistencies, e.g. un-thickened milk in cereal.
Soups
Add one or more of the following:
- Cream or double cream* / Fortified milk
- Milk powder / Grated cheese
- Extra meat or pulses, e.g. lentils
- Soft cooked rice/pasta/mashed potato
Mashed Potato
Add one or more of the following:
- Butter or spread* / Grated cheese
- Cream* / Fortified milk
Vegetables
Melt butter or spread on top of vegetables or sprinkle with grated cheese or chopped hard-boiled egg, add milk or cream based sauces*.
Puddings
Add one or more of the following:
- Cream or double cream* / Custard
- Sugar / Honey / Syrup* / Jam*
- Evaporated milk / Condensed milk*
Avoid ‘diet’ and ‘low fat‘ yoghurts and desserts, and choose ‘thick and creamy’ or ‘full fat’ instead.*
Nourishing Drinks
- Whenever you do not feel like eating, have a nourishing drink.
- High protein drinks can be bought from most chemists, e.g. Build-Up, Meritene or Complan and are available in a variety of flavours.
- Try adding your own ingredients such as Crusha Syrup, pureed fruit, mashed banana, drinking chocolate* to natural/vanilla flavoured drinks.
- Prepare home-made shakes using fortified milk and, e.g. ice cream, cream*, banana or honey*.
- Drinking chocolate*, malted drinks and cocoa made with full-fat* or fortified milk.
- Have nourishing drinks between meals rather than at mealtime to prevent filling up on fluid.
If you need thickened fluids, make sure your drinks, sauces and soups are the correct consistency as advised by your Speech and language therapist. Avoid foods that turn to liquid in the mouth, e.g. ice cream, jelly.
If you are concerned about your food /fluid intake, are experiencing symptoms such as constipation/ weight loss or require more information on appropriate meal ideas or recipes, please speak to your dietitian.
Meal Suggestions
Breakfast
- Weetabix, porridge, ReadyBrek
- Scrambled, poached or boiled eggs, omelette
- Yoghurt
- Preserved fruit (stewed apples, tinned peaches – drain juice if on thickened fluids)
- Soft fresh fruit (bananas, ripe pears)
- Pancakes with butter* or maple syrup
- Baked beans with bread (no crusts)
- Skinless sausages*, tinned tomatoes
Main Meals
- Well cooked vegetables – fresh, frozen, tinned (e.g. broccoli, cauliflower, potato, carrot)
- Potato, sweet potato, yams, plantain, (no skin/crusts) – mash with milk and butter*
- Steamed/baked/poached fish with extra sauce
- Flaked fish (e.g. tuna) with extra sauce/mayo
- Braised, stewed or roasted tender meat, finely chopped with extra sauce
- Minced meat (chicken, pork, lamb, beef) with extra gravy/sauce
- Fish or shepherd’s pie with soft filling
- Corned beef hash
- Vegetable curry
- Lentil dhal
- Soft pasta with sauce, macaroni cheese, lasagne
- Skinless sausages*
- Eggs – scrambled, boiled, omelette (plain or cheese)
- Small, very soft chips in gravy
- Ripe avocado with mayonnaise
- Quiche (no crusts)
- Cauliflower cheese
- Spaghetti bolognaise
- Dumplings soaked in dhal, e.g. channa or moong. Lentils should be cooked until soft and mashed down with margarine*, ghee* or gravy
Desserts
- Crème caramel*
- Yoghurt, blancmange, mousse (full fat varieties*)
- Trifle*
- Arctic roll*
- Custard or baked custard
- Creamed rice or tapioca (made with fortified milk and cream*)
- Moist steamed puddings
- Sponge cakes
- Stewed, tinned or soft fresh fruit (no skins or hard dry fruit) with cream*/ full- fat yoghurt *
- Jelly/ice-cream**
** If a person is recommended to be on thickened fluids, these items may not suitable as they melt to a thinner liquid consistency in the mouth.
Light Meals and Snacks
- Soups (thickened if necessary)
- Tinned spaghetti or spaghetti hoops
- Soft pasta filled with meat or vegetables (e.g. ravioli)
- Jacket potato (discard skins) mixed with cheese/tuna/baked beans/ cream and butter
- Omelettes
- Blended fruit drinks or supplements
- Smooth dips such as hummus or avocado
- Biscuits dunked in tea or fortified milk/ full fat milk*
- Cottage Cheese
* If you’ve had a stroke, heart attack or have diabetes, these foods may not be suitable as part of your everyday diet. Please contact a Dietitian for more advice.
Sandwiches
You may be advised against bread/sandwiches by your Speech & Language Therapist, if this is the case, do not eat these.
If you have not been advised against sandwiches, ensure the following:
- Ensure the bread is soft and fresh
- Remove the crusts of the sandwich, and cut it into small pieces
- Use plenty of butter and plenty of filling
- Have a filling that is moist, such as:
- Tinned tuna and mayonnaise
- Boiled eggs, mashed well with mayonnaise
- Cream*/soft cheese
- Jam/Marmalade*
- Meat or fish spreads/pastes, e.g. paté
AVOID Salad ingredients such as lettuce, cucumber or tomato. Crusty rolls or multigrain bread
How do I test my food to make sure it is Level 7 Easy to Chew?
Foods should be able to be cut or broken apart with the side of a fork or spoon. It is then safest to test Regular Easy to Chew food using the IDDSI Fork Pressure test.
Good Feeding Practices
People who experience difficulty swallowing may require extra help when eating and drinking to ensure that food and drink go down the right way. Below is a list of helpful tips to encourage safe eating and drinking.
Alertness
- Eat and drink when most alert
- If eating and drinking is tiring try to eat smaller but more frequent meals, a ‘little and often approach’ with appropriate snacks between meals
Positioning
- Ensure sitting fully upright when eating and drinking (i.e. at 90o)
- Stay sitting upright for 30 minutes after eating and drinking
- Encourage sitting out in a chair for meals if possible, with hips well back and feet flat on the floor
- If eating and drinking in bed use pillows to support upright sitting if necessary
Oral Care
- Ensure mouth is kept clean and moist
- Ensure dentures are put in before eating
- When you have finished eating, clean mouth and dentures and remove any food residue remaining in the mouth
Environment
- Ensure you can concentrate on eating and drinking and are not distracted by the television, radio or conversation
- If feeding somebody, sit at the same level as them and make eye contact when feeding them
Food
- Explain what the food is and be positive about it
- Make meals look appetising
- Do not mix entire meal together, serve meat, vegetables, carbohydrates separately on the plate
- Make sure your mouth is clear of food and drink before taking the next mouthful. You may need to swallow more than once to clear each mouthful
- Try to keep meals warm if they take a while to eat
Feeding
- Feed yourself where possible
- If self-feeding is not possible, try to support the person to feed themselves using hand over hand assistance
- Small mouthfuls of food/drink are better than large mouthfuls
- Allow plenty of time to swallow
- If you become tired, take regular breaks
- If impulsive - try cutting up the food into small pieces or only offering small volumes of food or fluid at once
- Try to avoid using beaker lids and straws as they encourage fluids to travel more quickly through the mouth, potentially reducing control over them and resulting in higher risk of aspiration. Only use them if absolutely necessary
Patients with Other Health Conditions
If you have other health conditions such as diabetes, food allergies, high cholesterol, high blood pressure etc. the information within this leaflet may not be suitable. Please contact your Dietitian if you need any further information.
Eating Out
If you are eating out, let the restaurant know in advance that you have special requirements –
most places will be happy to help
Additional Notes
Soft food/easy chew cookbooks are available on amazon.co.uk
High Risk Foods
|
Food characteristics to AVOID |
Examples of foods to AVOID |
|
Mixed thick and thin textures |
soup with pieces, cereal with milk |
|
Hard or dry food |
nuts, raw vegetables, dry cakes, bread, dry cereal |
|
Tough or fibrous foods |
steak, pineapple, non-tender meat |
|
Chewy |
sweets, cheese chunks, chewing gum, dry/sticky foods |
|
Crispy |
crackling, crispy bacon, cornflakes |
|
Crunchy food |
raw carrot, raw apple, popcorn |
|
Sharp or spiky |
corn chips and crisps |
|
Crumbly bits |
dry cake, dry biscuits |
|
Pips, seeds |
apple seeds, pumpkin seeds |
|
Food with skins or outer shell |
peas, grapes, chicken skin, salmon skin, sausage skin, oranges |
|
Foods with husks |
corn, shredded wheat, bran |
|
Bone or gristle |
meat/fish bones, meat with gristle |
|
Sticky or gummy food |
nut butter, overcooked porridge |
|
Stringy food |
beans, rhubarb, lettuce |
|
Floppy foods |
lettuce, cucumber, raw spinach |
|
Crust formed during cooking or heating |
cheese topping, crusty mashed potato |
|
Juicy food |
where juice separates from the food piece in the mouth, for example watermelon, grapes |
Reference
The International Dysphagia Diet Standardisation Initiative 2019 https://
Contact us
If you have any queries relating to this information, please contact the Speech and language therapy service.
About this information
Service:
Speech and language therapy
Reference:
VV/012
Approval date:
20 September 2024
Review date:
1 July 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.