Why Might a Pureed Diet be Needed
None of us usually have a second thought about the eating and drinking process, as much of it is controlled by the autonomic system, like breathing. But when you break down the process of biting, chewing, mixing with saliva, forming a ball (bolus) of the food and moving it to the back of the mouth and then safely down the throat past the entrance to the lungs (trachea) there is really a lot involved. If there is an injury to the mouth or tongue, or disruption to the messages being sent from the brain to the mouth and throat, then this process can cause some safety issues, namely bits of food, drink or saliva could go into the lungs, leading to infections (pneumonia). If the cough reflex isn't working well, then any stray bits can't be stopped from entering the lungs. This is when a pureed diet is needed.
Pureed diets are when foods, and possibly liquids too, are made into a uniform texture as this is easier for the person to control in their eating process and get it into the stomach safely. There can be 3 textures to the pureed diet advised by the Speech and Language Therapists depending on the individual,. If the swallow or cough reflex isn't safe, then they will need to receive all their nutrition via a tube, but that is a whole other topic 😉
A pureed diet sounds simple but there are some associated problems.
When food is all the same texture, it can lose a lot of it's visual attraction from what is 'normal'. This can put people off from eating well. Also, it is tempting to puree the foods together but then they go the same colour - brown! The thought that we 'eat with our eyes' is very true and taking away the structure of the foods in their normal state is quite disconcerting.
We mustn't underestimate how good a variety of colours and textures are in a normal diet. Following a pureed diet can get boring very quickly and make meal times something to dread or avoid.
Low in Calories
Due to getting bored or put off by the same texture, eating enough energy and nutrients from the food is tricky. Also, it can be hard to puree some foods, limiting some foods. See the next section for tips to improve the nutritional content of some foods below.
Here are some tips to follow should you be following a pureed diet and need to increase your intake:
- Eat little and often, aiming for 6 meals/snacks
- Add energy quickly using healthier plant oils/fats such as olive oil, peanut oil and avocados more often than animal fats such as butter, cream or coconut oil (an unusual plant oil in that it is saturated like animal fats)
- Aim for creamy soups and milky drinks/desserts
- Add cream cheese, cooked eggs, skimmed milk powder or powdered nuts to boost protein
- Supplement drinks like Ensure, or Boost either via your GP or over the counter at a Pharmacy can help add protein and calories
- Keep up with fruit and vegetables to help keep food moving well through the body, so smoothies can be useful. Some puree down better than others
- Puree foods separately and use moulds to shape each part separately to make it look more appealing
- See a Dietitian to give you more support and individual advice
At IDH Training we want to support carers as well as the individuals with these difficult needs, so if you care for someone needing a special diet, such as a pureed diet, we can offer high quality, flexible training for you or your staff.