Eating Guide for Puréed Diets

You may have to follow a puréed diet if you are having trouble chewing or swallowing. A puréed food diet is a texture-modified diet that can be useful for people with dysphagia, gastroparesis, or chewing difficulties. If you’re on a puréed diet, you will eat foods that you will not need to breakdown when you chew. All puree consistencies are much like mashed potatoes and pudding. You can make almost any meal or snack into a purée by simply blending it with a little extra liquid, such as juice, water, or broth and add a recommended thickening agent if needed.

Some common reasons a person may need to use a puréed diet include:

Oral, dental issues and/or surgery, jaw injury or surgery
Difficulty eating or swallowing problems (dysphagia) caused by a stroke, Parkinson's disease, Alzheimer's disease, ALS, MS, other neurological conditions as well as other trauma injuries.
Digestive disorders or Bariatric surgery
Infection, injury, to the mouth, throat, or esophagus
Head or neck radiation treatment for cancer
Feeding of older adults (especially if they have poor teeth or a form of dementia)

Most people only stay on a puréed diet until they can get therapy, recover and return to eating solid food. However, the diet can also be a long-term solution if you cannot tolerate or manage eating solid foods at all.

How do I know what is puree?

Pureed foods do not need chewing. They are completely smooth with no lumps, skins, strings or seeds. It is usually eaten with a spoon and holds its shape on the spoon. Make sure you have the right equipment to prepare food. A food processor works best to properly puree foods. If you don’t have one, use a good blender or hand mixer instead. Choose foods that puree easily and avoid foods that are stringy, like celery and onions; foods with nuts or seeds; and foods with tough outer skins. Take out any pits, bones, seeds, skins, or other tough inedible parts before you puree your food.

This handout includes a list of foods that puree very well, but some foods do not puree well. These include breads, cakes, cookies, muffins, biscuits, or other crumbly foods. Instead, they can be softened and thickened using a slurry mixture that helps food stick together. Gelatin can be used to slurry foods. You can use flavored or unflavored gelatins depending on what food you want to slurry.

Slurry Recipe: Dissolve 1 tablespoon gelatin in 2 cups of liquid. Do not chill or let solidify. Pour over food and allow to set for 15 minutes or until completely softened and mashable.
Thickeners: thicken items up by adding more food, dried potato flakes, gelatin, flour, or a commercial thickener such as Simply Thick. www.simplythick.com

Puréed meal ideas

Main meals

Soups. Consider lentil, split pea, and pumpkin, butternut squash, tomato, and white bean soup. Simply prepare them as usual, then blend them with a hand mixer. Add a thickening agent if needed.
Pasta. You can purée any of your favorites, such as spaghetti, macaroni and cheese, or penne. Cook them as you normally would, add a little extra water or sauce, and blend the dish until it’s fully puréed. Add tomato sauce.
Scrambles. Scrambled eggs or scrambled tofu work well, too. Blend them with a veggie broth.
Meat or veggie stews. Ratatouille, lentil dahl, and black bean stew are great options. Prepare as per the usual recipe, then blend them into a pudding-like consistency. Thin them with a little extra water or sauce if needed.
Meats. cooked meats, fish and chicken can be pureed. To cook the meat, it is best to slow cook for flavor flavor –braise, boil, slow cook, or pressure cook. Refrigerate for at least 2 hours, Chop into 1-inch pieces, Put a cup of meat into your food processor or blender. Blend the meat until it’s fine and powder, almost like sand and then add ½ cup of water, meat broth, or reserved cooking liquid per cup of meat. Add ¼ teaspoon salt and ½ teaspoon of spices of your choice to 1 cup of pureed meat. Save in refrigerate for 3-4 days. Or freeze it.
Cooked breakfast cereal. Examples include cream of wheat, cooked breakfast quinoa, or oatmeal. Blend them with a nut butter and milk. Top with puréed fruit.
Baked goods. You can try blending French toast, pancakes, muffins, or bread with milk.

Sides

Mashed potato. Make this with white, sweet, or red potatoes, using milk, butter, or margarine to soften it. You can serve it with melted cheese (dairy or plant-based) or mixed with other puréed vegetables.
Blended vegetables. Examples include corn, carrots, turnips, broccoli, cauliflower, red peppers, and mushrooms. Cook as per usual and blend them with a little vegetable broth.
Baked beans and peas. Baked black beans, chickpeas, or red kidney beans are great options. Blend them with a little water, tahini, oil, tomato sauce, or vegetable broth.
Leafy vegetables such as spinach, kale, or collards are all healthy choices. Chop in small pieces and boil them in a little vegetable broth. Blend them until smooth and thicken with potato flakes, as needed.
Homemade sauces. These are great, especially more satisfying sauces, such as pesto, hummus, gravy, or peanut sauce. Thicken them with potato starch or arrowroot powder or gel thickener, if needed.

Snacks

Yogurt.
Fruit smoothies.
Puddings. Consider both homemade and store-bought options.

Eating Out

Eat at restaurants that offer a variety of foods and that will cater to people on special diets.

Many places will purée or prepare foods for your needs. Call ahead and speak to a manager or chef. You may be surprised at how helpful they will be. You may also want to order sides of broth, gravy, or milk to moisten your foods.

Add more calories to your diet

If you need to eat more calories, here are some easy tips:

Add calories with milk/half & half, margarine/butter, gravies, jellies, syrups, powdered milk or any other calorie and protein enhancers.
Eat small meals 6 to 8 times a day instead of 3 main meals.
Add canned coconut milk or cream to smoothies, shakes, cereals, or yogurts for extra calories.
Choose creamy soups, add puree cooked eggs to your soups
Have puddings and custards
Add sauces, gravies, or extra vegetable oil to your meals.
Drink fruit shakes or fruit smoothies made with yogurt.
Drink high-calorie drinks, such as milkshakes, soy milkshakes, or pasteurized eggnog.
Drink a liquid nutritional supplement, such as Ensure or Boost, add thickener to maintain appropriate thickness.
Add honey or maple syrup to smoothies, tea, yogurt, hot cereals, shakes, or ice cream.
If you aren’t on a low-fat diet, add sour cream, half and half, heavy cream, or whole milk to your foods. You can add it to mashed potatoes, sauces, gravies, cereals, soups, and casseroles.
Add mayonnaise, sour cream or cheese to your eggs, chicken, tuna, pasta, or potatoes to make a smooth.
Blend frozen fruit with milk and add thickener as needed. For extra nutrients, add protein powder, bananas, ground nuts (grind nuts with a coffee grinder), or even leafy greens, or avocados. Sieve to remove skins and seeds, and add pectin to thicken, if needed. Add nut butters, such as peanut butter, plain Greek yogurt, non-fat dried milk powder, protein powder to shakes and smoothies.

Make Puree Pizazz!

Garnishes to add color and taste:

Paprika
Whipped cream
Cinnamon sugar mixture
Jelly
Honey
Maple syrup
Parmesan cheese
Hollandaise sauce
Chocolate syrup
Butterscotch syrup
Carmel syrup
Brown sugar
Bar BQ sauce
Cranberry sauce can be piped through a pastry bag to use as a garnish
Fruit sauces or salad dressings
Gravy, catsup, mustard, mayonnaise, and/or cheese sauce

Sell it!

Serve on China or colorful plates
Contrast colors of foods
Garnish for visual appeal and taste
Gravies and sauces
Use pastry bags for appearance and contrasting colors
Shape and mold food to close to normal shape as possible

Resources:

Puree cookbooks - You can find a number of Puree cookbooks for people with dysphagia:

Essential Puree offers a number of cookbooks under $20
The Soft Foods for Easier Eating Cookbook - Written by nutritionists Sandra Woodruff and Leah Gilbert-Henderson. Each recipe is marked for the level and contains nutritional information.
Easy-to-Swallow, Easy-to-Chew Cookbook - Written by nutritionist Donna Weihofen and speech-language pathologists JoAnne Robbins and Paula Sullivan This cookbook includes more than 150 recipes marked for level: “easy to chew”, “very easy to chew”, or “soft and smooth”. Some recipes give instructions for different levels. Each recipe contains nutritional information.
Simply Thick has a variety of fun recipes on their website at www.simplythick.com

Purchasing pureed food

Gourmet Pureed sells 14 pureed meals through Mom’s Meals. Meals have to be refrigerated.
Blossom Foods was developed by speech-language pathologist Sue Adams. The company sells 18 frozen pureed meals Recipes were developed by a Swiss chef, Juerg Aeschbach. Meals are shipped frozen.
Hormel offers Thick & Easy Pureed Meals that don’t require refrigeration.
Phagia sells pureed mixes for fruit, vegetables, pasta, and bread products.
Smoothe Foods sells eight 6-oz pureed vegetarian meals that are shipped frozen overnight in the US.
Simple Serve sells canned pureed beef, chicken, ham, pork, and turkey.
Thick-It offers canned pureed meals for sale, which can be purchased in pharmacies (may have to order), online, or by phone.
Dysphagia Diets carries a complete line of dysphagia friendly products that can be delivered directly to you home. www.Dysphagia-diets.com