Texture-modified foods and nutrition; your most common questions answered

What is the texture modified diet?  
Foods and/or fluids that have been prepared in a way to create a certain texture or consistency are called ‘texture modified’.  When one eats these regularly, it is called a texture modified diet.  

People who require this special diet are typically those who suffer from a condition called dysphagia. Which is when the muscles and nerves in the mouth weaken, causing difficulties like coughing, choking and gagging when trying to swallow food or drinks.  

Why are texture modified foods needed?  
Texture modified foods are required when individuals suffer from swallowing issues including dysphagia. By adopting a texture modified diet, those suffering swallowing issues are able to continue to enjoy food and drink in a way that doesn’t put them at risk of choking, malnutrition and dehydration.  

In consultation with a speech pathologist, residents within aged care homes who have co-existing health conditions that worsens their dysphagia, can greatly benefit from a texture modified diet. These health conditions include: 

• Age-related muscle loss 
• Neurological conditions like dementia 
• Cancer 
• Head/neck operations 
• Stroke 

When foods are well presented, this diet is a positive step towards making eating and drinking fun again for aged care residents living with dysphagia and other underlying health conditions.  

How to present texture-modified foods?  
One of the biggest challenges when taking care of those suffering from dysphagia is being able to prepare meals safely while making them both nutritious and taste like real food.  

Some of the commonly shared tips include: 

• Focus on high-protein, high-energy meals. 
• Use a mould and moulding powder to form puree and mince into shapes that are easily recognisable.  
• Consider foods that naturally have IDDSI levels. Many foods are Level 4 - 6, therefore it is recommended to use them appropriately rather than creating unnecessary purees.  
• Create sauces and flavour combinations in the same way you would when eating and preparing a normal meal.  

Do texture modified meals need to be prepared with silicone moulds?   
It is not a necessity to prepare texture modified foods with moulds, however it can be useful. Moulds give catering staff, chefs and cooks the ability to reform purees and minces that have been naturally fortified with real ingredients, into easily identifiable shapes that residents will recognise, want to eat and meet their nutritional requirements.  

Plating the moulded foods is essential to improving the overall appeal of the meal. Best practice indicates that sauces should be served on the side, so they don’t overwhelm and overpower the mealtime experience. However, as mealtimes is often one of the few daily pleasures that residents look forward to, staff should engage with residents to better understand their culture, preferences and foods that they enjoy eating. This will ensure that they can serve nutritious and tasty meals that meet each resident’s needs and preferences.  

How to fortify texture modified meals?  
Older people need a higher volume of nutrients, particularly calcium and protein. To meet these nutritional requirements catering staff, chefs and cooks need a well-planned menu that includes foods the residents like but also incorporate all the food groups and nutrients that they need.  

A texture modified diet will limit resident's options, and when their appetite is poor, they can struggle to eat the wide variety of foods they used to. To combat this catering staff, chefs and cooks can fortify texture modified foods to boost resident's nutrient intake. For example:  

• Adding milk, egg, milk powder, grated cheese and legume powders to meals can help to boost protein within the small amount of food that is consumed.  
• Using full-fat dairy foods to boost protein.  
• Offering preferred foods, for instance, if a resident has refused the main course but likes desserts, offer them two desserts instead.