When medical conditions make eating difficult, the consistency and texture of foods can be altered so patients can eat more easily. A texture-modified diet designed by their health care team helps patients receive adequate nutrition and reduces their risk of choking on or aspirating foods or liquids.
Reasons for Texture-Modified Diets
Trouble swallowing, called dysphagia, is the chief reason medical professionals recommend texture-modified diets for their patients. More than 50 per cent of nursing home residents have some degree of dysphagia, according to registered dietitian Becky Dorner. Among the causes of dysphagia are neurological disorders, Alzheimer's disease, muscular and vascular disease and chronic heartburn, according to doctors at Cedars-Sinai Medical Center, who note that although dysphagia is most common in the elderly, it can occur at any age. Missing teeth or conditions affecting jaw movement also contribute to the need for texture-modified diets.
Types of Modifications
Doctors, speech pathologists, nutritionists and dietitians work together to tailor food modifications to fit individual patients' ability to chew and swallow. Soft food is cut into small, easily chewed pieces, minced into tiny pieces that require little chewing or blended or food processed into lump-free purées. Hard, chewy and fibrous foods are excluded. Because some patients choke on thin, watery liquids, thickeners are added to make them more easily swallowed.
Problems With Texture-Modified Diets
Agents used to thin or thicken foods or drinks can weaken their flavour and change their aroma. That, combined with dramatic changes in accustomed texture and appearance, may make food unappealing to the patient, leading to reduced caloric intake and undesired weight loss. A 2005 study at a hospital in London showed a group of elderly patients on a texture-modified diet consumed significantly fewer calories and less protein than a group of elderly patients eating a normal hospital diet.
Providing a variety of foods of different flavours, aromas, temperatures and colours is important in helping patients retain their enjoyment of food and mealtimes. Serving typical meal courses of salad, main dish, side dish and dessert, and keeping foods separate on the plate help patients better associate them with their unmodified counterparts. When patients' appetite is low, calorie and protein boosters mixed with foods increase their nutritional value without a large increase in volume.
- National Association Directors of Nursing Administration; A Practical Approach to Nutritional Care of Dysphagia; Becky Dorner; 2005
- Cedars-Sinai Medical Center: Dysphagia
- Disability Services Division Victorian Government Dept of Human Services: Good Food for All
- "Journal of Human Nutrition and Dietetics"; Comparison of Energy and Protein Intakes of Older People Consuming a Texture-Modified Diet With a Normal Hospital Diet; L. Wright et al.; June 2005
- University of Florida Institute of Food and Agricultural Sciences; Modifying Food Texture for an Older Adult; Wendy J. Dahl; October 2008