Each year, individuals of all ages all around the world are diagnosed with feeding or swallowing difficulties (dysphagia). Put simply, dysphagia can be described as difficulty moving food, liquid, saliva or medication from the mouth to the stomach.
The consequences of dysphagia include dehydration, malnutrition, aspiration and asphyxiation, and a negative impact on quality of life and social participation in eating and drinking. IDDSI (International Dysphagia Diet Standardisation Initiative) suggests that over 590 million people worldwide are currently living with Dysphagia.
Dysphagia touches individuals across their life span, but it is most prevalent at the end of life, with the elderly being most affected. Although people are sometimes unaware of the disorder, dysphagia is a widespread clinical condition as it affects more than 30% of patients with stroke, 60–80% of patients with neurodegenerative diseases, 10–30% of adults aged 65 and older, and more than 51% of elderly residents living in care settings.
Due to difficulties with swallowing normally, and the high risk of aspiration or food and drink entering the lungs, people who display any signs of Dysphagia, such as coughing or choking on food, should be referred to a SLT (Speech and Language Therapist) who will assess them and recommend appropriate texture-modified drinks and meals of a specific consistency that are safest and easiest for the individual to swallow. It is essential that the entire meal meets the recommended texture standards -not just part of the meal.
In recent years, IDDSI have developed The IDDSI Framework to describe food textures and drink thicknesses to improve safety for individuals with swallowing difficulties.
Level 4 of the food framework is a puree diet which is designed to minimise the amount of chewing of food required for people who have trouble chewing and swallowing normal texture foods.
A puree diet:
- Should have the same taste, look and nutritional value as a normal texture diet.
- Should be presented at mealtimes as separate food items, not blended together.
- Requires a blender or food processor (and possibly a strainer) to achieve a smooth, thick, lump-free texture.
- Must meet daily dietary requirements.
- Can be made up of small, nutritionally fortified, frequent meals to ensure nutritional adequacy is achieved.
Characteristics of a puree diet
Particle size: Puree food is completely smooth and lump-free, and feels smooth (without lumps) when tasted (similar in consistency to a commercial pudding).
Moisture: Solids and liquids do not separate.
Stickiness: Food will hold shape on a spoon but must pour/slide off if spoon is tilted or lightly shaken.
Softness: No chewing or biting is required. Solids and liquids are one. No lumps observed.
Presentation of a puree diet
It is paramount to ensure that pureed food always looks appetising and is attractively presented. We all eat with our eyes first, so improving meal presentation with colour and contrast on the plate for everyone, regardless of their condition, ensures that nobody feels isolated or treated differently.
It is common for people with a Dementia to refuse to eat what they cannot recognise.
The use of food molds is becoming increasingly popular to recreate the original shapes of pureed foods as family members and care caterers understand the key benefits:
- Improved meal presentation and nutrition
- Increased dignity at mealtimes
- Greater meal variety
- Reduced preparation time ad wastage
Shaping up pureed meals in 5 easy steps
Step 1: Puree
Place cooked food in a food processor and puree until a smooth, thick, lump-free consistency is achieved.
Step 2: Thicken
Add a small amount of food thickener to the puree to ensure the food can retain its new shape when it is removed from the mold and is reheated. Look for a puree mixture consistency which will hold shape on a spoon but pours/slides off if spoon is tilted or lightly shaken.
Step 3: Mold
Using a spatula, evenly distribute the puree into the individual mold cavities. Cover the molds with the mold lid and place in the freezer to set for a minimum of 4 hours. NB: to save space, frozen molded food portions can be placed in suitable freezer bags, logged and labelled in accordance with HACCP requirements.
Step 4: Present
Once frozen, remove the individual food portions from the mold onto a plate. Cover and allow to thaw in the fridge.
Step 5: Heat and Serve
Cover molded meal with heatproof cover to retain moisture and reheat to 75 degrees (minimum heat requirement) using one of the following methods in order of suitability:
Regeneration oven/trolley
Bain Marie
Combi steam oven
Oven
Food molds are available in 13 styles, enabling you to make a large variety of pureed meals.
Richard Edwards of ’Outstanding’-rated The Close Care Home told us how food molds have transformed mealtimes for his residents on pureed diets:
"The puree food molds have been a revelation in the home for residents on a puree diet. Nobody ever wants to be on a puree diet, but with the molds we can restore the dignity in eating by giving a well-balanced meal for puree diets in an appetising and visually stimulating way. Many visitors to the home have no idea the meals are pureed for some residents."
Nutritious Puree Food Recipes
All recipes have been created and tested by a health care professional (R.M. BSc Nutrition and Food Science, Grad Dip Dietetics).
Delicious Pork Stroganoff
Mold Type - Pork Chop
Yield- 8 portions (110g / 4oz each)
Ingredients:
- Vegetable oil 1 tblspn
- Garlic purée 1 tspn
- Sliced onions 100g / 3 ½ oz
- Carrots 100g / 3 ½ oz
- Diced pork 300g / 10 ½ oz
- Sage (dried) 1 tspn
- Chicken or vegetable stock 800ml / 1 1/3 pints
- Chopped mixed peppers 80g / 3oz
- Mushrooms (thin sliced) 80g / 3oz
- Mixed seasoning
- Cooking cream 100ml / 3 ½ fl oz
- Thickener
Method
Heat the oil in a saucepan, gently sweat the onions, carrots and garlic, and cook for a couple of minutes
- Add the diced pork and sage, stir in well, and cook for a further 10 minutes
- Add the stock, stir in well to allow even distribution. Cover the pan with a lid and simmer for 1 hour, stirring occasionally
- Add the peppers and mushrooms and simmer for a further 25 minutes, or until all the ingredients are tender. Leave uncovered, and allow the cooking liquid to reduce by two-thirds
- Add the cream and season to taste
- Remove from the heat
- Allow to cool slightly, decant meal into blender and blend completely to a smooth purée that is smooth and lump-free
- Slowly add small amount of thickener, so as not to over thicken the mixture. Blend in thoroughly until the mixture reaches a firm consistency that will hold on a spoon inverted/retain its texture when forked.
Molding
Once the mix has reached the correct consistency, spread mixture into a Silicone Puree Food Mold. Once cavities have been filled, cover with lid and then place in freezer.
Heat & Serve
Once frozen, take mold tray out of freezer. Turn mold tray over and apply gentle pressure to release frozen food from mold. Place frozen food directly onto plate and allow to thaw in fridge. Prior to heating, cover plated food appropriately to prevent molded food from drying out e.g metal plate cover, insulated plate cover, heat-proof polycarbonate lid. Reheat molded food on plate to desired temperature. Serve.
Nutrient Per Serve Energy 710kJ Protein 11.5g Total Fat 10.7g Carbohydrate 7.3g Dietary Fibre 1g Sodium 405mg
Hearty Irish Stew
Mold Type - Sirloin Steak
Yield- 4-5 portions (100g / 4oz each)
Ingredients:
- Vegetable oil 1 tblspn
- Diced onions 100g / 3 ½ oz
- Diced vegetables (carrots and swede) 200g / 7 oz
- Diced lamb 300g / 10 ½ oz
- Beef or lamb stock 800ml / 1 ½ pints
- Fresh diced leeks 70g / 2 ½ oz
- Shredded green cabbage 70g / 2 ½ oz
- Diced potatoes 150g / 5 ½ oz
- Fresh parsley 50g / 2 oz
- Mixed seasoning
- Thickener
Method
- Heat the oil in a large saucepan, gently sweat the onions, and cook for a couple of minutes
- Add the mixed vegetables, stir in well and cook for a further 10 minutes
- Add the diced lamb and seal with the onions and vegetables
- Add the stock, stirring continuously
- Bring to the boil, then reduce to a simmer and cook for approx. 60 minutes
- Add the diced potatoes, leeks and shredded cabbage, cook for a further 30 minutes until all the ingredients are tender
- Remove from the heat, and season to taste
- Allow to cool slightly, decant meal into blender and blend completely to a smooth purée that is lump-free
- Slowly add small amounts of thickener, so as not to over-thicken the mixture. Blend in thoroughly until the mixture reaches a firm consistency that will hold on a spoon inverted/retain its texture when forked.
Molding
Once the mix has reached the correct consistency, spread mixture into a Silicone Puree Food Mold. Once cavities have been filled, cover with lid and then place in freezer.
Heat & Serve
Once frozen, take mold tray out of freezer. Turn mold tray over and apply gentle pressure to release frozen food from mold. Place frozen food directly onto plate and allow to thaw in fridge. Prior to heating, cover plated food appropriately to prevent molded food from drying out e.g. metal plate cover, insulated plate cover, heat-proof polycarbonate lid. Reheat molded food on plate to desired temperature. Serve.
Nutrient Per Serve Energy 712kJ Protein 12g Total Fat 8.9g Carbohydrate 10.6g Dietary Fibre 2.2g Sodium 410mg
Mild Chicken Curry
Mold Type - Chicken Mold
Yield- 8 portions (80g / 3 oz each)
Ingredients
- Vegetable oil 1 tblspn
- Diced onions 50g / 2 oz
- Garlic purée 1 tspn
- Diced chicken breast 300g / 10 ½ oz
- Curry powder 1 tblspn
- Diced potatoes 150g / 5 ½ oz
- Tomato paste 1 tblspn
- Chicken stock 300ml / ½ pint
- Coconut milk 100ml / 3 ½ fl oz
- Tinned chopped tomatoes 400g / 14oz
- Mixed seasoning
- Thickener
Method
- Heat the oil in a saucepan, gently sweat the onions and garlic, and cook for a couple of minutes
- Increase the heat and add the diced chicken. Stir in until the flesh starts to firm up and cook
- Add the curry powder, stir in, and cook for a further 5 minutes
- Add the chicken stock, coconut milk and chopped tomatoes, simmer for 30-40 minutes
- Add the diced potatoes and tomato paste, bring to the boil and reduce the sauce whilst stirring constantly. Ensure that the ingredients do not stick to the base of the pan
- Remove from the heat, and season to taste
- Allow to cool slightly, decant meal into blender and blend completely to a smooth purée that is smooth and lump-free
- Slowly add small amount so thickener, so as not to over thicken the mixture. Blend in thoroughly until the mixture reaches a firm consistency that will hold on a spoon inverted/retain its texture when forked
Molding
Once the mix has reached the correct consistency, spread mixture into a Silicone Puree Food Mold. Once cavities have been filled, cover with lid and then place in freezer.
Heat & Serve
Once frozen, take mold tray out of freezer. Turn mold tray over and apply gentle pressure to release frozen food from mold. Place frozen food directly onto plate and allow to thaw in fridge. Prior to heating, cover plated food appropriately to prevent molded food from drying out e.g. metal plate cover, insulated plate cover, heat-proof polycarbonate lid. Reheat molded food on plate to desired temperature. Serve.
Nutrient Per Serve Energy 635kJ Protein 11.3g Total Fat 7.5g Carbohydrate 9.6g Dietary Fibre 1.3g Sodium 70mg
Seasoned Chicken and Vegetable Casserole
Mold Type - Chicken Mold
Yield- 8 portions (80g / 3 oz each)
Ingredients
- Vegetable oil 1 tblspn
- Diced onions 50g / 2 oz
- Diced mixed vegetables (Carrot and swede) 150g / 5 ½ oz
- Diced chicken 350g / 12 ½ oz
- Tarragon (dried) 1 tspn
- Diced potatoes 100g 12 oz
- Tomato paste 1 tblspn
- Chicken stock 500ml / 18 fl oz
- Mixed seasoning
- Thickener
Method
- Heat the oil in a saucepan, gently sweat the onions and diced mixed vegetables, and cook for 5 minutes
- Increase the heat and add the diced chicken and tarragon, stir in until the flesh starts to firm up and cook
- Add the chicken stock, diced potatoes and tomato purée, bring to the boil, and then reduce the heat to a simmer. Cook for 30-40 minutes until all the ingredients are soft
- Reduce the sauce whilst stirring constantly. Ensure that the ingredients do not stick to the base of the pan. If the sauce becomes too thick, add a little hot chicken stock before blending
- Remove from the heat, and season to taste
- Allow to cool slightly, decant meal into blender and blend completely to a smooth purée that is smooth and lump-free
- Slowly add small amount of thickener so as not to over-thicken the mixture. Blend in thoroughly until the mixture reaches a firm consistency that will hold on a spoon inverted/retain its texture when forked
Molding
Once the mix has reached the correct consistency, spread mixture into a Silicone Puree Food Mold. Once cavities have been filled, cover with lid and then place in freezer.
Heat & Serve
Once frozen take mold tray out of freezer. Turn mold tray over and apply gentle pressure to release frozen food from mold. Place frozen food directly onto plate and allow to thaw in fridge. Prior to heating, cover plated food appropriately to prevent molded food from drying out e.g. insulated plate cover, heat-proof polycarbonate lid. Reheat molded food on plate to desired temperature. Serve.
Nutrient Per Serve Energy 565kJ Protein 12.4g Total Fat 5.8g Carbohydrate 8.3g Dietary Fibre 1g Sodium 296mg
FREQUENTLY ASKED QUESTIONS
What are your puree food molds made from?
Beware of cheap and poor quality imitations!!
Our Silicone Puree Food Molds are made from top quality 3mm thick 100% food grade certified silicone rubber.
Are the puree food molds dishwasher-safe?
Yes, all food molds are dishwasher-safe making cleaning a breeze.
Are the puree food molds oven-safe?
The Silicone Puree Food Molds are safe for use in all types of ovens and microwaves up to a temperature of 465°F or 230°C.
What is the average lifespan of the food molds?
With correct use and cleaning the silicone food molds can last up to 40 years of daily use.
Can puree food molds ONLY be used in cook fresh catering systems?
No. Our molds have been successfully implemented into cook fresh, cook freeze and cook chill catering systems.
Does molding puree food take more time?
No - using puree food molds will actually save you time. Consider all the time you spend cooking and preparing puree food every day, plus the time spent cleaning the blender numerous times in one day each time you want to puree a different food. Using food molds, you may only have to prepare puree food once a week! By preparing puree food in larger batches, placing them in the food molds and freezing them for later use, there is a significant reduction in time spent preparing puree meals, and cleaning the food blender multiple times afterwards!
How do I ensure I get the best food mold results every time?
When you're ready to use molded food simply pop the frozen molded food items directly onto a plate - exactly as you would like it presented as a meal - cover with cling wrap or plate cover and allow to thaw in the fridge overnight. The next day, simply cover the molded meal with a heat-proof lid and re-heat in a Burlodge style retherm system, a combi oven (steam/heat) or in a Bain Marie.
Why do some molded puree foods not keep their shape when heated?
Due to the unique properties of different foods (water content, molecular structure) some puree foods molded may not keep their shape as well as others when reheated. For this reason, be very careful how much fluid is added to the blender when preparing the puree mixture to ensure the right consistency before placing into the molds. It is also important to always add a sufficient amount of food thickener.
To download our FREE Easy 5 Step Guide to pureeing meals please click here.
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