Dysphagia diet level 1 (puree diet)

Patient education

• Pureed food is thick, smooth and moist with no lumps.
• It requires no chewing and should be one single consistency.
• It should not separate into a liquid and a solid. It can be prepared with a blender or a food processor.

Bread, cereals, rice, pasta and noodles

Recommended foods

• Smooth, lump-free breakfast cereals (e.g. semolina, pureed oats, porridge, baby rice)
• Pureed pasta or noodles
• Pureed rice
• Smooth lump-free mashed potatoes

Foods to avoid

• Cereals with lumps or large pieces
• All dry cereals
• All bread
• Crackers

Vegetables

Recommended foods

• Peeled, cooked and pureed vegetables

Foods to avoid

• Lumpy mashed vegetables
• All vegetable skins or seeds (remove before blending)

Fruit

Recommended foods

• Peeled, cooked and pureed fruits

Foods to avoid

• Pureed fruit with visible lumps
• Whole dates
• All skins or seeds (removed before blending)

Dairy

Recommended foods

• Lump-free yogurt (e.g. plain or Greek)
• Laban (thickened to the correct consistency)
• Smooth milk-based sauces (e.g. cheese sauce thickened to correct consistency)

Foods to avoid

• Yogurt with lumps, seeds or pieces of fruit
• All solid and semi-solid cheese, including cottage cheese

Meat, fish, poultry, eggs, nuts and legumes

Recommended foods

• Pureed meat, chicken or fish; remove all skin, rind and fat prior to blending (use sauce/ gravy to achieve a thick moist texture - discuss with your Speech and Language Therapist if you are on thickened fluids)
• Soufflés and mousses (e.g. well-blended arseeyah or harees)
• Pureed legumes (baked beans, lentils or chickpeas passed through a sieve prior to serving to make sure there are no husks in the final puree; alternatively you can cook these with a little baking soda)
• Soft silken tofu
• Pureed, scrambled or poached eggs

Foods to avoid

• Minced or partially pureed meats
• Scrambled eggs
• Sticky foods (e.g. pâté or peanut butter)

Desserts

Recommended foods

• Dairy desserts (custards, mousse, instant puddings, muhallabiah, crème caramel)

Foods to avoid

• Desserts with fruit pieces, nuts, seeds, crumble, pastry or non-pureed garnishes

Additional items

Recommended foods

• Soups that have been blended or strained to remove lumps
• Smooth jams, condiments and sauces
• Smooth savory dips

Foods to avoid

• Soup with lumps
• Avoid thin watery soups or broths if on thickened fluids
• Jams and condiments with seeds, pulps or lumps

What do I do if I feel I am losing weight?

• Fortify foods to make them higher in calories or protein by adding extra butter, oil or sugar
• Add mayonnaise, labneh, cream cheese or milk powder to foods
• Choose high calorie cooking methods by adding oil or cream or butter
• Drink high calorie drinks such as milk, laban, juice, smoothies, milkshakes or karak tea (thickened to the right consistency if you are on thickened fluids)
• Tea, water and coffee have no calories or protein, choose them less frequently