MECHANICAL SOFT VS.

MODIFIED MECHANICAL SOFT

DIETS Prepared by:

Emily Cook, OHSU Dietetic Intern

April 2015

DEFINITION

The mechanical soft diet includes any foods that have been mechanically altered to aid in chewing and swallowing

Ways foods are prepared to become mechanically soft include: Chopped

Ground

Pureed

Boiled

Steamed (long enough for food to become soft)

Tools used to mechanically alter the foods include, but are not limited to: Blender ● Potato Masher

Meat grinder ● Fork

Knife

This diet only limits texture and consistencies

PURPOSE OF THESE DIETS

Ensure the patient is safely and successfully

swallowing foods and liquids

Avoid aspiration

Avoid pocketing food

Foods on these diets require little chewing and

are soft in texture

BARIUM SWALLOW STUDY

https://www.youtube.com/watch?v=Ri8bBhw9msQ

IMPORTANT NOTE

These diets can be modified for the individual

patient based on the Speech Pathologist’s

recommendations!

WHEN ARE THESE DIETS PRESCRIBED?

Speech Pathologist (SLP) will come evaluate the

patient

Assist patient in trialing different textures and

thicknesses of foods and liquids

Make recommendations based on the patient’s:

Physical ability to chew

Ability to safely swallow

WHEN DO WE SEE THESE DIETS?

KEY FOODS ALLOWED

Mechanical Soft Modified Mechanical Soft

Meat & Meat

Substitutes Ground and tender-baked meats Ground and tender-baked meats

Eggs Scrambled, poached, or hard boiled Scrambled, poached, or hard boiled

Cheese Cottage and mild cheeses Cottage and mild cheeses

Peanut Butter Smooth Smooth

Lentils and Beans Soft-cooked lentils, beans, peas, tofu

mashed by fork

Soft-cooked lentils, beans, peas, tofu

mashed by fork

Casseroles All soft and moist Soft and moist without stringy veggies

Fruits & Fruit

Juices

All juices. Soft fruits without tough skins

or seeds Fruit approved by SLP

Vegetables &

Vegetable Juice

All Juices. Well-cooked veggies able to be

mashed by fork. Fresh tomato.

Well-cooked veggies able to be mashed by

fork

Breads & Other

Starches

Soft breads including waffles, pancakes,

French toast and muffins. Dry cereals

without dried fruit. Oatmeal. Pasta and

potatoes

Cream of Wheat/Rice. Oatmeal.

Blenderized pancakes, muffins, toast. Soft

pasta, mashed potatoes with gravy.

Desserts Cakes, puddings, Jello, ice cream, cookies Pudding, custard, ice cream, Jello, Katie

whips

Soups All Thickened, strained, cream soups.

FOODS TO AVOID

Mechanical Soft Modified Mechanical Soft

Meat & Meat

Substitutes Meats that aren't ground

Those with stringy, dry, doughy

components

Eggs Fried eggs Fried eggs

Cheese Hard cheeses & cheeses containing

particles that are difficult to chew Hard cheeses & cheeses containing

particles that are difficult to chew

Peanut Butter Crunchy nut butters Crunchy nut butters

Casseroles -- Dry, doughy, crumbly

Fruits & Fruit

Juices Fruits with tough skins or seeds, raw,

hard fresh fruits, dried fruit, coconut Fruits with tough skins, raw, hard fresh

fruits, dried fruit, coconut

Vegetables &

Vegetable Juice

Whole kernel corn/corn on the cob, peas,

lima beans, raw vegetables except fresh

tomato and lettuce as liners for salads

Vegetable juices, peas, lima beans, whole

kernel corn/corn on the cob, spinach,

green beans, cooked greens, celery

Breads & Other

Starches

Hard, crusty breads or rolls, English

muffins, bagels, hard/coarse/dry cereals,

crisply fried potatoes, fried rice, baked

potato with skin

Dry cereals, whole wheat, coarse textured

cereals, breads

Fats & Oils Nuts Nuts, peanut butter, bacon

Desserts Any containing coconut, nuts, or dried

fruit Cake, cookies, pastries, pie, candy

Condiments Whole pickles and pickled vegetables,

coarse pepper, marmalade Pickles, marmalade

Soups Soup containing whole kernel corn or peas Broth, unthickened blenderized soups

SPECIAL CIRCUMSTANCES: MODIFIED

MECHANICAL SOFT

Veggies prepared on this diet in the hospital will

always be pureed

WHEN TO ADD EXTRA SAUCE AND GRAVY?

Most modified mechanical soft foods will be

prepared with added gravy or sauce

Sometimes, SLP will assign the Slick diet in

addition to the soft diets

Patients and providers can always ask for a side

of gravy to be sent on meal trays

LIQUIDS

Thickened liquid consistencies:

Nectar-thick

Honey-thick

Pudding-thick

The thickness of the liquid will be assigned by

the SLP based on the patient’s ability to safely

swallow

Thickness of liquid is at room temperature

Jell-O

Soup

Milkshakes/Ice Cream

QUESTIONS?

Speech Pathologists are now on Vocera!

Feel free to call them with additional questions

during ‘normal business hours’

REFERENCES

Academy of Nutrition and Dietetics. Nutrition Care Manual. Dysphagia level 2: Mechanically Altered.

https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=44. Accessed April 2, 2015.

Academy of Nutrition and Dietetics. Nutrition Care Manual. Head and Neck Cancer Nutrition Therapy.

https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=135. Accessed April 2, 2015.

Academy of Nutrition and Dietetics. Nutrition Care Manual. Mechanically Altered Foods Nutrition Therapy.

https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=40. Accessed April 2, 2015.

Academy of Nutrition and Dietetics. Nutrition Care Manual. Soft Foods Nutrition Therapy.

https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=39]. Accessed April 2, 2015.

Amanda Brown, SLP. Kaiser Sunnyside Medical Center

Aurora Health Care. Mechanical Soft Foods. Version current March 2012. Internet:

http://www.aurorahealthcare.org/fywb_pdfs/x26790.pdf. (accessed 2 April 2015).

KP Diet Manual: Mechanical Soft Diet

KP Diet Manual: Mechanical Soft Diet, Modified

KP Diet Manual: Slick Diet

KP PolicyTech: Inpatient Evaluation of Speech, Language, Cognitive, and/or Swallowing Skills

Jackson Siegelbaum Gastroenterology. Jackson, FW. Soft and Mechanical Soft Diet. Internet:

http://gicare.com/diets/soft-and-mechanical-soft-diet/. (accessed 2 April 2015).

Memorial Sloan Kettering Cancer Center. Patient Education: Eating Guide for Pureed and Mechanical Soft Diets.

Version current 1 March 2013. Internet: http://www.mskcc.org/cancer-care/patient-education/resources/eating-guide-

pureed-and-mechanical-soft-diets. (accessed 2 April 2015).

Wikipedia, The Free Encyclopedia. Soft diet. Version current 31 December 2013. Internet:

http://en.wikipedia.org/wiki/Soft_diet. (accessed 2 April 2015).