What to Eat When You Have Trouble Swallowing
When Diane Wolff's 85-year-old mother was diagnosed with a swallowing disorder in 2010, the prognosis see-med dismal, at least when it came to diet. "Everything had to be pureed, and I couldn't find anything ready-made for her that tasted good. It was institutional, like dog food," Wolff remembers. But pureed food was the only option, as it is for many people with swallowing disorders.
- Mild dysphagia requires only that a person avoids very hard, sticky or crunchy foods (like pretzels, apples or marshmallows) and takes small bites.
- Moderate dysphagia requires soft, moist textures that are easier to push to the back of the throat. "Chewing can be fatiguing when the muscles are weak. Therefore, moist foods are easier to swallow," Schaude says. Those types of foods include cereals softened in milk, ground meat softened in sauce, cooked fruits and vegetables without skins or seeds, fish and casseroles.
- Severe dysphagia may require pureed food. "It's a pudding-like texture that's easier to hold in the mouth and swallow," Schaude explains. "You have to avoid raw, course textures that require you to chew and manipulate the food." Just about any type of food can be pureed in a food processor or blender, as long as a small amount of liquid is added to it.
Dysphagia Diet Challenges
Sticking to a dysphagia diet can have a negative effect on quality of life. "Eating is cultural," Schaude points out. "Gatherings often center on food, drink and socializing with others. When patients can't eat the same food, there can be an emotional component with negative outcomes. People with dysphagia may develop depres-sion, socialize less, eat less and feel they've lost their independence."
Loss of interest in food and social withdrawal are common, Schaude notes, when pureed (often bland) food is necessary.
Wolff knew the risks for her mother. As her caregiver, she took on cooking duties from day one. "I wanted to get variety and flavor into her so she didn't feel like she was stuck eating oatmeal for the rest of her life," Wolff says.
But keeping pureed food flavorful wasn't easy. "It's basic food chemistry," Wolff says. "When you puree it you're increasing the surface area of the food, so it loses flavor."
Another breakthrough came when Wolff realized the secret to keeping dishes flavorful was in the liquid you add to it. "Sauce is the medium of flavor. If you're blending cooked fish," she explains, "you put it in the food processor and slowly add a little lemon butter sauce and then add thickener, until there's a pudding consis-tency."
Other discoveries:
- Fibrous or stringy foods, such as turkey thighs, don't puree well.
- Steaming vegetables and pressure-cooking rice keeps them moist, more flavorful and full of nutrition when later pureeing them.
- Allowing diners to see the cooked food before it's pureed and take in the aroma of the foods helps engage the senses and add to the enjoyment of the meal.