Level 4 Puree food
| What is extremely thick pureed food? | |
| Smooth
|
Smooth and moist
No lumps or bits (from skins, shells, husks etc) Liquid must not separate from puree Not sticky No hard pieces such as a crust or skin have formed during cooking or standing |
| Thick
|
Cannot be drunk from a cup
Cannot be sucked through a straw Any fluid on the plate is as thick as the puree |
| No chewing
|
Does not require biting or chewing |
| Holds its shape
|
Can be piped, layered or moulded
Falls off a spoon in a single spoonful when tilted Continues to hold it’s shape on the plate Can’t be poured (but can show some very slow movement when tilted) Does not ‘spread out’ if spilled |
| Sits on a fork | Can be eaten with a fork because it doesn’t drip through
Usually eaten with a spoon |
| How to test Level extremely thick puree | |
| Fork pressure test
|
Fork prongs make a clear pattern on surface
Sits in a pile on the fork, a small amount may drip through but doesn’t flow or drip continuously |
| Spoon tilt test
|
Holds its shape on the spoon
A full spoonful tilts off the spoon, should slide off easily e.g. should not be sticky or firm Little food left on the spoon |
Tips for presentation
- Puree each food separately so that the food can keep its colour and taste
- Do not puree a whole meal together as it looks less appetizing
- Pureed food can be put on the plate with an ice-cream scoop, piping it or using food moulds so that it looks more tasty
How to make pureed food
Food can be pureed using a blender, liquidiser or food processor.
General advice:
- Cut food into small chunks before blending
- Always puree dry foods (e.g. meat) with extra liquid such as gravy, milk or stock (try to avoid water as this dilutes the nutritional value).
- Remove tough skins and large seeds before blending.
- If available/necessary, add thickening powder when blending to achieve correct consistency
- Check tub instructions/ask SLT for advice if adding thickener (as some thickeners cannot be added to foods after they have been blended).
Main Course
The look of puree food is important…
- Each food should be pureed separately so there are individual portions of each food on the plate.
- Never puree a whole meal together.
- If available, food moulds may be used to improve the appearance of the food on the plate.
Different types of food and how to puree:
Vegetables, potatoes and soups
- Puree steamed or boiled vegetables. Add extra liquid as necessary, such as milk or cheese sauce.
- All types of potatoes can be pureed. If liquid is needed, add warm milk, butter or sour cream.
- Pureed soups can contain vegetables, noodles or meat. Add thickening powder as required (remember to check instructions for adding thickener).
Pasta and Rice
- Puree using warm milk and butter.
Fruits
- Always remove the stones, core or tough skins before blend-ing
- Use the tinned juices or fruit juice as extra liquid
- Add thickening powder as appropriate to maintain texture.
Desserts
- Many desserts are smooth and do not need pureeing e.g. custard, semolina, chocolate mousse, yoghurt.
Meat and fish
Puree meat on its own to a smooth pate before adding any liquid, to avoid a grainy texture. Gradually add liquid to the blender. You could try:
- Beef– add gravy or horseradish sauce or fruit juices
- Chicken-add gravy or cream sauce or fruit juices
- Ham-add pineapple or fruit juices
- Pork-add gravy or apple sauce or apple juice
- Fish-add cheese sauce or white sauce or tartar sauce
If you need to increase the thickness you can add thicken-ing powder, mashed potato or bread crumbs.
What do you need to do?
Share this information with anyone who supports you or any staff you work with.
Continue modifying your food texture as you currently do
You don’t need a reassessment by a speech and language therapist unless you feel your swallow has changed
Please be aware: This page is intended to give you examples of food that would be suitable for a level 4 diet. It is not intended as a meal planner. Please discuss with your SLT or dietician if you need any further ideas/options.
