High risk foods for people with swallowing difficulties
Eating and drinking should feel safe, comfortable and enjoyable. However, for people with swallowing difficulties, some foods can increase the risk of choking or food going down the wrong way.
High risk foods can be especially difficult to clear from the mouth and also from the throat (pharynx). This can result in food dropping into the voice box (larynx) and windpipe (trachea) causing coughing or choking. If food gets into the lung via your windpipe, it can cause an infection.
Simple adaptations and avoiding foods causing difficulty can reduce the risk and may be sufficient to manage early swallowing difficulties.
Examples of high risk foods
Stringy, fibrous textures
For example, pineapple, runner beans, celery, lettuce, steak which is dry.
Vegetable and fruit skins including beans
For example, broad, baked or soya beans, peas including black-eye beans, grapes, tomato skins.
This also includes skins on sausages.
Mixed consistency foods
For example, cereals that do not blend with milk such as muesli, mince with thin gravy or soup with lumps.
Crunchy foods
For example, toast, flaky pastry, dry biscuits, crisps.
Crumbly foods
For example, bread crusts, pie crusts, crumble topping, dry biscuits.
Hard foods
For example, boiled or chewy sweets and toffees, nuts and seeds, crispy bacon.
Husks
For example, sweetcorn and granary bread.
Meal ideas that avoid high risk foods
- Porridge
- Weetabix
- Ready Brek
- Cereals softened with milk (avoiding cereals that do not soften or blend with milk, for example, muesli)
- Scrambled eggs or omelette with cheese or soft vegetables
- Yoghurt
- Sweet pancakes
- Croissant
- Fish pie (with mashed potato topping), fish in sauce (no batter) or fish cakes
- Casseroles or stew
- Shepherd’s pie
- Corned beef hash
- Pasta: well cooked (for example, gnocchi, ravioli, lasagne, spaghetti bolognaise, macaroni cheese)
- Corn beef hash
- Polenta
- Moussaka (vegetarian option, for example, quorn or lentil based)
- Curries: no husks, well cooked vegetables (for example, lentil based (dahl), chicken, vegetable, fish)
- Cauliflower cheese
- Bakes (no husks, well cooked vegetables)
- Omelette or frittata
- Flan
- Burgers: no tough outer (vegetarian option, for example, quorn)
- Meat balls, soft, no hard outer (vegetarian option, for example, quorn)
- Chips (soft outer)
- Yorkshire pudding
- Savoury pancake
- Potato waffle
- Souffle
- Jacket potato (insides only)
- Tinned fish (for example, tuna, salmon, mixed with mayonnaise or salad cream)
- Sandwiches with soft fillings (for example, cheese, egg or tuna mayonnaise using soft bread rolls or with the crusts removed)
- Soft potatoes (mashed, boiled, or fried or roasted if not too crispy or hard, add gravy or sauce if needed)
- Softly boiled vegetables without the skins (for example, carrots, turnips, parsnips, cauliflower, courgettes, beetroot, mushy peas)
Remember to remove any excess juice or thicken it. If vegetables look at all hard, gently mash before serving.
- Gravy
- White sauce, parsley sauce
- Mayonnaise, salad cream, dips, sour cream
- Houmous, guacamole
- Tomato ketchup, brown sauce
- Banana
- Fresh or tinned soft fruits, for example, mango, strawberries, melon
- Stewed hard fruits with skins removed and excess juice drained (for example, rhubarb, apple)
- Milk puddings (for example, rice pudding, semolina, tapioca)
- Blancmange
- Jelly
- Custard or egg custard (insides)
- Crème caramel
- Trifle
- Plain sponge with cream or custard
- Chocolate mousse or soft chocolate bars with no bits (for example, Milkyway, fondants)
- Biscuits soaked in milk, coffee, tea
- Scotch pancakes
- Smoothies
