What is the easy chew diet?
The easy chew diet, officially recognized by the International Dysphagia Diet Standardisation Initiative (IDDSI) as Level 7 (Regular Easy to Chew), is a modified texture diet designed for individuals who have trouble with hard or tough foods. It is distinct from other soft diets because it includes normal, everyday foods that are naturally soft or have been cooked to a tender texture. The key characteristic is that food on this diet can be easily mashed or separated using the side of a fork or spoon, requiring only a moderate amount of chewing. This allows people to manage bite sizes safely and consume a wider variety of foods than on more restrictive diets like pureed or minced. The ultimate goal is to maintain or improve nutritional intake and make meals an enjoyable experience for those with chewing difficulties.
Who needs an easy chew diet?
An easy chew diet is recommended for several different groups of people, based on their specific health needs. These can range from temporary issues following a procedure to long-term conditions affecting muscle strength. Some common candidates for this diet include:
- Seniors and individuals with weaker chewing muscles: Age-related changes or muscular weakness can make chewing hard foods tiring and difficult.
- People with dental problems: Individuals with missing teeth, new or poorly fitting dentures, or those recovering from dental surgery can benefit from avoiding crunchy or tough items.
- Individuals recovering from illness: A period of sickness can weaken chewing muscles, and an easy chew diet can be a good intermediate step back to a regular diet.
- Patients with dysphagia (swallowing difficulties): For those with mild to moderate dysphagia, an easy chew diet is sometimes recommended by a speech and language therapist to reduce the risk of choking and manage the process of swallowing.
- People with mouth pain: Conditions like dry mouth, mouth sores, or oral cancer treatment can cause significant discomfort when chewing, making softer foods a more comfortable option.
Foods to eat on an easy chew diet
The easy chew diet includes a wide range of flavorful and nutritious foods that are naturally soft or can be cooked to a tender consistency.
Proteins:
- Soft-cooked or ground meats and poultry, such as meatballs, meatloaf, and tender casseroles.
- Fish, cooked until it flakes easily (e.g., poached, baked).
- Eggs, prepared scrambled, poached, or as a soft omelette.
- Soft cheeses like cottage cheese and ricotta.
- Smooth nut butters, soft beans, or lentils.
Grains:
- Hot cereals like oatmeal and cream of wheat.
- Soft pasta, macaroni and cheese, or rice dishes.
- Moistened bread products, with crusts removed if necessary.
- Pancakes or french toast.
Fruits and Vegetables:
- Soft, ripe fruits like bananas, peeled peaches, and mangoes.
- Canned or stewed fruits (with skins and seeds removed).
- Well-cooked, fork-tender vegetables like carrots, squash, cauliflower, and zucchini.
- Mashed potatoes or the insides of a baked potato.
Dairy and Desserts:
- Yogurt, pudding, and custard.
- Milkshakes and smoothies.
- Soft sponge cakes with cream or custard.
- Ice cream and sherbet.
Foods to avoid on an easy chew diet
On the easy chew diet, the focus is on texture, so many common foods must be avoided to prevent chewing fatigue or choking hazards. This includes:
- Hard, tough, or dry foods: Nuts, raw crunchy vegetables (e.g., carrot, celery), hard cheeses, and hard bread crusts.
- Fibrous or stringy foods: Pineapple, celery, and rhubarb.
- Chewy foods: Toffees, tough meats, dried fruits, marshmallows, and chewing gum.
- Crispy or crunchy foods: Crackling, crispy bacon, crisps, popcorn, and flaky pastry.
- Crumbly foods: Dry cakes, biscuits, and some cereals.
- Sticky or gummy foods: Sticky rice, gelatin, and some cheese chunks.
- Mixed consistency foods: Cereal with milk that doesn't soften well, or soups with chunks of meat that are too firm to chew easily.
Easy chew diet vs. other soft diets
Understanding the differences between modified texture diets is important for ensuring proper and safe nutrition. While the easy chew diet is for those who can chew but may have weaker muscles, other diets are for those with more severe swallowing issues.
| Feature | Easy Chew Diet (IDDSI Level 7) | Mechanical Soft Diet (Dysphagia) | Pureed Diet (Dysphagia) |
|---|---|---|---|
| Chewing Ability | Can chew soft/tender foods without tiring. | Requires some chewing; foods are chopped, ground, or mashed. | Requires little to no chewing; food is blended to a smooth, pudding-like consistency. |
| Food Texture | Soft, tender, and moist foods; no specific size restriction. | Foods are moist and easily form a cohesive bolus. | Smooth and free of lumps, seeds, or skins. |
| Food Preparation | May involve cooking until tender, moistening with sauces or gravy. | Requires food to be cut into small pieces (e.g., less than 1/2 inch). | Requires blending or pureeing to a uniform consistency. |
| Examples | Shepherd's pie, tender casseroles, soft pancakes. | Moist ground meats, soft cooked vegetables diced small. | Cream soups, blended meats, and pureed fruits. |
Tips for preparing easy chew meals
Making meals enjoyable and nutritious on an easy chew diet is all about preparation. Following these tips can make a significant difference in a person's quality of life:
- Moisten with sauces and gravies: Adding moisture can make even naturally soft foods easier to manage. Use gravies, creamy sauces, butter, or broth to soften dishes.
- Use slow cookers and pressure cookers: These methods are excellent for tenderizing meats and vegetables until they become soft and easily digestible.
- Mash and puree: For fruits and vegetables, mashing them with a fork or using a food processor can create a smooth, manageable texture.
- Chop and mince: Cutting food into very small, bite-sized pieces can reduce the effort required for chewing. This is especially helpful for proteins like chicken or beef.
- Fortify foods for extra nutrition: For those with a poor appetite, fortifying meals can help prevent weight loss. Add extra calories and protein by mixing in ingredients like skimmed milk powder, butter, cream, or cheese to soups, sauces, and mashed potatoes.
How to ensure nutritional adequacy
Eating an easy chew diet should not mean a compromise on nutrition. To ensure a balanced intake of nutrients:
- Prioritize protein: Protein is vital for maintaining muscle mass and promoting healing. Incorporate soft protein sources like eggs, poultry, fish, and dairy products into meals.
- Eat small, frequent meals: If appetite is an issue or getting full quickly, eating smaller portions more frequently throughout the day can ensure adequate calorie and nutrient intake.
- Use nutritional supplements: Consider liquid meal replacement shakes like Ensure or Boost, particularly if weight loss is a concern.
- Focus on variety: Eating a wide variety of permitted foods from all food groups—carbohydrates, proteins, fruits, vegetables, and dairy—is key to getting all the necessary vitamins and minerals.
Conclusion
The easy chew diet is a valuable nutritional strategy for individuals who find it difficult or tiring to chew hard, tough, or crunchy foods. By focusing on soft, tender, and moist foods, it helps maintain adequate nutrition while minimizing the risk of complications like choking or unintentional weight loss. With proper preparation techniques, this diet can still be varied and full of flavor, allowing people to enjoy their meals. Consulting with a healthcare professional, such as a doctor, dietitian, or speech and language therapist, is crucial for assessing individual needs and ensuring the diet is implemented safely and effectively. You can find additional resources and testing methods on the official IDDSI website to ensure food safety for this diet.
