Menu ideas for a soft mushy crispy diet (stage 3) Information for patients Sheffield Dietetics
Introduction This booklet is designed to help ensure you choose correctly textured food when you are at stage 3 (soft/mushy/crispy) of the diet following your bariatric (weight loss) surgery. At stage 3 of the diet you are ready to move on from pureed foods to more textured foods. This does not mean normal, solid foods; your body is adjusting after your surgery and you must be careful not to rush to start normal, solid foods which are too textured at this stage. What does a soft, mushy, crispy diet mean? This means that most of your foods will be soft or mashed in texture. Crispy foods are foods which will fall apart in water, such as Melba toast, crisp breads and bread sticks. They are not the same as crunchy foods such as raw vegetables and salad. Vegetables should be cooked until soft; remove any skins. Meats should be slow cooked, casseroled or stewed. There are lots of examples of foods to try at this stage of the diet further on in this leaflet. Soft, mushy, crispy foods should be: Soft, tender, well cooked and moist but need some chewing Able to be mashed with a fork Meat needs to be soft and tender, or finely minced It usually requires a thick, smooth low fat sauce or gravy to help get the right texture page 2 of 8
What foods should I avoid at this stage of the diet? Baby food should be avoided as although the texture is suitable, these foods do not provide enough important nutrients for adults. Caution: Foods to be avoided These foods should be avoided at this stage of the diet. They are only to be included once you are well established at the final stage of the diet, stage 4 (normal, solid foods), and are tolerating a wide variety of foods. Non-toasted bread, particularly soft, white, doughy bread Pasta, unless small shapes with plenty of sauce, cooked until very soft Rice, unless risotto rice Tough, dry meat, particularly steak, chops, barbequed meat and meats with skin, such as sausages Skins and husks from potatoes, vegetables and fruits, such as sweetcorn, peppers and jacket potatoes Stringy vegetables and fruits, such as green beans, celery, lettuce, and pineapple Mushrooms Pips, seeds and piths from fruit and vegetables Nuts Dried fruit page 3 of 8
Soft, mushy, crispy diet plan Most people can still only manage between 2-5 tablespoons (tbsp) of food at meal times. This menu plan is intended as a guide only. Remember if foods are chosen that aren t on this plan, you must ensure that they are soft, mushy or crispy! Breakfast ½ - 1 slice wholemeal toast (no crust) and scraping of margarine with 1 very soft scrambled egg or baked beans Or - Soft fruit such as a ripe banana, or melon with low fat yoghurt or fromage frais Or - Rice Krispies, Weetabix, Corn Flakes (fully softened with skimmed or semi-skimmed milk) Or - Porridge with skimmed or semi-skimmed milk (could add soft fruit for sweetness) Mid-morning ½ - 1 small low fat yogurt with soft fruits (such as raspberries, strawberries, melon, mango) Lunch Flaked fish in a sauce or minced meat or slow cooked casseroled meat, tinned meat such as stewed beef, or wafer thin meat with mashed potato and softly cooked vegetables Or - A small matchbox size of low fat/reduced fat cheese with 2 cream crackers Or - ½ tin soup, such as bean/lentil/meat varieties with vegetables page 4 of 8
Or - ½ - 1 slice wholemeal toast with beans or cheese or scrambled egg or tinned fish without bones (not in oil) Or - Tinned macaroni cheese or ravioli or Bolognese Or - 2 crackers or 2 crisp breads or 2 cream crackers with suitable topping, such as tuna with low fat mayonnaise or egg with low fat mayonnaise or grated low fat cheese or low fat cream cheese or low fat cottage cheese Mid-afternoon Glass (200mls) of skimmed or semi-skimmed milk Dinner ½ - 1 slice toast or 2 crackers or 2 crisp breads with light cream cheese or houmous, meat or fish paste or 1-2 tbsp cottage cheese Or - 1 soft boiled egg with 2 cream crackers or 2 crisp breads Or - 1 small jacket potato (no skin) with tinned tuna in light salad cream / mayonnaise or baked beans or low fat cheese Or - 1 oven baked fish cake or 2 fish fingers with chopped tinned tomatoes or mushy peas or baked beans Or - Egg omelette with grated cheese and chopped tinned tomatoes Or - Minced meat or poultry with gravy, mashed potatoes and softly cooked vegetables Or - Beef stew with cous cous or mashed potato and mushy peas Or - Cottage pie with mushy peas Or - Flaked fish in parsley sauce with mashed sweet potato and softly cooked vegetables page 5 of 8
Or - Lasagne with softly cooked vegetables Or - Cauliflower cheese Supper Stewed fruit such as apples, or soft raw fruit (for example banana, strawberries, melon, tinned peaches, ripe pears without skins, pips or seeds) Drinks Aim for 2000ml of fluid a day; this can include water, tea or coffee with sweeteners and low fat milk, low sugar squash or low fat milk. Remember not to drink 30 minutes before or after a meal. Carry a bottle of fluid with you and sip fluids throughout the day. If you are well hydrated it can improve symptoms such as tiredness, hunger, constipation, and headaches. Multivitamins and medications Once you have established that you can eat stage 3 foods without any problems, begin changing your liquid / dissolvable medications over to tablet forms. If you are on a lot of medications please do this gradually. You should also switch from a chewable multivitamin to an A-Z multivitamin and mineral in tablet form as these are more complete in vitamins and minerals than chewable form. Take two per day lifelong. page 6 of 8
What should I do if I have had problems trying new foods at stage 3 of the diet? If you have problems with pain, discomfort, or vomiting it is important that you try to identify the reasons why, as this can help you make changes to avoid the same thing happening in the future. Ask yourself: Did I eat too quickly or not chew my food well enough? Did I over-eat? Did I take fluids with a meal, or too close to a meal time? Did I try a food that was too textured at this stage? Remember, foods at this stage must be soft, mushy or crispy in texture. When do I move onto stage 4? After your operation, it should take you between 3 and 6 months to be able to start eating a variety of solid foods. At this point you should be able to eat up to a tea plate sized portion. Including solid foods in your diet is important, as these help you to feel fuller for longer and will help to encourage further weight loss or weight maintenance. Refer to your surgery dietary booklet for more information on stage 4 of the diet. page 7 of 8
Name:... Specialist Dietitian for Weight Loss Surgery: 0114 226 9083 Clinical Nurse Specialist for Weight Loss Surgery: 0114 226 9083 Produced with support from Sheffield Hospitals Charity Working together we can help local patients feel even better To donate visit www.sheffieldhospitalscharity.org.uk Registered Charity No 1169762 Alternative formats can be available on request. Please email: alternativeformats@sth.nhs.uk Sheffield Teaching Hospitals NHS Foundation Trust 2018 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No.1515. Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. Email infogov@sth.nhs.uk PD8086-PIL3402 v3 Issue Date: January 2017. Review Date: January 2020