What to eat with swallowing difficulties after a stroke
After a stroke, it is very common for individuals to experience difficulties in their swallowing abilities. This is medically known as dysphagia.
This guide offers advice on where to seek help and what foods you can safely eat depending on your level of swallowing difficulty.
The Stroke Association’s latest report stated that roughly half of all stroke survivors leave hospital with a swallowing difficulty .
Signs of dysphagia can include:
- coughing or choking on food or drink.
- a wet voice or drooling.
- breathlessness or sweating during mealtimes.
If you’re experiencing challenges when swallowing, it’s highly recommended to discuss this with your GP. They will then be able to refer you to a Speech and Language Therapist (SLT). They will assess the quality of your swallow by asking you to try small samples of foods and fluids. In certain cases, you may be required to swallow during a video x-ray for a more detailed assessment.
If you have been diagnosed with dysphagia by an SLT, they may recommend that you modify the consistency of your food and drinks.
 Stroke Association. Stroke statistics. [Internet].2022 [cited 2022 Dec 01]. Available from https://www.stroke.org.uk/what-is-stroke/stroke-statistics
Food texture levels
If you are asked to change the consistency of your food, you may be told to use one of the following texture levels:
- Level 4 Puréed Diet
- Level 5 Minced & Moist Diet
- Level 6 Soft & Bite-Sized Diet
It’s important that you follow these recommendations to ensure that the food you are eating is safe.
If food or fluid is not the correct texture, there is a risk that you could either choke or aspirate. Aspirating is when you inhale food or fluid into your lungs.
Level 4 Puréed Diet
Level 4 Puréed meals should have no lumps. It should be of one consistent texture, meaning that liquid should not separate from solids.
Additionally, these foods should not be able to be poured from a cup. They should fall off a spoon in one single mass when the spoon is tilted.
Some foods that may be naturally appropriate for a Puréed diet include:
- Instant porridge
- Mashed potato (with no lumps)
- Smooth, thick yoghurt
- Thick custard
Some foods that can be more easily puréed at home include:
- Stewed fruit without skins
- Fully mashed banana
- Boiled carrots
- Boiled cauliflower
- Boiled broccoli
- Well cooked pasta (must be blended until smooth with a sauce)
- Soft meat or fish in sauce or gravy
Level 5 Minced & Moist Diet
Minced & Moist meals should be soft, moist and require minimal chewing. Individual food pieces should not exceed 4mm in size. Sauces should be thick enough to combine with these pieces of food and not separate out.
You should be able to scoop and shape food of this texture onto a plate.
Some naturally appropriate foods to eat that can fit these requirements include:
- Porridge or instant porridge
- Tender minced meat
- Mashed fish such as tuna with mayonnaise
- Mashed corned beef hash
- Mashed vegetables such as carrot or swede
- Rice pudding of an appropriate size
- Rice in a thick sauce
Level 6 Soft & Bite-Sized Diet
Soft & Bite-Sized meals should consist of bite-sized pieces that are roughly the size of a thumbnail (1.5cm x 1.5cm). They should be very soft, tender, and moist. There should be no liquids that separate and drip from the food. These pieces should also be easily mashed with a fork or spoon.
Some examples of naturally ‘soft’ foods to eat that can fit these requirements include:
- Bite-sized (1.5cm x 1.5cm) pieces of very tender meat or soft fish
- Well boiled vegetables that are diced
- Scrambled egg
- Mashed Potato
- Rice in a thick sauce
Struggling to prepare foods with the right texture?
It can be technically difficult to make your food the right texture. But people who are unable to do so risk becoming malnourished.
Pre-prepared options can offer a solution to this. The benefits of these include how easy they are to prepare. You just have to pop them in the oven or microwave.
They can also increase the variety of meal options available.
In our recent video, stroke survivor David Jones talk openly about his journey with food. He talks about how quality of life can be improved through good nutrition and appropriately textured meals.
If you are concerned about preparing texture modified meals at home, Wiltshire Farm Foods provides a solution that not only gives you peace of mind but also exceptional convenience and great taste!
Disclaimer: The Stroke Association provides the details of other organisations and apps for information only. Inclusion on My Stroke Guide does not constitute a recommendation or endorsement.