Soft and Mechanical Soft Diet

Author:  Frank W. Jackson, M.D.

Purpose

The soft diet serves as a transition from liquids to a regular diet for individuals who are recovering from surgery or a long illness. It can help to ease difficulty in chewing and/or swallowing due to dental problems or extreme weakness, and it is sometimes recommended to relieve mild intestinal or stomach discomfort. The soft diet can be especially helpful to patients who are undergoing treatments like chemotherapy, or radiation to the head, neck or abdominal areas, which may cause digestive problems or make the mouth and throat very sore.

The soft diet limits or eliminates foods that are hard to chew and swallow, such as raw fruits and vegetables, chewy breads, and tough meats. In some cases, high-fiber foods like whole-grain breads and cereals and “gas-forming” vegetables like broccoli or cauliflower may be restricted to ease digestion. Fried, greasy foods and highly-seasoned or spicy foods may also be limited for this reason.

Foods may be softened by cooking or mashing. Canned or soft-cooked fruits and vegetables may be used in place of raw or dried varieties. Refined breads and cereals are usually recommended over coarse, whole-grain types. Moist, tender meats, fish, and poultry are permitted; it is not necessary to grind them unless desired. Eating small, frequent meals can help to reduce gas or bloating.

The mechanical soft diet is a close cousin of the soft diet. It gets its name from the fact that household tools and machines, like a blender, meat grinder, or knife, are used to make foods easier to chew and swallow.

In contrast to the soft diet, the mechanical soft diet does not restrict fat, fiber, spices, or seasonings. Only the texture and consistency of foods are changed. Fruits and vegetables may be soft-cooked or pureed. Meats, fish, and poultry can be cooked, ground, and moistened with sauce or gravy to make chewing and swallowing more comfortable. Breads and crackers may be limited at first, as they can be dry and difficult to swallow. Milk and other dairy products like pudding, custard, and smooth yogurt may not need to be changed at all!

The mechanical soft diet is appropriate for patients who are recovering from head, neck, or mouth surgery, who have dysphagia (difficulty swallowing), narrowing of the esophagus (food tube), or who are too ill or weak to chew. The diet also benefits those who have poorly fitting dentures, no teeth, or other dental problems.

Guidelines for the Soft Diet
Food Group Foods Allowed Foods to Avoid
Beverages all none
Soups mildly seasoned broth, bouillon, or cream soup; strained vegetable soup bean, gumbo, split pea, or onion soup; chunky soups or chowders
Meats any moist, tender meats, fish, or poultry (lamb, veal, chicken, turkey, tender beef, liver stewed pork); eggs (see exceptions); creamy peanut butter Fried chicken or fish; fish with bones; shellfish; fried, salted, or smoked meats; sausage; cold cuts; raw or fried eggs; dried beans; nuts and seeds
Dairy all low-fat milk products, smooth yogurt, mild-flavored cheese, cottage cheese (avoid milk if lactose-intolerant), yogurt with nuts or seeds, sharp or strong cheeses, cheeses with whole seeds or spices
Fruits cooked or canned fruit, soft, fresh banana or avocado, fruit juice all raw fruit (except banana or avocado), dried fruit (dates, raisins), coconut
Vegetables soft-cooked or canned vegetables (see exceptions), fresh lettuce or tomato, potatoes (mashed, baked, boiled, or creamed), vegetable gas-forming vegetables (broccoli, Brussels sprouts, cabbage, cauliflower, cucumber, green pepper, onion turnip), whole kernel corn, raw vegetables (excerpt lettuce or tomato), fried vegetables french fries, hash browns
Grains refined cooked or ready-to-eat cereal; refined white, wheat, or rye bread, rolls, or crackers; plain white rice; pasta whole-grain breads and cereals (bran, rye with seeds, or whole wheat); breads or rolls with coconut, raisins, nuts, or seeds
Fats butter, margarine, mild salsas dressing, mayonnaise, gravy, cream, cream substitute, sour cream, vegetable oil Spicy salad dressings, fried foods
Desserts & Sweets smooth ice cream, ice milk, or frozen yogurt; sherbet; fruit ices; custards; puddings; cake or cookies made without nuts or coconut desserts or candy made with dried fruit, nuts, coconut; candied fruit; peanut brittle
Seasonings ketchup; cheese, cream, tomato, or white sauces; soy sauce; chopped or ground leaf herbs garlic, horseradish, chili powder, whole or seed herbs and spices, barbeque or cajun seasonings, worchestershire sauce

Nutrition Facts

Both the soft and mechanical soft diets meet the National Research Council’s Recommended Dietary Allowances (RDAs) for all nutrients. However, if a patient has a poor appetite or is physically unable to eat enough food, either diet may be deficient in calories, protein, vitamins, or minerals. The physician or registered dietitian may recommend nutritional supplements or snacks if this is the case. Consult a professional if either diet is to be combined with other dietary restrictions (e.g. low-sodium diets).

Special Considerations

As one person may tolerate foods that cause discomfort to another, advice for both the soft and mechanical soft diets will vary according to what is appropriate for each individual patient. Guidelines for the soft diet are looser today than they were in the past, especially with regard to the elimination of high-fiber foods like whole grains and vegetables. The mechanical soft diet may also vary according to what textures of food the patient can best chew or swallow. As everyone’s case is different, it is best to get a personalized recommendation on either diet from a physician or registered dietitian.

Sample Menu Soft Diet
Breakfastorange juice – 1/2 cup
oatmeal – 1 cup
whole wheat toast – 2 slices
margarine – 2 tsp
sugar – 1 tsp
whole milk – 1 cup
banana – 1 med
Lunchspaghetti with marinara sauce – 11/2 cups
Italian bread – 2 slices
margarine – 1 tsp
applesauce – 1 cup
grape juice – 1/2 cup
Dinnermarinated chicken breast – 3 oz
grilled zucchini – 1/2 cup
pasta salad – 1/2 cup
whole wheat roll – 1
margarine – 1 tsp
peach cobbler – 1/2 cup
whole milk – 1/2 cup
This Sample Diet Provides the Following
Calories 1940 Fat 53 gm
Protein 72 gm Sodium 1938 mg
Carbohydrates 302 gm Fiber 24 gm
Sample Menu Mechanical Soft Diet
Breakfastorange juice – 1/2 cup
oatmeal – 1 cup
sugar – 1 tsp
banana – 1 med
whole milk – 1 cup
Lunchground spaghetti with ground meat
sauce – 11/2 cups
ground broccoli – 1/2 cup
margarine – 2 tsp
applesauce – 1/2 cup
chocolate pudding – 1/2 cup
chocolate milkshake – 1 cup
Dinnerground chicken breast – 3 oz
ground zucchini – 1/2 cup
margarine – 1 tsp
ground pasta salad – 1/2 cup
vanilla ice cream- 1/2 cup
vanilla milkshake- 1 cup
This Sample Diet Provides the Following
Calories 2043 Fat 61 gm
Protein 81gm Sodium 1584 mg
Carbohydrates 306 gm Fiber 19 gm

© Frank W. Jackson, M.D.