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Department of Veterans Affairs



Back to Basics:
The Minced Diet
In-Service FSW/Cooks




Emily Elliott, Renee Ingalls
Table of Contents
In-Service Training: The Minced Diet .................................................................................................................................... 2

Cheat Sheet: Appropriate Texted Foods for Minced Diet ..................................................................................................... 4

Back to Basics: The Minced Diet ........................................................................................................................................... 5

Back to Basics: The Minced Diet Quiz ................................................................................................................................... 6

Back to Basics: The Minced Diet Quiz Answer Sheet ............................................................................................................ 7




                                                                                    [1]
In-Service Training: The Minced Diet
    Time                                                 Sequence of Events
2:00-2:05pm   Brief Introduction
               Intern Introduction
               Staff Introduction

2:05-2:10pm   Purpose:
               The Minced Diet is not an actual diet; it is a texture modifications used for those who are
                 experiencing swallowing and/or chewing difficulties. It is also used for patients who tend to eat too
                 rapidly. This is determined by a Speech Language Pathologist. This could be as a result of:
                      o Stroke (CVA)
                      o Cancer of the throat/neck/mouth.
                      o Dementia/Alzheimer’s
                      o Age
                      o Generalized weakness
                      o Traumatic brain injury
                      o Poor dentition
                      o Other neurological and/or physiological problems
               Dysphagia is a common medical issue for hospital patients, especially in the VA system. It is the
                 medical term for difficulty swallowing. Symptoms include:
                      o Choking or breathing saliva into lungs while swallowing
                      o Coughing while swallowing
                      o Regurgitating liquid through nose
                      o Breathing in food while swallowing (aspiration)
                      o Weak voice
                      o Chronic heartburn
                      o Sensation of food stuck in throat/chest
                      o Weight loss
               This condition, can lead to life-threatening choking episodes, as well as inhalation of foods. In order
                 for food and liquid to be safely eaten, its texture has to be altered to make it easier to swallow.

                  Question: Have you ever had to modify your diet because of a toothache, surgery, etc? How did you
                  like it? Does anyone have any questions about this diet modification?

2:10-2:25     What applies to Food Service?
               Transition – Now that we have talked a little about why someone would need to be on a minced diet,
                let’s talk a little about what you need to know when preparing the patient’s tray.
               There are 3 key principles to a Minced Diet. They include:
                     o Foods need to be easy to swallow with a minimum of chewing required. They are also
                          modified to prevent obstruction of the airway (“choking”).
                     o Foods must be moist, soft-textured, and can be easily formed into a ball for ease of
                          swallowing (without risk of aspiration).
                                Meats are ground or diced to no larger than ¼” pieces.
                     o All foods from the pureed diet are acceptable at this level.
               Note: It is important to remember that texture modification is separate than the liquid/beverage
                modification. There are many food items on the minced diet that would not be appropriate for a
                patient requiring thickened liquids (i.e. dry cereal with milk, coffee, thin soups, etc.)
               Transition: We just reviewed the main concepts of the Minced Diet that are already incorporated
                into your meal tickets. Now let’s over what you will need to know on your own.
               Pass out and Discuss Cheat Sheet
                                                          [2]
o   Let’s look at it together
                              The chart compiles all foods that are either allowed or not allowed on the meal tray
                                  for a patient on a Minced Diet.
                              Activity: We are going to read off a few different complex menu items. Can you
                                  figure out if they are allowed on this diet? Does anyone have any questions?
2:25-2:30pm   Conclusion:
               Today we learned:
                     o Why somebody would be on a minced diet; what dsyphagia is.
                     o What foods are allowed and what foods may be harmful for somebody with dysphagia.
                          .
               Does anyone have any questions? Thank you for your time!




                                                        [3]
Cheat Sheet:
                                     Appropriate Minced Foods
                      Choose These!                                                      Avoid These

Meat/Meat Alternatives                                             Meat/Meat Alternatives
 Moistened ground or cooked meat, poultry, or fish                 Whole, sliced, or shaved meats such as bacon,
   (serve with sauces or gravy); tofu; moist or mashed                sausage, or hot dogs; peanut butter; hard-cooked or
   beans (like baked or refried); poached, scrambled, or              crisp fried eggs; sandwiches and pizza
   soft-cooked eggs

Breads                                                             Breads
 Soft, well-moistened pancakes; pureed bread mixes or              Slices of bread; toast; any bread with nuts
   slurried breads

Cereals                                                            Cereals
 Cooked cereals with little texture, including oatmeal;            All cereals with whole grain, dried fruit, coconut, nuts,
   Slightly moistened, dry cereals with little texture,               or seeds
   including corn flakes, Rice Krispies, and Wheaties.
   *If patient is on thickened liquids, all liquid needs to be
   absorbed into the cereal.

Fruit                                                              Fruit
 Soft and drained canned or cooked fruits without                  Fresh or frozen fruits; cooked fruit with skin or seeds;
    seeds or skin; and ripe bananas                                    cherries; pineapple

Vegetables                                                         Vegetables
 All soft, well-cooked vegetables that are less than ¼             Cooked corn and peas; tomatoes with seeds; brussels
   inch pieces and are easily mashed with a fork                      sprouts; broccoli; cabbage, asparagus; or other
                                                                      rubbery cooked vegetable

Potatoes/Starches                                                  Potatoes/Starches
 Well-cooked and moistened boiled, baked, shredded,                Potato skins and chips; fried potatoes or French fries;
   or mashed potatoes; hash browns that are not crisp;                rice; plain noodles
   chopped noodles; well-cooked pasta noodles in sauce

Desserts/Sweets                                                    Desserts/Sweets
 Puddings and custards; soft fruit pies (bottom crust              Dry, coarse cakes and cookies; desserts with nuts,
   only); Crisps and cobblers with soft topping and no                seeds, coconut, pineapple, or dried fruit; rice or bread
   seeds; ice cream; sherbet; gelatin; mousse; soft moist             pudding
   cakes with icing or slurried cakes; jam or jelly without
   seeds; syrup; chocolate bars; soft cookies; well-
   moistened cakes

Beverages                                                          Beverages
 All beverages with little texture or pulp                         All beverages with thick texture and pulp




                                                                 [4]
Back to Basics: The Minced Diet

What is the purpose of the Minced Diet?
The Minced Diet is not an actual diet; it is a texture modification used
for those who are experiencing dysphagia. It is also used for patients
who tend to eat too rapidly. This is determined by a Speech Language
 Pathologist. This could be as a result of:

        o   Stroke (CVA)
        o   Cancer of the throat/neck/mouth.
        o   Dementia/Alzheimer’s
        o   Age
        o   Generalized weakness
        o   Traumatic brain injury
        o   Poor dentition
        o   Other neurological and/or physiological problems

What is Dysphagia?
Dysphagia is a common medical issue for hospital patients, especially in the VA system. It is the medical term for
difficulty swallowing. Symptoms include:
         o Choking or breathing saliva into lungs while swallowing
         o Coughing while swallowing
         o Regurgitating liquid through nose
         o Breathing in food while swallowing (aspiration)
         o Weak voice
         o Chronic heartburn
         o Sensation of food stuck in throat/chest
         o Weight loss

 This condition, can lead to life-threatening choking episodes, as well as inhalation of foods. In order for food and
  liquid to be safely eaten, its texture has to be altered to make it easier to swallow.

 It is important to remember that texture modification is separate than the liquid/beverage modification. There are
  many food items on the minced diet that would not be appropriate for a patient requiring thickened liquids (i.e. dry
  cereal with milk, coffee, thin soups, etc.)

What are the texture modifications for the Minced Diet?

     Foods that are soft textured and moist, making them easy to swallow

     Soft, well-cooked foods, and well-moistened ground meats

     Moist and well-cooked potatoes, and noodles

     Nothing larger than ¼ inch in size!

     All foods of a pureed consistency are allowed on this diet.

                                                             [5]
Name: _______________________________________                           Date: _________________



                           Back to Basics: The Minced Diet
                                         Quiz

   1. Which of the following food items would not be appropriate for a Minced Diet?
        a. 1/4” cut chicken breast with gravy
        b. Mashed potatoes
        c. Banana nut bread
        d. Pureed carrots

   2. What is the medical term for difficulty swallowing?
        a. Dyslexia
        b. Jabudy
        c. Iatrogenic
        d. Dysphagia

   3. When would it be inappropriate to provide coffee to a patient on a Minced diet?
        a. When they are on a calorie-restricted diet
        b. When they are on thickened liquids
        c. When they have too much energy already
        d. None of the above

   4. What may happen if a patient who requires a minced textured diet receives a regular
      textured diet?
         a. The patient could choke on larger food pieces
         b. The patient may not be able to chew the food
         c. They may lose weight due to the inability to eat the regular textured food
         d. All of the above

   5. What is the largest acceptable size for a piece of minced beef?
        a. 1/4”
        b. 1/2”
        c. 1/3”
        d. 1/8”



                                                [6]
Name: _______________________________________ Date: _________________


                       Back to Basics: The Minced Diet
                                  Quiz Answer Key

  1. Which of the following food items would not be appropriate for a Minced Diet?
       a. 1/4” cut chicken breast with gravy
       b. Mashed potatoes
       c. Banana nut bread
       d. Pureed carrots

  2. What is the medical term for difficulty swallowing?
       a. Dyslexia
       b. Jabudy
       c. Iatrogenic
       d. Dysphagia

  3. When would it be inappropriate to provide coffee to a patient on a Minced diet?
       a. When they are on a calorie-restricted diet
       b. When they are on thickened liquids
       c. When they have too much energy already
       d. None of the above

  4. What may happen if a patient who requires a minced textured diet receives a regular
     textured diet?
        a. The patient could choke on larger food pieces
        b. The patient may not be able to chew the food
        c. They may lose weight due to the inability to eat the regular textured food
        d. All of the above

  5. What is the largest acceptable size for a piece of minced beef?
       a. 1/4”
       b. 1/2”
       c. 1/3”
       d. 1/8”
                                             [7]

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Foodservice minced diet in-service

  • 1. Department of Veterans Affairs Back to Basics: The Minced Diet In-Service FSW/Cooks Emily Elliott, Renee Ingalls
  • 2. Table of Contents In-Service Training: The Minced Diet .................................................................................................................................... 2 Cheat Sheet: Appropriate Texted Foods for Minced Diet ..................................................................................................... 4 Back to Basics: The Minced Diet ........................................................................................................................................... 5 Back to Basics: The Minced Diet Quiz ................................................................................................................................... 6 Back to Basics: The Minced Diet Quiz Answer Sheet ............................................................................................................ 7 [1]
  • 3. In-Service Training: The Minced Diet Time Sequence of Events 2:00-2:05pm Brief Introduction  Intern Introduction  Staff Introduction 2:05-2:10pm Purpose:  The Minced Diet is not an actual diet; it is a texture modifications used for those who are experiencing swallowing and/or chewing difficulties. It is also used for patients who tend to eat too rapidly. This is determined by a Speech Language Pathologist. This could be as a result of: o Stroke (CVA) o Cancer of the throat/neck/mouth. o Dementia/Alzheimer’s o Age o Generalized weakness o Traumatic brain injury o Poor dentition o Other neurological and/or physiological problems  Dysphagia is a common medical issue for hospital patients, especially in the VA system. It is the medical term for difficulty swallowing. Symptoms include: o Choking or breathing saliva into lungs while swallowing o Coughing while swallowing o Regurgitating liquid through nose o Breathing in food while swallowing (aspiration) o Weak voice o Chronic heartburn o Sensation of food stuck in throat/chest o Weight loss  This condition, can lead to life-threatening choking episodes, as well as inhalation of foods. In order for food and liquid to be safely eaten, its texture has to be altered to make it easier to swallow. Question: Have you ever had to modify your diet because of a toothache, surgery, etc? How did you like it? Does anyone have any questions about this diet modification? 2:10-2:25 What applies to Food Service?  Transition – Now that we have talked a little about why someone would need to be on a minced diet, let’s talk a little about what you need to know when preparing the patient’s tray.  There are 3 key principles to a Minced Diet. They include: o Foods need to be easy to swallow with a minimum of chewing required. They are also modified to prevent obstruction of the airway (“choking”). o Foods must be moist, soft-textured, and can be easily formed into a ball for ease of swallowing (without risk of aspiration).  Meats are ground or diced to no larger than ¼” pieces. o All foods from the pureed diet are acceptable at this level.  Note: It is important to remember that texture modification is separate than the liquid/beverage modification. There are many food items on the minced diet that would not be appropriate for a patient requiring thickened liquids (i.e. dry cereal with milk, coffee, thin soups, etc.)  Transition: We just reviewed the main concepts of the Minced Diet that are already incorporated into your meal tickets. Now let’s over what you will need to know on your own.  Pass out and Discuss Cheat Sheet [2]
  • 4. o Let’s look at it together  The chart compiles all foods that are either allowed or not allowed on the meal tray for a patient on a Minced Diet.  Activity: We are going to read off a few different complex menu items. Can you figure out if they are allowed on this diet? Does anyone have any questions? 2:25-2:30pm Conclusion:  Today we learned: o Why somebody would be on a minced diet; what dsyphagia is. o What foods are allowed and what foods may be harmful for somebody with dysphagia. .  Does anyone have any questions? Thank you for your time! [3]
  • 5. Cheat Sheet: Appropriate Minced Foods Choose These! Avoid These Meat/Meat Alternatives Meat/Meat Alternatives  Moistened ground or cooked meat, poultry, or fish  Whole, sliced, or shaved meats such as bacon, (serve with sauces or gravy); tofu; moist or mashed sausage, or hot dogs; peanut butter; hard-cooked or beans (like baked or refried); poached, scrambled, or crisp fried eggs; sandwiches and pizza soft-cooked eggs Breads Breads  Soft, well-moistened pancakes; pureed bread mixes or  Slices of bread; toast; any bread with nuts slurried breads Cereals Cereals  Cooked cereals with little texture, including oatmeal;  All cereals with whole grain, dried fruit, coconut, nuts, Slightly moistened, dry cereals with little texture, or seeds including corn flakes, Rice Krispies, and Wheaties. *If patient is on thickened liquids, all liquid needs to be absorbed into the cereal. Fruit Fruit  Soft and drained canned or cooked fruits without  Fresh or frozen fruits; cooked fruit with skin or seeds; seeds or skin; and ripe bananas cherries; pineapple Vegetables Vegetables  All soft, well-cooked vegetables that are less than ¼  Cooked corn and peas; tomatoes with seeds; brussels inch pieces and are easily mashed with a fork sprouts; broccoli; cabbage, asparagus; or other rubbery cooked vegetable Potatoes/Starches Potatoes/Starches  Well-cooked and moistened boiled, baked, shredded,  Potato skins and chips; fried potatoes or French fries; or mashed potatoes; hash browns that are not crisp; rice; plain noodles chopped noodles; well-cooked pasta noodles in sauce Desserts/Sweets Desserts/Sweets  Puddings and custards; soft fruit pies (bottom crust  Dry, coarse cakes and cookies; desserts with nuts, only); Crisps and cobblers with soft topping and no seeds, coconut, pineapple, or dried fruit; rice or bread seeds; ice cream; sherbet; gelatin; mousse; soft moist pudding cakes with icing or slurried cakes; jam or jelly without seeds; syrup; chocolate bars; soft cookies; well- moistened cakes Beverages Beverages  All beverages with little texture or pulp  All beverages with thick texture and pulp [4]
  • 6. Back to Basics: The Minced Diet What is the purpose of the Minced Diet? The Minced Diet is not an actual diet; it is a texture modification used for those who are experiencing dysphagia. It is also used for patients who tend to eat too rapidly. This is determined by a Speech Language Pathologist. This could be as a result of: o Stroke (CVA) o Cancer of the throat/neck/mouth. o Dementia/Alzheimer’s o Age o Generalized weakness o Traumatic brain injury o Poor dentition o Other neurological and/or physiological problems What is Dysphagia? Dysphagia is a common medical issue for hospital patients, especially in the VA system. It is the medical term for difficulty swallowing. Symptoms include: o Choking or breathing saliva into lungs while swallowing o Coughing while swallowing o Regurgitating liquid through nose o Breathing in food while swallowing (aspiration) o Weak voice o Chronic heartburn o Sensation of food stuck in throat/chest o Weight loss  This condition, can lead to life-threatening choking episodes, as well as inhalation of foods. In order for food and liquid to be safely eaten, its texture has to be altered to make it easier to swallow.  It is important to remember that texture modification is separate than the liquid/beverage modification. There are many food items on the minced diet that would not be appropriate for a patient requiring thickened liquids (i.e. dry cereal with milk, coffee, thin soups, etc.) What are the texture modifications for the Minced Diet?  Foods that are soft textured and moist, making them easy to swallow  Soft, well-cooked foods, and well-moistened ground meats  Moist and well-cooked potatoes, and noodles  Nothing larger than ¼ inch in size!  All foods of a pureed consistency are allowed on this diet. [5]
  • 7. Name: _______________________________________ Date: _________________ Back to Basics: The Minced Diet Quiz 1. Which of the following food items would not be appropriate for a Minced Diet? a. 1/4” cut chicken breast with gravy b. Mashed potatoes c. Banana nut bread d. Pureed carrots 2. What is the medical term for difficulty swallowing? a. Dyslexia b. Jabudy c. Iatrogenic d. Dysphagia 3. When would it be inappropriate to provide coffee to a patient on a Minced diet? a. When they are on a calorie-restricted diet b. When they are on thickened liquids c. When they have too much energy already d. None of the above 4. What may happen if a patient who requires a minced textured diet receives a regular textured diet? a. The patient could choke on larger food pieces b. The patient may not be able to chew the food c. They may lose weight due to the inability to eat the regular textured food d. All of the above 5. What is the largest acceptable size for a piece of minced beef? a. 1/4” b. 1/2” c. 1/3” d. 1/8” [6]
  • 8. Name: _______________________________________ Date: _________________ Back to Basics: The Minced Diet Quiz Answer Key 1. Which of the following food items would not be appropriate for a Minced Diet? a. 1/4” cut chicken breast with gravy b. Mashed potatoes c. Banana nut bread d. Pureed carrots 2. What is the medical term for difficulty swallowing? a. Dyslexia b. Jabudy c. Iatrogenic d. Dysphagia 3. When would it be inappropriate to provide coffee to a patient on a Minced diet? a. When they are on a calorie-restricted diet b. When they are on thickened liquids c. When they have too much energy already d. None of the above 4. What may happen if a patient who requires a minced textured diet receives a regular textured diet? a. The patient could choke on larger food pieces b. The patient may not be able to chew the food c. They may lose weight due to the inability to eat the regular textured food d. All of the above 5. What is the largest acceptable size for a piece of minced beef? a. 1/4” b. 1/2” c. 1/3” d. 1/8” [7]