Nutritious & Appetizing Pureed Foods for Elderly People

“Nutritious & Appetizing Pureed Foods for Elderly People” was written by Beverly Garden, RDN, LDN & edited/reviewed by Aly Bouzek, MS, RDN. 

If you or a loved one have been told that you need to be on a pureed diet (whether temporary or permanent), then you may have felt overwhelmed or confused. Maybe you didn’t know where to start?

You may wonder what conditions require pureed foods for elderly people? How do I prepare pureed food? You may also be concerned whether pureed foods for elderly people can provide adequate nutrition.     

This article will answer all of the above questions. It will explain how, with proper techniques and a little planning, one can easily prepare nourishing and appealing pureed food. 

Because the elderly population is at a higher risk for malnutrition than the general population, a large portion of this article will focus on tricks, techniques, and considerations to prevent unintentional weight loss and ensure adequate nutrition when using pureed foods for elderly people. (1)

What is Pureed Food?

Pureed food is basically regular food that has been blended to a smooth, moist consistency. Think foods that are the texture of smooth mashed potatoes so that no chewing and minimal mouth manipulation is required.  

A blender or food processor is usually used to achieve this texture. For some foods, such as avocados or bananas, a pureed consistency can be accomplished via mashing the food with a fork or other utensil.

Food with dry, courser textures and food with skin, seeds, and nuts are usually not appropriate for a pureed diet because they cannot be blended to a completely smooth texture.  

Certain foods such as mashed potatoes, pudding, ice cream, and smooth applesauce may already be the proper texture and no further blending/mashing is needed (more on these foods later!).

Why Would Pureed Foods for Elderly People Be Necessary?

One common reason for the recommendation of pureed foods for elderly people is swallowing difficulties (also called dysphagia). Those with dysphagia may only need a pureed diet short term, or it may be needed permanently.

Dysphagia may be due to a variety of medical conditions, including: 

• stroke
• multiple sclerosis
• Parkinson’s disease
• certain cancers 
• the effects of aging 

Other causes may include:

• dementia
• malnutrition 
• general weakness

Certain digestive problems or problems with the esophagus can cause dysphagia as well, which could require pureed foods for elderly people.  

Examples include:

• gastro-esophageal reflux disease (GERD) 
• narrowing of the opening of the esophagus
• weak esophagus muscles

Another frequent reason to implement pureed foods for elderly people is chewing difficulties or mouth pain. Causes of chewing difficulties or mouth pain that can make it difficult to eat solid food can include:

• poor dentition (missing teeth or cavities) 
• no natural teeth 
• ill-fitting dentures
• mouth sores

Who Recommends Pureed Foods for Elderly People?

A doctor or a speech language pathologist/SLP (also called a speech therapist) often diagnoses swallowing problems and recommends pureed foods for elderly people.  

They can make the diagnosis through special x-rays and/or a special study with a camera and light going through the nose and into the esophagus. Observations at meals can also help with the diagnosis of dysphagia.

Likewise, a doctor or speech therapist may also be the health practitioner recommending pureed food for chewing or mouth pain.

How Do I Prepare Pureed Food?

In short, pureeing food involves the following basic guidelines:

1. Remove any skin, seeds, pits or fibrous, hard, or inedible parts of the food item that is to be pureed. 

2. Some food does not puree well and should be avoided. 

Examples include: 

• corn
• coconut
• nuts
• dry cereal
• many raw fruits and vegetables 

3. Cook food to a soft or tender consistency, if applicable.

4. Cut food into small chunks, if necessary.

5. Blend food in a blender or food processor until completely smooth with no lumps.  It may work better to blend in small batches.

6. If necessary, before and/or after pureeing, add an appropriate liquid such as water, milk, broth, gravy, fruit or vegetable juice, etc. to achieve the desired consistency.  A food thickener may also be necessary (see the fork test and spoon test below).

NOTE: The liquid added should “make sense” and compliment the taste of the food being prepared. For example, broth can be used when pureeing meats, or juice can be added when pureeing fruit.

Two General Tests for Proper Pureed Food Consistency

Fork Test: This tests for the proper thickness and how well the food holds together (cohesiveness).   

To be the proper consistency, when the pureed food is on a fork, it needs to hold its shape on the fork. If it drips or flows continuously through the tines, then the food is too thin.

If the food is determined to be too thin or runny, a commercial food thickener can be added (usually found at the pharmacy). Mashed potato flakes can also be used if it fits with the food being prepared.

Spoon Test: This test also determines the cohesiveness of the food, as well as assesses the stickiness.

Pureed food that is the desired consistency will hold its shape on the spoon but will fall off easily when the spoon is tilted. 

If it does not, the food is too thick.

In addition, there should not be a large amount of food sticking to the spoon after it is tilted (a small amount of food residue left on the spoon is ok).

If the food is determined to be too thick or sticky, then more liquid needs to be added to achieve the correct consistency.

Note: Those requiring a pureed diet for chewing or digestive problems rather than swallowing problems may be able to tolerate food that does not pass the fork or spoon test. Consult your physician or speech therapist for guidance.

For details on the best blenders and food processors to prepare pureed foods for elderly people, and for information on purchasing premade pureed foods for elderly people, be sure to check out our article: Pureed Food for Adults [Homemade & Premade]!

Ensuring Adequate Nutrition using Pureed Foods for Elderly People

As discussed in our article, Chronic Malnutrition in Seniors, the elderly population is at particular risk for malnutrition, including all complications and risk factors that go along with it. 

 Some examples of these complications include:

• a higher risk of illness and infection
• poor wound healing
•  loss of bone mass and muscle weakness (which can result in a loss of independence)
• increased risk of hospitalization and death  

Furthermore, individuals with dysphagia have demonstrated a higher rate of malnutrition. (2)

Studies show that those with a texture modified diet (which includes pureed foods for elderly people) often consume a diet that is lower in calories and fluid than those on a regular consistency diet. (3)

Below are several suggestions to meet nutritional needs of elderly people following a pureed foods diet.

Make it Look Appealing!

It is important that the food provided looks as pleasing to the eye as possible. Food that looks more appealing is more likely to be eaten! Below are some suggestions to make pureed food look appetizing:

1. Offer a variety of food in a variety of colors.

2. Serve the food on a nice plate or dish.

3. Prepare each pureed food separately.  Blending all the food together might save time, but it is often unappealing. 

4. Use garnishes. Some appropriate garnishes for pureed food include:

• A dollop of sour cream, smooth yogurt, or whipped topping/cream
• Smooth gravies, sauces, and condiments
• A sprinkle of a ground or powdered spices such as cinnamon, chili powder, etc.
• A swirl of pureed fruit on foods such as hot cereals or meats
• Smooth guacamole

5. Pipe food out of a pastry bag into a pleasing shape on the plate instead of a scoop.

6. Use food molds so that the food is similar in shape to its regular form. For more information on pureed food molds, visit Pureed Food for Adults [Homemade & Premade].

Make it Taste Good!

When at all possible and appropriate, prepare food the “normal” way before pureeing. For example, pureed roasted chicken will generally have more flavor than chicken boiled on the stove top.  

Seasoning is important! Use butter, sauces, and spices in preparation. Pureed food shouldn’t be bland!

Speak to your or your loved one’s doctor about liberalizing diet restrictions such as low fat/low cholesterol or low sodium. A liberalized diet generally tastes better!

Make it Smell Good!

Serve warm/hot foods at the appropriate temperature, or warm up foods such as applesauce to increase aroma.

In addition to increasing food’s flavor, adding spices will also make food smell more appealing.

Serve a Variety of Foods

Just like all people, serving those individuals needing pureed foods a diet that includes a wide variety of different foods and food groups is more likely to include the key nutrients needed for adequate nutrition.

Pump Up the Calories!

Below are some methods to use when needing to increase calories and protein to prevent or combat unintended weight loss and malnutrition: 

1. Add extra fat in/on pureed foods for elderly. Examples include oil, butter, or avocado.

2. Add sugar, syrup, honey, seedless jams/jellies etc. to food.

3. Use the full-calorie and full-fat versions of foods in recipes and in food preparation instead of water or lower fat/calorie liquids. Examples include:

• Whole milk or half and half instead of lower fat milk
• Whole milk yogurt instead of low or non-fat yogurt
• Use calorie-containing liquids instead of water to add to foods when pureeing to achieve the proper consistency
• Avoid “diet” or sugar-free versions of foods such as pudding, ice cream, etc.
• Use fruit packed in syrup instead of water or juice

4. In addition to improving the taste of food, liberalizing diet restrictions as suggested above will also usually result in an overall higher calorie diet.

5. Use calorie-rich liquids in cooking when possible. For example, make oatmeal with whole milk instead of water. Add butter and brown sugar for even more calories!

6. Make beverages count! Instead of water or coffee, drink high calorie and/or high protein beverages such as whole milk, juice, and nutrition supplements.  

For additional beverage ideas, check out: 

• High Calorie Smoothies for Weight Gain
• 5 Best High Calorie Drinks
• High Calorie Drinks for Cancer Patients (which can be applicable to people needing to increase calories and protein on a pureed diet)
• Protein Drinks for the Elderly

Also visit our sister website, High Calorie Recipes, for additional drink and smoothie recipes. Remember to modify the recipes if needed, to produce a completely smooth beverage without chunks or lumps.

Use Foods That are Naturally a Pureed Texture

Despite our best efforts to make pureed foods as appetizing as possible, some people still have difficulty finding it appealing because it just doesn’t look like “normal” food.  

One way to work around this is to serve foods that are already naturally a pureed texture. Foods are typically accepted well when they are naturally close to a pureed consistency.     

Examples of such foods include:

• Mashed potatoes
• Souffles
• Applesauce
• Pudding
• Custard
• Cream pie or cheesecake without the crust
• Mousse
• Smooth yogurt without fruit chunks or add-ins
• Smooth hot cereal
• Blended/strained (if necessary) cream soup
• Blended cottage cheese 
• Blended scrambled eggs 
• Pate
• Smoothies
• Gelatin*
• Ice cream* without chunks of nut, fruit or other food
• Smooth Hummus
• Smooth guacamole

*Note: These foods are not appropriate for individuals needing thickened liquids

Below is a sample day’s menu of a diet with food already, or almost already, a naturally pureed consistency.

Breakfast: 

• Smooth oatmeal topped with pureed peach sauce and brown sugar 
• Scrambled eggs, blended smooth
• Strawberry yogurt (smooth variety)
• Hot chocolate (can make with milk for extra calories and protein, if needed)
• Orange juice

Lunch:

• Cream of tomato soup, made with whole milk
• Cottage cheese, 4% milk fat, blended smooth
• Mashed potatoes with gravy  
• Chocolate pudding
• Grape juice

Dinner:

• Split pea soup (smooth and strained if needed)
• Cheese grits (may need additional blending)
• Whipped sweet potatoes
• V-8 juice
• Vanilla ice cream

Snacks:

• Applesauce
• Custard
• If unintentional weight loss is a concern, then try this Peanut Butter Powder Smoothie recipe.

Pureed Foods for Elderly Wrap-up

A pureed diet can be prescribed for chewing or swallowing difficulties, mouth pain, or digestive issues. We hope this article has provided you with the confidence and knowledge to help you make pureed foods that are safe, look and taste appealing, and are nutritionally adequate. 

For additional information on soft foods, be sure to check out Soft Foods 101: A Comprehensive Guide.

Good Luck!