How To Follow a Level 5 Minced and Moist Diet

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Time to Read: About 8 minutes

This information explains what a level 5 minced and moist diet is and how to follow it. It explains how to test your food’s thickness. It also lists foods to include and avoid while following this diet.

What is a level 5 minced and moist diet?

A level 5 minced and moist diet is when you only eat foods that:

  • Are soft and moist.
  • Need very little chewing.
  • Are easy to mash with your tongue.
  • Are cut up or ground into very small pieces.

Mincing your food means grinding, cutting, or chopping it into very small pieces. Minced foods should be 4 millimeters (.16 inches) or smaller. This is about the size of the gap between the prongs on a standard dinner fork. Some foods may be hard to mince to this size.

Add liquid to your food to make sure it’s moist. You can add any liquid, including water, milk, broth, or gravy.

If you’re having trouble mincing your food, you can puree it instead using a blender or food processor. To learn more, read How To Follow a Level 4 Pureed Diet.

Why do I need to follow a level 5 minced and moist food diet?

You may have to follow a minced and moist diet if you:

  • Have dysphagia (dis-FAY-jee-uh). Dysphagia is when you have trouble swallowing.
  • Cannot bite off pieces of food safely.
  • Have pain when chewing food.
  • Have trouble chewing food.
  • Get tired when chewing foods.

How can I make sure my food is the right thickness and texture?

You can check your food’s thickness and texture by doing a fork test and spoon tilt test. Follow the steps in this section.

Your food’s texture can change based on its temperature and how you cooked it. Test your food right before you start eating it to make sure it’s the right thickness.

Fork test

  1. Pick up some of your food with a fork.
  2. Check that food pieces fit between the prongs of the fork. Pieces should not be wider than this gap, which is about 4 mm (.16 inches).

Spoon tilt test

  1. Pick up some of your food with a spoon. Your food should hold its shape on the spoon.
  2. Tilt your spoon slightly to the side.
  3. Check if any food slides off.

Your food should easily slide off with almost no food left on the spoon. It’s OK if you need to gently flick the spoon to get the food to fall off.

Your food is too thick if it sticks to the spoon or does not fall off the tilted spoon.

fork pressure test and spoon tilt test

Figure 1. Fork pressure and spoon tilt tests

Fork pressure test

Place your fork over your food. Using your thumb, press down on your fork. Your food is soft enough if it is completely squashed and does not go back to its original shape.

What can I eat on a level 5 minced and moist diet?

Here are some foods you can eat while following this diet. We also list some foods you should avoid.

These tables are not a complete list of foods you can eat on this diet. Other foods may be OK to eat if you test them and they are the right size and texture. 

If you have trouble swallowing liquids, your speech language pathologist may recommend you thicken your liquids. If you need to thicken liquids, read About Thickening Liquids.

Milk and dairy

Milk and dairy to includeMilk and dairy to avoid
  • Smooth yogurt.
  • Drinkable yogurt.
  • Cottage cheese, finely mashed.
  • Ricotta cheese.
  • Cheese sauces, grated cheeses, and cream cheese.
  • Sour cream.
  • Ice cream, frozen yogurt, gelato, milkshakes, and smoothies.
  • Cheese chunks that are 4 mm (.16 inches) or smaller.
  • Yogurt with hard toppings such as nuts or coconut.
  • Hard cheeses and cheeses with nuts, fruits, and seeds.
  • Cheese chunks that are bigger than 4 mm (.16 inches).

Proteins

Proteins to includeProteins to avoid
  • Red meat, such as beef, pork, and sausage, without skin or casing.
  • Poultry, such as chicken and turkey, without skin or bones.
  • Seafood, such as fish, shrimp, lobster, clams, and scallops.
  • Eggs and egg substitutes (may be best to puree it).
  • Soy foods, such as tofu and tempeh.
  • Moistened legumes, such as cooked beans and lentils. Serve in a thick and smooth sauce or gravy.
  • Prepared, moistened meat alternatives, such as plant-protein veggie burgers and plant-based sausages. Serve in a thick and smooth sauce or gravy.
  • Casseroles with small, minced pieces of meat, ground meats, or tender meats. Serve in a thick and smooth sauce or gravy.
  • Chicken, egg, or tuna salad without raw vegetables, unless they’re blended in well.
  • Smooth nut butter mixed into foods that are allowed.
  • Whole cuts of meat or poultry.
  • Chicken, turkey, and fish with bones.
  • Meats with outer skin or casing, such as hot dogs, sausage, and bratwurst.
  • Tough meats, such as steak and bacon, even if minced.
  • Fried meats.
  • Whole nuts and seeds.

Vegetables

Vegetables to includeVegetables to avoid
  • Well-cooked and tender vegetables that are minced, blended, or mashed, such as carrots, beets, butternut, and acorn squash. If needed, serve in a smooth, thick sauce or liquid.
  • Peas, creamed peas, and creamed corn with soft skins. You can blend these into stews and soups.
  • Finely minced or creamed spinach.
  • Vegetable custards.
  • All raw vegetables, including lettuce.
  • Cooked vegetables bigger than 4 mm.
  • Cooked vegetables that are fibrous, tough, or firm, such as stir-fried vegetables and eggplant skin.
  • Vegetable seeds.

Fruits

Fruits to includeFruits to avoid
  • Canned and cooked fruits.
  • Soft, peeled fresh fruits, such as peaches, kiwi, nectarines, cantaloupe, and honeydew.
  • Soft berries with small seeds, such as strawberries.
  • Smooth applesauce, pureed fruits, and baby food fruits.
  • Ripe bananas.
  • Avocado, including guacamole.

You can add liquid or a smooth sauce to these.

  • Soft fruit pieces larger than 4 mm or fruits served with excess juices.
  • Fresh fruits with chewy skins or seeds, such as grapes, apples, and pears.
  • Stringy, high-pulp fruits and fibrous fruits, such as rhubarb and fresh pineapple.
  • Fresh fruits with high water content where the juice separates from the solid once chewed, such as watermelon.
  • Dried fruits, freeze-dried fruits, and fruit snacks.

Starches

Starches to includeStarches to avoid
  • All cooked hot cereals, well-moistened and soft.
  • Well-moistened, cold cereal.
  • Whipped or smooth mashed potatoes.
  • Muffins, pancakes, waffles, and biscuits served moist. These foods may be best served pureed.
  • These foods must be served in a thick, smooth sauce that does not separate from the food:
    • Rice, couscous, and quinoa that are not sticky.
    • Long grain rice, such as jasmine and basmati rice.
    • Soft, cooked pasta, minced.
    • Soft whole grains, such as barley and farro.
  • Bread or toast.
  • Dry crackers, chips, popcorn, and taco shells.

Fats

Fats to includeFats to avoid
  • Butter, margarine, oils, cream, mayonnaise, sour cream, and gravies.
  • Whole nuts and seeds.
  • Coconut.

Soups

Soups to includeSoups to avoid
  • Broth or bouillon.
  • Soups with small chunks that are 4 mm or smaller.
  • Soups with chunks of meat or crunchy vegetables that are bigger than 4 mm.

Sweets and desserts

Sweets and desserts to includeSweets and desserts to avoid
  • Smooth pudding, smooth custard, and whipped toppings.
  • ice cream, sherbet, and sorbet.
  • Gelatin (such as Jell-O®), flavored fruit ices, and popsicles.
  • Crustless New York-style cheesecake.
  • Cakes, pies with soft crusts, and pastries without nuts or dried fruits. These must be served moist and minced to meet size requirements. These foods may be best served pureed.
  • Sweets and desserts with coconut, nuts, or dried fruits.
  • Granola bars, protein bars, and energy bars.
  • Cakes and pies with a hard crust.
  • Chewy, crunchy, or hard candy.
  • Crunchy cookies.

Other

Other things to includeOther things to avoid
  • Salt, pepper, ketchup, mustard, herbs, and spices.
  • Seedless jellies, jams, and preserves.
  • Honey, sugar, and sugar substitutes.
  • All syrups, including chocolate syrup and maple syrup.
  • Jellies, jams, and preserves with seeds.

Sample menu for a level 5 minced and moist diet

Use this sample menu to get ideas for making your own level 5 minced and moist diet meals.

Level 5 minced and moist diet menu
Breakfast
  • A glass of orange juice
  • Cream of Wheat® with milk and sugar
  • Mashed scrambled eggs with margarine
Mid-morning snack
  • Custard
Lunch
  • Minced flounder with butter sauce
  • Soft, cooked pasta
  • Pureed spinach
  • Gelatin, such as Jell-O
  • Mashed banana
  • Tea with sugar
Mid-afternoon snack
  • Butterscotch pudding
Dinner
  • Chicken noodle soup
  • Minced meat with gravy
  • Mashed sweet potatoes
  • Pureed green beans
  • Cooked mashed peaches
  • Tea with sugar
  • Sorbet
Evening snack
  • Carnation Breakfast Essentials®

How to plan your meals on a level 5 minced and moist diet

Changing your eating habits can be hard. It’s best to plan your meals ahead of time. This can help you make sure you have enough of the right foods to eat at mealtimes.

Here are some questions to think about when planning your meals:

  • Where will you be eating? Will you be eating at home, a restaurant, work, or someone else’s house?
  • If you’re eating at a restaurant, can you call ahead and ask for special meals?
  • Will you have a kitchen and refrigerator available? Can you boil water? Can you microwave? Can you use a blender or food processor?
  • Can you carry a thermos with food already made and ready to eat?

Tips for eating at home

You can change most foods to meet your needs by finely mincing or mashing them. If the food cannot be finely minced, you should puree it.

Kitchen items to help you make food

Here are some items that can help you make foods at home.

  • Potato masher: Use a potato masher or fork to mash soft foods like bananas, avocados, and potatoes.
  • Knife: Cut food into small pieces with a knife so they are 4 mm or smaller.
  • Food processor: Food processors are useful for shredding, slicing, chopping, mincing, and blending foods. They come in different sizes. If you often make just 1 portion of food, buy a small food processor.
  • Household mesh strainer or sieve: You can use this to strain fruits and vegetables, but not meats. They are inexpensive, good to make 1 serving, and do not need electricity. But using a strainer can take more time than using the other kitchen items listed here.

Tips for eating at restaurants

Eat at restaurants that offer different types of foods and that will make adjustments for people on special diets. Many places will puree or make foods for your needs. Call ahead and speak to a manager or chef. You may be surprised at how helpful they will be.

Tips for adding more calories to your diet

  • Eat small meals 6 to 8 times a day instead of 3 main meals.
  • Add 2 to 4 tablespoons of canned coconut milk or cream to smoothies, shakes, cereals, and yogurts for extra calories. You can also add it to pureed dishes for extra calories, flavor, and moisture.
  • Choose creamy soups rather than soups with clear broths.
  • Have puddings and custards rather than gelatin desserts, such as Jell-O.
  • Add sauces, gravies, butter, or extra vegetable oil to your meals.
  • Drink fruit shakes or fruit smoothies made with yogurt or ice cream.
  • Make ice cubes from milk or fruit nectar. Use these high-calorie ice cubes in smoothies or to keep your shakes cold. As they melt, they will add calories to your drinks.
  • Drink high-calorie drinks, such as whole milk, milkshakes, or pasteurized eggnog.
  • Use oral nutrition supplements, such as Ensure® or Boost®, as a nutritious, high-calorie liquid base in smoothies and milkshakes.
  • Add honey to smoothies, tea, yogurt, hot cereals, shakes, or ice cream.
  • Add sour cream, half and half, heavy cream, or whole milk to your foods. You can add them to mashed potatoes, sauces, gravies, cereals, soups, and casseroles.
  • Add avocado to dishes or smoothies and blend.
  • Add nut butters, such as peanut butter, to shakes and smoothies and blend.

Tips for adding more protein to your diet

  • Add pureed tofu to cooked vegetables, soups, or smoothies. You can also eat tofu instead of chicken or meat if you’re having trouble eating animal proteins.
  • Add pureed cooked eggs to your soups, broths, and cooked vegetables.
  • Use plain full-fat Greek yogurt in smoothies, cream sauces, or wherever you would use sour cream.
  • Use a plain protein powder, such as whey or pea protein powder, in liquids and shakes.
  • Add full-fat ricotta cheese to moisten a dish and add calories and protein.
  • Add cottage cheese to smoothies or pureed fruit.

Contact information

If you have questions or want to make an appointment with a clinical dietitian nutritionist, call 212-639-7312.

Last Updated

Thursday, April 25, 2024

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