Mechanical Soft Diet (MSD), also known as the Geriatric Diet or Dental Soft Diet, is a variation of the regular diet, wherein the texture is modified, especially for individuals who are unable to chew or swallow properly. This type of diet can be made through many different cooking processes such as grinding, pureeing, liquefying, chopping, or tender cooking. Other processes may be possible as long as the food items used must have a soft texture and should be easy to swallow. MSD is similar to Soft Diet, but what makes the former different from the latter is that MSD allows the consumption of fried foods, seasonings, spices, and fibrous foods. 

MSD is recommended for individuals experiencing cases such as:

• Broken Jaw
• Dental caries, missing or no teeth, poorly fitted dentures, and periodontal disease
• Dry mouth, ulceration of the mouth or gums.
• Undergoing radiation therapy for head, neck, or stomach area, which may lead to digestive upset or pain in mouth or throat
• Previously on a liquid diet after surgery or long-term illness and are gradually reintroducing solid foods
• Other conditions when dysphagia or swallowing problem is present: Alzheimer’s disease, AIDS, cancer, chemotherapy, congenital defects of oral cavity, Guillain-Barre syndrome, multiple sclerosis, myasthenia gravis, Parkinsonism, and stroke.

Since MSD is a regular diet with a modified texture, it can be nutritionally adequate if all essential nutrients are present, and the food items used are selected from a variety of sources. But if an individual experiences poor appetite or does not eat enough, then it is suggested to supplement the diet with nutritional formula or snacks.

There are certain food items that can be consumed in MSD, and these items include:

• Fruits and vegetables: likely to require peeling, fine chopping, mashing, cooking, and/or blending to be safe to eat, although some vegetables (such as avocado) are soft enough to eat as is
• Grains: hot cereals like oatmeal, porridge, grits; soft bread, finely cut pasta, cooked rice, refined grains, and similar foods
• Meat, poultry, fish: tender meats (e.g., canned tuna, ground beef), thinly shaved meat, and other meats that have been mechanically altered.
• Dairy: milk, powdered milk, cottage cheese, soft cheeses, grated and shredded cheeses, yogurt, ice cream, and other soft dairy products
• Eggs: most cooking methods acceptable — but if eating boiled eggs, ensure they’re chopped finely or mashed, as in egg salad
• Plant-based proteins: tofu (silken, regular, firm), cooked beans, pureed beans, soy milk, hummus, peanut butter, and other products
• Fats: butter, margarine, and all plant-based oils (e.g., olive, sesame, coconut)
• Desserts: any soft cake, pastry, cookie, or other dessert that does not contain nuts, candy, fruit, or other hard pieces of food
• Other foods: protein powders, liquid nutritional supplements, casseroles, soups without large pieces of meat, jams without seeds, broth, gravy, sauces, condiments, and other products.
• Beverages: all beverages (including juices with pulp), except for any that contain solid food pieces.

Below are the food items that should be avoided when having a mechanical soft diet:

• Fruits and vegetables: raw or stir-fried vegetables, fruit with seeds or pits, unpeeled fruit and vegetables, dried fruit (e.g., raisins, apricots), whole fruits (e.g., grapes, olives), corn on the cob, raw coconut, and fried vegetables.
• Grains: hard or crunchy bread, toast, buckwheat, egg noodles, garlic bread, granola, muesli, crackers, melba toast, shredded wheat, undercooked pasta, popcorn, hard taco shells, and others
• Meats, poultry, fish: hard cuts of meat, meats or poultry with the bone, hot dogs, sausage, shellfish, fried meat or fish, and others
• Dairy: hard cheeses (e.g., cheddar, Parmesan, Swiss), soft cheeses with dried fruit or nuts, and more
• Plant-based proteins: nuts, seeds, extra-firm tofu, seitan, crunchy peanut butter, and others
• Desserts: chips, pretzels, popcorn, candy, hard cookies, licorice, any sticky dessert (e.g., caramel. taffy), candied nuts, pie crust, and more
• Other foods: jams with seeds (e.g., raspberry jam), gum, marshmallows, any foods that cannot be mechanically altered, etc.

// Roan Angela G. Rillon, CMU Intern

References:

Davidson, K. M. (2021, October 7). What Is a Mechanical Soft Diet? All You Need to Know. Healthline. Retrieved September 29, 2022, from https://www.healthline.com/nutrition/mechanical-soft-diet#foods-to-avoid

Dellova, C. V., Roxas, M. G. R., Velasco, Z. F., & Pataunia, M. C. A. (2006). ABCs of Nutrition and Diet Therapy for Healthcare Students and Practitioners.

Eating Guide for Puréed and Mechanical Soft Diets. (2018, April 4). Memorial Sloan Kettering Cancer Center. Retrieved September 29, 2022, from https://www.mskcc.org/cancer-care/patient-education/pureed-and-mechanical-soft-diets#:%7E:text=Liquids%2C%20such%20as%20broth%2C%20milk,%2C%20ground%2C%20and%20pur%C3%A9ed%20foods.

Patients & Families | UW Health. (n.d.). Retrieved September 29, 2022, from https://patient.uwhealth.org/healthfacts/363