Strawberries for Dysphagia Diets

2 Jul 2021

Wimbledon is fully underway, here in the UK, bringing a sense of familiarity to our lives…. and with-it the usual drama, excitement, rain, tears, joy, all washed down with copious amounts of strawberries! In this article we look at how we can prepare strawberries for dysphagia.


Bringing back wonderful memories

Strawberries are really one of those wonderfully evocative things in life that take us back to childhood, long summer days, pick-your-own adventures and joyful delight that comes from the sweetness and fragrant aroma.

Whenever we put strawberries on the menu in the care home, and I mean in season, beautifully red ripe and bristling with juice, they are the standout favourite! No nonsense – just cut strawberries, a smidge of sugar to create that wonderful strawberry syrup you get with maceration, and some poured double cream!

The association of food, the tastes and smells, with memory; and its positive impact on wellbeing, especially with those suffering with dementia means that inclusion of such evocative things can be a powerful tool.


Strawberries for dysphagia

For those suffering from dysphagia strawberries are pretty straightforward in their ability to be included across all the IDDSI Levels. There are, though, a few points to watch out for.


Strawberries for dysphagia: what to consider

Seeds – The seeds of strawberries are tiny but firm and would need to be excluded from the completely smooth PU4 and LQ3 (as well as any drinks you may want to make). The easiest wat to do this is to finely process the strawberries first and then pass the resulting puree through a sieve before texturizing.

They would also need to be excluded from the pieces, or lumps of food at IDDSI Levels SB6 and MM5. This can be done simply with a knife, and you will find it easier to do by selecting the largest strawberries for this process.

Juice – Bristling ripe strawberries can be wonderfully moist, full of deliciously sweet juice. This can constitute mixed textures when squashed. This can be remedied simply, by adding a very slight amount of modified food thickener, just to absorb any excess juices. Alternatively, the cut strawberries can be laid on clean, absorbent material, for an hour or so in the fridge – any loss of flavour or nutrition will need to be weighed up with the safety of the food, and can be compensated for in the recipe.

Size – Most ripe and flavourful strawberries will need to be resized to meet the requirements of SB6 and MM5, at both adult and paediatric requirements. This can be done easily with a paring knife for SB6; and with a large chef’s knife for MM5.

Tenderness – You may find that the ripest of strawberries will be tender enough to pass the IDDSI fork pressure test at both IDDSI Levels MM5 and SB6. If the strawberries you have don’t meet this requirement you will need to tenderise the fruit. This can be done by marinading or gently poaching in a stock syrup.

Texturisation – Strawberries can be finely processed very easily using any processing equipment designed to puree. Thickening or thinning may be required, depending on the IDDSI Level you are looking to achieve.

Another reason for texturizing the finely processed strawberries could be due to the high water content of the berries. This can lead to moisture seeping out from the puree. This is easily remedied by using just enough instant food thickener to hold the liquid, and in this case, shouldn’t affect the thickness in any way.

Flavour – Certain reform processes for IDDSI Levels MM5 and SB6, can affect the fresh, clean flavour of the strawberries: such as cooking or introducing other flavours in tenderisation processes. To reintroduce the fresh strawberry flavour, there is no reason why the pieces of strawberries can’t be bound with a cohesive, non-sticky, fresh strawberry puree – this will reintroduce the wonderful bouquet and sweet flavour that everyone loves.

Take a look at our PU4 Strawberry Pavlova recipe.