What is Nursing Care Food? Explanation of 4 Types and Cooking Tips! Introducing Ways for People with Disabilities to Enjoy Meals

Regardless of age or disability, everyone likely thinks, "I want to enjoy delicious meals no matter how old I get." This is where the concept of "food accessibility" becomes essential.

For individuals with swallowing difficulties, such as those with disabilities or the elderly with reduced chewing and swallowing abilities, incorporating "care food" designed for safe and nutritious consumption is advisable.

This article will clearly explain how to prepare care food and tips for people with disabilities to enjoy meals.

1. What is Care Food?

Care food refers to meals prepared to be easily consumable for individuals with weakened chewing and swallowing abilities. In medical settings, it is sometimes called "dysphagia-modified food."

Eating naturally requires the power to chew and timely swallow food. However, with aging, the ability to chew and swallow tends to decline. Additionally, oral and cognitive functions may deteriorate due to severe illnesses or disabilities.

Care food is prepared according to the eater's chewing and swallowing abilities. There are four types: "chopped food," "soft food," "blender food," and "jelly food" (names may vary depending on classification). Each preparation method has its own characteristics and points to consider.

2. Four Types and Characteristics of Care Food

2-1. Chopped Food

Chopped food refers to meals cut into pieces about 5mm to 1cm in size, making them easy to swallow without chewing. It is easy to eat for those with weakened chewing abilities, and the size can be adjusted.

Since it is regular food that has been chopped, it retains the aroma and appearance of regular meals, enhancing appetite.

The downside is the risk of aspiration.

Food may not form well in the mouth, and if the swallowing timing is off, it can get stuck in the airway. To prevent aspiration, it's essential to make the food cohesive and easy to swallow.

Additionally, food can easily get stuck between teeth, increasing the risk of cavities, making oral care important.

2-2. Soft Food

Soft food is made by simmering or blending ingredients into a paste and molding them. It is easy to eat for those with weakened chewing and swallowing abilities.

It is soft enough to be crushed with the gums or tongue, allowing enjoyment of the aroma and appearance of the ingredients.

However, if the softness does not match the eater's needs, there is a risk of aspiration, so observe the swallowing process carefully.

2-3. Blender Food

Blender food is made by adding broth to ingredients and blending them into a soup-like consistency. It is easy to eat for those who find soft food difficult to consume.

However, liquid-like foods can easily flow into the back of the throat, increasing the risk of choking or aspiration, so adding thickeners or gelatin to create a "thickened" consistency is essential.

Additionally, the color and shape of the ingredients are less noticeable, which may reduce appetite. Consider adding color when serving to enhance the "joy of eating."

2-4. Jelly Food

Jelly food is made by pureeing ingredients and solidifying them with gelatin. It is easy to eat for those who find chewing difficult and have weak swallowing abilities.

For those at high risk of aspiration with blender food, jelly food can make swallowing easier.

3. "Universal Design Food®" as a Standard for Choosing Care Food

The Japan Care Food Council (hereafter referred to as the Council) refers to foods designed with ease of eating in mind as "Universal Design Food®".

Products that meet the standards set by the Council bear the "UDF (Universal Design Food) logo" and indicate the "hardness" and "viscosity" of the food on the packaging, making it easier for consumers to choose the appropriate meal type.

The categories of hardness and viscosity are as follows:

Using these categories as a reference, choose foods that suit the eater.

4. "Smile Care Food" Established by the Ministry of Agriculture, Forestry and Fisheries

With the anticipated expansion of the care food market, including the spread of Universal Design Food®︎, in 2013, the Ministry of Agriculture, Forestry and Fisheries announced a new framework called "Smile Care Food".

This initiative aims to increase awareness and maintain suitable dietary habits for more people by ① classifying care foods into three categories, ② setting marks as a guide for choosing foods, and ③ naming it "Smile Care Food."

The Ministry's website states the following:

"Smile Care Food" displays a "blue" mark for foods necessary for nutritional supplementation for health maintenance, a "yellow" mark for foods for those who have difficulty chewing, and a "red" mark for foods for those who have difficulty swallowing, contributing to the selection of "new care foods" tailored to each individual's condition.

Source: Smile Care Food (New Care Food)｜Ministry of Agriculture, Forestry and Fisheries

Additionally, in 2016, the "Japanese Agricultural Standard for Chewing Considerate Foods" (JAS Standard) was established.

This standardization has led to initiatives to improve the quality of Smile Care Food, such as requiring the "JAS Mark for Chewing Considerate Foods" for displaying the "yellow" mark on Smile Care Food.

Reference: Japanese Agricultural Standard for Chewing Considerate Foods｜Ministry of Agriculture, Forestry and Fisheries
Reference: Initiatives for Smile Care Food｜Ministry of Agriculture, Forestry and Fisheries

Thus, the development of systems related to care food is also supporting its spread.

5. Benefits of Retort Care Food

We have emphasized the importance of preparing meals according to chewing and swallowing abilities. Equally important is reducing the burden on those preparing care food.

We recommend utilizing commercially available retort care foods. They minimize the time and equipment needed for preparation while providing meals suitable for the eater.

Some are also designed with essential and often lacking nutrients in mind, so consider them as a reference.

・Kewpie "Gentle Menu" Series
The series offers products in four stages to match the eater's chewing and swallowing abilities.

Reference: Gentle Menu｜Kewpie Corporation

・Yoshinoya Co., Ltd. "Yoshinoya's Gentle Rice®︎" Series
These products are crafted with a focus on taste, driven by the desire to recreate Yoshinoya's deliciousness in care food.

Reference: Yoshinoya's Gentle Rice®︎｜Yoshinoya Co., Ltd.

6. Tips and Cautions for Preparing Care Food

6-1. Choosing Ingredients

When making care food, you might wonder which ingredients are best. Preventing aspiration is crucial in care food. Therefore, it's important to choose ingredients that are not only nutritious but also less likely to cause aspiration.

Blender food and jelly food, which contain a lot of water, can be bulky and make it difficult to obtain nutrients, so consider ingredients and foods that provide efficient nutrition.

Ingredients suitable for care food include soft foods or those with natural slipperiness.

For protein intake, eggs, fish, tofu, and natto are easy to prepare softly. Dairy products like cheese and butter are also easy to process and provide fats.

However, for those with limited mobility or conditions like hypertension or diabetes, consult a doctor and be mindful of intake amounts.

When seeking fiber and vitamins from vegetables and fruits, choosing seasonal items can help efficiently obtain nutrients. For example, cabbage in spring, tomatoes in summer, eggplant in fall, and daikon in winter.

6-2. Cooking and Processing Methods

Preparation methods vary depending on the eater. To cook softly, techniques like simmering, steaming, and extending with tofu, broth, or milk are effective. Using a pressure cooker or rice cooker is also beneficial.

For vegetables, peel the skin, remove seeds and stems, and make them as easy to swallow as possible.

Nowadays, cooking tools have evolved to make preparing care food easier. Here are some recommended tools.

・Gifmo Co., Ltd. "Delisofter"
Even dishes like tonkatsu or fried chicken, which are "delicious but hard to cook softly," can be softened while retaining their shape by chopping and applying pressure.

Reference: Delisofter｜Gifmo Co., Ltd.

・robot coupe®︎ "Blixer" Paste Making Machine
A cooking appliance that can quickly turn nuts and fibrous vegetables into paste.

Reference: Blixer Paste Making Machine｜FMI Corporation

6-3. Seasoning

It's important to create meals with appropriate salt and sugar levels. Especially for the elderly, taste cells regenerate less easily, making it harder to perceive flavors, leading to overly seasoned dishes.

To prevent excessive salt and sugar, using well-prepared broth or aromatic ingredients like herbs and spices can lead to delicious meals that enhance appetite.

6-4. Presentation

Appearance is also a crucial factor in enjoying meals. For soft food, shape it as close to the original ingredient as possible, and for blender food, utilize the colors of the ingredients. Adding edible flowers or parsley can also enhance the presentation.

Don't forget the joy of visual appeal, and make necessary efforts.

7. Ways for People with Disabilities to Enjoy Meals