J Nutr Sci Vitaminol, 63, 256–262, 2017

Cooking Methods for a Soft Diet Using Chicken Based on

Food Texture Analysis

Emi Watanabe1,2, Masami Maeno2,3, Jun Kayashita4,

Ken-ichi Miyamoto1 and Miho Kogirima2,*
1 
Graduate School of Nutrition and Bioscience, Tokushima University, 3–18–15 Kuramoto-cho,
Tokushima 770–8503, Japan
2 
Department of Food Science and Nutrition, Doshisha Women’s College of Liberal Arts,
Imadegawa Teramachi, Kamigyo-ku, Kyoto 602–0893, Japan
3 
Long-Term Care Health Facility Nukumorinosato, Simogyo-ku, Kyoto 600–8876, Japan
4 
Department of Health Sciences, Prefectural University of Hiroshima, 1–1–71 Ujina-Higashi,
Minami-ku, Hiroshima 734–8558, Japan
(Received February 16, 2017)

Summary  Undernutrition caused by difficulties in masticating is of growing concern

among the elderly. Soft diets are often served at nursing homes; however, the styles differ with
nursing homes. Improperly modified food texture and consistency may lead to further loss of
nutritive value. Therefore, we developed a method to produce a soft diet using chicken. The
texture-modified chicken was prepared by boiling a mixture of minced chicken and addi-
tive foodstuff that softened the meat. The best food additive was determined through test-
ing cooking process, size after modification and texture. The optimum proportions of each
component in the mixture were determined measuring food texture using a creep meter.
Teriyaki chicken was cooked using the texture-modified chicken, and provided to a nurs-
ing home. The amount of food intake by elderly residents was subsequently surveyed. This
study involved 22 residents (1 man and 21 women; mean age 91.465.3 y). Consequently,
yakifu, which was made from wheat gluten, was the most suitable additive foodstuff. The
hardness of the texture-modified chicken, with proportions of minced chicken, yakifu, and
water being 50%, 10%, and 40% respectively, was under 40,000 N/m2. The intake amount
of the texture-modified chicken of subjects whose intake amount of conventional chicken
using chicken thigh was not 100% was significantly higher. These findings suggest that
properly modified food textures could contribute to improve the quality of meals by prevent-
ing undernutrition among the elderly with mastication difficulties.
Key Words  soft diet, food texture, elderly, intake amount

The average life expectancy of the Japanese popu-
lation is increasing. According to the 2010 complete
life table, men and women live, on average, until the
age of 79.59 and 86.35 y, respectively (1). However,
the healthy life expectancy of men being 70.42 y and
women 73.62 y (2), we can consider that Japanese men
and women live with physical limitations for about 9
and 13 y, respectively. The number of people certified for
long-term care and support in 2013 was 5.64 million
in the Long-Term Care Insurance business (3). With the
number of certifications for long-term care constantly
increasing with the growing elderly population, it
becomes difficult to sustain both the medical and long-
term care insurance systems. Therefore, it is important
to enhance the healthy life expectancy.
Many elderly use dentures due to the loss of their
teeth (4). Incompatible dentures, muscle weakness,
and stomatitis cause a decline in masticatory strength.
Weak masticatory strength causes difficulties in eating
* To whom correspondence should be addressed.
E-mail: mkogirim@dwc.doshisha.ac.jp
ordinary diets, resulting in a decreased intake amount
and undernutrition (5). Consequently, decline of muscle
strength leads to a need for long-term care and support.
In many nursing homes, residents who have difficul-
ties in eating ordinary diets are provided with a soft diet
(6–8). However, it has been reported that many nursing
homes provide diets following their own standards (9).
Since the dysphagia diet committee of the Japanese Soci-
ety of Dysphagia Rehabilitation introduced the Japanese
Dysphagia Diet 2013 (10), standardization of a soft diet
has been proceeding in Japan. But this criterion shows
properties of the soft diet only with words. To evaluate
the texture adequacy of a soft diet objectively, a physi-
cal measurement method is necessary. The Dysphagia
Diets Pyramid (11) is a well-known physical assessment
method for food texture. Therefore, we referred the Dys-
phagia Diets Pyramid in this study. It is classified into
six steps: the diet composed of jelly with less than 2 g of
protein per 100 g of food used to start rehabilitation of
dysphagia patients who suffered a stroke (L0), the diets
consisting of jelly, pudding or mousse containing pro-
tein (L1, L2), the diet made of puree or paste (L3), soft

256
 Soft Diet Based on Food Texture
diets (L4) and ordinary diets (L5), depending on the val-
ues obtained from the texture measurement (12). The
standard physical properties of the Dysphagia Diets Pyr-
amid were determined by texture measurement of grad-
ual meals, depending on the level of dysphagia, and was
provided by the Seirei Mikatahara Hospital (11, 12).
To prevent a decrease in food intake by the elderly
whose masticatory strengths are weak, it is essential
to set quantitative standards of soft diet textures and
share cooking methods that allow meeting these stan-
dards. Moreover, to maintain the nutritional level of the
elderly, soft diets should have similar nutrition values to
those of ordinary diets. Whereas a number of studies on
intake levels and physical properties of dysphagia diets
have been reported (13, 14), none focused on soft diets.
We studied soft diet cooking methods that could yield
hardness below 40,000 N/m2, corresponding to L4 of
the Dysphagia Diets Pyramid. Moreover, we focused on
main dishes, which provide high protein intake, and
selected chicken, a meat that is more difficult to soften
through cooking compared to pork and beef, which can
be sliced.
To soften meat, the freeze impregnation method using
protease is well-known (15, 16). However, a vacuum
packaging machine is necessary. We tried to soften
chicken using commercially available softening agent
for meat without a vacuum packaging machine, but the
chicken did not become softer and was consequently not
suitable as a soft diet. Therefore, we used minced chicken
whose connective tissues were cut. Because the dump-
ling made from minced chicken only was hard, foodstuff
was added to soften the meat and obtain a form mim-
icking a chicken cut. We selected some foodstuff that
contain high levels of protein (e.g. baked wheat gluten
named “yakifu,” which is traditional Japanese food) to
maintain the same amount of protein as conventional
chicken. We also assessed the stability of protein con-
tent after adding the foodstuff.
Finally, the intake amount by elderly residents of the
newly created soft diet was assessed and compared with
that of their conventional soft diet in order to evaluate
its appropriateness.
METHODS
Study of additive foodstuff and proportions for texture-
modified chicken.
Preparation of samples: We used chicken breast
for texture-modified meat, because chicken breast
contained more protein than chicken thigh. Chicken
breast with skin and fat removed was used in this
study. About 80 g of 25 mm-cut chicken was ground
for 45 s using the food processer MK-K81 (Panasonic)
in rough mode. We tested five types of additive food-
stuffs: canned soy beans, soy powder, tofu, freeze-dried
tofu, and “yakifu,” all of them commercially available.
Canned soy beans were ground using the food proces-
ser in high-speed mode and strained to remove the skin.
Water was removed from some of the tofu. To do so,
100 g of tofu was wrapped in kitchen paper and com-
pressed with a 260-g weight for 30 min. As a result, the
257
Fig. 1.  Triangular diagram of three ingredients. The
solid line, dotted line, and broken line show the propor-
tion of minced chicken, yakifu, and water respectively.
weight of the tofu became 70 g. The freeze-dried tofu
was grated. Yakifu was ground using the food proces-
ser in high-speed mode. Minced chicken and the addi-
tive foodstuff were mixed, divided in 10-g samples, and
boiled for 5 min, ensuring they spent 1 min above 75˚C.
Even though we decided the amount of each foodstuff
that was added to 30 g of minced chicken to equalize
the protein content of texture-modified chicken with
70 g of chicken thigh before the experiment, soy pow-
der, freeze-dried tofu and yakifu could not be mixed with
minced chicken as planned. Thus, water was necessary
to mix soy powder, freeze-dried tofu and yakifu with
chicken. When the additive foodstuff soaked with water
was added to minced chicken, we focused on softening
the texture-modified chicken. Consequently, the added
weight of each foodstuff is shown in Table 1.
Test method for additive foodstuff (Table 1): The cook-
ing processes of the samples were evaluated subjectively
from very easy “11”, to difficult “2”. We also assessed
the size of the texture-modified chicken containing
the same amount of protein as conventional teriyaki
chicken obtained when using 70 g of chicken thigh. We
compared the samples visually. A sample that was as
small as the conventional teriyaki chicken was evaluated
“11”, and one that was too large for one portion was
evaluated “2”. Texture was also judged by eating the
samples. A sample much softer than the conventional
teriyaki chicken was evaluated “11”, whereas one too
hard was evaluated “2”. “1” was used as an interme-
diate appreciation between “11” and “2”. These tests
were carried out and discussed by four researchers.
Test method for proportions in the texture-modified
chicken using yakifu: We decided that yakifu was the
most suitable additive foodstuff. Then we studied pro-
portions of minced chicken, yakifu and water in the
texture-modified chicken. To determine the proportions
used in the samples undergoing texture measurements,
the triangular diagram (Fig. 1) was used. An optional
point on the triangular diagram shows the proportions
258 Watanabe E et al.
of minced chicken, yakifu, and water used. Solid lines,
dotted lines and broken lines show the weight percent-
ages of minced chicken, yakifu, and water, respectively.
In the case of yakifu/water.1/2, yakifu could not be
soaked in water in the preliminary study; this area was
thus omitted. With yakifu/water,1/6, water was too
abundant to allow chicken cut-like forms; thus, this
area was also omitted. Moreover, when minced chicken
contents were lower than 30%, the meat taste could not
be detected; this area was consequently omitted. We
created seven samples for which we measured textures,
where minced chicken, yakifu, and water contents were
(a) 30%, 10%, 60%, (b) 40%, 10%, 50%, (c) 50%, 10%,
40%, (d) 60%, 10%, 30%, (e) 70%, 10%, 20%, (f) 30%,
20%, 50%, and (g) 40%, 20%, 40%, respectively.
Texture measurement: The texture measurement
method was based on the Dysphagia Diets Pyramid.
Samples were packed into a laboratory stainless dish with
a diameter of 40 mm and depth of 15 mm. A 20-mm
diameter cylindrical plunger was then plunged into the
samples. The samples were kept at 2062˚C, a 20 N load
cell was used, the distortion factor was 66.67%, and the
plunging rate was 1 mm/s. Hardness was calculated
from the highest point on the texture curve. Each mea-
surement was repeated five times, the highest and the
lowest values were omitted, and the average was calcu-
lated using the remaining three values.
The hardness of sample (b) was under 40,000 N/m2,
and that of sample (c) was near 40,000 N/m2 (Table 2).
We measured the hardness of sample (b) and (c) after
stewing in soup containing soy sauce, mirin-like season-
ing, cooking sake, sugar and water to decide the propor-
tion of texture-modified chicken to provide. Each mea-
surement was repeated two times, and the average was
calculated.
Providing meals and survey of intake amount.
Survey dates and subjects: Surveys were conducted
by researchers at a nursing home in Kyoto twice in
the month of November 2014. We provided teriyaki
chicken for lunch using the texture-modified chicken on
the first survey date (9 November), and the conventional
chicken thigh on the second survey date (17 November)
as a soft diet. All the other dishes were kept unchanged.
The subjects were composed of 22 residents (1 man and
21 women; mean age 91.465.3 y). They did not need
assistance for eating. We confirmed subjects did not
have wheat allergy prior to the study. The type of diet
assigned to each resident was determined based on their
eating status, their own requests and observations made
after admission by the medical doctor, the physical ther-
apist, the occupational therapist, the nurse and the reg-
istered dietitian of the facility. This study was approved
by the Ethics Committee of Doshisha Women’s College
of Liberal Arts (No. 56), and the study was conducted
in accordance with the principles of the Declaration of
Helsinki.
Cooking method of the conventional teriyaki chicken
(one serving): Seventy grams of chicken thigh was cut
into bite-size chunks and baked with 2 g of salad oil.
It was then introduced into a pressure cooker along
with 5 g of soy sauce, 3 g of mirin-like seasoning, 2 g
of cooking sake, 1 g of sugar, and water in which all
foodstuff was immersed and stewed. A mixture of 2 g of
starch and 2 g of water was subsequently added into the
cooker to thicken the soup. We prepared 45 servings.
Cooking method of teriyaki chicken using the texture-
modified chicken (one serving): Thirty-seven grams of
water, 0.5 g of ginger juice and 1 g of soy sauce were
added to 9 g of ground yakifu. Then 46 g of minced
chicken breast was added to them and mixed. The mix-
ture was divided into three parts, which were shaped
like chicken cuts and boiled for 5 min. These texture-
modified chicken portions were put into a pot with 4 g
of soy sauce, 3 g of mirin-like seasoning, 2 g of cooking
sake, 1 g of sugar and water in which all foodstuff was
immersed and stewed. A mixture of 2 g of starch and
2 g of water was subsequently added into the cooker to
thicken the soup. We prepared 45 servings.
Texture measurement: A sample of the meal provided
in the nursing home was brought back to the laboratory
with refrigerant packs and the texture was measured
within 4 h. The measurement method was the same as
mentioned above. Each measurement was repeated five
times, the highest and the lowest values were omitted,
and the average was calculated using the remaining
three values.
Measurement method of intake amount: During
the preparation of tray service, the texture-modified
chicken and the chicken thigh of the main dishes were
weighed; three servings of texture-modified chicken or
chicken thigh were picked from the dish and weighed,
their average weight was then treated as one serving.
When the subject left some texture-modified or chicken
thigh, the leftovers were weighed and deducted from the
total weight of served chicken. The resulting value was
treated as the intake amount. The intake rate was cal-
culated by dividing the intake amount by the amount
served.
Nutritional value calculation: Nutritional values were
calculated using the sixth edition of the Japanese Stan-
dard Tables of Food Composition.
Data analysis: We used the data of 10 subjects whose
intake rate of the conventional chicken thigh was not
100%. The Wilcoxon rank sum test was carried out
using IBM SPSS Statistics v22.0.
RESULTS
Study on additive foodstuff (Table 1)
We carried out preliminary studies to decide which
additive foodstuff to use for softening chicken. We pre-
pared five type of the foodstuff: canned soy beans, soy
powder, tofu, freeze-dried tofu and yakifu. When using
canned soy beans, removing the thin skin was a difficult
task. The taste of soy was too strong to sense a chicken
taste from the texture-modified chicken using soy pow-
der. Tofu contains too much water. Even after water was
removed from the tofu, the size of the texture-modified
chicken was much bigger than that of the conventional
chicken. The texture-modified chicken using freeze-
dried tofu was too hard to provide a suitable soft diet.
 Soft Diet Based on Food Texture 259

Table  1.  Added weight per 30 g of minced chicken and assessment of texture-modified chicken.

Added weight Added weight Cooking Size after

Foodstuff for softening Texture
of foodstuff (g) of water (g) process modification

Canned soy beans 40 0 2 1 11

Soy powder  6 14 11 1 1

Tofu 70 0 11 2 11
Tofu with water 701 0 11 2 11
  removed with weight

Freeze-dried tofu  6 0 11 1 2
Freeze-dried tofu with  3 17 11 1 2
  added water

Yakifu  5 0 11 1 2
Yakifu with added water  9 51 11 1 11

Cooking process: Easiness of cooking texture-modified chicken 11. very easy; 1, easy; 2, complicated.
Size after modification: Volume of texture-modified chicken whose protein content was the same as 70 g of conventional
chicken thigh. 11, same as 70 g of chicken thigh; 1, large; 2, too large.
Texture: Compared with conventional chicken thigh. 11, much softer; 1, softer; 2, too hard.
1 
The weight of tofu after water was removed.

Table  2.  Proportion and hardness of texture-modified chicken.

Minced chicken Yakifu Water Hardness Hardness after stewing

Sample name
(wt%) (wt%) (wt%) (3104 N/m2)1 (3104 N/m2)2

(a) 30 10 60 too soft 2

(b) 40 10 50 2.5360.26 1.50
(c) 50 10 40 4.2660.13 2.513
(d) 60 10 30 6.1660.18 2
(e) 70 10 20 .6.30 2
(f) 30 20 50 5.0360.26 2
(g) 40 20 40 .6.30 2

Proportions of samples were decided by Fig. 1.

Sample (a) was too soft to shape.
1 
Each measurement was repeated five times, the highest and the lowest values were omitted, and the average was calculated
using the remaining three values.
2 
Hardness of (b) and (c) after stewing in a seasoning soup. Each measurement was repeated two times, and the average was
calculated.
3 
The hardness of (c) provided in nursing home was 2.803104 N/m2.

The texture-modified chicken with added yakifu and
water received a good evaluation in terms of cooking
process, size after modification and texture.
Study of proportions in the texture-modified chicken using
yakifu
Table 2 shows the hardness of the samples determined
by texture measurements. Even though sample (b) was
the only sample with hardness lower than 40,000 N/
m2 after boiling for 2 min, the hardness of sample (c)
dropped to 25,100 N/m2 after stewing in a seasoning
soup. We detected a stronger meat taste in sample (c),
which contained more minced chicken than sample
(b). Consequently, the proportions of the sample that
was provided in the nursing home were 50% minced
chicken, 10% yakifu, and 40% water. The hardness of
the provided texture-modified chicken was 28,000 N/
m2. The hardness of the teriyaki chicken thigh was
.63,000 N/m2, hence higher than the upper limit of
the measurement in these conditions.
Nutritional value
Table 3 shows the energy, protein, fat, and carbohy-
drate per 100 g of texture-modified chicken or chicken
thigh. The energy levels, as well as the protein and fat
contents of the texture-modified chicken containing
yakifu and water were lower than those of the chicken
thigh. The amino acid score of texture-modified chicken
was 100%, as with chicken breast. The weight of the tex-
ture-modified chicken that was provided in the nursing
260 Watanabe E et al.

Table  3.  Nutritional value of texture-modified chicken and chicken thigh (per 100 g before cooking).

Energy (kcal) Protein (g) Fat (g) Carbohydrate (g)

Texture-modified chicken  91 13.8 1.0 5.6

Chicken thigh 116 18.9 3.9 0.0

Fig.  2.  Intake rate of each of 10 subject of teriyaki chicken using chicken thigh and texture-modified chicken. The intake
rates of 12 subjects whose intake rates of chicken thigh were 100% were not included.

Table  4.  Intake rate of teriyaki chicken using texture-modified chicken and chicken thigh.

Texture-modified chicken Chicken thigh

(n510) (n510)
means6SD means6SD

Intake rate (%) 79.5622.3** 29.5625.7

Intake amount (g) 93.2626.2** 15.6613.5
Protein intake (g) 10.262.9** 3.963.4
Energy intake (kcal) 68619** 24621

Weight before cooking (g) 93.5 70.0

Weight after cooking (g) 117.3 52.7
Total protein (g) 12.9 13.2
Total energy (kcal) 85 81

** p,0.01 compared with chicken thigh by Wilcoxon rank sum test.

Weight of texture-modified chicken increased and that of chicken thigh decreased after cooking.

home was adapted in order to match the protein content
in 70 g of chicken thigh. Therefore, 9 g of yakifu was
added to the texture-modified chicken, which is equiva-
lent to one serving size of the ordinary stew dish.
Survey of intake amount
The number of subjects whose intake rate of the con-
ventional chicken thigh was 100% was 12. We decided
to focus on 10 subjects whose intake rate was not 100%,
to prevent undernutrition. The intake rate of each of the
10 subjects of the texture-modified chicken was higher
than that of the conventional chicken thigh (Fig. 2).
Table 4 shows the means of intake rate, intake amount,
protein intake and energy intake of the 10 subjects. As
shown in Table 3, the protein content of texture-mod-
ified chicken was less than that of chicken thigh. To
make the amount of protein the same for both kinds of
chicken, we had to prepare the texture-modified chicken
in bigger portions. Also, its size became larger after
stewing because yakifu absorbed seasoning soup. Con-
sequently, the weight of the texture-modified chicken
was about twice that of the conventional chicken thigh,
but the intake rate and intake amount were significantly
higher (p,0.01) (Table 4).
DISCUSSION
Cooking method of chicken for soft diet
We evaluated various chicken cooking methods based
on physical properties in order to provide food as a soft
diet in a nursing home. As a result, we managed to cook
teriyaki chicken at a final hardness equivalent to the L4
 Soft Diet Based on Food Texture
level of the Dysphagia Diets Pyramid, obtaining a final
texture-modified chicken product composed of 50%
minced chicken, 10% yakifu and 40% water, stewed in
a seasoning soup.
The cooking of softened texture-modified meat has
been reported previously. Kuroda et al. (17) and Taka-
hashi et al. (18) developed texture-modified meat using
minced chicken thigh with onion, and minced pork with
some types of tuber, respectively. We estimated the pro-
tein contents of the texture-modified meats obtained
using onion or potato, which contained a lot of carbo-
hydrate and little protein. To maintain the protein intake
of the eaters, it is good to use additive foodstuff contain-
ing high levels of protein. We thus focused on soy bean
and yakifu processed food.
Even though soy bean-processed foods were suitable
for protein sources, they were not selected as an additive
foodstuff. Because commercially available soy powder
was not heated, much harshness arose from the tex-
ture-modified chicken using soy powder during the boil,
and the taste of soy was strong. The texture-modified
chicken obtained using grated freeze-dried tofu was the
hardest among the soy bean-processed samples (Table
1). It is well established that stewed freeze-dried tofu is
not suitable for a soft diet because of its tendency to lose
water and its difficult mastication pattern.
Even though the protein content of yakifu is lower
than in soy bean-processed food, it remains higher than
that of onion or potato. Thus, the texture-modified
chicken developed in this study provided a better protein
source for the elderly than the texture-modified meat
created in former studies. However, it cannot be pro-
vided for people with wheat allergy.
Suitable hardness for soft diet
When providing teriyaki chicken in the nursing home,
the intake rate of the texture-modified chicken, for which
the hardness was under 40,000 N/m2, of the subjects
whose intake amount of conventional chicken thigh
was not 100%, was significantly higher than that of the
conventional chicken thigh, for which the hardness was
above 63,000 N/m2. We could not obtain the hardness
value of the conventional chicken thigh because of the
limitation of the load cell at a texture measurement. The
breaking stresses, measured by using a 5-mm diameter
plunger and at 80% of distortion factor, of the texture-
modified chicken, the chicken thigh for a soft diet or an
ordinary diet were 60,000 N/m2, 150,000 N/m2 and
450,000 N/m2, respectively. Even though the chicken
thigh cooked for a soft diet was softer than when pre-
pared for an ordinary diet, the texture-modified chicken
was still much softer.
We inferred that the masticatory force of subjects
whose intake amount of conventional chicken thigh was
not 100% might be weak. It would be helpful to provide
two kinds of soft diet: conventional chicken thigh and
texture-modified chicken, but it takes time and effort. To
avoid undernutrition, there was a high probability that
the meal containing the texture-modified chicken with
a 28,000 N/m2 hardness would be more suitable for a
soft diet.
261
Nursing homes rarely have a texture measurement
instrument in their kitchen; therefore, cooks evaluated
the softness of a soft diet by individual judgement. In
this study, by surveying the intake amount of meals
cooked with quantitative assessment of hardness, we
could determine the most suitable meal. We suggest
that the intake rate of the elderly eating appropriate
soft diets would increase and their nutritional status be
maintained, through sharing of suitable cooking meth-
ods among nursing homes.
Water contents and sizes of texture-modified chicken
Mousse-formed and blended foods are softer than soft
diet (9) but cooked with much more water (19). It is nec-
essary to add water in order to soften food. The provided
weight of texture-modified chicken including water-
soaked yakifu was about twice that of the conventional
chicken thigh (Table 4). According to the interviews we
carried out with some subjects, the provided amount of
texture-modified chicken was too much.
Limitations of this study
Texture measurements should be done at the tem-
perature at which the food is provided. Indeed, physical
properties of cooked meat are affected by its tempera-
ture (19). However, we measured the textures of the
samples at 20˚C, at which they would have been softer
than at the provided temperature.
The provided amount values in this study correspond
to an average weight of three servings. We judged that
this method would limit disturbance to the ordinary
running of lunch service in the nursing home. A similar
method was reported in a previous work (20). Neverthe-
less, we could not correctly measure individual intake
amounts due to discrepancies in the amounts dished up.
This method is suitable to evaluate the general trends
among all subjects, but not accurate enough to assess
the intake amounts for each subject and subsequently
suggest methods to increase them. Therefore, it is neces-
sary to improve the methods for measuring the provided
and intake amounts while keeping disturbances to the
ordinary service to a minimum.
Acknowledgments
None of the authors had any financial conflicts of
interest to declare. We are deeply grateful to the staff
and residents of the nursing home for participating in
this study. We would like to thank Ms. Risa Amano,
Ms. Yuki Kuwano, and Ms. Saki Yoshizawa for cooking
teriyaki chicken in the laboratory and surveying intake
amounts.
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