Seasonal Feast: Summertime Cookout Ideas

Gathering with family and friends is a summertime cookout tradition while celebrating July 4th, Labor Day, or just the fact that the weather is beautiful and it’s time to be outside. Those suffering from dysphagia may be reluctant to attend or host a summertime cookout because of the perceived difficulty in enjoying those delicious traditional foods and liquids. We are going to walk you through typical summertime cookout foods and give you tips and techniques to make them safer for those with dysphagia who require an altered consistency.

Cookout Menu

Hamburgers, Hotdogs/Sausage, Barbecue Chicken

Potato Salad, Macaroni Salad, Grilled Veggies

Strawberry Shortcake, Ice Cream, Fruit Salad

Lemonade, Iced Tea, Milkshake


The goal with the hamburger is to decide what type of beef you are going to use. As you are using a grill and the juices are going to fall through the grate, using a low fat beef is great, but not as vital with this cooking method.

Regular Consistency: Prepare as you normally would. If you have a dysphagia patient that fatigues while eating, consider foregoing the bun in order to make chewing one single consistency easier. Adding cheese to the hamburger would help with that cohesiveness.

Mechanical Soft: Prepare as you normally would. A hamburger is already a mechanical soft consistency. In order to make it more cohesive, put the ketchup and mustard on the bun or add cheese when cooking. Consider not adding the pickle relish or pickles, as they can separate and make it more difficult to contain in the mouth. Consider not toasting the bun as the softer bun will make this a more cohesive bite. Cut the hamburger up into four pieces to assist with taking small bites.

Puree/Soft – Making a hamburger puree is not usually a very good idea because the hamburger will retain a grainy consistency that is not pleasant to the palate. A substitute might be a liver pate’ or getting a Braunschweiger loaf at the deli counter and adding a little liquid such as beef broth before smashing it with a fork to a puree consistency. This gives the taste of beef with the safety of the puree.

*** Note that for all of the hamburgers, mince a cup of mushrooms and add to the ground beef. Add a touch of Worcestershire Sauce to the mixture and season as you normally do. This is intended to make them all a softer and more cohesive consistency as the mushrooms give a smooth texture when cooked and add moisture to the mix. There is not an added mushroom taste as it combines with the beef during the grilling process. I suggest using the white mushrooms as they tend to mix best.


When choosing hotdogs or sausages on the grill, one wants to consider fresh sausages from the deli counter as that will have a more moist consistency. Hot dogs come in all types and flavors and it does not seem to matter too much which you choose. Please remember that with hot dogs or sausages, the risk is that the food item is the same shape as the trachea and if someone aspirates a piece it can be difficult to dislodge. Therefore, no matter which of these that you consider, please be sure to slice them in half lengthwise before serving.

Regular Consistency: For the patient on a regular diet it is vital to cut in half lengthwise before serving just to be sure it cannot block the airway if accidentally aspirated. Using a non-toasted bun with an abundance of condiments is preferable. If adding pickle relish or sauerkraut it is suggested that you take small bites and chew well before swallowing.

Mechanical Soft: The safest way to consume either a sausage or a hot dog is by removing the skin. I would pick the sausage over the hot dog for the mechanical soft diet. Either way, be sure to not only cut lengthwise, but also in small pieces. I would consider not using the bun in this case and staying away from pickle relish and sauerkraut as they can be difficult to transit into the esophagus and have a propensity to leave residue in the pharynx which can be more difficult to clear. If you are the cook, consider buying some of the sausage in patties or bulk and cooking it with some cheese on top. This will be tasty and add some cohesiveness to the dish.

Puree/Soft – There is not a good way to make a hot dog or sausage a puree that has a great texture because of the grainy texture of each. I would stay away from this food item at the cookout.

Barbeque Chicken

Consider choosing chicken thighs as one of the chicken parts for the cookout. The chicken thigh is a more tender and juicer consistency than the chicken breast and is easier to manipulate for the patient with dysphagia. Marinating the chicken prior to the cookout is always a good idea to add the flavor and also begin to break down the texture prior to cooking. Using a vinegar based barbeque sauce might help with this tenderization.

Regular: For the regular diet it is important to assess the fatigue factor of the patient. If the patient gets tired from chewing during a meal, consider taking the chicken off the bone prior to eating. No one notices this technique and it saves a lot of energy in the long run. It is always a good idea to maximize energy at the cookout with friends and family in order to enjoy all of the fun!

Mechanical Soft: Making grilled chicken a mechanical soft diet simply requires taking the chicken off the bone and cutting it up into small pieces that are not big enough to block the airway if aspirated. Use your thumb as the guide as to the size of your trachea. The pieces should not be bigger than that diameter and the more irregular the pieces, the better. Be sure to put enough barbeque sauce on the chicken to keep it moist and help with the bites being cohesive. Do you load up your fork with too many pieces at once! One at a time is best. Chew the food well and consider shredding the chicken thigh meat rather than cutting it into pieces. This would give you the most safety, especially if you fatigue when eating. You can then put the shredded chicken barbeque on an untoasted bun with adequate barbecue sauce and eat this in small bites and pieces.

Puree/Soft: Pureed chicken has a tendency to be grainy and would not necessarily be comforting to the patient at a cookout. Consider the Braunschweiger alternative prepared as a ‘pate in this case.

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