Food Guide – Dysphagia Diets

NDD Level 3: Dysphagia-Advanced (Soft)

Diet Description: Foods are moist, soft, and require more chewing ability; however should still be in “bite” sized pieces. Foods are nearly regular in texture. Bread and rice are included. Hard, sticky, and crunchy foods are excluded.

Food Group / Foods Allowed / Foods Excluded
Cereals and Breads
All items must be well- moistened with milk (orjust enough milk to moisten if regular/thinliquids are restricted). /
  • All well-moistened cereals
  • Any well moistened breads, biscuits, muffins, pancakes, waffles, etc(with butter, margarine, syrup, or jelly).
  • Grilled cheese sandwich with no crust cut into bite size pieces
/
  • Coarse or dry cereals such as All Bran, Shredded Wheat, etc.
  • Dry bread, toast, crackers, etc.
  • Tough, crusty breads such as French bread or baguettes

Vegetables /
  • Tender soft-cooked vegetables
  • Shredded lettuce
/
  • Raw vegetables
  • Cooked corn
  • Stewed tomatoes
  • Non-tender or rubbery cooked vegetables

Fruits /
  • Soft, peeled fresh fruits such as ripe banana, peaches, nectarines, kiwi, cantaloupe, honeydew, watermelon without seeds, and soft berries with small seeds (i.e. strawberries).
  • All canned or cooked fruit without skins or seeds.
/
  • Difficult to chew fresh fruits such as apples or pears.
  • Stringy, high pulp fruits like papaya, pineapple, and mango.
  • Fruits with difficult to chew skins such as grapes.
  • Dried fruit, fruit snacks, raisins, and fruit roll ups

Meats, Meat Substitutes, and Entrees
All meats must be well-moistened. Add extra gravy or sauces asneeded. /
  • Thin-sliced, tender, or ground meat and poultry
  • Well moistened fish
  • Cheese cubes or slices
  • Casseroles with small chunks of meat, ground meat, or tender meat
  • Meat salads mixed with mayonnaise without large chunks or celery
  • Eggs (prepared any way)
  • Smooth quiche or soufflés without large chunks
  • Tofu, legumes that are well cooked
  • Creamy peanut butter
  • Yogurt without nuts or coconut
/
  • Dry or tough meat and poultry (such asbacon, sausage, hot dogs, bratwurst)
  • Dry fish or fish with bones
  • Chunky peanut butter
  • Yogurt containing nuts or coconut

Food Group / Foods Allowed / Foods Excluded
Desserts /
  • All except those listed to avoid.
/
  • Dry cakes, cookies that are chewy, dry or very hard.
  • Any foods containing coconut, dried fruit, nuts, pineapple, raisins, or seeds.
  • Foods that become thin at room or body temperature need to be avoided or thickened if thin liquids are not allowed (i.e. milk shakes/malts, frozen yogurt, eggnog, ice cream, sherbet, jello).

Soups
Soups may need to be thickened to your diet/liquid prescription. /
  • All except those listed to avoid
  • Strained corn or clam chowders
/
  • Soups with tough meat and poultry
  • Chowders (clam, corn) unless strained
  • Soups with chunks (meats and vegetables) larger than one inch.

Potatoes and Starches /
  • All including rice, wild rice, moist bread dressing, and tender, fried potatoes
/
  • Tough crisp-fried potatoes
  • Potato skins
  • Dry bread dressing

Miscellaneous /
  • Non chewy candy without nuts, seeds, or coconut
  • Jams, jellies, preserves, honey
  • All sauces
/
  • Coconut, nuts, seeds
  • Chewy caramel or taffy-like candy
  • Candy containing coconut, nuts, and seeds
  • Hard candy
  • Coconut, nuts, seeds

Food Guide – Dysphagia Diets

NDD Level 2: Dysphagia-Mechanically Altered (Mechanical Soft)

Diet Description: Foods are moist, soft, and simple to chew. The diet is intended to provide a transition from puree to easy-to-chew foods. Moistened ground meats (pieces should not exceed ¼-inch pieces), vegetables cooked to a soft mashable texture, soft-cooked or canned fruits, and bananas are included.

Food Group / Foods Allowed / Foods Excluded
Breads /
  • Soft pancakes, well moistened with syrup
  • Pureed bread mixes
  • Pre-gelled or slurried breads, sweet rolls, pastries, french toast, etc.
/
  • All others

Cereals
Cereals may have just enough milk to moisten if liquids are restricted; mixture should be well blended and absorbed into the cereal. /
  • Cooked cereals with little texture (Farina, Cream of Wheat, Malto-Meal, Cocoa Wheat, Oatmeal)
  • Dry cereals with little texture softened with milk (Corn Flakes, Rice Krispies, Wheaties, etc)
  • Unprocessed wheat bran may be stirred into cereals for bulk
/
  • Coarse cooked cereals
  • Cereals with seeds, coconut, dried fruit, or nuts
  • Whole grain dry or coarse cereals

Vegetables
Vegetables should be < ½ inch and easily mashed with a fork. /
  • Soft, well cooked vegetables
/
  • Asparagus, broccoli, brussel sprouts, cabbage, corn, and peas.
  • Fibrous non-tender or rubbery cooked vegetables
  • Raw vegetables
  • Stewed tomatoes

Fruits
Diced no larger than ½ inch if canned fruit is not soft. /
  • Soft drained canned or cooked fruit without seeds or skins
  • Soft and ripe bananas
/
  • Fruits that are dried, fresh, or frozen
  • Cooked fruit with skins and/or seeds
  • All pineapple
  • Raisins

Soups
May need to be thickened to liquid prescription /
  • Soups with easy to chew or easy to swallow meats or vegetables. Food piece sizes should be less than ½ inch in size.
/
  • Soups containing corn, peas, or rice
  • Soups with large chunks of meat and vegetables

Potatoes and Starches
All potatoes must be moist and in a sauce /
  • Baked, boiled, or mashed potatoes that are well cooked and moistened. No skins.
  • Shredded hash browns well cooked and not crisp.
  • Well cooked noodles in a sauce.
  • Spaetzel or soft dumplings moistened with butter or gravy.
/
  • Potato skins
  • Potato Chips
  • French fries or other fried potatoes
  • Rice
  • Spaghetti

Food Group / Foods Allowed / Foods Excluded
Meats, Meat Substitutes, and Entrees
Meat pieces should not exceed ¼-inch cube and should be tender. /
  • Moist ground or cooked meat, chicken, turkey, or fish. Serve with sauce or gravy to moisten
  • Casseroles without rice
  • Macaroni and cheese that is moist, well-cooked pasta with meat sauce, tuna and noodle casserole (no peas), lasagna that is soft and moist
  • Raviolis well cooked and cut into ¼ inch pieces with sauce
  • Fish loaf, meat loaf, and meatballs that are moist and have sauce/gravy
  • Meat salads (mixed with mayonnaise), such as tuna, egg, ground ham, ground chicken, ground beef without large chunks, celery, or onion
  • Cottage cheese
  • Smooth quiche without large chunks
  • Scrambled eggs, poached or soft eggs, soufflés, and quiche. All eggs should be moist and mashed with a fork with butter or margarine.
  • Well-cooked, slightly mashed,
moist tofu or legumes such as baked beans /
  • Dry or tough meats (such as
bacon, sausage, hot dogs, bratwurst)
  • Dry casseroles or casseroles with
rice or large chunks
  • Cheese slices or cubes
  • Hard-cooked egg
  • Peanut butter
  • Sandwiches
  • Pizza

Desserts /
  • Custard and pudding
  • Soft fruit pies with bottom crust only
  • Plain cheesecake with thin crust (fruit glaze on top without fruit pieces).
  • Soft, moist cakes with icing
  • Crisps and cobblers without seeds, coconut, or nuts and with soft breading or crumb mixture
  • Soft, moist cookies that have been dunked in milk, coffee, or other liquid
  • Canned fruit (no pineapple)
/
  • Ice cream, sherbet, frozen yogurt,
other ices (may be given if regular liquids are allowed)
  • Dry cookies or cake
  • Any foods containing coconut, dried fruit, nuts, pineapple, raisins, or seeds.
  • Cooked fruit with skins and/or seeds
  • Bread and rice pudding

Miscellaneous /
  • Butter, margarine, gravy, cream
sauces, mayonnaise, salad
dressings, cream cheese, sour
cream, whipped toppings
  • BBQ sauce, ketchup, mustard, honey
  • Jams and preserves without seeds; jelly
  • Sauces and salsas with small
tender chunks < ½inch /
  • Miscellaneous items (sauces, condiments, etc.) with coarse or chunky
additives
  • Seeds, coconut, nuts
  • Sticky or hard foods
  • Chewy candy like caramel, licorice, and taffy

Food Guide – Dysphagia Diets

NDD Level 1: Dysphagia Pureed (Puree)

Diet Description: Foods are thick and smooth and have a moist pudding-like consistency without pulp or small food particles (i.e. foods are “blenderized”). They cling together, are easy to swallow, and require a minimum amount of manipulation in the mouth.

Food Group / Foods Allowed / Foods Excluded
Breads /
  • Pre-gelled or slurried breads, pancakes, pastries, french toast
  • Pureed bread
/
  • All breads and bread products that are not pre-gelled or slurried.
  • Crackers

Cereals /
  • Thick, smooth, moist hot cereals. The cereal should have a “pudding like” consistency (i.e. Malt-O-Meal, Farina, Cream of Wheat, Cocoa Wheat) (thickness of milk based on liquid restrictions)
/
  • All ready to eat cereals.
  • Cooked cereal with chunks, lumps, or seeds
  • Oatmeal

Fruits /
  • Applesauce, pureed fruits, well-mashed bananas
/
  • Regular canned, fresh, dried, or frozen
fruits
Vegetables /
  • Blended/pureed vegetables without chunks, lumps or seeds; mashed white potatoes; tomato paste
/
  • All vegetables that have not been blended/pureed

Soups /
  • Smooth creamy and strained soups. (thickness of soup based on liquid restrictions)
/
  • Soups with chunks, lumps, pieces of meat, vegetable, noodles, rice, potatoes, etc.

Potatoes and Starches /
  • Mashed potatoes with butter, margarine, gravy, sauce, or sour cream
  • Well cooked pasta, bread dressing, or rice that has been pureed
/
  • All other items that are not pureed.

Meats, Meat Substitutes, and Entrees /
  • Pureed meats, poultry, or fish
  • Pureed scrambled eggs that hold their form
  • Pureed smooth Hummus or other legume spread
  • Smooth softened tofu mixed with liquid
/
  • All other meats that are not pureed
  • Cottage cheese
  • Cheese slices or cubes
  • Scrambled or hard cooked egg
  • Peanut butter
  • Sandwiches
  • Pizza

Desserts /
  • Smooth custard and pudding
  • Plain or custard-style yogurt
  • Souffles
  • Desserts pureed to a smooth and
moist consistency /
  • Ice cream, sherbet, malts, frozen yogurt, other ices (may be given only if regular
liquids are allowed)
  • Regular cake, pie, cookies
  • Bread and rice pudding
  • Yogurt with fruit pieces

Miscellaneous /
  • Butter, margarine, smooth gravy, cream sauces, mayonnaise, salad dressings, cream cheese, sour cream, whipped toppings
  • Sugar, jelly, honey, syrup
  • Ketchup, mustard, smooth sauces
/
  • Miscellaneous items (sauces, condiments, etc.) with coarse or chunky
additives
  • Jams and preserves with fruit pieces
  • Chunky peanut butter