Dysphagia Diets:
Level 1 Pureed
Patient and Family Information
When providing this pureed level, it is
important to follow the therapeutic recommendations
of the physician, registered dietitian, and/or
speech-language pathologist. Guidelines for
the number of servings of each food group
recommended within the MyPyramid are also
key to maintenance of optimal health.
Foods are totally pureed. No coarse textures
or lumps of any sort are allowed.
Fluid consistency is ordered separately from
the meal plan and may be thin, nectar-thick,
honey-like, or spoon-thick. Beverages should
be very smooth, but at the liquid consistency
designated by the nutrition prescription.
Breads must be pureed or pregelled, slurried
through the entire product thickness.
Cereals are to be very homogenous and "pudding-like" (e.g.,
cream of wheat or rice, farina). Avoid oatmeal.
Desserts should be smooth, like custard or
yogurt. No coarse or textured desserts.
Fats are generally smooth, so there really
is not much adjustment for the level 1 pureed
diet.
Fruits must be pureed or well-mashed without
pulp, seeds, or skins and juices thickened
to the prescribed consistency.
Meats and meat substitutes must be of very
smooth consistency or pureed. No peanut butter
unless part of a pureed recipe that would
be easy to swallow.
Mashed potatoes and pureed pasta are the
main components of the potatoes and starches
food group. These should be served with gravy,
sauce, or extra butter/margarine to ensure
it is moist and not sticky.
Soups should be strained to ensure no chunks
or lumps with smooth consistency or pureed
to appropriate fluid consistency. Because
soup is a fluid, it is important to have
it thickened using the fluid recommendations
for the individual patient.
Vegetables are pureed and vegetable juices
thickened to the prescribed consistency.
Honey, ketchup, and smoothly ground spices
may be used.
Smooth jellies and very soft, smooth candies
may be included.
Because texture is so homogenous at this
phase, the flavorings or garnishing touches
of syrup or sauce that are added are important
to maximize palatability, eye appeal, and
enjoyment of the food.
Source: National Dysphagia
Diet Task Force. National Dysphagia Diet ñ Standardization
for Optimal Care. Chicago, Ill: American
Dietetic Association; 2002:10-12.
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