Dysphagia Diets:
Level 2 Mechanically Altered
Foods are soft-textured and moist so that
they may easily form a bolus.
When providing this level of mechanically
altered, 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.
Fluid consistency is ordered separately in
the nutrition prescription and maybe thin,
nectar-thick, honey-like, or spoon-thick.
Beverages may have suspended pulp or bits
of texture, but at liquid consistency specified
by the nutrition prescription.
Breads need to be slurried/pregelled through
entire thickness, but soft, well-moistened
pancakes are allowed.
Cooked cereals may have a little texture
and some dry, but well-moistened cereals
are allowed. Dry or coarse whole grain cereals
are still not allowed. Any cereal with flaxseed,
coconut, dried fruit, nuts, or other seeds
must be avoided.
Desserts at this level may include most canned
fruits, moist cobblers, and moist soft cookies.
Most fats are allowed. Exceptions are those
with chunky additives.
Soft canned or cooked fruits, soft banana,
and fruit juices with a small amount of pulp
at the prescribed consistency may be consumed.
No fruits with skin or seeds.
Moist-ground or minced, tender-cooked meat
with no larger than 1/4" pieces, well-cooked
pasta casseroles, cottage cheese, and tofu
are allowed. Avoid peanut butter, sandwiches,
and pizza.
Moist, well-cooked potatoes, noodles, and
dumplings are allowed. Continue to avoid
rice or casseroles with rice.
Almost all soups with less than 1/2" chunks
of easy-to-chew meat or vegetables are allowed.
Soft, well-cooked vegetables with less than
1/2" pieces are allowed with the exception
of corn, peas, and specific fibrous varieties.
Vegetables should mash easily with a fork.
Salsa and sauces may include small, soft,
tender chunks. Other miscellaneous smooth
jellies and jams without seeds are allowed.
Source:
National Dysphagia Diet Task Force. National
Dysphagia Diet ñ Standardization
for Optimal Care. Chicago, Ill: American
Dietetic Association; 2002:13-16.
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