Level 3 Advanced
Foods are nearly normal textures, yet exclude
crunchy, sticky, or very hard foods. There
is a need for food items to be bite-sized
and moist.
When providing this advanced dysphagia 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 MyPyramid
are also key to maintenance of optimal health.
Fluid consistency is ordered separately from
the nutrition therapy and maybe thin, nectar-thick,
honey-like, or spoon-thick.
All beverages are allowed as long as they
meet the prescribed liquid consistency.
All moist breads are allowed. No tough, crusty
breads.
Moist cereals may be consumed. Only very
coarse or dry grains need to be avoided.
Most desserts are allowed, except those that
are dry; chewy;†or†have nuts,
seeds, coconut, pineapple, or dried fruit.
All fats are allowed except those with chunky
additives.
Fruits should be soft, peeled, and without
seeds.
Meats that are moist and tender or casseroles
with small chunks of meat are allowed. Only
dry meats and fish, chunky peanut butter,
and yogurt with nuts or coconut should be
avoided.
Moist potatoes, rice, and moist stuffing
are allowed. Potato skins, crisp-fried potatoes,
and dry stuffing are to be avoided.
All soups are allowed except those with tough
meats or vegetables.
Most cooked, tender vegetables are allowed
except corn and vegetables that are rubbery
when cooked; may add shredded lettuce.
In the miscellaneous category, the only foods
to be avoided are nuts, seeds, coconut, and
chewy candies.
Source: National Dysphagia Diet Task
Force. National Dysphagia Diet ñ Standardization
for Optimal Care. Chicago, Ill: American
Dietetic Association; 2002:17-19. |
