Which of the following is an appropriate diet for a client with dysphagia?

Dysphagia diet is a special eating plan recommended for patients who are unable to swallow foods. In very serious cases of dysphagia, a pureed diet (or the most restrictive diet) is often recommended for these patients so as to prevent aspiration, choking or pneumonia. Those on this diet are only able to eat pureed “pudding-like” foods, and should avoid all foods with coarse textures.

When it comes to preparing meals for someone with dysphagia, it is important to use the right ingredients. Choosing ingredients that cannot be easily swallowed by the patient may lead to potential life threatening consequences. Here’s a list of high-risk foods that should be avoided by dysphagia patients.

Mixed Consistency Foods
These are foods with more than one texture or consistency. Examples include mixing cereal with milk, or bread that has been dipped in soup. Variance in food consistency makes it harder for patients to swallow and they might end up having food lumps stuck in their throat.

If you are looking to enhance the food with sauces or soup, take note to puree all the food and mix them together instead of serving foods with different consistencies.

Foods with Husks/Hulls
Husks or hulls refer to the dry outer covering of some foods - seeds, fruits or vegetables. The texture and dryness of the husks make it very difficult and dangerous for dysphagia patients, as they may trigger choking and aspiration. Some examples of foods with husks include granary, multi-grain breads, and vegetables such as corn on cob and barley.

If you are preparing meals involving foods such as corn, barley and wheat, it is important to check and that the packaging states that the ingredients have been hulled. Otherwise, you may also hull the ingredients at home by hand.

Fibrous Foods
Foods with a fibrous or “stringy” texture should also be avoided as they may cause a gag reflex when dysphagia patients try to swallow them. Examples of such foods include celery, string beans, melted cheese and pineapple.

If you are looking to prepare a well-balanced and nutritious meal, consider replacing the stringy, fibrous ingredients with items such as GentleFoods’ pureed broccoli, pumpkin and fruit juices that are available for immediate consumption.

A Dysphagia Diet is used for people who have difficulty swallowing. Foods on this diet are easier to chew and move around in your mouth. This will reduce the risk of food and liquids going the wrong way. Foods that are on mechanical soft diets are all made of moist and soft textures. Eating foods not allowed on this diet will increase your chance of swallowing problems and can result in food going into your airway (windpipe) instead of your esophagus (food tube). Food or liquid that goes into your airway instead of your stomach puts you at risk for not getting enough nutrition and getting sick (pneumonia).

Recommended Foods:

Beverages/Liquids:

• Liquids should be the thickness recommended by your SLP or doctor: thin, nectar, or honey-thickened.

Starches, Breads, and Cereals:

• Pancakes or French Toast, well moistened with syrup
• Well cooked, moistened, boiled, baked, or mashed potatoes
• Oatmeal
• Cold cereal moistened with milk
• Moist macaroni and cheese/well-cooked pasta with meat sauce

Foods to avoid: Chips, dry breads/rolls, coarse cereals that include seeds/nuts

Meats and Meat Substitutes:

• Moist, ground/finely diced meats, poultry, or fish (served with gravy or sauces)
• Poached, scrambled, or soft cooked eggs
• Slightly mashed, moist legumes (baked beans)
• Tofu
• Tuna or egg salads (without large chunks, celery, or onion)

Foods to avoid: Dry, tough meats (bacon, hot dogs, sausage), sandwiches, peanut butter

Fruits and Vegetables:

• Fresh, soft ripe bananas or soft drained, canned fruit without seeds or skin
• Soft, cooked vegetables that are fork tender and diced to less than ½ inch

Foods to avoid: Raw fruits and vegetables (no fresh, canned, or cooked pineapple), cooked corn or peas, broccoli, cabbage

Desserts:

• Pudding, custard, apple sauce
• Jello, sherbert, sorbet, ice cream
• Cobblers without seeds/nuts and with soft breading or crumb mixture

Foods to avoid: Dry, coarse cakes or cookies, rice or bread pudding, hard candies

Tips for getting enough nutrition:

• Try to eat from a variety of food groups, so your body gets the nutrients it needs.
• To make sure you get enough calories and protein, you may include liquid nutrition supplements, such as Ensure, Boost, or Carnation Instant Breakfast if they are thickened to the correct texture, if needed. “Plus” versions of these products provide the most calories and protein per serving. Taste is best when served cold.
• Eat small, frequent meals, especially if you are not able to eat large meals.
• Add gravies or sauces to enhance flavor and to increase moisture of foods to ease swallowing.
• Serve hot foods hot and cold foods cold to provide a variety of temperatures in your diet and to avoid food contamination.

Talk with your Speech-Language Pathologist (SLP) regarding any questions you may have about your diet recommendations or your swallowing. UMMC Speech-Language Pathology 601-815-6064.

What diet is best for dysphagia?

What foods should you avoid with dysphagia?