Dysphagia Diet Level 1

Dysphagia Diet Level 1Patient EducationNameDietitianPhoneE-mailWho Should Use the Level 1 Dysphagia Diet?Dysphagia is a condition in which people havedifficulty swallowing. People with minimal abilityto chew and swallow need the level 1 dysphagiadiet. It is appropriate for people with thefollowing conditions:• Inability to clear all food out of the mouth• Frequent choking on mixed consistencies of liquidand solid food such as casseroles, cold cereal withmilk, or soups with chopped meat and vegetables• Inability to swallow food without remindersto follow swallowing techniques taught byspeech therapist• Weak cough when food or liquid penetrateinto lungs• Weak or limited chewing abilityThe Level 1 DietAt this level of dysphagia, it is essential to preparefoods so they require no chewing. Foods in this dietmust be smooth, moist, homogenous, and cohesivewith a pudding-like texture and no lumps orchunks. No coarse textures, raw fruits, dried fruits,nuts, seeds, or raw vegetables are allowed.Dysphagia also affects the kinds of liquids aperson can swallow. At this diet level, thin liquidbeverages may require thickening with Thick-Itor a comparable product (see the table on page 4).The nursing staff or a trained caregiver will thickenbeverages at bedside as needed.Special RecommendationsThe list on the following pages is not all-inclusive.Please ask your dietitian or speech therapist foradditional recommendations and suggestions.For more patient education information, call 1-888-424-2100 toll free or go to www.huntsmancancer.orgProduced by Huntsman Cancer Institute © 2010 • Approved by PESC November 2010 • Review Date November 2013

Food Group Recommended Avoid If All Liquids AllowedPlain custardCheese cubes or slices MilkPlain yogurt or flavored Cottage cheeseCarnation ® Instantsmooth yogurt without Custard with dried fruit Breakfast ®fruit piecesor nutsIce creamDairy productsWhite sauce or cheese sauceMilk thickened* toconsistency advised byspeech therapistYogurt with fruit pieces,nuts, or coconutEggnogMilkshakesPureed meat, fish, andpoultryWhole or ground meat, fish,and poultryPureed lentils or beansUnpureed lentils or beansMeat and meatsubstitutesSmooth soufflés with aconsistent textureSoftened tofu pureed withadded moisturePeanut butter, unless creamyand pureed thoroughlyinto foodsFried foodsHummus or otherpureed spreadsNon-pureed foodsScrambled, boiled, orpoached eggsFruitApplesaucePureed fruitThickened* fruit juicewithout pulp, seeds,or chunksWhole fresh fruitCanned fruit, unless pureedDried fruitFrozen fruitFruit juice with pulpFruit juice without pulp,seeds, or chunksTomato juiceVegetablesPureed vegetables withoutpulp, seeds, or chunksThickened* tomato juice orvegetable juiceAll unpureed vegetablesVegetable juiceDysphagia Diet Level 1 Patient Education - Page 2

Food Group Recommended Avoid If All Liquids AllowedPureed breads, pancakes, Unpureed breads, rolls,sweet rolls, French toast French toast, and pancakesCream of Wheat ® Bread stuffingCream of Rice ®CrackersMalt-O-Meal ®BiscuitsGritsWafflesGrains andstarchesPureed pasta or noodlesMashed potatoes with gravy,butter, margarine, or sourcreamMuffinsAll cold cerealsCooked cereals with lumps,seeds, or nutsOatmealRice, cooked or pureedUnpureed potatoes andnoodlesSoupsStrained creamed soups; nolumps or grainy textureThickened* broths ortomato soupSoups with lumps, chunks,or seedsUnthickened broth ortomato soupDessertsSmooth puddingCustardMousseSmooth soufflésPureed dessertsThickened* eggnog andnutrition supplements suchas Ensure ® or Boost ®Tapioca, bread, andrice puddingsCookiesCakesPiesAny dessert with seeds, nutsor coconutFrozen malts andmilkshakesFrozen yogurt, ice cream,and sherbetEggnogPlain flavored gelatinsNutrition supplementssuch as Ensure ® or Boost ®Dysphagia Diet Level 1 Patient Education - Page 3

Food Group Recommended Avoid If All Liquids AllowedMiscellaneousSugarSugar substituteSaltFinely ground spicesKetchupMustardBarbecue sauceCoarsely ground pepper andherbsFruit preserves or seedy jamsSeedsNutsSticky foodsCandy with sprinklesMayonnaiseChewy candy such as caramelor licoriceSmooth sauces and gravyHoneyJellySmooth candy suchas truffles*Thickened liquidsThicker liquids may be easier to swallow than thin liquids. Your dietitian or speech therapist may recommend thatyou avoid thin liquids, and drink liquids with a thicker consistency similar to nectar or pudding. The table belowsuggests ways to thicken beverages, sauces, and soups.Thickening Product Recommended Use Helpful InformationTapioca, flour, or cornstarchStir into cooked gravies or saucesto desired thickness.These must be used in heated foodsonly. They will not change the flavorof sauces.Thick-It or Hydra AidPureed vegetables andinstant mashed potatoesFollow directions on productpackage to thicken foods orliquids to desired thickness.Stir into soups to desired thickness.These can be purchased at drug storesor on the Internet. They will notchange the flavor of foods and liquids.These will change the flavor of soups.Baby cereal Stir into liquids to desired thickness. This will change the flavor of liquids.Dysphagia Diet Level 1 Patient Education - Page 4