Symptoms of a stroke can include sudden weakness or paralysis and can involve muscles used in swallowing and breathing. This results in a condition known as dysphagia and makes eating difficult and dangerous because food can be aspirated into the lungs. Depending on the severity of swallowing problems, a patient may be assigned one of three levels of a dysphagia diet, with level 1 being the most restrictive and level 3 the least restrictive.
Meat and Meat Substitutes
On a level 1 dysphagia diet, meat must be pureed. This is done by thoroughly cooking meat, cutting it up into small pieces, then mixing with liquid in a blender and pureeing to a smooth consistency. No solid chunks of meat are allowed. On a level 2 diet, moist ground or diced meat is permitted. Level 2 includes meat loaf, hamburger patties without a bun, shredded cheese, cottage cheese and chicken, egg or tuna salads. On level 3, solid tender pieces of meat and cheese slices may be added. Peanut butter, cubed cheese, hot dogs, sausage links, crisp bacon and dry, tough meats are not permitted at any level, according to the Ohio State University Medical Center.
Starches and Grains
The OSU Medical Center advises hot cereals, including rice cereal, are safe for a level 1 diet, but that pancakes, French toast, pasta and casseroles must be pureed. No other grain products, such as bread, rice or muffins, are allowed. Level 2 adds cold flake cereal. It is no longer necessary to puree pancakes, pasta or casseroles as long as there are no solid chunks of food, such as nuts or meats, in them. Level 3 adds grilled cheese, soft breads and moist rice. At no level is it considered safe to eat bagels, granola, bread sticks, French bread or breaded fried foods.
Fruits and Vegetables
On level 1, only fruits and vegetables pureed without skin or seeds should be served. Some foods, such as applesauce and refried beans, may be served without further pureeing. On level 2, soft canned fruits without seeds or skin and ripe bananas are added, along with soft-cooked vegetables. On level 3, shredded lettuce and tender fried potatoes are added. The OSU Medical Center advises raw fruit, other than ripe bananas, and raw vegetables, salad, corn and peas are not safe at any level.
Liquids
Thin liquids, such as water, milk or ice cream as it melts when being eaten, can easily be aspirated by a person with dysphagia. The OSU Medical Center explains liquids should be thickened to one of three consistencies: nectar-like, honey-like or spoon-thick. Some foods are the right thickness naturally. For example, cream soups are considered nectar-like and pudding is considered spoon-thick. To thicken other liquids, commercial starch or gel-based thickeners are available. If normal ice cubes are used, they will thin the beverage. Instead, first thicken water to the desired consistency, then freeze into cubes for later use.
