Dysphagia is difficulty swallowing, commonly associated with weakened tongue and cheek muscles. This weakness can cause swallowing and chewing to become dangerous as it increases the risk for aspiration pneumonia. To help individuals with dysphagia eat safely, the American Dietetic Association has developed a set of national dysphagia diets with appropriate levels of texture modification, depending on your condition.
Level Two Dysphagia Diet Description
Foods that can be eaten on a level two dysphagia diet should be moist, soft in texture, and easily digested. This diet is a transition from the pureed foods recommended on the level one dysphagia diet to more solid textures. If you are attempting this diet, you should be able to chew and tolerate mixed textures. The American Dietetic Association suggests this diet level if you have mild-to-moderate oral dysphagia.
Beverages
Smooth, beverages, free of chunks and pulp, are allowed while on the level two dysphagia diet. Your speech-language pathologist should determine the consistency of these beverages and will decide between a thin, nectarlike, honeylike or spoon-thick consistency. If thin liquids are allowed, you may have milk, juices, coffee, tea and carbonated beverages.
Fruits and Vegetables
Fruits and vegetables that have a soft texture are allowed on this diet. Drained canned or cooked fruits with no seeds or skins, such as pears or peaches, are good examples. Soft, ripe bananas are the only type of fresh fruits recommended. Other dried, frozen or fresh fruits should be avoided, especially pineapple. Vegetables that are well cooked and fork tender are great options, while raw vegetables, corn, peas, and salads will increase your risk of aspiration.
Meats and Fats
Moist ground and finely diced meats are good protein sources. Meatloaf, hamburgers and sloppy joes with no bun, sausage patties and chili are great examples of what you can eat. Sliced deli meat and tuna or egg salads with no large chunks are safer choices as well. Dry meats like bacon or sausage links, cheese slices or cubes, peanut butter, pizza and sandwiches should be avoided. Butter and any other creamy condiment, such as mayonnaise or cream cheese, can be eaten -- just be sure you're not using these to top bread products.
Starches and Desserts
Similar to the other recommended foods, starch and dessert products that are of smooth consistency should be safe. Hot cereals, soft and syrup-moistened pancakes, macaroni and cheese and pureed breads are suggested. Do stay away from bread, bagels, rice and cold cereals with granola, nuts or raisins. You can enjoy desserts like crust-less cheesecake, pudding, custard and yogurt. Ice cream and Jell-O may be allowed depending upon the allowable consistency of your liquids.
References
- "Krause's Food and Nutrition Therapy"; Kathleen Mahan and Sylvia Escott-Stump; 2008
- "National Dysphagia Diet: Standardization for Optimal Care"; National Dysphagia Diet Task Force; 2003
