Dysphagia Diet Level 3, Advanced

This dysphagia advanced diet is restricted to:

  • Foods that are moist, with "bite-size" pieces.

  • Foods that are not hard, sticky, or crunchy.

  • Well-moistened breads with extra margarine, jelly, and syrup. No dry bread such as toast or crackers.

  • Foods that do not include nuts, seeds, dry fruit, coconut, or pineapple.

  • Vegetables that are less than 1 inch in size. No cooked corn or non-tender, rubbery cooked vegetables such as broccoli, cabbage, Brussels sprouts, asparagus, or cauliflower.

FOOD TEXTURES

Beverages

  • Recommended: Any beverages, depending on recommendations for liquid consistency.

  • You are currently limited to one of the following liquid consistency levels:

  • Thin.

  • Nectar-like.

  • Honey-like.

  • Spoon-thick.

Breads

  • Recommended: Any well-moistened breads, biscuits, muffins, pancakes, and waffles. Need to add adequate syrup, jelly, margarine, or butter to moisten well.

  • Avoid: Dry bread, toast, and crackers. Tough, crusty breads such as French bread or baguettes.

Cereals

  • Recommended: Cooked cereals with little texture, including oatmeal. Unprocessed wheat bran stirred into cereals for bulk. If thin liquids are restricted, it is important that all of the liquid is absorbed into the cereal.

  • Avoid: All dry cereals and any cooked cereals that may contain flax seeds or other seeds or nuts. Whole-grain, dry, or coarse cereals. Cereals with nuts, seeds, dried fruit, or coconut.

Desserts

  • Recommended: All except those listed to avoid.

  • Avoid: Dry cakes or cookies that are chewy or very dry. Anything with nuts, seeds, coconut, pineapple, or dried fruit.

  • These foods are considered thin liquids and should be avoided if thin liquids are restricted:

  • Frozen malts, milk shakes, frozen yogurt, eggnog, nutritional supplements, ice cream, sherbet, regular or sugar-free gelatin, or any foods that become thin liquid at either room temperature, 70° F (21.1° C) or body temperature, 98° F (36.7° C).

Fats

  • Recommended: All except those listed to avoid.

  • Avoid: All fats with coarse, difficult-to-chew, or chunky additives such as cream cheese spread with nuts or pineapple.

Fruits

  • Recommended: All canned and cooked fruits. Soft, peeled fresh fruits such as peaches, nectarines, kiwi, mangoes, cantaloupe, and honeydew. Soft berries with small seeds such as strawberries.

  • Avoid: Difficult-to-chew fresh fruits such as apples or pears. Stringy, high-pulp fruits such as papaya, pineapple, or mango. Fresh fruits with difficult-to-chew peels, such as grapes. Uncooked dried fruits such as prunes and apricots. Fruit leather, fruit snacks, and dried fruits.

Meats and Meat Substitutes

Meat should be chopped into ¼-inch to ½-inch pieces.

  • Recommended: Thin-sliced, tender, or ground meats and poultry. Well-moistened fish. Eggs prepared any way. Yogurt without nuts or coconut. Casseroles with small chunks of meat, ground meats, or tender meats.

  • Avoid: Tough, dry meats and poultry. Dry fish or fish with bones. Chunky peanut butter. Yogurt with nuts or coconut.

Potatoes and Starches

  • Recommended: All, including rice, wild rice, moist bread dressing, and tender, fried potatoes.

  • Avoid: Tough, crisp fried potatoes. Potato skins. Dry bread dressing.

Soups

  • Recommended: All soups except those listed to avoid. Strained corn or clam chowder. Soups will need to be thickened to appropriate consistency, if soup is thinner than prescribed liquid consistency.

  • Avoid: Soups with tough meats. Corn or clam chowders. Soups with large chunks of meat and vegetables that are bigger than 1 inch.

Vegetables

  • Recommended: All cooked, tender vegetables. Shredded lettuce.

  • Avoid: All raw vegetables except shredded lettuce. Cooked corn. Non-tender or rubbery cooked vegetables.

Miscellaneous

  • Recommended: All seasonings and sweeteners. All sauces. Non-chewy candies without nuts, seeds, or coconut. Jams, jellies, honey, and preserves.

  • Avoid: Seeds, nuts, and coconut. Chewy caramel or taffy candies. Candies with nuts, seeds, or coconut.