Emily Sinn

ND 568
Marywood University

Academy Nutrition Care Manual Assignments # 2

Dysphagia

Go to the NCM Tab at the top and select Conditions choose Dysphagia from the left
hand margin. Under Dysphagia choose Dysphagia.
Go to Overview on the right: List 5 issues that can result from Dysphagia, if untreated?
1. Malnutrition
2. Dehydration
3. Aspiration
4. Weight Loss
5. Pneumonia

Go to Consistency and Thickeners on the right: Name the 4 standard liquid consistencies
available?

______Thin________ ____Nectar______ _______Honey_______ ______Spoon_______

Go to: Also under Dysphagia, find the three levels.

Level I Pureed Diet

Types of food recommended:
Grains- soft pancakes, breads, well-cooked pastas, noodles, rice, pureed oatmeal, cooked
cereals, moist cake with icing
Protein Foods- pureed, moistened red meat, beef, pork, lamb, seafood (salmon, shrimp,
lobster, clams and scallops), ham, hot dogs and deli meats, poached eggs, pureed smooth
casseroles, smooth nut or seed butters, ground soy foods, moistened meat alternatives or
legumes
Dairy- milk, plain yogurt, sour cream, fortified soymilk, pureed cottage cheese and cream
cheese, frozen desserts made from milk such as smooth pudding, custard, ice cream,
sherbet, malts and frozen yogurt
Vegetables- all pureed, cooked, canned or frozen tender vegetables including dark-green,
red and orange vegetables, legumes (beans and peas), and starchy vegetables, tomato
sauce/paste without seeds, mashed or pureed potatoes without skins
Fruits- all soft, drained pureed fruits including canned and cooked fruits (without skin),
gelatin with canned fruit (except pineapple), well-mashed banana or avocado; pureed
fresh watermelon without seeds and 100% fruit juice
Oils- vegetable oils, including olive, peanut, and canola oils, margarine salad dressing
and mayonnaise, butter, gravy, cream sauces etc.
Beverages- coffee, tea, water, 100% fruit juice at recommended consistency
Level 2 Mechanically Altered Diet
Types of food recommended:
Grains- soft pancakes, breads, sweet rolls, well-cooked chopped pasta, noodles, well-
cooked noodles in sauces, spatzel or soft dumplings, pureed rice, pureed bread products,
cooked cereals with little texture, including oatmeal, moistened dry cereals (corn wheat
flakes, puffed rice), soft moist cakes with icing dissolved in milk or juice, soft moist
cookies and bread pudding
Protein Foods- prepared, moistened and ground red meat including beef, pork or lamb,
moist meatballs, meat load, ground poultry (chicken or turkey), prepared moistened and
fresh or frozen seafood (salmon, shrimp, lobster, clams and scallops), ground ham,
sausages and deli meats, tuna or egg salads, eggs, chopped casseroles with small chunks
of meat, smooth nut and seed butters, ground soy foods, prepared moistened and ground
meat alternatives (veggie burgers) or mashed legumes such as dried beans, lentils or peas
Dairy- milk, yogurt, cottage cheese, cream cheese, sour cream and cheeses, frozen
desserts made from milk such as pudding, custard, ice cream, sherbet, malts and frozen
yogurt
Vegetables- well-cooked soft, canned or frozen tender vegetables including dark-green,
red and orange vegetables, legumes (beans and peas) and starchy vegetables, well-cooked
boiled or mashed potatoes or vegetable juices
Fruits- all soft canned and cooked fruits without skin, gelatin with canned fruit (except
pineapple), fresh ripe banana, fruit pie with bottom crust only and soft crust or crumb
topping, 100% fruit juice or fruit ices
Oils- vegetable oils, olive, peanut and canola oils, margarines, salad dressing and
mayonnaise, butter, gravy and cream sauces
Beverages- coffee, tea, water, 100% fruit juice at recommended consistency

Level 3Advanced Diet

Types of food recommended:
Grains- any well-moistened breads, biscuits, muffins, pancakes, waffles with syrup, jelly,
margarine, butter etc., all well-moistened cereals, all starches such as pasta and moist
bread dressing or rice
Protein Foods- thin sliced, tender or ground prepared moistened red meat (beef, pork,
lamb) or poultry (chicken or turkey) or seafood (salmon, shrimp, lobster, clams and
scallops), ham or salami chopped, ground hot dogs, thinly sliced deli meats, ground
bacon and sausage, eggs, casseroles with small chunks of meats, unsalted nut and seed
butters, moistened soy foods (tofu), moistened meat alternatives (veggie burgers) or
legumes (beans, lentils or peas)
Dairy- milk, yogurt, cottage cheese and cheeses, cream cheese, sour cream and whipped
topping, frozen desserts made from low-fat milk such as pudding, custard, ice cream,
sherbet, malts and frozen yogurt, fortified soymilk
Vegetables- fresh shredded lettuce, sliced tomatoes, finely chopped tomatoes/salsas, all
tender, cooked or canned tender vegetables including dark-green, red and orange
vegetables, legumes (beans) and starchy vegetables, all potatoes tender and vegetable
juices
 Fruits- all canned or cooked fruits, crushed pineapple, soft peeled fruits (peaches,
nectarines, kiwi, cantaloupe, honeydew and watermelon without seeds), soft berries with
small seeds (strawberries) or 100% fruit juices
Oils- olive, peanut and canola oils, margarines and spreads, salad dressing and
mayonnaise, butter, gravy and cream sauces
Beverages- coffee, tea, water, 100% fruit juice at recommended consistency

Go to the Client Ed/Diet Tab at the top choose Dysphagia from the left hand margin.

How would you rate the client education available for the patients with dysphagia?
I would rate the client education available for the patients with dysphagia as strong.
From the Nutrition Care Manual website there are 8 reputable sources of information for
patients to review. Of those listed, 6 are either new or updated with more beneficial and
current information. The only downfall of the resources available is that they are not
offered in any other language other than English.

Used with permission: Pauli Landhuis, MS, RD, LD; University of Missouri