Skip to Content

Level 2 National Dysphagia Diet


What is a level 2 national dysphagia diet?

A level 2 national dysphagia diet includes only moist, soft foods. Regular foods need to be modified to make them easier to chew and swallow. This can be done by blending, chopping, grinding, mashing, shredding, or cooking the food. You need to have some chewing ability to eat these foods. Thin liquids need to be thickened because they are hard to swallow. The level of thickness you need depends on how well you can swallow. Your healthcare provider will tell you how long you need to follow this diet.

What do I need to know about thickened liquids?

Thin liquids can be thickened with special thickeners, flour, cornstarch, or potato flakes. Thin liquids include milk, juice, coffee, tea, soda, and nutritional supplements. Foods that are liquid at room temperature should also be thickened. These include frozen malts, yogurt, milk shakes, eggnog, ice cream, and gelatin. Your healthcare provider or dietitian will tell you which of the following types of thickened liquids you need.

  • Nectar-like liquids have the same thickness as nectars, vegetable juices, and milkshakes.
  • Honey-like liquids are thicker than nectar-like liquids. The thickness is similar to honey at room temperature.
  • Spoon-thick liquids are the thickest. The thickness is similar to that of pudding. These liquids need to be eaten with a spoon.

How do I prepare foods?

  • Use a blender, food processor, food chopper, grinder, or potato masher to soften your food. Make the pieces ¼ inch (0.635 cm) or smaller. Add gravy, sauce, vegetable or fruit juice, milk, or half and half to moisten the food.
  • Pour sauce or gravy over bread slices or syrup over pancakes. Allow the food to soften and dissolve.
  • Add dry milk powder to foods for extra protein and calories, if needed.
  • Cook vegetables so they are tender enough to be mashed with a fork.
  • Prepared foods can be frozen in small portions and reheated later. When you reheat foods, do not allow a tough outer crust to form on the food. This can make the food hard to swallow.

Which foods can I eat?

Remember to make the pieces of any food ¼ inch (0.635 cm) or smaller.

  • Grains:
    • Soft pancakes, breads, sweet rolls, Danish pastries, and French toast with syrup or sauce
    • Soft dumplings moistened with butter or gravy
    • Cooked cereals such as oatmeal
    • Moistened dry cereal with little texture, such as corn flakes or puffed rice
    • Cakes or cookies moistened and softened with milk, coffee, or other liquid
  • Vegetables and fruits:
    • Well-cooked, boiled, baked, or mashed potatoes
    • Well-cooked vegetables
    • Drained, canned, or cooked fruits without seeds or skins
    • Ripe banana
  • Dairy products:
    • Pudding, custard, or cottage cheese
    • Ice cream, sherbet, frozen yogurt, and malts
  • Meat and other protein foods:
    • Moistened ground or tender cooked meat, poultry, and fish with gravy or sauce
    • Any casserole without rice
    • Tuna, egg, or meat salad without large chunks or hard-to-chew vegetables
    • Poached, scrambled, or soft-cooked eggs mashed with butter, margarine, sauce, or gravy
    • Tofu and well-cooked, moistened, or mashed cooked bean, peas, baked beans, and other legumes
  • Fats and oils:
    • Butter, margarine, gravy, and cream sauces
    • Mayonnaise and salad dressing
    • Cream cheese and sour cream

Which foods should I avoid?

  • Grains:
    • Very coarse cereals that contain seeds, nuts, or dried fruit
    • Rice, rice pudding, and bread pudding
  • Vegetables and fruits:
    • Raw fruits and raw, undercooked vegetables
    • Fried or French fried potatoes
    • Cooked corn and peas
    • Cooked fibrous, tough, or stringy vegetables such as broccoli, cabbage, brussel sprouts, and asparagus
    • Pineapple, fruit with seeds, coconut, and dried fruit
  • Dairy, meat, and other foods:
    • Cheese slices and cubes
    • Dry meats and tough meats such as bacon, sausage, and hot dogs
    • Nuts, seeds, or peanut butter
    • Hard cooked or crisp fried eggs
    • Pizza or sandwiches

Care Agreement

You have the right to help plan your care. Discuss treatment options with your healthcare provider to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright IBM Corporation 2020 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.