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Level 3 National Dysphagia Diet


A level 3 national dysphagia diet includes moist foods in bite-sized pieces. These foods are easier for you to chew and swallow. Avoid foods that are hard, sticky, crunchy, or very dry. Thin liquids may need to be thickened if they are hard for you 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.


How to thicken 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 if you need any of the following types of thickened liquids.

  • 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 to prepare foods:

  • Make food pieces smaller than 1 inch (2.54 cm).
  • To moisten foods and add flavor, serve your food with gravies or sauces.
  • Pour sauce or gravy over bread slices or syrup over pancakes. Allow the food to soften.
  • Cook vegetables until they are tender.
  • 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.

Foods you can eat:

Remember to make food pieces smaller than 1 inch (2.54 cm).

  • Grains:
    • Soft pancakes, breads, sweet rolls, Danish pastries, and French toast with syrup or sauce
    • Soft dumplings moistened with butter or gravy
    • Rice or wild rice, if healthcare providers tell you it is safe for you
    • Dry cereals moistened and softened with milk or cooked cereals
    • Cakes or cookies moistened and softened with milk, coffee, or other liquid
  • Vegetables and fruits:
    • Cooked, boiled, baked, or mashed potatoes
    • Cooked, tender vegetables
    • Shredded lettuce
    • Soft, peeled fresh fruits such as peaches, nectarines, kiwi, mangoes, cantaloupe, honeydew melon, or watermelon
    • Canned or cooked fruits without seeds or skins
  • 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
    • Eggs
    • Casseroles with small chunks of meat, ground meats, or tender meats
    • Strained corn and clam chowder

Foods to avoid:

  • Grains:
    • Dry toast, crackers, or tough crusty breads such as French bread
    • Bread that contains nuts
    • Very coarse cereals such as shredded wheat or bran cereals
    • Dry cakes or dry or chewy cookies
  • Vegetables and fruits:
    • Raw or fried vegetables
    • Tough, crisp-fried potatoes or potato skins
    • Cooked corn
    • Fruits that are difficult to chew, such as apples or pears
    • Stringy fruits such as pineapple, papaya, or mango
    • Grapes, dried fruits, or coconut
  • Dairy, meat, and other foods:
    • Tough, dry meats and poultry (chicken and turkey)
    • Nuts, seeds, or peanut butter
    • Pizza
    • Soups with tough meats
    • Chewy caramel or taffy
    • Yogurt that contains nuts

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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.

Further information

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