NDD [National Dysphagia Diet] Level 3 – Dysphagia Advanced

9 Jun

Here are some basic facts & guidelines provided by the American Dietetic Association regarding Level 3 of the NDD:

This level:
*consists of foods that are soft and easy to chew and swallow (preferably moist “bite-size” pieces – 1/2″/smaller)

*resembles a regular diet but excludes very hard, sticky, or crunchy foods

Some preparation tips for this level include:

• Using moist cooking methods for meat (braising, stewing, or baking in liquid)
• Cooking vegetables until tender enough to mash with a fork.
• Peeling allowed fresh fruits, serving canned fruit, and/or cooking dried fruits until soft.
• Serving soups/broths with small pieces of meat and vegetables or straining them if pieces of meat and vegetables are larger than ½ inch.
• Reheating foods carefully so that a tough outer crust does not form on them.

Off the Menu: (All bold items are those that I currently eat on a regular basis and will be the hardest for me not to eat!)

*Dairy: no dairy products are prohibited unless liquids are restricted. (I’ll only be experimenting with thickened liquids during the pureed diet.  However, liquid modifications can be ordered during any stage of the NDD.)

*Grains: dry bread, toast and crackers that have not been moistened, corn chips, tough, crusty breads (eg. French bread), coarse/dry cereals

*Vegetables: all raw vegetables except shredded lettuce/baby spinach, cooked corn, fried potato skins, other fibrous, tough or stringy cooked vegetables

*Fruits: difficult-to-chew fresh fruits (apples, pears…),stringy, high pulp fruits (papaya, pineapple, mango…), fresh fruits with
difficult-to-chew peels (grapes…), uncooked dried fruits (prunes, apricots…), fruit leathers

*Meat, poultry, eggs & fish: tough dry meats & poultry, dry fish/fish with bones

*Nuts/Seeds: all whole nuts/seeds (I’m calling chia seeds an exception, because they are tiny & form a gel when combined with liquid)

*Beans/Legumes: chunky peanut butter

*Food additives/misc: coconut

*Fun Stuff: dry cakes, chewy/very dry cookies, fruit roll-ups, fruit snacks

What I ate my first day on Level 3 of the NDD:

Breakfast: oatmeal with soymilk, cinnamon, sliced strawberries, blueberries, raspberries, & chia seeds

Snack: Giant heaping spoonful of almond butter (In hindsight, even though smooth nut butters are allowed, eating them by themselves leaves a film in the throat that is probably a bad idea for anyone with dysphagia.  Sins to confess already?!)

Lunch: Victory burrito!  (So named because it was my first meal at a restaurant since becoming a guinea pig!) Soft tortilla with black turtle & pinto beans, rice, pico, guac, and a bit of hot sauce

Supper: Millet with black soy beans, shredded spinach, raw mushrooms, creamy peanut butter & lemon juice

Dessert: Fruit “soup” with blueberries, sliced strawberries, raspberries, almond butter, and soy milk

(So I’m obsessed with nut butters.  You wanna make something of it?!)

Source:

http://nutritioncaremanual.org/vault/editor/Docs/Level%203%20NT%20for%20Dysphagia_Advanced.pdf

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