Dysphagia Diets: What can I eat?

When I was in graduate school, I envisioned myself becoming the kind of Speech Language Pathologist (SLP) who would specialize in helping adults regain their ability to communicate but  as destiny would have it, my early career path led me to the one area of Speech Pathology that I would have sworn I had no interest in: swallowing disorders. 

Thinking back, it was no wonder I became a swallowing specialist. I am the penultimate FOODIE, and thinking about food, shopping for food, cooking food, and eating food are probably my top 4 hobbies (undoubtedly in reverse order than what is listed.) OF COURSE I’d make it my life’s work to make sure that anyone who had their ability to enjoy food taken from them would have a chance at eating again. 

One way an SLP manages a patient with dysphagia is to modify their diet to make it easier for them to swallow. We can alter the consistency of solid foods by cutting, chopping, mincing, blending, or adding moistening agents. We can alter the consistencies of the liquids we drink by adding starch-based or Xantham gum-based thickeners. This slows the flow rate down to allow the throat muscles to control it more easily. 

Several years ago, the deglutologists of the world joined forces to create the International Dysphagia Diet Standardization Initiative or “IDDSI” for short (pronounced “ID-SEE”). This encouraged institutions and clinicians to begin using the same terminology and measuring tools with our dysphagia diets, which led to greater compliance between SLPs and health care organizations. 

The IDDSI diets are as follows:

• SOLID TEXTURES:

  • Level 7 - Regular consistency (no texture/viscosity restrictions)

    • This may also be referred to as “Easy to Chew” in pediatric populations. 

  • Level 6 - Soft and Bite Sized

  • Level 5 - Minced and Moist

• SOLID OR LIQUID TEXTURES (Could be considered either)

  • Level 4 - Pureed (solids) or Extremely thick (liquids)

  • Level 3 - Liquidized (solids) or Moderately thick (liquids

• LIQUID CONSISTENCIES

  • Level 2 - Mildly Thick

  • Level 1 - Thin liquids

(The above description is an incredibly simplified outline of what the standard dysphagia diets are, and is not an official IDDSI resource, nor meant to replace official IDDSI resources. For those interested in the full IDDSI diet descriptions, standardization requirements, and a whole boatload of amazing graphics, educational resources, and food suggestions, please check out www.IDDSI.org.) 

Hands down, the most common discussion I have when treating patients with dysphagia is regarding what they can eat. Which is great for me because like I said, talking about food is one of my favorite hobbies (Wait...I didn’t mention that one earlier? Add it to the list.) So getting to do a deep dive with my patients about what they like, what they don’t like, what they have in their house, and what endless possibilities are actually available to them is one of my favorite things to do. 

My diet counseling skills went next-level when I began practicing in my patients’ homes, and I could see for myself what was in their refrigerator. I could see how they typically prepare foods, store food, and check out what kinds of kitchen gadgets they had access to. I saw that there as so much more available to them than they even knew! And eating a wider variety of foods is tremendously important. The more foods someone can eat - even if they are radically modified - means better nutritional intake, which results in better medical outcomes and quality of life. Win-win...win! 

So if you’re a patient with dysphagia who is feeling seriously limited by your texture/consistency restrictions, perhaps you just need a little help understanding how many options you actually have access to. A simple Google search of dysphagia recipes may broaden your horizons, or there are a number of dysphagia cookbooks available in your local library or bookstore, if you’re into a good old-fashioned, propped-open book full of food stains (guilty as charged!) 

Of course, if you’re in Saratoga Springs or surrounding areas, or even in New York state (yes, we can foodie-geek out together over teletherapy), I’m happy to help you do this on a more individualized basis. Just drop me an e-mail or give me a call and we can chat more. 

For now, I’m off to make my lunch…