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Nutritional Management of Dysphagia

Living with dysphagia can be challenging, however, there is plenty of information to help successfully manage this condition at home.

Strategies for care

Following a plan can help you manage your dysphagia. Ask your dysphagia care specialist about a plan that may be right for you. In the meantime, see below for some examples of strategies that are followed by some people living with dysphagia.

Eating properly to make sure you get enough nutrients to maintain good health
Modifying the consistency of your foods and drinks to help you swallow safely
Practicing good oral hygiene

These measures are explained in greater detail below.

Nutrition in dysphagia management

Good nutrition is especially important for people with dysphagia. There are two main goals of nutrition management in dysphagia:

Make sure you eat and drink enough
Minimize choking and aspiration risk

Regular foods and liquids may cause problems for someone with dysphagia. In order to reduce the risk of aspiration and choking, managing dysphagia may involve changing the textures of food and drinks. Drinks and other liquids may need to be thickened so they are more easily managed in the mouth and throat. Solid foods may need to be chopped, minced or pureed to decrease the amount of chewing required and to reduce the risk of blocking the airway. The thickness of liquids and the textures of food vary according to individual needs. Your healthcare professional can advise you on what texture is right for you.

Adapting your diet

A dysphagia diet has two separate parts: liquids and solid foods. Based on an assessment of your swallowing ability, your healthcare professional will tell you which liquid consistency and what food texture modifications are right for you.

How do texture-modified liquids and foods help with safer swallowing?

Thickened beverages and texture-modified foods may help with swallowing safety by slowing down the movement of liquids in the mouth and throat, and creating food textures that are easier to chew and manage in the mouth. In people with dysphagia, the normal swallowing process can be impaired. Specifically, there is a muscle called the “epiglottis” that is responsible for making sure food or drink goes down the right way (into your esophagus and to the stomach, avoiding the airway). Normally, the airway should close as the foods or liquids enter the throat to make sure a swallow is successful. However, for some people with dysphagia, this function can be impaired, leading to food or liquid going down the wrong way, into the airway. Thickened beverages move more slowly and are often easier to handle in the mouth than thin liquids. This gives more time to close off the airway so the liquids can travel down the esophagus to the stomach. See the accompanying video for a visual explanation.

Drink consistencies

Some examples of thickened fluid consistencies are:

Nectar-like/mildly thick

Nectar-like or mildly thick fluids can be sipped from a cup and will fall off a spoon if tipped. They flow slower than thin drinks. These drinks can be consumed through a straw but will require some effort.

Honey-like/moderately thick

Honey-like or moderately thick fluids can be eaten with a spoon but do not hold their shape. These fluids are very difficult to eat with a fork since they will drip slowly through the prongs. Moderately thick drinks can be sipped from a cup, as well as consumed through a straw, however, doing so will generally require considerable effort.

Pudding-like/extremely thick

Extremely thick fluids are best eaten with a spoon, but using a fork is also an option. They hold their shape on a spoon and are too thick to be sipped from a cup or through a straw. Thick apple sauce and puddings are examples of extremely thick liquids.

Food consistencies

Some examples of modified food consistencies are:

Soft and bite-sized

Soft, bite-sized foods can be eaten with fork, spoon, chopsticks or your fingers. With this consistency, chewing is required before swallowing. A knife is not necessary to cut this type of food, which can also be mashed with a fork, spoon or chopsticks. The bite-sized pieces should be no larger than 1.5 cm for adults and 8 mm for children.

Minced and moist

Minced and moist foods can be eaten with a fork, spoon, chopsticks or your fingers. Minced and moist foods should be soft and moist, and can be scooped and shaped. No thin liquid should separate from the food. It may have small visible lumps that are easy to mash with the tongue, and they should be no larger than 4 mm for adults or 2 mm for children.

Pureed

Pureed foods are equivalent in terms of consistency to pudding-like or extremely thick liquids. This refers to foods that are pureed to a uniform, cohesive texture without lumps that don’t require chewing. Extremely thick, pureed foods can be piped or molded. Liquids must not separate from the solid, and the food must be lump free.

Liquidized

Liquidized foods are equivalent in terms of consistency to honey-like or moderately thick liquids. Runny fruit purees (such as those used for infant “first foods”) and some thinner pureed soups are examples of foods that fit in this category. Liquidized foods cannot be piped, layered or hold a shape on their own. They should have a smooth texture with no discernible bits such as lumps, fibres or particles.

Learn more

Learn more about solutions for texture modified diets

Nestlé Health Science has made every effort to include on this website only information that it believes to be accurate and reliable. Information provided on this site is for education purposes. It is not intended to replace the advice or instruction of your healthcare professionals, or to substitute medical care. Contact a qualified healthcare professional if you have questions or issues about what is best for you as you manage your swallowing difficulties at home.

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