Dysphagia Level 3 Diet
Sometimes patients who have trouble chewing and/or swallowing whole foods need a special diet. The National Dysphagia Diet, published in 2002, developed universal terminology for texture-modified diets. The dysphagia advanced diet (level 3) is one of three levels of texture modification that is used.
Who orders a dysphagia advanced diet?
Normally a speech and language pathologist will recommend a dysphagia advanced diet after evaluating a patient who has problems chewing or swallowing food. In some cases, medical tests are used to determine the best texture for a patient.
What types of foods are allowed on this diet?
Foods that are nearly normal textures are allowed on the dysphagia advanced diet, with the exception of crunchy, sticky, or very hard foods. The diet includes bite-sized foods that are moist. Foods that are allowed on dysphagia level 1 and level 2 diets also are allowed on the dysphagia advanced diet.
It is important to include a variety of foods from all different food groups when providing a dysphagia advanced diet, including fruits, vegetables, grains, meats and meat substitutes, and dairy foods. The following table provides specific information about foods that are allowed on the dysphagia level 3 diet.
Food Textures for Dysphagia Advanced Diet
(dysphagia level 3)
Foods to Avoid
Meat and meat substitutes
Potatoes and starches
Can I drink regular liquids if I am on a dysphagia pureed diet?
Possibly. For some patients, regular liquids are OK. However, depending on your condition, you might need to have thickened liquids, so you can swallow them safely. Talk to your speech and language pathologist to learn more.
References and recommended readings
American Dietetic Association. Level 3 advanced diet: patient handout. In: Nutrition Care Manual®.
Available to subscribers at: www.nutritioncaremanual.org.
Accessed January 13, 2011.
National Dysphagia Diet Task Force. National Dysphagia Diet: Standardization for Optimal Care. Chicago, IL: The American Dietetic Association; 2002.
Review Date 3/11