Level of Diet
Three levels of solid textures
Level 1: Pureed
Foods are totally pureed to a smooth, homogenous, and cohesive consistency. Eliminates sticky foods, such as peanut butter, and coarse-textured foods, such as nuts and raw fruits and vegetables
Smooth cooked cereals; slurried or pureed bread products; milk; smooth desserts such as yogurt, pudding, custard, and applesauce; pureed fruits, vegetables, meats, scrambled eggs, and soups
Level 2: Mechanically altered
Soft-textured, moist foods that are easily formed into a bolus. Eliminates coarse textures, nuts, and raw fruits and vegetables (except bananas)
Cooked cereals may have a little texture; some well-moistened, ready-to-eat cereals; well-moistened pancakes with syrup; slurried bread; moist well-cooked potatoes, noodles, and dumplings; soft poached or scrambled eggs; soft canned or cooked fruit; soft, well-cooked vegetables with 1/2 pieces (except no corn, peas, and other fibrous vegetables). Moist ground or minced tender meat in pieces no larger than 1/4 in, soft casseroles, cottage cheese, tofu; moist cobblers and moist soft cookies; soups with easy-to-chew meat or vegetables
Level 3: Advanced
Near-normal textured foods; excludes crunchy, sticky, or very hard foods. Food is bite-sized and moist.
All breads are allowed except for those that are crusty; moist cereals; most desserts except those with nuts, seeds, coconut, pineapple, or dried fruit; soft, peeled fruit without seeds; moist tender meats or casseroles with small pieces of meat; moist potatoes, rice, and stuffing; all soups except those with chewy meats or vegetables; most cooked, tender vegetables, except corn; shredded lettuce. No nuts, seeds, coconut, and chewy candy.
Four standard liquid consistencies
All regular unthickened beverages and supplements
Clear juices, frozen yogurt, ice cream, milk, water, coffee, tea, soda, broth, plain gelatin, liquidy fruits such as watermelon
Liquids thicker than water but thin enough to sip through a straw
Nectars, vegetable juices, chocolate milk, buttermilk, thin milkshakes, cream soups, other properly thickened beverages
Liquids that are too thick to sip through a straw; can be eaten with a spoon but do not hold their shape
Honey, tomato sauce, yogurt
Liquids thickened to pudding consistency that need to be eaten with a spoon
Pudding, custard, hot cereal
Source: National Dysphagia Diet Task Force. (2002). The national dysphagia diet: Standardization for optimal care. Chicago, IL: American Dietetic Association.