The following is an excerpt from an article in the ASHA Leader online publication titled, “National Dysphagia Diet: What to Swallow?” It was published on November 04, 2003 and written by Gary McCullough, Cathy Pelletier, and Catriona Steele.
The National Dysphagia Diet (NDD), published in 2002 by the American Dietetic Association, aims to establish standard terminology and practice applications of dietary texture modification in dysphagia management. While the publication of common terminology is long overdue, SLPs need to exercise caution when interpreting and applying the proposed terminology. As the NDD states, “Further study and peer-reviewed, scientific data will be needed to truly quantify the management parameters surrounding the complex diagnosis of dysphagia.”
The NDD was developed through consensus by a panel of dietitians, SLPs, and a food scientist. It proposes the classification of foods according to eight textural properties, and anchor foods to represent points along continua for each property. A hierarchy of diet levels is then proposed, with inclusion and exclusion of items at each level based on subjective comparison with these anchor foods. There are four levels of semisolid/solid foods were proposed in the NDD:
- NDD Level 1: Dysphagia-Pureed (homogenous, very cohesive, pudding-like, requiring very little chewing ability).
- NDD Level 2: Dysphagia-Mechanical Altered (cohesive, moist, semisolid foods, requiring some chewing).
- NDD Level 3: Dysphagia-Advanced (soft foods that require more chewing ability).
- Regular (all foods allowed).
A Spice of Life Soup for Thanksgiving Day
Taking the above NDD classifications into account, this Thanksgiving Day soup may be a zesty treat for dysphagia patients who have been approved for NDD Level 1 food intake by their medical team or clinician. This recipe was prepared by Zachary Taylor, a student at the Culinary Institute of America.
INGREDIENTS (makes about 1 quart)
- 1 quart chicken stock (warm)
- 6 ounces finely chopped bacon (not cooked)
- 8 ounces mirepoix (4 ounces onions, 2 ounces carrots, 2 ounces celery)
- 1 cup dry lentils
- Seasoning (to taste) – a total of ½ to ¾ tablespoon mixture of cayenne pepper, paprika, chili powder, and chipotle powder
- Salt to taste – start with a teaspoon
- 1 cup half and half cream
- Place finely chopped bacon in a sauce pot and cook on medium heat (do not let it get crisp)
- Add vegetables and sweat them (do not let them become crisp)
- Add warm chicken stock and simmer
- Add lentils and simmer for 15 minutes or until lentils are tender
- Add seasoning and cream and simmer 3 minutes
- Use an immersion blender until the texture is smooth (Note, a regular blender is not recommended as it lets more air into the mixture. Plus, pouring hot liquids into a blender and turning the blender on can cause hot liquids of this type texture to quickly expand and cause a mini-explosion.)
SERVE WARM – enjoy!
This recipe is not a food recommendation as each dysphagia patient is different. Please check with your medical team or clinician if in doubt before trying any new food.
The NFOSD Team