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Dysphagia: Dysphagia Mechanically Altered Diced HF#459

What is a Dysphagia Mechanically Altered Diced diet?

This diet consists of foods that are moist, soft, and are easy to swallow. Meats are ground or finely diced into pieces that are no larger than ¼ inch. Please see picture below. Some foods that contain mixed textures such as saucy casseroles, soft whole vegetables, pasta, and fruits are allowed. Food should not be thin, runny, or sticky.

Why is this diet safer for me?

This diet is designed to serve you easier to chew foods that may prevent food from “going down the wrong pipe”. As the result of a stroke, injury, or disease some people have problems safely swallowing. This is known as dysphagia. This diet is the next step in moving from eating minced food to more solid food. You will need to be able to chew your food.

Food Groups	Safe Foods	Foods to Avoid	Thin liquids (if allowed)
Milk Products	Yogurt (smooth or fruited) Cottage cheese Thin sliced or small cubed cheese
Meat and Protein	Diced (1/4 inch) or ground tender cooked meat and poultry moistened with gravy Moist meatballs Baked, soft cooked fin fish or salmon Casseroles with ground or ¼ inch diced meat and tender vegetables such as beef stew and chicken ala king Eggs Tuna or egg salad without large chunks of celery or other raw vegetables Soufflés Tofu	Cold cuts, sausage, bacon, wieners, hamburgers, casseroles with large chunks of food or nuts, sandwiches, peanut butter, nuts
Vegetables	Soft cooked, minced vegetables, squash, legumes, potatoes Canned green beans	Raw or hard stringy vegetables, frozen green beans

How to Prepare Diced Meat and Vegetables

All food must be in pieces that are no larger than ¼ inch.

Cut meat or veggies into strips that are ¼ inch or less.
Turn and cut every ¼ inch or less. You will want to be sure that all cubes are smaller than ¼ inch.

Food Groups	Safe Foods	Foods to Avoid	Thin liquids (if allowed)
Fruits	Applesauce Canned drained fruits Soft, ripe bananas	Hard fresh fruits, dried fruit, fruits with skins, seeds or pits, pineapple	Mandarin oranges, fruit juice
Breads, Cereals, and Starches	Cream of wheat, cream of rice, oatmeal, malt-o-meal Soft pancakes with syrup Thin slice French toast with syrup Soft pasta Slightly moistened dry cereal with little texture	White or wild rice, bagels, English Muffins, breads, rolls, muffins, bread with nuts or seeds, saltine crackers	Milk or cream for cereal
Soup	Any cream soup strained or put in a blender Broth based soups that have been put in a blender.	Large chucks of food in soups
Desserts	Custards, pudding, rice pudding or bread pudding Cakes; soft cookies; pies	Popsicles, gelatin, desserts with nuts, seeds, sticky caramels or dried fruit	Sherbet, sorbet, pudding popsicles, ice cream

What is the big deal about mixtures of liquids and solids like soups and canned fruits?

Thin liquids go down very quickly, but solids require chewing. While you are busy chewing some of the thin liquid races down your throat before you can protect your windpipe and it can end up in your lungs. So it is safer to do one thing at a time.

Food Groups

Safe Foods

Foods to Avoid

Thin liquids

(if allowed)

Beverages

Beverages that are a safe liquid thickness for you.

Tip: Beverages may need to be thickened.

Milk, juice, coffee, tea, soda, carbonated beverages, alcoholic beverages, nutritional supplements, ice chips

Other

Butter; margarine, oils, or vegetable shortening
Smooth cream cheese
Salad dressings, mayonnaise, vinegar;
Gravies
Salt, pepper, herbs, spices,
Catsup, mustard
Honey, jelly, jams and preserves without seeds
Sugar, syrup, molasses
Horseradish, chili sauce
Sauces and salsa that have small tender chunks smaller than ¼ inch
Soft, smooth chocolate bars

Cream cheese with chunks such as nuts, pineapples or vegetables, olives, seeds, nuts, coconuts, sticky foods, hard or chewy candies or candy with nuts

Adapted from the American Dietetic Association Nutrition Care Manual: National Dysphagia Diet Task Forces. Nation Dysphagia Diet-Standardization for Optimal Care. Chicago, IL: American Dietetic Association; 2002: 10-12. This diet is similar to the NDD2-Dysphagia Mechanically Altered Diet.

If you would like to make an appointment or are a UW Health patient with more questions please contact UW Health at one of the phone numbers listed below.

University Station
Nutrition Clinic Room L33
2880 University Avenue
Madison, WI 53705
(608) 263-4360 appointments
(608) 263-5012

UW Health West Clinic
Nutrition Clinic Room 1296
451 Junction Road
Madison, WI 53717
(608) 262-9181 appointments
(608) 265-7526

UW Health East Clinic
Nutrition Clinic Room 2106
5249 East Terrace Drive
Madison, WI 53718
(608) 265-7405 appointments
(608) 265-0963

American Family Children’s Hospital

1675 Highland Ave, Madison, WI 53792
Pediatric Specialty Clinics - Nutrition

(608) 890-8298 or 263-6420 Appointments

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 08/14/2012

Copyright © 06/07/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#459

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