Dysphagia is a medical condition characterized by difficulty swallowing.
People with dysphagia may experience discomfort or pain while swallowing, and in some cases, people with severe dysphagia might not be able to swallow at all.
This condition can result from various causes, including neurological disorders (like stroke or Parkinson’s disease), structural problems in the throat or esophagus, and certain muscle or nerve conditions.
Dysphagia affects up to 33 percent of older adults, says Mayo Clinic. It can happen to people of all ages, but it is more common in elderly people.
Managing dysphagia often involves dietary modifications, therapy to improve swallowing techniques, and sometimes medical or surgical treatment.
A dysphagia diet will ensure proper nutrition and varied meals, so what should it include?
You’ll want to incorporate soft foods like souffles, pureed foods (meats and vegetables), soups and soft fruit, yogurts and custards, pre-gelled (pureed) breads, mashed potatoes, and puddings under the dysphagic diet.
These foods are easier to swallow and shouldn’t cause pain.
If you’ve received a dysphagia diagnosis or are caring for a family member or someone who has this medical condition, you probably have more questions about what you should or shouldn’t eat.
That’s why I put together this guide. You’ll have all the info you need to create an actionable diet plan today with the approval of your health care provider.
What Foods Are Allowed On A Dysphagia Diet?
Here’s the number-one rule on the dysphagic diet: the softer, the better. The food processor is your friend when you have trouble swallowing.
Bearing that in mind, this overview of permissible foods in various food groups will help you enjoy a balanced diet of three meals a day and snacks, even if you can’t swallow easily because of stroke or certain medications.
Whole grains should still be a major part of your diet, as they’re a great source of nutrients, minerals, and vitamins and can reduce heart disease and diabetes risks.
Grains are also excellent at keeping your blood pressure, weight, and cholesterol under control.
However, you have to play it safe. Try these grains:
- Soft, chewy cereal bars (but not too chewy)
- Well-cooked pasta moistened with sauce (nothing too chunky)
- Pancakes or waffles softened with applesauce or syrup
- Cereal and milk (but let the cereal sit for several minutes until it gets mushy)
- Hot cereals
- French toast moistened with syrup
- Macaroni and cheese
- Soft oatmeal
Dysphagia patients can’t stop eating veggies just because some of them cause swallowing problems.
Doing so means missing out on minerals and vitamins from potassium to vitamin C, dietary fiber, and folate.
Harder-to-swallow raw vegetables should be avoided, but they can be cooked and then pureed or made into a smoothie.
If you don’t like the savory taste of a vegetable smoothie, honey will sweeten it up and complement the flavors.
- Creamed corn
- Shredded salads (the finer, the better)
- Minced green beans and other vegetables
- Mashed vegetables, including sweet potatoes, regular potates, spinach, or peas
- Soft-cooked vegetables, like carrots (pre-dice them before or after cooking)
Nutritious and low-calorie, fruits are an important part of a healthy diet. Gravitating toward softer fruits like ripe bananas instead of apples will surely help with swallowing, but you don’t only have to eat those fruits.
Try these ways of enjoying fruits:
- Blending them into a smoothie by blending with whole milk and fruit juice
- Pureeing them
- Mashing them
- Eating canned versions
Ensure you skip the skin and seeds when eating fruit with dysphagia.
Some elderly patients assume that solid foods, like meat, must be off the menu when someone has a swallowing problem.
Fortunately, that’s not true! You need the protein from meat (and other sources like poultry, beans, and fish), as well as the B vitamins, zinc, and iron.
You might not be able to cut into a big, juicy steak anymore, but the good news is that you can eat meat in these forms:
- Finely diced or ground (including fish and poultry)
- With sauce and gravy
- In a salad, finely chopped
- In a chicken broth or beef broth-based soup, finely chopped
Baked, moist legumes and tofu are great meat substitutes you can consider.
Life without dessert just isn’t as fun. While coarse, dry desserts are hard to plow through, you can satisfy your sweet tooth with these treats:
- Cobblers (no nuts or seeds)
- Ice cream and gelato
- Frozen and non-frozen yogurt
Please feel free to incorporate these foods into your diet:
- Scrambled eggs
- Pureed soup
- Pre-gelled (pureed) breads
- Cream cheese, ricotta, and cottage cheese (with small chunks)
What Foods Make Dysphagia Worse?
Your diet doesn’t have to be boring if you have dysphagia. You can still eat nutritious, delicious foods aplenty.
However, for as many tasty treats as you can enjoy, you have to watch out for these food choices that will cause or worsen swallowing difficulties, as tempting as it is to eat them.
Many vegetables are hard when raw, such as carrots and broccoli. You can and should eat these veggies, but only after properly preparing them, such as steaming, mashing, or cooking them so they soften.
Avoid whole-kernel corn, stringy veggies like string beans, hard vegetables such as celery, and any form of vegetables that are dry and hard when cooked, like fried potatoes.
Again, while you shouldn’t turn your nose up at all fruits, you have to skip those with seeds you can’t easily remove, like blackberries and raspberries.
Dried fruits are another no-no, as are hard fruits such as apples without properly softening them first.
Also, skip pineapple, as it has a fibrous texture that’s difficult to swallow.
Stringy cheese, including when it’s melted, whether eaten on its own or as a topping, is difficult to skip, but you have to.
Crispy cheese is also another food to cut out of your diet, as are all hard cheeses like gouda.
Hard, fried eggs should be omitted. While you can eat any variety of yogurt and ice cream, be careful about what you mix in. Chocolate chips, raspberries, granola, and small pieces of fruit are hard to swallow.
Any crumbly, hard, crunchy items, like pie crusts, biscuits, cookies, crackers, and chips must exit your diet. That goes for breakfast bars like granola too.
Peanut butter is difficult enough to swallow as it is; if you have dysphagia, it’s simply too risky to eat. Bread is also difficult to consume unless it’s pureed, so you’ll have to stop eating sandwiches.
Sausages, hot dogs, and bacon are tougher meats that aren’t traditionally moistened.
While you could soften them up, they lose their appeal, so you’re better off not eating them at all. If enjoying tuna salad, ask what’s in it.
You shouldn’t eat it if it has large chunks or pieces of onion, celery, and other tough vegetables.
By all means, enjoy soft desserts, but not bread pudding, rice-based treats, hard cookies, coarse and dense cakes, and dry desserts. Hard candies are also off the table.
What Helps Senior Adults With Dysphagia?
While monitoring one’s diet goes a long way if you have dysphagia, older people can also try these tactics to improve their day-to-day comfort and ease while eating.
Sit Up Straight When Eating
Your posture affects how easily you swallow.
If you’re bedbound, sit up (with assistance, if required), and use a pillow or a chair to maintain correct posture.
Avoid slumping forward, which will make it just as hard to swallow as if you’re reclined.
Maintaining good hydration is a cornerstone of health.
More important to your dysphagia, it helps your body continue making enough saliva that you can swallow softer foods.
Aim to drink 1.7 liters or 57.5 fluid ounces a day to stay hydrated.
Use Liquid Thickeners
For many people with dysphagia, thick liquids can be easier to swallow than thin liquids.
Thickening liquids slows down the flow, giving more control over the swallowing process and reducing the risk of aspiration (liquid entering the lungs).
The specific consistency that works best can vary depending on the individual’s condition and needs.
Thickening products such as Thick-It reduce your choking risk so their use should be considered.
However, it’s a good idea to talk to your doctor before starting a thickening agent, as they come in different thicknesses.
Your doctor can recommend the thickness most appropriate for you.
Take Your Time
Set aside plenty of time for meals, as rushing through them increases your risk of choking.
Take smaller bites of food, fully chewing and swallowing each bite before moving on to another. If it’s easier, consider smaller serving sizes.
Skip The Straws
While sipping through a straw might seem like a great idea to help liquid go down if you struggle to swallow, it’s actually ill-advised.
Drinking through a straw sends a large portion of liquid into your mouth all at once, increasing your risk of choking.
What Not To Do With Dysphagia
Here are yet more pointers on how to make mealtimes with dysphagia smoother sailing:
- Don’t eat alone: Not only does eating with others help you keep a relaxed pace, but they can also recognize if you’re choking and get you immediate assistance.
- Minimize distractions: No phones at mealtime and turn the television off as well. Listening to music is fine, but don’t sing along with food in your mouth.
- Reduce spices: Spicy foods can be tougher to swallow, even if they’re otherwise fine to eat. Go easy on the spices if you must use them at all.
- Cut back on salt: Sodium will dry you out, leaving you with less saliva to swallow your meals.
- Eat ice cream before it melts: Once ice cream becomes liquid-like, it’s dangerous to swallow it, so try to enjoy it before it becomes like soup. At that point, discard it.
Dysphagia makes it hard to eat, but you can still enjoy the types of foods that make up a healthy diet, from poultry to meat, fruits, vegetables, and grains. You just have to modify what you eat.
Besides your dietary choices, watch out for your dining environment.
You should eat in a quiet, distraction-free spot where you can take your time. In addition, always sit up straight when eating or drinking.