What is a Modified Diet?
Modified diets involve the physical manipulation of food and drinks for the purpose of assisting people with swallowing difficulties (also known as Dysphagia). Different foods can be modified by changing the content, texture and consistency of solids. Drinks can be modified by increasing the thickness of the fluid.
How is a Speech Pathologist Involved?
Speech Pathologists are involved in the assessment and treatment of Dysphagia involving the oral phase (involving the mouth i.e. chewing) and the pharyngeal phase (involving the throat i.e. initial swallow reflex). If a person is referred to a Speech Pathologist due to swallowing difficulties, the speech pathologist will often do an assessment of the structure and movements of the muscles in the head and neck. The speech pathologist will then conduct a trial of different food and fluid consistencies (explained below) before giving recommendations of the appropriate diet consistency to ensure safe swallowing.
The Dietitians Association of Australia have developed 4 standard categories of food modification levels, these include the following:
1. Regular Diet
This is a normal diet that has not been modified. This category includes all foods from hard and crunchy through to naturally soft.
2. Soft Diet (Texture A)
Foods in this category may be naturally soft (eg. ripened banana) or cooked/cut to alter the texture so that it is easily broken up with a fork (e.g. mashed potato). Food should be moist and served with gravy or sauce (at the recommended thickness – see fluid consistency below)
3. Minced and Moist (Texture B)
Food in this category should be soft and moist. Food should be easily formed into a ball and individuals use the tongue rather than teeth to break the small lumps in the texture (e.g. porridge).
4. Smooth Pureed (Texture C)
Food in this category is smooth and lump free (e.g. pudding). Food should be moist however still hold its shape on a spoon and not run and mix in with other foods on the plate.
The Dietitians Association of Australia have also developed 4 standard categories for modification levels of fluids, these include the following:
1. Thin Fluids (Unmodified)
Unmodified fluids include a variety of consistency levels, including thin fluids (e.g. water and milk) and slightly thick fluids (e.g. fruit nectar). This type of fluid is very fast flowing and does not contain thickening agents.
2. Mild Thick (Level 150)
Mildly thick fluids are a similar consistency to fruit nectars. They pour quickly from a cup however not as quick as thin fluids and may leave a coating film of residue in the cup after being poured.
3. Moderately Thick (Level 400)
Moderately thick fluids are a similar thickness to honey at room temperature. These fluids pour out of a cup slowly and are difficult to drink through a straw. The consistency is usually artificially produced using thickening powders. Often a spoon is used to assist with drinking.
4. Extremely Thick (Level 900)
Extremely thick fluids are a similar consistency to pudding and are not able to be poured from the cup into the mouth. This consistency does not flow though the prongs of a fork and is also often produced using thickening powders. A spoon is required to scoop extremely thick fluids into the mouth.
About Ashleigh Fattah
Ashleigh Fattah is a Speech Pathologist who sees both children and adults. She has experience from a Master of Speech and Language Pathology degree and a spectrum of clinical environments including private practice, inpatient and outpatient hospitals, school and community based practice.
Ashleigh is committed to providing evidence-based intervention for children and adults alike, tailoring therapy to each client’s individual needs. Her clinical experience enables her to provide comprehensive one-on-one, group and school program interventions. Ashleigh is trained in providing an array of up-to-date therapy techniques such as the PROMPT and Hanen Programs to help both children and adults achieve their goals.
If you have questions about a modified diet make an appointment today. Click here.
Read more about modified diets at the nutrition and dietetics reference for the Australian standardised definitions and terminology for texture-modiﬁed foods and ﬂuids. Click here daa.asn.au