Nutrient Requirements

A variety of approaches to the estimation of energy requirements can he used. Predictive equations can

Level Dysphagia severity

Designation

Food textures omitted

I Severely impaired oral preparatory stage Reduced pharyngeal peristalsis Reduced swallowing reflexa

Moderately impaired oral preparation Reduced pharyngeal peristalsis

Mild impairment of oral preparation Mild chewing problems

Patients unable to chew solids or swallow thin liquids safely

Patients who cannot swallow thin liquids and have minimum tolerance of chewed food Patients who can tolerate soft foods and liquids

Coarse, hard, or brittle textures Unsuitable foods: fruits, nuts, raw vegetables, sticky foods, all foods requiring bolus formation or controlled oral manipulation No thin liquids

Coarse, hard, brittle textures No thin liquids

Coarse, hard, brittle textures Unsuitable foods: nuts, minced meat, raw, stringy, crisp vegetables

Mild oral preparation impairment Can chew soft textures

Patients who can tolerate soft food textures and liquids

Coarse, fibrous, hard foods Unsuitable foods: nuts, deep fried or raw, crisp foods aVideofluoroscopy screening essential for safety.

Adapted from Martin (1991) Dietary management of swallowing disorders. Dysphagia 6: 129-134.

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