Trouble Swallowing or Chewing? Try These 6 Dysphagia-Friendly Recipes.
Dysphagia, the clinical term for difficulty swallowing and chewing, affects an individual’s ability to eat and drink with ease. People with the condition follow a specific diet of foods that are easy to swallow and chew. While clinically appropriate, these options can lack the variety and taste that make eating enjoyable.
Still, food and cooking can be means of restoring health, routine, and community, especially for those dealing with the isolation that can accompany the condition and the reason behind it (such as head and neck cancer, Parkinson’s disease, stroke, or traumatic brain injury). Sharing a meal with loved ones can help people maintain social bonds, improve quality of life, and dispel any sense of shame that may accompany a swallowing difficulty.
With thoughtful preparation, many meals can be adapted to align with a diet modified for dysphagia. Created by Speech@Baylor, this online cookbook offers six dysphagia-friendly recipes for those experiencing swallowing or chewing difficulties.
What Is a Dysphagia Diet?
Each recipe indicates the diet levels it is most appropriate for. The International Dysphagia Diet Standardisation Initiative (IDDSI) framework consists of eight levels. Each corresponds to a different standard of drink thickness and food texture an individual within that level can safely consume.
At one end of the spectrum is Level 0, Thin, in which individuals can have thin liquids that flow like water. At the other is Level 7, Regular, in which an individual can consume foods of various textures; people in this group do not have a swallowing disorder. In the middle is Level 4, Extremely Thick, a modified diet that consists of very thick liquids that are smooth with no lumps, do not require chewing, and hold their shape on a spoon, such as mashed potatoes or pudding.
Not all recipes will work for every level and individual. Consult with your health care provider before following any of the information provided. For more information on dysphagia diet levels, see the “Consumer Handouts (Adults)” tab on the IDDSI resources page.
What Can I Cook for a Dysphagia Diet?
Chicken Tikka Masala With Sticky Rice
Adapted from Cafe Delites Chicken Tikka Masala
Serves: 5 to 6 people
Most suitable for: Levels 5 and 6
Chicken tikka masala is both flavorful and flexible. The chicken can be chopped into small pieces that are easier to swallow, while the heavy sauce helps them go down smoothly. Sticky rice is a safer option than other kinds of rice because the grains hold together better; it can be prepared at home or bought in a microwavable package to save time.
INGREDIENTS
- Boneless skinless chicken breasts, finely chopped (4 mm, approximately the gap between the prongs of a standard dinner fork), 28 ounces
Marinade
- Garam masala, 2 teaspoons
- Fresh ginger, peeled and grated, 1 tablespoon
- Ground cumin, 1 teaspoon
- Ground red chili powder, ½ teaspoon
- Ground turmeric, 1 teaspoon
- Garlic, minced, 1 ½ tablespoons
- Plain yogurt, 1 cup
- Salt, 1 teaspoon
Sauce
- Vegetable or canola oil, 2 tablespoons
- Butter, 2 tablespoons
- Onion, finely diced, 1 large
- Garlic, 1 ½ tablespoons finely grated
- Fresh ginger, peeled and grated, 1 tablespoon
- Garam masala, 1 ½ teaspoons
- Ground cumin, 1 ½ teaspoons
- Ground turmeric, 1 teaspoon
- Ground coriander, 1 teaspoon
- Tomato purée (or tomato sauce), 14 ounces
- Ground red chili powder, 1 teaspoon
- Salt, 1 teaspoon
- Heavy or thickened cream, 1 ¼ cups
- Brown sugar, 1 teaspoon
- Water, if needed
- Cilantro or coriander for garnish
Sticky Rice
Adapted from The Woks of Life Sticky Rice
- Raw sticky rice, 1 cup per serving
- Water, as needed
METHOD
- Prepare sticky rice: Pour desired amount of rice into a large bowl. Add room-temperature water until the water level is 3 inches higher than the rice grains. Soak for 6 to 24 hours.
- Combine marinade ingredients in a bowl. Add chicken and let marinate for 10 minutes to 1 hour (or overnight).
- Drain water from soaked sticky rice. Line a steamer basket or a metal strainer or colander with parchment paper. Set the basket over a large pot of boiling water. Cover and steam for 30 to 45 minutes. Keep covered until serving.
- Heat oil in a large skillet or nonstick pan over medium-high heat. Add chicken in small batches and fry until browned, about 3 minutes on either side. Set aside.
- In the skillet or pan, heat butter over medium-high heat. Cook onions until soft and translucent.
Roasted Cauliflower Macaroni and Cheese
Adapted from Hello Fresh Cauliflower Mac ‘n’ Cheese
Serves: 4 people
Most suitable for: Levels 5 and 6
Roasted cauliflower macaroni and cheese is comforting and nourishing. When making the cheese sauce, be sure to water down or thicken the mixture to the level appropriate for those consuming it. For variety, try adding any kind of vegetable chopped into bite-size pieces and roasted until tender.
INGREDIENTS
- Macaroni pasta noodles, 12 ounces
- Cauliflower florets, chopped (4 mm, approximately the gap between the prongs of a standard dinner fork), 20 ounces
- Flour, 2 tablespoons
- Dairy milk, any percentage, 2 cups (plus ¾ cup as needed for consistency)
- Italian cheese blend, 1 cup
- Chicken stock, ¾ cups
- Olive oil, 3 tablespoons plus more for coating baking sheets
- Butter, 2 tablespoons
- Green onions, green and white parts, sliced and separated, 1 bunch
- Salt and pepper, to taste
METHOD
- Preheat oven to 425 degrees. Line two baking sheets with aluminum foil; lightly grease with olive oil.
- Spread cauliflower florets onto baking sheets, leaving out crumbly bits. Drizzle with olive oil and season generously with salt and pepper. Roast in oven for 20 to 25 minutes, until very tender.
- Bring a large pot of water to a boil. Add a pinch of salt and macaroni pasta noodles to pot. Cook until very tender, stirring occasionally. Drain pasta and return to pot.
- Heat a large nonstick pan over medium-high heat. Add onion whites and cook until browned. Add butter and melt. Add flour and stir, cooking for 1 to 2 minutes. Slowly pour in milk and whisk to combine. Add chicken stock and simmer until thickened. If needed, add thickener.
- Remove from heat, stir in cheese. If needed, add extra milk, ½ to ¾ cup, to make creamier. Season with salt and pepper.
- Add pasta and cauliflower to cheese mixture in pan, reserving some cauliflower for topping. Transfer mixture to a greased, oven-safe baking dish. Spread remaining cauliflower on top. Bake until bubbling, 5 to 7 minutes.
- Garnish with onion greens and serve.
Black Bean Soup
Adapted from Cookie and Kate Spicy Black Bean Soup
Serves: 4 people
Most suitable for: Level 4
Canned beans and store-bought chicken stock make this soup a simple, protein-rich option to feed a group. The consistency can be adjusted for individual diet needs: Add thickener for a more viscous soup or chicken stock for a thinner version.
INGREDIENTS
- Olive oil, 3 tablespoons
- Onion, thinly sliced, 1 large
- Sea salt, 1 ½ teaspoons
- Garlic, minced, 3 cloves
- Fresh coriander, chopped, 12 sprigs
- Ground cumin, 1 teaspoon
- Ground chili powder, ½ teaspoon
- Chipotle chili powder, ½ teaspoon
- Black beans, drained and rinsed, two 14-ounce cans
- Chicken stock, 3 cups
Avocado Crème
- Avocado, ½ whole
- Limes, 2
- Salt, ¼ teaspoon
- Water, ¼ cup
Toppings (optional): Greek yogurt or sour cream
METHOD
- Heat olive oil in large pot or casserole dish over medium-high heat. Add onion and salt and sauté for 5 minutes. Stir often to prevent onions from getting too brown.
- Add garlic, coriander, and spices. Cover and cook for 5 minutes, checking to ensure ingredients are not burning.
- Add black beans and chicken stock. Bring soup to boil, and then simmer, uncovered, for 15 minutes.
- To make avocado crème, mash avocado and mix with the juice of two limes, salt, and water.
- Use an immersion blender to blend soup directly in the pot or dish until very smooth, with no lumps.* Add food thickener to soup, if needed. For a thinner soup, add chicken stock and mix.
- Pour soup into bowls, add toppings and avocado crème as desired, and serve.
* A stand blender can also be used.
Turkey Burgers With Roasted Sweet Potatoes
Adapted from Hello Fresh Sriracha Turkey Burgers
Serves: 4 people
Most suitable for: Levels 5 and 6
These spicy, tangy burgers are made with Southeast Asian chili sauce, ginger, and soy sauce. For those with swallowing concerns, plate the burger on a bed of baby greens or a bun drenched in sauce.
INGREDIENTS
Sweet Potatoes
- Sweet potatoes, peeled, 4 medium
- Olive oil, 2 tablespoons plus more for coating baking sheets
- Cayenne pepper, to taste
- Salt and pepper, to taste
- Baby greens, one handful per person
Turkey Burgers
- Ground turkey, 20 ounces
- Garlic, minced, 4 cloves
- Fresh ginger, peeled and grated, 4 teaspoons
- Cilantro, finely chopped, ¼ cup
- Southeast Asian chili sauce, ½ teaspoon
- Soy sauce, 4 teaspoons
- Buns, 4
Sauce
Mayonnaise, 4 tablespoons
Southeast Asian chili sauce sauce, 2 teaspoons
METHOD
- Preheat oven to 450 degrees. Line baking sheet with aluminum foil; lightly grease with olive oil.
- Slice sweet potatoes into half-inch discs. Toss with olive oil and salt and pepper. Roast until very soft, about 25 minutes, flipping halfway through. Remove and let cool, but do not turn off oven.
- In a large bowl, combine ground turkey, garlic, ginger, cilantro, ½ teaspoon Southeast Asian chili sauce, and soy sauce. Season with salt and pepper. Form mixture into four patties.
- Heat drizzle of olive oil over medium-high heat in an iron skillet or large oven-safe pan. Add patties and cook until browned, 2 to 3 minutes per side. Transfer pan to preheated oven and bake burgers about 5 to 7 minutes.
- For sauce, combine mayonnaise with Southeast Asian chili sauce.
- Remove burgers from oven. To test for doneness, insert a meat thermometer through the side of a burger into the center (recommended internal temperature is 165 degrees Fahrenheit).
- Serve on buns with roasted sweet potatoes and baby greens on the side. Use sauce as a dip or drizzle over burgers.
Chicken Croquettes With Mashed Potatoes
Chicken croquettes adapted from “The Best I Ever Tasted” by Margaret Galbreath
Mashed potatoes adapted from Delish Best Mashed Potatoes
Serves: 6 people
Most suitable for: Levels 5 and 6
Served with mashed potatoes, these crisp and creamy chicken croquettes make a rich, comforting supper. Allow time to refrigerate croquettes for two hours before serving. For those with swallowing concerns: Make sure day-old bread is not too crumbly, add thickener to sauce if needed, and serve with extra sauce.
INGREDIENTS
Croquettes
- Butter, melted, 2 tablespoons
- Self-rising flour, 3 tablespoons
- Chicken broth, 1 cup
- Boneless, skinless chicken breasts, cooked and chopped, 2 cups
- Celery, finely chopped, 1 rib
- “Day-old” white bread, crusts removed, 10 slices
- Eggs (large), beaten, 2
- Salt and pepper, to taste
- Peanut oil, dash
- Parsley, chopped, dash
Sauce
- Butter, 4 tablespoons (½ stick)
- Mushrooms, finely chopped, 16 ounces
- Cream of mushroom soup, 1 can
- Cooking sherry, ½ to 1 cup as needed
- Lemon juice, 1 tablespoon
Mashed Potatoes
- Yukon Gold or russet potatoes, peeled and diced, 4 large (about 3 pounds)
- Kosher salt, pinch
- Butter, 4 tablespoons (½ stick)
- Dairy milk, whole, ½ cup
- Sour cream, full fat, ½ cup
- Freshly ground black pepper, to taste
METHOD
- Remove crust from bread. Cut into small cubes, no larger than 4 mm, (approximately the gap between the prongs of a standard dinner fork).
- Combine 2 tablespoons butter, self-rising flour, and chicken broth in a medium pan over low heat. Stir until thickened. Add flour or food thickener as needed to thicken sauce.
- Add cooked chicken, celery, salt, and pepper to mixture. Cover and chill for two hours.
- Place potatoes in a large pot and cover with water. Add a pinch of salt. Bring to a boil and cook until very soft, about 16 to 18 minutes. Drain water.
- Melt 4 tablespoons butter in a small saucepan over low heat. Stir in milk. Pour over potatoes and mix until combined. Then add sour cream and mix. Transfer potatoes to a large bowl. Use an electric mixer to beat until smooth and creamy, with no lumps. Season with salt and pepper to taste.
- Remove cooled chicken mixture from refrigerator and shape into croquettes (about the size of a large egg). Dip croquettes in beaten eggs and then roll in bread cubes. Place on a tray covered with wax paper. Refrigerate until ready to cook.
- Just before serving, pan fry croquettes in peanut oil until brown, turning to cook evenly. Remove from heat before an outer crust can form. Drain excess oil on paper towels before ready to plate.
- While croquettes are frying, make the sauce: Melt the remaining 4 tablespoons of butter in a skillet. Add mushrooms; sauté until soft. Stir in cream of mushroom soup,½ cup sherry, and lemon juice until thoroughly heated. Add more sherry to thin, if necessary.
- Pour sauce over croquettes and garnish with parsley. Serve with mashed potatoes.
Pumpkin Crisp
Adapted from: Southern Living Pumpkin Crisp
Serves: 8 to 10 people
Most suitable for: Levels 5 and 6
Pumpkin crisp makes a delicious and warm dessert for cold nights and holiday gatherings. The topping can also be made with chopped pecans (1 cup), which are sprinkled on before baking. Try making half without nuts and half with to satisfy guests who have swallowing concerns and those who do not.
INGREDIENTS
- Pumpkin, one 15-ounce can
- Evaporated milk, 1 cup
- Granulated sugar, ½ cup
- Vanilla, 1 teaspoon
- Cinnamon, ½ teaspoon
- Yellow cake mix with butter, 1 box (18 ¼ ounces)
- Butter, melted, 1 cup (2 sticks)
- Topping: Whipped cream, grated nutmeg
METHOD
- Preheat oven to 350 degrees.
- In a medium bowl, combine pumpkin, evaporated milk, sugar, vanilla, and cinnamon and mix until combined. Pour into a 11-by-7-inch baking pan.
- Sprinkle evenly with yellow cake mix. Drizzle butter on top.
- Bake for 1 hour. Remove from oven and let cool for 10 minutes. Sprinkle with grated nutmeg to taste and serve with whipped cream.
Citation for this content: The online speech pathology program from Baylor University’s Robbins College of Health and Human Sciences