1. Frozen Treats

IDDSI considers ice cream, frozen yogurt, and popsicles as transitional foods, defined as “food that starts as one texture (e.g., firm solid) and changes into another texture specifically when moisture (e.g., water or saliva) is applied, or when a change in temperature occurs (e.g., heating)”⁷. These are usually used for chewing and swallowing development and rehabilitation. Since ice cream, frozen yogurt, and popsicles are thin liquids when swallowed, they may not be suitable for those with dysphagia. Individuals should be assessed by a clinician to determine if transitional foods are safe for that individual.

An alternative to these common frozen treats is the Magic Cup – a product like ice cream when frozen but pudding when thawed⁸. This characteristic allows for texture safety while providing a high calorie and protein content, which is often beneficial for individuals who are malnourished⁹.

2. BBQ Items

Hamburgers, grilled meats, and chips are frequently consumed foods when the weather is warm. There are hamburger recipes for “Level 5 Minced & Moist” and “Level 6 Soft & Bite-sized” textures, which look and taste similar to regular hamburgers⁸. The desired levels are achieved by modifying the texture of the meat, bread, and being selective of the toppings added.

Grilled meats are the main component of BBQs, but this process results in a crispy and crunchy outer texture, leading to a choking risk. To mitigate this, pre-cooked meats that are stamped with dark stripes to give the appearance of a grill mark can be purchased and prepared. You can also use BBQ sauce to flavor and moisten texture-modified meats to bring those classic BBQ flavors to the meal.

IDDSI also identifies the consumption of chips as a choking risk due to their sharp and spiky texture. Some chips made from mashed potato (e.g., Pringles), are considered transitional foods because they can melt in the mouth⁷. Note: Individuals should always be assessed by a clinician to determine if transitional foods are safe for that individual.

3. Watermelon

Watermelon is considered a mixed consistency item, as it contains both a solid and a liquid component. To eat watermelon, individuals need to be able to swallow the juice while controlling the solid piece in the mouth, which then requires complete chewing before being swallowed. For this reason, IDDSI recommends for those with dysphagia to avoid watermelon in its natural form⁷. Watermelon, however, can be blended, strained, and thickened (if applicable) to the appropriate viscosity for consumption.

4. Small Round Fruits

This category includes whole grapes, cherry tomatoes, cherries, olives, and most berries. These fruits are also considered unsafe because if swallowed whole, they can completely obstruct the airway and lead to choking¹⁰. Some of these fruits may be texture-modified per the IDDSI framework for the appropriate diet and evaluated per the IDDSI testing methods to determine safety for consumption.

5. S'mores

This product is made with graham crackers, marshmallows, and chocolate. In addition to classifying as a mixed consistency food, sticky residues can fall into the airway, increasing the risk of complications⁷. This treat should be replaced with an alternative known to be safe to the specified diet order.

Warm weather comes with summer seasonal favorites, but it is important to be aware of foods that can pose a risk for those with dysphagia. As diet texture modification is a major component of the management of this condition, following the IDDSI framework is necessary to ensure safety of the individuals affected.

There are various ways to alter foods to achieve the required level, as well as viable substitutions that allow for meal satisfaction. As a general rule, items should be tested for adequacy under the intended serving conditions, and if unsure of their safety, the SLP should be consulted.