In the past, the National Dysphagia Diet (NDD) was the only standardized diet tool in the United States, and it was developed around trying to provide some consistent guidance for food and beverages used for individuals with swallowing problems.

NDD was published in 2002 by the American Dietetic Association (ADA) (now known as the Academy of Nutrition and Dietetics). It was created as an official project of ADA, but NDD was not officially supported by the American Speech-Language-Hearing Association. NDD was, however, based on consensus among dietitians, speech-language pathologists, and food scientists.

Currently, NDD is still the framework used in many long term care facilities, with speech language pathologists and registered dietitians then defining specific consistencies needed for individual residents.

In spite of using NDD, there are continued challenges in having a standard for thickness, thinness, dryness, and sizes of food prepared for serving. There is a lack of standardization in textures among therapists, dietary staff, and nursing staff. There is also an increased risk during care transitions that resident’s dysphagia recommendations may be interpreted differently in the new facility; there is no common nomenclature between facilities or professionals.