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NCM® Diet Manual Updates

IDDSI Levels

  • Level 4 Pureed (Green)
  • Level 6 Soft and Bite-Sized (Blue) Definition
  • Thickened Liquids

NCM Diet Manual Crosswalk

NCM Diet Order Terminology and Definitions

NCM® Condition Section Clinical Updates

Review new and updated clinical content featuring comprehensive nutritional management and evidence-based practice recommendations with our new consolidated format for the following conditions:

  • Cirrhosis (Updated)
  • Diverticular Conditions (Updated)
  • Obesity & Overweight (Updated)


New and Improved NCM® Client Education Handouts

Now access 28 more vegetarian (lacto-ovo) and vegan menus for NCM® client education handouts:

  • Bariatric Surgery Soft Diet Stage Nutrition Therapy
  • Post-Surgery Meal Plan: 6 Months After Surgery and Beyond
  • Tyramine-Restricted Nutrition Therapy
  • Cholesterol-Lowering Nutrition Therapy
  • Heart Failure Nutrition Therapy for the Undernourished
  • Hearth Healthy – Reduced Sodium Nutrition Therapy
  • Milk Allergy Nutrition Therapy
  • Fish Allergy Nutrition Therapy
  • Wheat Allergy Nutrition Therapy
  • Esophageal Surgery Nutrition Therapy
  • Lactose-Controlled Nutrition Therapy
  • Difficulty Eating Nutrition Therapy
  • Jaw Fracture Nutrition Therapy
  • Pulmonary Nutrition Therapy


Don’t miss the expanded and updated NCM® client education handouts:



  • Cirrhosis Nutrition Therapy (Updated)


  • IDDSI Level 4 Pureed (Green) Nutrition Therapy (Updated)

Normal Nutrition

  • MyPlate for Meal Planning (New)

Weight Management

  • High-Calorie, High-Protein Nutrition Therapy (Updated; consolidated with Suggestions for Increasing Calories and Protein)
  • Setting Goals for Weight Management (New)
  • Tips to Support Weight Loss (Updated; previously Weight Loss Tips and consolidated with Weight Management Cooking Tips)

Transgender Nutrition Handouts

  • Nutrition education handouts developed and provided by the Saint Louis University Transgender Health Collaborative. These handouts provide nutrition guidance for transgender and gender diverse individuals.

Additional Client Education Handout Information

  • Spanish translations will soon be available for the client education handouts included in this update along with Arabic, Chinese, and Vietnamese translations for most popular client education handouts.
  • The redesigned PDF format will soon be available for the client education handouts included in this update.

NCM® Resources Updates

  • Dietary Guidelines for Americans, 2020
  • Academy Publications: A new section that lists Academy publications related to various conditions.

Relocated NCM® Content 

  • Kosher Dietary Guidelines was moved from the Normal Nutrition Client Education section to the Resources section under Cultural Foods Practices.

Retired NCM® Content 

NCM Diet Manual

  • National Dysphagia Diets
  • National Dysphagia Diet Advanced
  • National Dysphagia Diet Mechanically Altered
  • National Dysphagia Diet Pureed

Condition Sections

The following condition sections were retired based on consensus among the members of the NCM® Board of Editors due to underutilization: Cancer Sites: Bladder, Brain, Carcinoid Tumors, Hepatobiliary/Gallbladder/Cholangiocarcinoma, Lung, Neuroendocrine Tumors, Ovarian, Prostate, Renal, Testicular, and Vaginal & Endometrial.

Client Education Handouts


  • Coronary Artery Bypass Graft (CABG) Nutrition Therapy (Consolidated; View Cardiac-TLC Nutrition Therapy)


  • Nephrotic Syndrome Exchange Meal Pattern
  • Nephrotic Syndrome Nutrition Therapy


  • National Dysphagia Diet Advanced Nutrition Therapy
  • National Dysphagia Diet Mechanically Altered Nutrition Therapy
  • National Dysphagia Diet Pureed Nutrition Therapy

The following client education handouts were retired based on consensus among the members of the NCM® Board of Editors due to underutilization: 1,300 Calorie Sample Meal Plan, 1,700 Calorie Sample Meal Plan, 1,900 Calorie Sample Meal Plan, Amputations, Bulimia Nervosa Nutrition Therapy, Corn Allergy Nutrition Therapy, Corn Allergy Tips, Dentures Nutrition Therapy, Difficulty Eating Nutrition Therapy: Considerations for People with Diabetes, Dry Mouth, Egg Allergy Nutrition Therapy, Egg Allergy Tips, Exercise for HIV/AIDS Patients, Food Safety for HIV/AIDS, Galactose-Controlled Nutrition Therapy, Guidelines for High-Calorie Nutrition Therapy, Heart-Healthy Eating: Soy Protein, HIV/AIDS Managing Diarrhea, HIV/AIDS Managing Nausea and Vomiting, HIV/AIDS Medications and Food Interactions, HIV/AIDS Micronutrients (Vitamins and Minerals), Kitchen Tips, Milk Allergy Tips, Multiple Gestation Nutrition Therapy, Nephrotic Syndrome Exchange Meal Pattern, Nephrotic Syndrome Nutrition Therapy, Nutrition Recommendations After Oral Surgery, Nutrition Recommendations After Oral Surgery for People with Diabetes, Nutrition Recommendations for Orofacial Pain, Nutrition Recommendations to Reduce Side Effects of Medications, Nutrition Recommendations when Wearing Partial Dentures, Osteoarthritis Nutrition Therapy, Phenylketonuria (PKU) Tips, Pica Nutrition Therapy, Sickle Cell Disease Nutrition Therapy, Soy Allergy Nutrition Therapy, Soy Allergy Tips, Tree Nut Allergy Nutrition Therapy, Tree Nut Allergy Tips, and Wheat Allergy Tips.

NCM® Transition to IDDSI Framework

As of October 2021, International Dysphagia Diet Standardization Initiative (IDDSI) is the only texture-modified diet recognized by the Academy of Nutrition and Dietetics and the only texture-modified diet included in the NCM®. The National Dysphagia Diet (NDD) and associated resources have been removed from the NCM®.

NCM® Technological Updates   

Due to functionality changes in Internet Explorer, some calculators and other functions in NCM® may not perform as expected. Consider converting to a supported browser for optimal performance. Supported browsers include Microsoft Edge, Mozilla Firefox, Apple Safari, and Google Chrome.

We hope you enjoy the 2021 Nutrition Care Manual® Updates! 


The NCM® Team