IDDSI Levels and Framework
When experiencing swallowing difficulties, it is important to make sure that all food is safe for consumption. Being diagnosed with dysphagia can be emotionally challenging and confusing with a lot of information to remember.
When someone starts to experience dysphagia, they are most commonly seen by a speech and language therapist (SLT) and a dietitian. Together, they will create a plan for the management of dysphagia. A speech and language therapist will explain in detail the importance of texture modified food and drinks and will work with you to carefully understand the right texture modification for you. This is where IDDSI can help you understand your recommended texture modified diet in more detail.
What is IDDSI?
IDDSI stands for International Dysphagia Diet Standardisation Initiative. This is a committee that have developed a framework of 8 levels which provide common terminology to describe food textures and the thickness of liquids for those living with dysphagia.
The purpose of IDDSI is to create standardised terminology and descriptors for texture modified foods and liquids that can be applied and understood globally – across all cultures and age spans.
Before the introduction of IDDSI, there were national descriptors in the UK which were formed by opinion rather than international standards. Having different terminology, categories and definitions in different countries caused some instances of food being of incorrect consistency. The IDDSI framework was fully adopted by food manufacturers and healthcare settings in the UK in March 2019.
The framework consists of levels for both drinks (liquids) and foods, some of which overlap as you can see in the image above. Here is a breakdown of each category in the IDDSI FOODS framework.
Level 3 – Liquidised/Moderately Thick
- Can be drunk from a cup
- Does not retain its shape
- Can be eaten with a spoon, not a fork
- Smooth texture with no 'bits'
Level 4 – Pureed/Extremely Thick
- Usually eaten with a spoon (a fork is possible)
- Does not flow easily
- Does not require chewing
- Retains its shape
- No lumps
- Not a sticky consistency
Level 5 – Minced
- Can be eaten with either a fork or a spoon
- Can be scooped and shaped
- Small lumps are visible, but are easy to squash with tongue
- Biting is not required
- Minimal chewing required
Level 6 – Soft & Bite-Sized
- Can be eaten with fork or spoon
- Can be mashed/broken down with pressure
- Chewing is required before swallowing
How can I check my meals are made to IDDSI standards?
You can check to see whether your food is compliant with the IDDSI Framework by watching these IDDSI Food Test videos.
We understand that mealtimes can be daunting when you are living with dysphagia. Whilst this blog helps you to understand the different textures in the IDDSI Framework, it’s also important to know which foods are more difficult to manage and harder to modify to IDDSI guidelines, especially when home blending. Read our blog on ‘Foods to avoid with dysphagia’.
How can Softer Foods help?
Here at Wiltshire Farm Foods our award-winning Softer Foods range offers over 80 meals across Level 4 (Pureed), Level 5 (Minced) and Level 6 (Soft & Bite-Sized) so you can find something that’s the right texture for you. Working together, our expert chef’s and dietitians have created a wide range of enjoyable and flavoursome meals that are safe for those experiencing swallowing difficulties and are tested to meet IDDSI guidelines.
You can simply visit our website or call your local Wiltshire Farm Foods branch to place you order and your meals will arrive frozen straight to your door and into your freezer ready for you to enjoy whenever you like.
Order your FREE brochure today to browse all our delicious dishes.