IDDSI Framework - Guide

The IDDSI (International Dysphagia Diet Standardisation Initiative) Framework The IDDSI Framework helps make mealtimes safer for anyone with swallowing difficulties. It’s used worldwide in care homes and healthcare settings. Whether you’re one of our chefs or just looking to learn, this guide is here to help!

Level	Texture	Test	Example	Appearance
Level 7 (Regular)	Regular / Normal	None required	All regular foods	Normal in every way
Level 7 (Easy to Chew)	Regular / Easy to Chew	Fork Pressure Test	Bread, soft fruits, rice	Normal appearance, soft foods
Level 6	Soft & Bite-Sized	Fork Pressure Test	Tender meats, soft veggies, casseroles	Bite-sized (1.5 cm), soft texture
Level 5	Minced & Moist	Fork Pressure Test, Spoon Tilt Test, Size (<4mm)	Finely minced meat with sauce, soft pasta	Soft, moist, small lumps (<4mm)
Level 4	Extremely Thick / Pureed	Fork Drip Test, Spoon Tilt Test	Pudding, mousse, mashed potato	Holds shape, no lumps
Level 3	Moderately Thick / Liquidised	Flow test (>8ml), Spoon Tilt Test	Honey-thick liquids, liquid yogurt	Pours slowly, requires more effort
Level 2	Mildly Thick	Flow test (4–8ml remains)	Nectar-thick juice, cream soup	Slight resistance to flow
Level 1	Slightly Thick	Flow test (1–4ml remains)	Anti-reflux fluids, paediatric thickeners	Thicker than water, pours easily
Level 0	Thin	Flow test (<1ml remains after 10 sec)	Water, coffee, broth	Flows like water