APPENDIX 4: International Dysphagia Diet Standardisation Initiative (IDDSI) Terminology

IDDSI Terminology

AHS Diet Terminology and Guidelines

Common Terms for Texture Modified Foods for Children Without Dysphagia

Liquidized (level 3): blended foods. Has a smooth texture with no lumps, or other particles.

Balanced Fluid: nutritionally adequate fluids able to pass through a straw.

Blenderized or blended diet: food or fluids blended to a consistent smooth thick liquid texture.

Pureed (level 4): smooth textured foods with no lumps, may hold its shape on a spoon, and is not sticky. Liquid does not separate from solids. Includes ‘no mixed consistencies’, moist, pre-gelled or slurried breads. Included as part of all IDDSI texture modified diets.

Pureed diet: pureed to consistency of pudding, including bread. Solids are thick enough to spoon 7.5-10 mL onto a teaspoon.  Liquid does not separate from solids. Includes ‘no mixed consistencies’.

Thin, runny or smooth puree: may vary in thickness between mildly, moderately and extremely thick consistencies. 

Minced and moist (level 5): soft and moist with no liquid leaking from food. Biting is not required and minimal chewing. Easily mashed. Lumps are 2 mm in size. Bread is pureed, pre-gelled or slurried. No mixed consistencies.

Minced diet: minced, grated, or finely mashed foods approximately 6 mm in size. Pureed if cannot be safely prepared in a minced format. Soft, moist bread. Mixed consistencies if tolerated.

Textured puree or soft mashed: graded up from smooth thick puree to assist with chewing and oral motor development. The consistency is a cohesive spoonful that requires only minimal chewing or munching.

Soft and bite-sized (level 6): soft, tender and moist with no thin liquid leaking from the food. Ability to chew bite-sized pieces is required for safe swallow. Pieces < 8mm. Fork mashable.

Dysphagia soft: soft, moist foods 1 cm diced, fork mashable. Chewing required.

Soft solid, diced or finger food: easily broken down in the mouth with minimal chewing or munching and is easily swallowed.

Mixed consistency: thin liquid and solid in the same bolus, e.g. cereal with milk.

Mixed consistency: thin liquids and solids in the same mouthful.

Mixed consistency: thin liquid and solid in the same bolus, e.g. fruit cocktail.

Easy to chew (level 7): everyday foods requiring teeth for biting or chewing. Avoid hard, fibrous textures.

Easy to chew: easy to chew softer food. Avoid dry, crispy, or stringy pieces.

Finger foods or firm solid foods: require more chewing as they do not break down as easily as soft finger foods.

Transitional foods: food that starts as one texture and changes into another texture specifically when moisture is added, or with a change in temperature, e.g. ice cream or wafers. Reduced effort to chew. Less likely to fatigue.

n/a

Bite and dissolvable foods: dissolve with saliva only. No or minimal intraoral pressure required to dissolve, e.g. baby biscuits/crackers, ice-blocks, chocolate.

Regular diet (level 7): everyday foods of various textures. Requiring teeth for biting or chewing.

Regular diet: No texture modification, provides a balanced, nutritionally adequate diet.

Hard munchables: will not break apart easily in the mouth; in early stages are for exploration, not consumption, e.g. raw carrot or dried fruit sticks, beef jerky.