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IDDSI Food & Drink Levels

A simple guide to textures and thickness to help you eat and drink more safely.

What is IDDSI?

IDDSI stands for International Dysphagia Diet Standardisation Initiative. It provides a global standard for describing food textures and drink thickness for people with swallowing difficulties.

The IDDSI continuum

One axis from 0 (thin liquid) to 7 (regular food). Drinks and foods meet in the middle at levels 3 & 4.

IDDSI LevelsRegular / Easy to Chew7Soft & Bite-Sized6Minced & Moist5PureedExtremely Thick4LiquidisedModerately Thick3Mildly Thick2Slightly Thick1Thin0DRINKS ←→ FOODS

Original schematic by stroke.food, inspired by the IDDSI framework. Not affiliated with IDDSI.

The 10-second flow test

Use a 10 mL slip-tip syringe (tip cut off). Fill, release for 10 seconds, then read what's left.

109876543210mL10-second flow result< 1 mLLevel 0 — Thin1–4 mLLevel 1 — Slightly4–8 mLLevel 2 — Mildly8–10 mLLevel 3 — ModerateNo flow mLLevel 4 — ExtremeOpen the flow-test timer →

Food Levels Explained

From regular texture to smooth pureed.

7food

Easy to Chew

Normal everyday foods of tender, soft texture. Requires chewing.

Examples

  • Tender cooked meat
  • Soft cooked vegetables
  • Rice, pasta
  • Soft fruits (banana)

Not suitable

  • Hard, crunchy foods
  • Tough, chewy meats
  • Dry foods
6food

Soft & Bite-Sized

Foods that can be chewed and mashed with the tongue. No tough or crunchy bits.

Examples

  • Meatballs
  • Soft bread (no crust)
  • Cooked veggies
  • Scrambled egg

Not suitable

  • Hard or crunchy
  • Sticky or chewy
  • Dry, crumbly foods
5food

Minced & Moist

Small, moist pieces that are easy to chew and swallow.

Examples

  • Minced meat with gravy
  • Soft fish flakes
  • Moist mashed beans
  • Soft cooked fruit

Not suitable

  • Large pieces
  • Mixed textures
  • Dry foods
4food

Pureed

Smooth, no lumps. Pudding-like texture. Holds shape on a spoon.

Examples

  • Pureed soup
  • Mashed potatoes (smooth)
  • Pureed fruits
  • Smooth yogurt

Not suitable

  • Lumpy or chunky
  • Fibrous pieces
  • Thin liquids
3food

Liquidised

Smooth, pourable, no chewing required. Cannot hold shape on a spoon.

Examples

  • Thin pureed soup
  • Smooth smoothies (strained)
  • Liquidised meals

Not suitable

  • Any lumps
  • Thick textures
  • Chunky foods

Drink Levels Explained

How thick should liquids be?

0drink

Thin

Flows like water.

Examples

  • Water
  • Tea, coffee
  • Juice (no pulp)
1drink

Slightly Thick

Slightly thicker than water.

Examples

  • Milk
  • Nutritional drinks
  • Thin smoothies
2drink

Mildly Thick

Flows off a spoon in a steady stream.

Examples

  • Fruity nectars
  • Thicker smoothies
  • Soup (thickened)
3drink

Moderately Thick

Drinks slowly from a cup, hard to use a straw.

Examples

  • Honey consistency
  • Spoon-thick drinks
  • Thickened soup
4drink

Extremely Thick

Eaten with a spoon, holds shape.

Examples

  • Pudding
  • Extremely thick supplements

Always follow your clinician's prescribed level. When in doubt, choose the safer option.

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