An Introduction to the IDDSI Framework

An Introduction to the IDDSI Framework


Heather de la Croix is a Speech and Language Therapist from North Somerset in the UK. She has over 30 years of experience working in the NHS and the private sector, during which she’s worked with thousands of people who have difficulties eating and drinking. Heather’s aim is to help people with chewing and swallowing difficulties enjoy their meals as safely as possible. Here, she provides an overview of the IDDSI framework.

A wide range of medical conditions can cause swallowing problems, such as stroke, dementia or progressive neurological conditions.

I have seen first-hand how difficulties with eating and drinking can have a huge negative impact on people’s quality of life. I have supported people who gradually needed to eat softer and softer meals to accommodate the evolution of their condition. Others I’ve worked with have progressed from tube feeding back to eating a normal diet, and have made a heartening full recovery over time.

This is why I would like to tell you more about Birds Eye Soft Meals and how you can adapt them to suit the variety of IDDSI levels by following a few simple steps.

What does IDDSI stand for, and what is the IDDSI framework?

IDDSI stands for International Dysphagia Diet Standardisation Initiative.

IDDSI levels are part of IDDSI framework, which explains how foods should be modified to make them safe to eat.

What are the different IDDSI levels?

The IDDSI framework consists of eight levels (0-7) of food or drink texture and thickness.

Image credit:  © The International Dysphagia Diet Standardisation Initiative 2019 @ Licensed under the CreativeCommons Attribution Sharealike 4.0 License Derivative works extending beyond language translation are NOT PERMITTED.

Food levels range from levels 3 to 7, and the framework provides a common terminology to describe food textures. These are:

  • Level 4 – Pureed
  • Level 5 – Minced & Moist
  • Level 6 – Soft & Bite-sized
  • Level 7 – Easy to Chew

The Birds Eye Soft Meal range is sold as IDDSI Level 7 (Easy to Chew), yet can be adapted to accommodate ranges 4-6 as well by following some simple steps.

They are not suitable for people who need a liquidised diet (IDDSI level 3).

How do I know which IDDSI level I require?

There are several different Healthcare Professionals who may be involved in an assessment of chewing or swallowing difficulties and its impact. This may include a Gastroenterologist, Speech and Language Therapist, Dietitian or Ear Nose and Throat Specialist.

People with chewing and swallowing difficulties often struggle to eat certain foods or textures. Foods can get stuck in the mouth or throat, and this can lead to infections of the mouth, as well as coughing, aspiration or choking. It is, therefore, important to understand the advice given by a Healthcare Professional about dietary recommendations, particularly if one of the specific IDDSI levels is recommended.  While many people are very conscious of the difficulties they have, a lot of others are not even aware of their condition. 

For some people, the recommendations will change as their medical condition evolves. This may be confusing, and your Healthcare Professional should explain why this happens. It may be because a person’s ability to eat safely improves with rehabilitation or deteriorates as the condition progresses. Fatigue and levels of alertness can also play a big part in how well someone can manage food.

It can be difficult to know how to prepare foods correctly to achieve the right texture. Your Healthcare Professional will be able to give you some ideas and suggestions. The option of ready-made meals can be very useful to ensure you are getting the right consistency of food, provide variety in your diet, and to reduce workload, as food modifications can be time-consuming to make.

If your GP or Speech and Language Therapist has recommended you follow an IDDSI level 4, 5 or 6 diet, click the links below to find out how you can adapt Birds Eye soft meals so you can still enjoy these delicious recipes, and their look and feel.