How to Modify Your Meal to IDDSI Level 4

How to Modify Your Meal to IDDSI Level 4


Heather de la Croix is a Speech and Language Therapist with over 30 years of experience in the NHS and the private sector, during which she’s worked with thousands of people who have difficulties eating and drinking. Her aim is to help people with chewing and swallowing difficulties enjoy their meals as safely as possible. In this guide, Heather explains how to adapt your Birds Eye Soft Meals to IDDSI level 4.

People with swallowing or chewing difficulties may be advised by their GP or Speech and Language Therapist to follow an IDDSI level 4 diet.

Birds Eye Soft Meals are developed to be a suitable consistency for those at IDDSI level 7 (Easy to Chew), but they can also be adapted for IDDSI level 4 (Pureed) by following just a few simple steps. Because of their smooth texture, they’re easy to modify, and you’ll need no special utensils to do so.

What is IDDSI Level 4 (Pureed)?

IDDSI level 4 is also called ‘Pureed’. It has a very smooth texture with no lumps. It holds its shape on a spoon but is not sticky and will fall off fairly easily if the spoon is tilted or lightly flicked. It does not drip continuously through the prongs of a fork. A blender or food processor is usually required to prepare your own level 4 home-cooked food.

IDDSI level 4 is recommended for people who are unable to chew food effectively, or who are sensitive to lumps in food. It is also easy to swallow for people who have oesophageal conditions. More detail is available here.

Certain foods are best avoided if you require this level. Your Healthcare Professional should be able to explain this to you, and there is also information on the IDDSI website. Some of these foods (e.g. sweetcorn, green beans, tomatoes, rice) are included in the Birds Eye Soft Meals, but are safe to eat because they have been texture modified. You can, therefore, safely enjoy the flavours of these foods.

Please note: Always consult a GP or Speech and Language Therapist before making any changes to your diet and to confirm which IDDSI level you may require.

How to Adapt Your Birds Eye Soft Meals to IDDSI Level 4

The Birds Eye soft meals are smooth textured but require mixing with the sauce to ensure they are not too sticky.

Follow these steps to make your Birds Eye Soft Meal suitable for IDDSI level 4:

  1. Cook your meal according to the instructions on the packaging
  2. Place the tray on a firm surface
  3. Use a fork to firmly mash the pieces of food. You need to break the pieces down so that it becomes smooth and moist. Use a ‘criss-cross’ movement to get the right consistency.
  4. Mix the sauce in as you mash it to make the food more moist and easier to swallow. This mixing of the sauce and food will reduce the stickiness of the food, and will reduce the risk of it getting stuck in the throat. You need to break down any particles, so that the meal is completely smooth in texture
  5. The meal can be eaten with a spoon or a fork, but a teaspoon will limit the ‘bolus’ size and make it safer

IMPORTANT: The Beef and Cauliflower Timbales with Onion Sauce and Mashed Potato meal is NOT suitable for a level 4 diet. This is because the cauliflower timbales contain small pieces of cauliflower and are not a smooth texture.

Useful tip: When someone eats very slowly, food may get cold towards the latter part of the meal. You can prevent this happening by using a ‘keep warm’ plate. If the food cools down a lot, a skin may form. You will need to ensure you re-mash the food to a completely smooth texture if this happens.

IDDSI Level 4 Birdseye Meal

General safety advice

  • Ensure you are sitting upright and are well supported when eating and drinking
  • If you wear dentures, make sure they are well fitting and do not move around when you eat. If they are loose, you may wish to remove them for eating. Discuss this with your Healthcare Professional
  • Avoid eating if you are feeling drowsy and are not fully awake/alert
  • Make sure you put just one spoonful of food into the mouth at a time. Using a teaspoon rather than a dessert spoon or fork will limit the ‘bolus’ size, making it safer
  • Finish one mouthful before you have another
  • Avoid talking and other distractions such as watching TV or reading, whilst eating
  • If you are assisting someone that is eating, give plenty of time for them to clear their mouth between each mouthful. Check their mouth is clear before offering the next mouthful
  • Always clean the mouth after eating to ensure any debris is cleared to reduce the risk of oral infections or the risk of aspiration/choking

I hope these tips will allow you to make mealtimes more enjoyable. If you have any further questions, please watch my tutorial videos for a step-by-step description, or kindly contact Alimento at or call 0800 083 4446.



Alimento Paid Advertisement Feature. This article was prepared by Heather de la Croix in her personal capacity and for general information purposes only. The opinions expressed are the author’s own. Alimento does not warrant that the steps as described to modify the meals to different IDDSI levels will work for everyone. Our meals are prepared and sold as IDDSI Level 7 (Easy to Chew) and you should consult a Healthcare or Medical Professional about your personal circumstances and before making any changes to your diet.