What is IDDSI and Should I Adopt it?


Over 590 million people worldwide are impacted by dysphagia (difficulty swallowing), making the condition a lot more common than you may think. For people living with the condition, the ability to consume food can be severely compromised and even dangerous, with many patients and residents needing foods specifically textured for their consumption.

Despite the many downfalls of living with dysphagia, the prevalence of cases worldwide means there are an increasing number of resources and services for people who have the condition, including the advocacy provided by the International Dysphagia Diet Standardization Initiative (IDDSI). 

What is IDDSI?

The International Dysphagia Diet Standardization Initiative (IDDSI) is a global movement to help improve the lives of people living with dysphagia. Their mission is to standardize the way textured-modified foods are named, described and classified. The development of terminology for a global audience is aimed to make life easier for all the aforementioned groups. 

The IDDSI Framework | Thicken Up Clear®

How does it work?

The IDDSI has created a framework consisting of 8 levels (0-7) which describe texture-modified foods and liquids, with 0 being the thinnest consistency . For easy identification, labels are numbered, colour coded, and have text to describe each level. 

Levels 0 through 4 describe liquids from thin to extremely thick, while levels 3 through 7 are to identify transitional foods from liquidised to regular. Levels 3 and 4 are used to classify both the thickness of liquids and the texture of foods.

A standardized testing methodology for the levels was also developed by the IDDSI and assists those impacted by dysphagia in identifying foods that are safe for consumption based on their individual ability to swallow. These methods come with lengthy descriptions for how the food should be texturized at each level to determine if food meets the standards for that specific level. Testing is broken down into five critical categories:

  • The Appearance
  • The flow test
  • The fork drip test
  • The spoon tilt test
  • The fork and spoon pressure test

The IDDSI also provides a description for the finger test as an alternative in instances where forks and spoons are not available.

Each level has lengthy descriptions for proper food consistency and testing to ensure patient and resident safety. When in doubt if a food meets a specific level's standards, the IDDSI offers extensive resources on best practices for proper texture testing for each level. 

How does adopting IDDSI benefit everyone?

Prepared meals labeled properly using IDDSI ensure that patients and residents with dysphagia are not only getting the proper textured foods they need, but also reduces their risk of malnutrition - a common problem amongst people living with dysphagia. The implementation of IDDSI also improves patient and resident safety and makes processes easier for caregivers in identifying what food to safely serve to each patient and resident. 

  • Patients and Residents

The greater clarity and compliance provided by IDDSI labeling and testing ensures patients and residents with dysphagia safely receive the proper nutrients through their food. This can assist patients and residents in maintaining a healthy weight and a balanced diet - two issues encountered by many suffering from dysphagia. Proper labeling also ensures patients and residents are staying safe and avoid choking on food or developing pneumonia from food or liquids that are not properly swallowed. 

  • Health care professionals and caregivers 

Properly tested and prepared meals that meet IDDSI standards will help patients and residents with dysphagia stay healthy through proper nutrition and regular meals. Serving meals with IDDSI labeling will give caregivers peace of mind when it comes to mealtime. As each patient or resident may have different needs when it comes to texture-modified foods, labeling will assist in ensuring each patient and resident receives the meals that are safe for their consumption. 

Should I adopt IDDSI?

Based on the above information, it is clear that adopting IDDSI is an effective method to keep patients and residents with dysphagia safe, healthy, and satisfied when it comes to mealtime. apetito HFS’s prepared meals offer long-term care facilities, nursing homes, health care settings, and Meals on Wheels with nutritious texture modified options that abide by IDDSI guidelines. This ensures patients and residents with dysphagia are not only receiving the properly textured foods for their needs, but continue to consume the proper nutrients needed to help them thrive. 

Settings who serve patients and residents with dysphagia and have not yet adopted IDDSI could consider starting by serving properly labeled, prepared meals from apetito HFS. This will not only improve patient and resident safety, but will ultimately assist in mealtime satisfaction. 

Back to Blog