Understanding the IDDSI Level 7 Easy to Chew Diet
The International Dysphagia Diet Standardisation Initiative (IDDSI) provides a global framework for describing food textures and drink thickness for people with swallowing difficulties (dysphagia). Level 7 represents two diet stages: Regular (RG7), for those with no chewing or swallowing issues, and Easy to Chew (EC7), for individuals who need softer textures. The Easy to Chew diet is designed for people who can chew and swallow with some effort but may struggle with harder, tougher foods due to weaker chewing muscles, dental issues, or fatigue. The key characteristic is that food must be soft and tender, breaking apart easily under pressure from the side of a fork or spoon.
How to Test Food for Level 7 Easy to Chew
Before serving any snack, it is critical to perform the Fork Pressure Test.
- Press: Apply enough pressure on the food with a fork until your thumbnail blanches (turns white).
- Lift: Remove the fork. The food should be completely squashed and should not regain its original shape.
- Check: The food should break apart easily with the side of the fork. A knife should not be necessary to cut the food.
Allowed Snack Options for IDDSI Level 7
Fruit-Based Snacks
- Soft Fresh Fruit: Ripe bananas, peeled peaches, nectarines, or kiwi, cut into manageable pieces.
- Canned or Stewed Fruit: Pears, peaches, or apricots are excellent choices, provided all skins and excess juice are drained.
- Berries: Soft berries with small seeds, like strawberries and raspberries, can be included.
- Pureed Fruit: Applesauce and other smooth fruit purees offer a safe and nutritious option.
Dairy and High-Protein Snacks
- Smooth Dairy: Smooth yogurts, thick and creamy yogurts, and mousses are ideal snacks. Avoid yogurts with fruit chunks or nuts.
- Soft Cheese: Cottage cheese or soft cheeses like cream cheese are suitable. Cream cheese should be thinly spread, not eaten in chunks.
- Eggs: Scrambled, poached, or soft-boiled eggs are great protein-rich snacks.
- Dips: Smooth dips like hummus or guacamole can be served with soft vegetables or bread.
Moist Baked Goods and Desserts
- Soft Cakes and Muffins: Moist, plain sponge cakes, plain muffins, or soft brownies are good choices, especially with added moisture like cream or custard. Avoid cakes with nuts, dried fruit, or hard icing.
- Puddings and Custards: Crème caramel, milk puddings, and egg custards are perfectly safe options.
- Soaked Biscuits: Plain biscuits like sponge fingers can be dunked in tea, coffee, or milk to soften thoroughly before consumption.
Preparing and Enhancing Your IDDSI Snacks
Proper preparation is just as important as choosing the right ingredients. To maintain moisture and enhance flavor in your snacks:
- Use Extra Fat and Moisture: For added calories and texture, mash potatoes or vegetables with butter, cream, or cream cheese.
- Fortify Milk: Boost the protein and calorie content of milk for cereals, drinks, and cooking by adding dried milk powder.
- Create Smoothies: Blend soft fruits with full-fat yogurt, milk, or cream for a nutritious, easy-to-consume snack. Ensure there are no lumps or seeds.
- Add Sauces: Use gravies, sauces, or custard to moisten baked goods or savories.
Comparison of Safe vs. Unsafe Snacks for IDDSI Level 7
| Safe Snacks (IDDSI EC7) | Unsafe Snacks (IDDSI EC7) |
|---|---|
| Ripe, peeled banana | Raw apples or carrots |
| Smooth yogurt (no chunks) | Yogurt with fruit or nut chunks |
| Moist, plain sponge cake | Dry cake, biscuits, or crackers |
| Steamed or boiled tender vegetables | Raw or stir-fried vegetables |
| Cottage cheese or cream cheese | Hard cheese chunks |
| Scrambled eggs | Bacon with crispy edges |
| Hummus or bean dip | Nuts and seeds |
| Soft, cooked pasta | Tough, fibrous meats |
Foods and Textures to Avoid at Level 7
- Hard or Dry Foods: This includes hard crackers, uncooked vegetables, tough bread crusts, and nuts.
- Chewy or Sticky Foods: Avoid items like dried fruit, chewing gum, sticky mash, marshmallows, and some types of hard or gummy candies.
- Crunchy or Crispy Foods: Popcorn, toast, chips, and crispy bacon are generally unsafe due to their hard texture and potential to crumble.
- Fibrous or Stringy Foods: Pineapple, celery, and rhubarb are examples of fibrous or stringy foods that are difficult to manage.
- Skins, Pips, and Seeds: Remove all skins from fruit and vegetables, and avoid seeds and pips, as these can pose a choking hazard.
- Mixed Consistencies: Foods with both solid and thin liquid components, such as cereal with milk or watery soup with large pieces, should be avoided.
The Importance of Professional Guidance
While this guide offers general information, it is crucial to consult a healthcare professional, such as a Speech-Language Therapist (SLT) or dietitian, for personalized advice. An SLT can confirm the correct IDDSI level and provide specific recommendations based on individual needs, chewing strength, and swallowing ability. Your healthcare team can offer guidance on fortifying foods to prevent weight loss and ensure adequate nutrition.
Conclusion: Safe and Enjoyable Snacking on an IDDSI Level 7 Diet
Adhering to the IDDSI Level 7 Easy to Chew diet allows for a wide variety of snacks that are both safe and enjoyable. The key is focusing on foods that are naturally soft or can be prepared to a tender, moist consistency that passes the Fork Pressure Test. By choosing appropriate snacks like ripe bananas, smooth yogurt, and moist cake while avoiding hard, crunchy, and fibrous textures, individuals can maintain their nutrition and enjoy satisfying treats without increasing their risk of choking. Always prioritize safety and consult with a healthcare provider for the best dietary plan.
