What are easy to chew meals for level 7?: A comprehensive nutrition guide

According to the International Dysphagia Diet Standardisation Initiative (IDDSI), a global framework designed to improve patient safety, Level 7 is classified as Regular Easy to Chew. This dietary approach is designed for those who can manage soft and tender foods without tiring, offering a wide range of nutritious and enjoyable options.

Quick Summary

This guide details the IDDSI Level 7 Easy to Chew diet, outlining the characteristics of suitable foods. It provides practical meal ideas, recipes, and cooking tips to ensure variety and proper nutrition for individuals with chewing difficulties, alongside important safety considerations.

Key Points

• Understand the IDDSI Scale: Level 7 (Regular Easy to Chew) applies to individuals who can chew soft, tender foods without fatigue or choking risk, following a healthcare provider's recommendation.

• Master the Fork Test: Use the IDDSI Fork Pressure Test to ensure foods can be easily squashed with a fork, indicating they are soft enough to chew and swallow safely.

• Prioritize Soft, Moist Textures: Ensure foods are moist by cooking with liquids, and adding sauces, gravy, or cream. Avoid tough, chewy, dry, or fibrous ingredients.

• Plan Balanced, Nutrient-Dense Meals: Counter potential weight loss and fatigue by enriching meals with calories and protein using full-fat dairy, soft protein sources, and nutrient-fortified drinks.

• Explore a Variety of Meal Ideas: Soft food options are diverse, including creamy cereals, tender casseroles, omelettes, moist sandwiches, and pureed fruits, keeping mealtimes interesting.

• Avoid Unsuitable Foods: Steer clear of raw vegetables, nuts, seeds, dried fruits, tough meats, hard-crusted bread, and crispy or crunchy snacks.

Understanding the IDDSI Framework: Level 7 Explained

The International Dysphagia Diet Standardisation Initiative (IDDSI) is a global framework with eight levels, from Level 0 (Thin Liquids) to Level 7 (Regular foods), designed to categorize food and drink textures for individuals with swallowing or chewing difficulties. Level 7 is unique because it includes two categories: 'Regular' and 'Regular Easy to Chew' (EC7). The EC7 diet is for individuals who have sufficient chewing ability but require softer foods due to a lack of dental hardware, fatigue, or other issues that prevent them from comfortably chewing tougher textures.

The most important characteristic of Level 7 Easy to Chew is that foods should be soft and tender enough to be broken apart easily with the side of a fork or spoon. The IDDSI recommends a 'Fork Pressure Test' where you press down on the food with a fork until your thumbnail turns white. If the food completely squashes and retains its shape, it's not soft enough.

Characteristics of Easy to Chew Foods

• Moist: Foods should not be dry or crumbly. Adding sauces, gravy, or butter can increase moisture.
• Tender: Meats, fish, and vegetables must be cooked until very tender. Slow-cooking or braising is an excellent method for achieving this.
• Without Separating Liquid: Foods with thin liquid that separates from the solid part in the mouth (like watermelon) can be problematic. Mixed textures are not always suitable.
• No Hard or Tough Elements: The food must be free from hard seeds, nuts, gristle, or bones.

Nutritious and Easy to Chew Meal Ideas

Creating a varied and appetizing menu is key to maintaining a healthy diet on Level 7. Here are some examples to inspire your meal planning:

Breakfast

• Porridge or Oatmeal: Cooked until creamy and soft, then topped with mashed banana or stewed, peeled fruit.
• Scrambled Eggs: Very moist and cooked with milk or cream. Can be served with soft bread (crusts removed).
• Yogurt Parfait: Layer creamy yogurt with mashed berries or seedless jam for added flavor and nutrients.
• Pancakes: Soft, moist pancakes with syrup or pureed fruit.

Lunch and Dinner

• Shepherd's Pie: Made with tender minced meat and a soft mashed potato topping.
• Fish Pie: Flaked fish in a creamy sauce with a soft potato topping.
• Macaroni and Cheese: Cook pasta until very soft and use a creamy cheese sauce.
• Spaghetti Bolognese: Well-cooked pasta with a minced beef sauce.
• Tender Chicken Casserole: Chicken and soft-cooked vegetables braised in a thick gravy.
• Tuna or Egg Mayonnaise Sandwich: Served on soft, crustless bread.
• Risotto: A creamy rice dish cooked until tender.

Snacks and Desserts

• Fruit Smoothies: Blend soft fruits like banana, mango, and peaches with yogurt or milk.
• Cottage Cheese: High in protein and can be paired with canned peaches or soft melon.
• Pudding or Custard: Creamy desserts like rice pudding, semolina, or crème caramel.
• Soft Fruit: Ripe banana, peeled peaches, or tinned fruit chunks.
• Avocado: Mashed avocado on its own or spread on soft toast can be a great source of healthy fats.

Balancing Your Nutrition on a Soft Diet

Maintaining a nutritionally balanced diet is crucial, especially when texture restrictions are in place. Here are some key nutritional considerations:

1. Prioritize Protein: Protein is essential for tissue repair and maintaining muscle mass. Include protein in at least two meals a day with options like eggs, soft fish, poultry, or dairy products. Protein powder can also be added to shakes or cereals for a boost.
2. Increase Caloric Density: If weight loss is a concern, increase the calories in your meals. Use full-fat dairy products instead of low-fat options and add butter, cream, or cheese to dishes like mashed potatoes and soups.
3. Ensure Adequate Fiber: While avoiding tough or fibrous skins, ensure a good intake of fiber from soft-cooked vegetables and fruits. Fiber helps maintain digestive health. Examples include soft-cooked carrots, sweet potato, and mushy peas.
4. Stay Hydrated: Drinking plenty of fluids is important. Choose milk, juice without pulp, smoothies, or nourishing hot drinks to stay hydrated. Sometimes, drinking between meals rather than with them can prevent feeling too full too quickly.

Comparison Table: Healthy vs. Unsuitable Foods (IDDSI Level 7)

Food Group	Suitable for Level 7 Easy to Chew	Unsuitable for Level 7 Easy to Chew
Protein	Tender chicken (shredded), flaky fish, soft meatballs, moist meatloaf, eggs (scrambled or poached), tofu	Tough, dry meat; bacon; meat with gristle or bones; nuts; seeds; crunchy peanut butter
Fruits	Soft, ripe fruits (banana, melon, berries), cooked/tinned fruit (peeled pears, peaches), applesauce, pureed fruits	Raw apple, hard pears, dried fruit, stringy fruit (pineapple), fibrous parts of fruit, fruit with seeds
Vegetables	Soft-cooked vegetables (carrots, sweet potato, butternut squash, spinach), mushy peas, well-cooked beans/lentils	Raw vegetables (carrots, broccoli), crispy or stringy vegetables (celery, runner beans), corn, vegetable skins
Grains/Starches	Well-cooked pasta, white rice (moistened), porridge, instant cereals softened with milk, moist soft bread (crusts removed)	Hard-crusted bread (bagels), crackers, popcorn, dry cake or biscuits, whole grains with seeds
Desserts/Snacks	Pudding, custard, ice cream, yogurt, mousse, soft cake with cream or custard	Chewy candies, toffee, dried fruit snacks, crunchy toppings (nuts, granola), flaky pastry

Conclusion: Making Mealtime Enjoyable and Safe

Adhering to an Easy to Chew diet doesn't mean sacrificing variety, flavor, or proper nutrition. With careful preparation and the right food choices, meals can remain satisfying and safe. For individuals on this diet, focusing on moisture, tenderness, and nutrient density is essential. Utilizing kitchen tools like blenders and slow cookers can simplify the process, while enhancing meals with sauces and healthy fats ensures adequate calorie intake. Always consult with a healthcare professional, such as a doctor or dietitian, to create a personalized plan that meets your specific nutritional and safety needs. The official IDDSI website provides additional resources and testing methods. Check the IDDSI website here.

Frequently Asked Questions

What is the difference between Level 7 Easy to Chew and other IDDSI levels?

Level 7 Easy to Chew consists of regular foods that are naturally soft and tender. Other levels, such as Level 5 (Minced and Moist) and Level 4 (Pureed), require more significant texture modifications due to greater chewing or swallowing difficulties.

How can I make meat soft enough for a Level 7 diet?

To make meat tender, use slow-cooking methods like stewing or braising. Alternatively, mince the meat and mix it with a thick gravy or sauce. Ensure all bones, gristle, and tough skin are removed.

Are sandwiches allowed on an Easy to Chew diet?

Yes, but with modifications. Use soft bread and remove the crusts. Fillings should also be soft, such as tuna or egg mayonnaise, soft cheese, or pate. Avoid crunchy or seeded ingredients.

What kind of fruits and vegetables are best for Easy to Chew meals?

For fruits, choose soft, ripe, and peeled options like bananas, peaches, or melons. Cooked or tinned fruits are also excellent. For vegetables, steam or boil them until tender and mash if necessary, opting for carrots, sweet potatoes, and cauliflower.

How can I increase the calories in Easy to Chew meals?

Add extra calories by using full-fat dairy products (milk, yogurt, cheese), butter, cream, or gravy. Stir protein powder into drinks or cereals, and use avocados or nut butters in smoothies.

What foods should be avoided on a Level 7 Easy to Chew diet?

Avoid hard, tough, chewy, or crunchy foods. This includes nuts, seeds, raw vegetables, hard fruit, dried fruit, crispy snacks, flaky pastry, and chewy sweets.

Do I need to test food textures myself?

The IDDSI recommends using the Fork Pressure Test to check that food is sufficiently soft and tender. Press down on the food with a fork until your thumbnail blanches white; the food should fully squash and not regain its shape.