What are the examples of food in the iddsi level 6?

January 7, 2026 •

4 min read

The International Dysphagia Diet Standardisation Initiative (IDDSI) provides a framework for texture-modified diets to improve safety for those with swallowing difficulties. Understanding the specific examples of food in the iddsi level 6, or Soft & Bite-Sized, is crucial for ensuring proper nutrition and meal safety.

Quick Summary

The IDDSI Level 6 diet consists of foods that are soft, moist, and tender, cut into bite-sized pieces (1.5cm max for adults). Moderate chewing is required, with an emphasis on safe preparation and texture testing to prevent choking.

Key Points

Soft & Bite-Sized: IDDSI Level 6 food is soft, tender, and moist, suitable for people who can chew but cannot bite off large pieces.
Size is Key: For adults, all food pieces must be pre-cut to no more than 1.5cm by 1.5cm to reduce choking risk.
Moisture is Mandatory: Foods should be served with thick, non-pouring sauces or gravies, and there must be no separate, thin liquids.
Fork Pressure Test: To ensure the correct consistency, the food should easily mash or break apart when pressed with the side of a fork.
Variety is Possible: A wide range of foods can be modified for this diet, including tender meats, soft fruits, cooked vegetables, and grains.
Professional Guidance: It is essential to consult with a speech-language pathologist or dietitian to determine the most appropriate and safest diet level.

Understanding the IDDSI Level 6 (Soft & Bite-Sized) Diet

The IDDSI Level 6 diet, referred to as Soft & Bite-Sized, is designed for individuals who have difficulty biting off large pieces of food but can safely chew and swallow smaller, soft-textured pieces. This food texture category is an important step towards a regular diet, often recommended by speech-language therapists and dietitians. For an individual to safely consume food at this level, it must be soft, moist, and tender throughout. Crucially, all food items must be pre-cut into bite-sized pieces no larger than 1.5 cm by 1.5 cm for adults, or 8mm for children. The food should not be sticky or separate into different consistencies (e.g., watery sauce and solid food). A key safety measure involves using the Fork Pressure Test to ensure the food breaks apart easily when pressed, indicating it's soft enough to prevent choking.

Examples of IDDSI Level 6 Foods by Category

To plan a meal for an IDDSI Level 6 diet, consider the following food examples, ensuring proper preparation and moisture levels.

Meats and Protein

Tender, cooked meat: Slow-cooked beef, pork, or lamb, cut into small, bite-sized pieces and served with a thick, non-pouring sauce or gravy.
Flaked fish: Skinless, boneless fish cooked until tender and flaked, then served in a thick sauce like parsley or cheese sauce.
Skinless sausages: Finely chopped or minced skinless sausages served in a thick sauce.
Eggs: Scrambled, poached, or hard-boiled eggs mashed with mayonnaise or butter to add moisture.
Tofu: Soft, tender tofu cut into small, bite-sized cubes and served with a thick sauce.
Pulses and Beans: Well-cooked, skinless beans or lentils, such as baked beans or red lentils, served mashed or with a thick sauce.

Vegetables and Fruits

Soft-cooked vegetables: Boiled or steamed vegetables, such as carrots, cauliflower, broccoli, sweet potatoes, and parsnips, cut into 1.5cm pieces.
Potatoes: Mashed potatoes, or the fluffy, tender centre of a jacket potato.
Ripe, soft fruits: Peeled and chopped ripe banana, stewed apple, canned peaches, or pears, with any excess juice drained off.

Grains and Starches

Softened cereals: Porridge or other cereals like Weetabix or Cornflakes, fully softened with milk and with excess liquid drained.
Moist rice: Well-cooked white rice served with a thick, moist sauce to prevent stickiness and separation.
Soft pasta: Cooked pasta cut into small, bite-sized pieces and mixed with plenty of sauce.

Dairy and Desserts

Yogurt: Smooth, full-fat yogurt, or yogurt with small, soft pieces of fruit.
Pudding and Custard: Milk puddings like custard or semolina, and smooth desserts like mousse or crème caramel.
Soft cakes: Plain sponge cake soaked in cream or custard.

Comparison: IDDSI Level 6 vs. Level 5

The distinction between Level 6 (Soft & Bite-Sized) and Level 5 (Minced & Moist) is important for safety. Here is a comparison highlighting the key differences.


Feature	IDDSI Level 6 (Soft & Bite-Sized)	IDDSI Level 5 (Minced & Moist)
Particle Size (Adults)	Bite-sized pieces, no larger than 1.5 cm x 1.5 cm.	Finely minced particles, no larger than 4 mm.
Chewing	Moderate chewing required before swallowing.	Mashing with the tongue is sufficient; biting is not required.
Moisture	Soft, tender, and moist throughout; no separate thin liquid.	Moist with some cohesive, soft lumps; no thin liquid.
Cohesion	Cohesive enough to form a bolus but can be mashed with a fork.	Food sticks together when pressed but breaks apart easily.
Visual Appearance	Identifiable bite-sized pieces of food.	Looks like mince, often uniform in texture.

The Importance of Professional Guidance

Following a texture-modified diet like IDDSI Level 6 should always be done under the supervision of a healthcare professional, such as a speech-language pathologist or dietitian. They can assess the individual's chewing and swallowing abilities to recommend the safest and least restrictive diet. They also ensure the meal plan is nutritionally balanced, as texture-modified meals can sometimes lack calories and nutrients. Regular weight monitoring is important to prevent unintended weight loss. For more information, the official International Dysphagia Diet Standardisation Initiative website is an excellent resource: www.iddsi.org.

Conclusion

Navigating the IDDSI framework can seem complex, but understanding the specific characteristics and examples of food in the iddsi level 6 is a crucial step for ensuring the safety and well-being of individuals with dysphagia. By preparing soft, moist, and bite-sized foods, caregivers can provide a varied and appealing diet that minimizes the risk of choking. Adhering to the 1.5 cm size limit for adults and consistently performing the Fork Pressure Test are fundamental practices. Regular consultation with a healthcare team is the best way to ensure the diet meets both safety and nutritional needs, contributing to a better quality of life. This approach makes mealtimes a safe, enjoyable, and nourishing experience.

Frequently Asked Questions

Level 6 (Soft & Bite-Sized) has a maximum particle size of 1.5cm for adults, a critical safety feature to reduce choking risk for individuals with chewing difficulties. Level 7 (Easy to Chew) does not have this particle size restriction, though it still emphasizes soft foods.

To prepare meat for Level 6, you should cook it until it is very tender and then cut it into bite-sized pieces (1.5cm max for adults). Serve it in a thick gravy or sauce to ensure it is moist throughout and easy to swallow.

Yes, but with specific modifications. Bread must be softened by soaking until it forms smooth, moist lumps no larger than 1.5cm. Dry or seeded bread, and excess fluid that separates, must be avoided.

No, some cooked vegetables, like fibrous stalks (celery, green beans) or those with tough skins, are unsuitable. Use soft-cooked vegetables like carrots, potatoes, or cauliflower, ensuring they are cut into the appropriate bite-sized pieces and mash easily.

Use a standard dinner fork to press down on a food sample. The food should squash easily and change shape without returning to its original form. Pressure should be light, only enough to cause your thumbnail to blanch white.

Suitable desserts include smooth yogurts, mousses, custards, and milk puddings. A plain sponge cake softened with cream or custard is also acceptable, provided there are no dry or hard parts.

No, it is important to avoid mixed consistencies where thin liquids separate from the solid food. Sauces or gravies served with the food must be thick and cohesive, not watery, to prevent aspiration.