What Does Level 7 Food Mean?: Decoding the IDDSI Diet Framework

October 13, 2025 •

4 min read

An estimated 590 million people worldwide experience dysphagia, or swallowing difficulties. The International Dysphagia Diet Standardisation Initiative (IDDSI) was created to improve safety for these individuals by standardizing food textures, explaining precisely what does level 7 food mean within its structured framework.

Quick Summary

The highest food texture level in the International Dysphagia Diet Standardisation Initiative (IDDSI) is Level 7. It includes both regular, everyday foods and an 'easy to chew' sub-category for those needing softer textures without specific particle size restrictions.

Key Points

IDDSI Framework: Level 7 is the top food texture category ('Regular') in the International Dysphagia Diet Standardisation Initiative, a global framework for modified diets.
Two Sub-Categories: Level 7 has a 'Regular' (RG7) category for people with no swallowing or chewing problems and a 'Regular Easy to Chew' (EC7) category for those needing softer textures.
Easy to Chew Characteristics: Easy to Chew (EC7) foods must be soft and tender, easily separated with a fork, and should not contain hard, tough, or stringy textures.
Particle Size: Unlike lower levels, Level 7 Easy to Chew foods do not have specific particle size restrictions, as the individual is expected to control their bite size.
Testing Method: The Fork Pressure Test confirms that Easy to Chew foods are soft enough by checking if they squash easily under light pressure.
Enhanced Safety: The standardized IDDSI framework and its clear terminology help prevent choking and aspiration for individuals with swallowing difficulties.

Understanding the IDDSI Framework

The International Dysphagia Diet Standardisation Initiative (IDDSI) provides a global standard for describing modified food textures and thickened liquids. Developed by an international team of experts, the IDDSI framework aims to eliminate confusion and improve safety for individuals with dysphagia, or swallowing difficulties. The framework uses a continuum of eight levels, from Level 0 (Thin Liquids) to Level 7 (Regular Food), with each level identified by a unique number, color, and name. This standardization is crucial for healthcare professionals and foodservice providers to communicate clearly and serve appropriate, safe meals, reducing the risk of choking and aspiration.

What is Level 7 food?

Within the IDDSI framework, Level 7 is the highest and least restrictive food texture category. It is designated as 'Regular' and is suitable for individuals with adequate chewing and swallowing function. However, recognizing that some individuals who do not have dysphagia may still require a softer texture due to other issues, Level 7 is further divided into two sub-categories:

Level 7: Regular (RG7)

This is the normal, everyday diet most people are familiar with. Foods at this level have no restrictions on piece size, texture, or moisture. An individual eating a Level 7 Regular diet can safely consume a full range of food items, including hard, chewy, crunchy, and crispy items, and manage mixed consistencies like soup with food pieces.

Level 7: Regular Easy to Chew (EC7)

This sub-category of Level 7 is intended for individuals who can chew and swallow safely but may struggle with very firm or hard textures. For example, a person might opt for an 'Easy to Chew' diet if they have dental problems, weakened chewing muscles, or are recovering from an illness. The key characteristics include:

Soft and Tender Texture: Food must be soft enough to break apart easily with the side of a fork or spoon.
No Hard or Tough Elements: Items with husks, pips, seeds, bones, or gristle should be avoided.
No Specific Size Restriction: Unlike Level 6, there is no limit on the particle size of the food pieces. However, the individual must be able to control their bite size and chewing pace.

Testing for Easy to Chew (EC7)

To ensure food meets the criteria for Level 7 Easy to Chew, a simple fork pressure test is used. This involves pressing down on a piece of food with the side of a fork. The food should squash and not return to its original shape when the pressure is released.

Examples of Easy-to-Chew (EC7) Foods

Suitable Foods for Level 7 Easy to Chew

Tender Meats: Slow-cooked stews, casseroles, or tender cuts of meat that flake easily.
Soft Fish: Flaky fish fillets like cod or haddock, fish pie, and fish cakes.
Well-Cooked Pasta: Cooked until soft, such as macaroni cheese or well-cooked spaghetti.
Soft Fruits: Ripe bananas, tinned peaches, and strawberries.
Tender Vegetables: Softly boiled carrots, parsnips, and mushy peas.
Moistened Bread: Soft sandwiches with fillings like egg or tuna mayo (crusts may be removed for extra softness).

Foods to Avoid on a Level 7 Easy to Chew Diet

Hard/Crunchy Foods: Nuts, raw carrots, apples, and crisps.
Chewy/Fibrous Foods: Steak, chewy sweets, dried fruit, and stringy beans.
Sticky Foods: Peanut butter, marshmallows, and some types of sticky rice.
Foods with Bones/Gristle: Meat with gristle or small fish bones.
Crumbly Foods: Dry biscuits and pie crust.
Skins/Seeds: Fruit skins, pips, and seeds.

Comparison: Level 7 Regular vs. Level 6 Soft & Bite-Sized


Feature	IDDSI Level 7: Regular (RG7)	IDDSI Level 6: Soft & Bite-Sized (SB6)	IDDSI Level 7: Easy to Chew (EC7)
Particle Size	No restriction on food piece size.	Food pieces must be no larger than 15mm for adults.	No restriction on food piece size.
Chewing Ability	Full chewing ability is expected.	Minimal chewing is required, often tongue or gum strength is sufficient.	Safe and efficient chewing of soft foods is required.
Texture Characteristics	Any texture is permitted, including hard, crunchy, and crispy.	Soft, tender, and moist foods only.	Soft, tender, and moist foods only, but no size restriction.
Food Types	Normal, everyday meals.	Finely chopped or minced meals with separate liquids.	Normal, everyday meals prepared with soft ingredients and methods.
Testing Method	No testing required beyond normal food checks.	Fork Pressure Test and Fork/Spoon Separation.	Fork Pressure Test and Fork/Spoon Separation to confirm softness.

The Role of Level 7 in Nutrition and Safety

For individuals with dysphagia, progressing to a Level 7 diet signifies a significant improvement in swallowing abilities. The ultimate goal of dysphagia treatment is often to reach the least restrictive diet possible, ensuring the best possible nutrition and quality of life. The existence of the 'Easy to Chew' sub-category within Level 7 ensures that individuals with good, but not perfect, chewing skills can still enjoy a wider variety of foods safely without being restricted to lower-level diets that may compromise nutritional intake and enjoyment.

IDDSI's clear terminology provides a consistent, global language for healthcare providers, caregivers, and patients. This reduces the risk of misinterpretation, which was a significant issue with previous, less standardized dietary descriptions. The standardized testing methods, like the fork pressure test, allow for easy verification of food texture, empowering staff to maintain a high level of patient safety.

Conclusion

To understand what does level 7 food mean, one must recognize its place within the IDDSI framework for dysphagia. Level 7 represents the pinnacle of food texture options—the regular diet—with a special, safe pathway for those who need softer textures. It ensures that even individuals with some chewing weakness can enjoy a nutritious and varied diet without the risks associated with harder, tougher foods. By promoting clear communication and providing reliable testing methods, the IDDSI framework, and its Level 7 guidelines, play a critical role in enhancing patient safety and quality of life. For further information and resources, the official IDDSI website is an excellent source: https://www.iddsi.org/.

Frequently Asked Questions

Level 7 Regular is a standard, unrestricted diet, while Level 7 Easy to Chew modifies the texture to be softer and more tender, though it has no specific particle size restriction. It is meant for those with minimal chewing difficulty, not dysphagia.

This diet is suitable for individuals who can chew and swallow safely but may have weaker chewing muscles, dental issues, or fatigue that makes chewing firm foods difficult.

Use the IDDSI Fork Pressure Test: press on a piece of food with the side of a fork. The food should flatten and hold the squashed shape without regaining its original form when the fork is lifted.

Avoid hard, tough, chewy, fibrous, or crunchy foods. This includes nuts, raw vegetables, dried fruits, steak, popcorn, and foods with bones, gristle, or skins.

Yes, mixed consistencies, such as soup with food pieces or cereal with milk, are permitted on the standard Level 7 Regular diet. For the Easy to Chew sub-category, mixed consistencies can be managed, but always consult a clinician.

Dysphagia is a medical term for difficulty swallowing. The IDDSI framework provides a standardized language and safe guidelines for food and liquid textures, helping to prevent choking and aspiration for affected individuals.

While similar, Level 7 Easy to Chew is a specific, standardized category within the IDDSI framework. The term 'soft diet' can be ambiguous, which is why IDDSI was developed to provide a clear, measurable definition.