What is a Class 7 Diet? Understanding the Easy-to-Chew Standard

According to the International Dysphagia Diet Standardisation Initiative (IDDSI), a Class 7 diet, or Regular Easy to Chew, is a specific food texture modification designed for individuals with reduced chewing ability. This dietary approach emphasizes soft, tender foods to ensure safety and comfort during meals.

Quick Summary

The Class 7 diet is a food texture modification developed by IDDSI for individuals with chewing difficulties, featuring soft, tender foods. It aims to ensure adequate nutrition and safe mealtimes while avoiding tough, crunchy, or chewy items.

Key Points

• IDDSI Level 7: The Class 7 diet is formally known as 'Regular Easy to Chew' within the International Dysphagia Diet Standardisation Initiative (IDDSI) framework.

• For Chewing Difficulties: This diet is designed for people who can chew soft, tender foods but struggle with harder, tougher, or chewy textures.

• Texture, Not Size: The primary modification is the softness of the food, not the size of the pieces, though foods should still be easily broken with a fork.

• Moisture is Key: Adding sauces, gravies, or using full-fat dairy products can increase moisture and calorie content, making food easier and more palatable.

• Professional Guidance: This diet should be recommended and monitored by a healthcare professional to ensure it meets the individual's nutritional needs and safety requirements.

• Avoidance is Important: Hard, crunchy, sticky, or fibrous foods are not suitable for this diet and should be avoided to prevent complications.

Understanding the Class 7 Diet: The IDDSI Framework

The Class 7 diet is a component of the International Dysphagia Diet Standardisation Initiative (IDDSI) framework, which provides a globally recognized system for describing modified food textures and drink thickness. IDDSI Level 7 is known as 'Regular Easy to Chew.' While the 'Regular' label might seem to imply no modification, the 'Easy to Chew' designation is crucial. It targets people who have enough chewing strength to break down soft and tender foods, but may struggle with harder, tougher, or more fibrous items. It is important to distinguish this from more severe swallowing difficulties (dysphagia), which may require softer, minced, or puréed diets (lower IDDSI levels). This texture is often recommended by healthcare professionals, such as a Speech and Language Therapist or a Registered Dietitian.

Key Characteristics of Easy-to-Chew Foods

Foods suitable for a Class 7 diet must be soft and tender. The texture can be easily broken apart with the side of a fork or spoon. This is often assessed with the 'IDDSI Fork Pressure Test,' where a fork is pressed down on a food item until the thumbnail blanches white. The food should squash easily and not regain its original shape. Unlike lower-level diets, there is no restriction on the size of the food pieces, though moisture is often required to assist with chewing and swallowing.

Suitable Foods for a Class 7 Diet

• Proteins: Moistened and tender meats (stews, casseroles), finely minced meats (shepherd's pie), skinless sausage, pâté, soft-cooked fish (poached, baked), eggs (scrambled, poached), soft tofu, and legumes that are moist and tender.
• Starches: Soft-cooked pasta, rice, moist potatoes (mashed, baked without skin), soaked cereals like porridge or cornflakes, soft bread or rolls (crusts removed).
• Fruits: Soft, peeled fresh fruits (ripe banana, kiwi, melon), canned fruits (peaches, pears), stewed fruits, and soft berries. Avoid fibrous parts like orange pith or seeds.
• Vegetables: Soft-boiled or steamed vegetables (carrots, broccoli, cauliflower, peas), soft-cooked leafy greens, and squash.
• Dairy and Desserts: Yogurt, cottage cheese, creamy puddings, custard, mousse, and soft cakes with cream or custard.

Foods to Avoid on a Class 7 Diet

• Hard or Dry Foods: Nuts, raw vegetables (raw carrots, broccoli), dry cakes or biscuits, dry cereals, popcorn, hard candy.
• Tough, Chewy, or Fibrous Foods: Tough cuts of meat (steak), crispy bacon, chewing gum, sticky candies, dried fruit, stringy beans, or rhubarb.
• Crunchy or Sharp Foods: Crisps, crackers, toasted bread, hard crusts, and flaky pastry.
• Items with Pips, Seeds, or Gristle: Seeds from fruits, bones in meat, and gristle.

How to Prepare Foods for the Class 7 Diet

Food preparation is key to ensuring a comfortable and safe meal. Cooking methods like braising, stewing, and boiling are ideal for making meats and vegetables tender. Adding extra moisture through sauces, gravies, butter, or creamy dressings can help soften food and make it easier to swallow. For individuals needing a higher caloric intake, using full-fat dairy products, cream, or avocado can boost nutrition without changing the texture significantly.

Sample Class 7 Diet Meal Plan

• Breakfast: Porridge with milk, honey, and mashed banana; scrambled eggs with soft toast and butter.
• Lunch: Flaked tuna or chicken salad mixed with mayonnaise, served on soft bread with the crusts removed; creamy vegetable soup with small, soft-cooked pieces.
• Dinner: Tender chicken and pasta bake with plenty of sauce; shepherd's pie with moist, minced meat and soft mashed potatoes.
• Snacks: Yogurt with soft fruit; creamy rice pudding; soft-cooked fruit compote.

Comparison of IDDSI Texture Levels

Feature	IDDSI Level 7: Regular Easy to Chew	IDDSI Level 6: Soft & Bite-Sized	IDDSI Level 5: Minced & Moist
Chewing Ability	Requires some chewing ability for soft, tender foods.	Requires some chewing ability.	Minimal chewing ability required.
Food Texture	Soft, tender, and moist. Easily broken with a fork.	Soft, moist, and tender. Pieces are no larger than 1.5 cm.	Minced or pureed food in a thick, cohesive sauce. Pieces are no larger than 0.4 cm.
Piece Size	Not restricted.	Limited to a maximum of 1.5 cm.	Limited to a maximum of 0.4 cm.
Fork Test	Food can be fully squashed with a fork and does not regain shape.	Food can be fully squashed with a fork, and the pieces stay together on the fork.	Forms a mound on the fork and holds its shape, but is easily broken.

Benefits and Considerations

Benefits

• Improved Nutrition: The Class 7 diet allows for a wider variety of foods than softer, lower-level diets, helping to maintain nutritional intake.
• Reduced Fatigue: For those with weakened chewing muscles, this diet reduces the effort required to eat, making mealtimes more manageable.
• Enhanced Dining Experience: With a greater variety of textures and flavours, it can improve the overall enjoyment of food and mealtime socialization.

Considerations

• Monitoring Nutritional Intake: As with any modified diet, it's essential to monitor the individual's weight and overall nutrition. Healthcare professionals should be consulted if weight loss occurs.
• Avoiding Risks: For individuals with specific risks, like choking or aspiration, adherence to a stricter diet level may be necessary.
• Supervision: Individuals with unsafe mealtime behaviours may require supervision on this diet.

Conclusion: Promoting Safe and Satisfying Meals

Ultimately, a Class 7 diet is a medically prescribed texture modification aimed at improving the safety and nutritional quality of meals for individuals with chewing challenges. By focusing on soft, tender, and moist foods while avoiding tough or difficult-to-chew items, it enables a more comfortable and enjoyable dining experience. It is not a generic wellness or weight-loss diet, but a specific tool within the broader IDDSI framework. Adherence to a healthcare professional's guidance is paramount to ensure the diet is appropriate and safely implemented. For more details on IDDSI standards and testing methods, please visit IDDSI.org.

Frequently Asked Questions

What is the primary purpose of a Class 7 diet?

The primary purpose of a Class 7 diet is to provide a safe and comfortable eating experience for individuals who have difficulty chewing tougher foods but do not have severe swallowing problems. It ensures they can maintain adequate nutrition without fatigue.

Is the Class 7 diet for weight loss?

No, the Class 7 diet is not a weight-loss diet. It is a medically prescribed dietary modification based on food texture, not a reduction in calorie intake. In fact, some recommendations for this diet suggest enriching meals with calories to prevent weight loss in at-risk individuals.

How do you test if a food is suitable for a Class 7 diet?

You can perform the 'IDDSI Fork Pressure Test' by pressing a fork down on the food item. If the food can be fully squashed by the pressure of the fork and does not regain its shape, it is considered soft enough for a Level 7 diet.

Can people on a Class 7 diet eat regular bread?

Soft bread or plain sandwich bread may be suitable, but hard or thick-crusted breads, seeded bread, and dry toast should be avoided. The texture must be soft enough and often needs to be moistened.

What are some examples of suitable vegetables for this diet?

Suitable vegetables include those cooked until soft and tender, such as steamed carrots, soft-boiled broccoli and cauliflower, and mashed potatoes. Raw, hard, or stir-fried vegetables are generally not recommended.

Are there any fruits that should be avoided?

Yes, fruits with tough skins, hard cores, or seeds should be avoided. Examples include raw apples, pineapple, and berries with large seeds. Soft, peeled fruits like bananas, melon, and canned peaches are good choices.

What is the difference between a Class 7 and a Class 6 diet?

A Class 7 (Easy to Chew) diet allows for food pieces of various sizes as long as they are tender. A Class 6 (Soft & Bite-Sized) diet requires food to be both soft and cut into pieces no larger than 1.5 cm.