What is a level 7 diet texture and who is it for?

November 19, 2025 •

4 min read

According to the International Dysphagia Diet Standardisation Initiative (IDDSI), a level 7 diet texture represents the highest tier of food consistency, encompassing both regular and easy-to-chew foods. Understanding what is a level 7 diet texture is crucial for providing safe and appropriate nutrition to individuals recovering from illness, with dental issues, or experiencing chewing difficulties without a high risk of choking.

Quick Summary

The IDDSI level 7 diet includes regular and easy-to-chew foods, making it suitable for individuals with adequate chewing skills but who benefit from softer textures due to issues like dental problems or fatigue. Easy-to-Chew foods must be soft and tender enough to break apart with a fork or spoon.

Key Points

Two Sub-Levels: IDDSI Level 7 includes a Regular (RG7) diet for individuals with normal chewing and swallowing, and an Easy to Chew (EC7) diet for those needing softer textures.
Easy to Chew Focus: The Easy to Chew (EC7) diet involves normal foods that are soft and tender, easily broken with the side of a fork or spoon, without tough, hard, or chewy textures.
Who Benefits: The EC7 diet is for people with adequate chewing ability who find hard foods difficult, such as those with dental issues, without having dysphagia or a high risk of choking.
Foods to Avoid: Foods that are hard, fibrous, sticky, or crunchy are avoided on the EC7 diet, along with any that contain bones, gristle, or tough skins.
IDDSI Framework: The IDDSI framework is a global standard providing clear definitions and testing methods to ensure patient safety and improve communication in clinical care and foodservice.
Testing is Simple: The Easy to Chew (EC7) diet can be tested by observing that food pieces can be easily mashed or separated with simple fork or spoon pressure.

The International Dysphagia Diet Standardisation Initiative (IDDSI) developed a global framework to provide standardized terminology for texture-modified foods and thickened liquids. This was designed to eliminate the confusion caused by varied and ambiguous descriptors previously used across healthcare settings. At the top of this framework is Level 7, a category with two distinct components: Regular (RG7) and Regular Easy to Chew (EC7). Both are assigned the color black in the IDDSI framework.

Regular (RG7): The Standard Diet

The Regular (RG7) diet is for individuals who do not have any identified chewing or swallowing problems. For this group, there are no restrictions on food size, shape, or texture. This includes hard, tough, chewy, fibrous, or crunchy foods, as the individual is considered fully capable of safely managing and chewing all everyday foods and drinks. For example, a person on a regular diet can safely eat raw vegetables, steak, nuts, and crispy snacks. Because there are no restrictions, there is no specific testing method for this sub-level beyond simply confirming the individual has a normal, healthy swallow function.

Easy to Chew (EC7): The Modified Normal Diet

The Easy to Chew (EC7) diet is a modified version of the Regular diet, intended for individuals who experience difficulty or pain when chewing hard or tough foods but do not have a clinically identified swallowing disorder (dysphagia) or an increased risk of choking. This might be due to age-related changes, dental issues, or recovery from an illness. The key characteristic is that while normal, everyday foods can be served, they must be soft and tender.

Characteristics of Easy to Chew (EC7) Foods

Soft and Tender: Foods must be soft enough to be easily broken apart or separated with the side of a fork or spoon. A knife is not required for cutting.
Easy to Mash: When pressed with a fork, the food should easily squash and not regain its shape when the pressure is released.
Variable Particle Size: Unlike lower IDDSI levels, there is no specific restriction on the size of the food pieces. The individual is able to safely take appropriately sized bites.
No Hard, Tough, or Chewy Bits: Foods with hard bits, tough skins, or chewy textures are to be avoided.
Appropriate for Mixing: Mixed-consistency foods, such as soups with soft food pieces, may be included, unlike diets for those with higher choking risks.

Examples of Suitable Easy to Chew (EC7) Foods

Soft Meats: Tender, slow-cooked meat that flakes easily, or meatloaf.
Tender Vegetables: Softly boiled, steamed, or roasted vegetables like carrots, cauliflower, or sweet potato.
Soft Fruits: Ripe bananas, peeled peaches, or canned fruit.
Moistened Starches: Well-cooked pasta, soft rice, or moistened cereals.
Fish: Flaked fish or tender fish cakes.
Eggs: Scrambled or soft-boiled eggs.

Examples of Foods to Avoid on an Easy to Chew (EC7) Diet

Hard Foods: Nuts, seeds, popcorn, or raw carrots.
Tough Foods: Steak, tough meat, or fibrous pineapple.
Chewy Foods: Chewy sweets, marshmallows, or dried fruit.
Stringy Foods: Runner beans, celery, or rhubarb.
Crumbly Foods: Dry biscuits or crackers.
Foods with Skins/Bones: Chicken with skin, peas with skins, or bony fish.

The Role of the IDDSI Framework in Clinical Practice

Adopting the IDDSI framework helps improve patient safety by ensuring clear and consistent communication regarding diet modifications. Health professionals, including doctors, dietitians, and speech-language therapists, work together to prescribe the correct diet level based on a patient's individual chewing and swallowing abilities. The specific terminology and testing methods allow kitchen staff and caregivers to prepare and check food textures accurately. This reduces the risk of errors and potential adverse events, such as choking. The IDDSI website provides comprehensive resources and testing methods to aid in implementation, making it an invaluable tool for global healthcare. For more information, visit the IDDSI website.

Conclusion

Understanding what a level 7 diet texture entails is vital for ensuring appropriate care for individuals with varying chewing abilities. The distinction between the Regular (RG7) and Regular Easy to Chew (EC7) sub-levels provides a clear and safe pathway for managing diet consistency. While Regular is for those with no chewing or swallowing issues, Easy to Chew offers a modified option for individuals who struggle with harder textures due to factors like dental problems or fatigue. By following the IDDSI framework and its clear guidelines, caregivers and clinicians can promote comfortable, safe, and dignified eating experiences for all.

Comparison of IDDSI Levels 6 and 7


Feature	IDDSI Level 6: Soft & Bite-Sized	IDDSI Level 7: Easy to Chew (EC7)
Chewing Required	Minimal chewing needed.	Chewing is required, but without fatigue or pain from hard/tough foods.
Food Particle Size	Standardized, controlled size (e.g., adult 1.5 cm pieces).	No restriction on food piece size.
Texture	Soft, moist, and tender, with no separate thin liquid.	Soft and tender, may include dual consistencies.
Testing Method	Fork pressure test (thumbnail blanches white) and particle size check.	Fork/spoon pressure test to ensure food mashes easily.
Appropriate For	Individuals who can chew but have reduced bite force due to missing teeth or poorly-fitting dentures.	Individuals with good chewing ability who find hard foods difficult or tiring, often due to dental issues or general fatigue.
Risk of Choking	Still requires monitoring, as controlled particle size is needed.	Not for those with an identified choking risk.

Frequently Asked Questions

A Level 7 Regular diet has no texture restrictions and is for individuals with normal chewing and swallowing function. A Level 7 Easy to Chew diet is a modified version for those who need softer, more tender textures but do not have a high choking risk.

For an Easy to Chew diet, the food should be soft and tender enough to be easily separated or mashed using the side of a fork or spoon. The IDDSI Fork/Spoon Pressure Test confirms this by ensuring the food squashes and does not regain its shape.

This diet is suitable for individuals who can chew and swallow safely but find hard, tough, or chewy foods difficult or painful. Reasons might include poor dental health, mouth pain, or fatigue from an illness.

No, the Easy to Chew diet does not have specific food piece size restrictions, as the individual is expected to be able to bite off and chew pieces safely on their own. This differs from the more restrictive Soft & Bite-Sized (Level 6) diet.

You should avoid foods that are hard (nuts, raw vegetables), tough (steak), chewy (marshmallows), fibrous (pineapple), crunchy (popcorn), or contain bones, gristle, or seeds.

Yes, unlike diets for those with dysphagia and higher choking risk, the Easy to Chew diet allows for foods with mixed consistencies, such as soup with soft food pieces, as the individual can safely manage them.

The IDDSI framework provides a single, standardized language and set of testing methods for modifying food and drink textures globally. This improves patient safety by reducing confusion and errors in prescribing, preparing, and serving diets.