What is IDDSI Level 5 Called? Understanding Minced & Moist Foods

October 28, 2025 •

3 min read

According to the International Dysphagia Diet Standardisation Initiative (IDDSI), a global framework created to improve patient safety, the food texture for IDDSI Level 5 is called Minced and Moist. This classification is designed for individuals with swallowing difficulties who can manage soft foods with minimal chewing.

Quick Summary

IDDSI Level 5, or Minced and Moist, is a texture-modified diet for people with dysphagia who have chewing difficulties. Foods are soft, moist, and minced into small, specific particle sizes to reduce the risk of choking and aspiration. The preparation involves specific guidelines and testing methods to ensure safety and consistency.

Key Points

Name: IDDSI Level 5 is officially named Minced and Moist.
Purpose: It is a food texture for individuals with swallowing disorders (dysphagia) who have minimal chewing ability.
Characteristics: Foods are soft, moist, and cohesive, with adult particle sizes no larger than 4mm.
Testing: Safety is confirmed using the Fork Pressure and Spoon Tilt tests to check for appropriate particle size and texture.
Preparation: Foods are finely minced and combined with a thick, non-pouring sauce or gravy to ensure adequate moisture and binding.
Avoid: Hard, dry, crumbly, tough, fibrous, and sticky foods are unsafe for a Level 5 diet.

Understanding the IDDSI Framework

The International Dysphagia Diet Standardisation Initiative (IDDSI) framework provides a global standard for describing food textures and liquid thickness, developed to improve safety for individuals with swallowing difficulties (dysphagia). Before IDDSI, inconsistent terminology like 'mechanical soft' or 'pureed' led to confusion and potential risks. The IDDSI system uses a continuum of eight levels, from 0 to 7, identified by numbers, color codes, and descriptive labels. Foods and drinks are classified within this framework based on precise characteristics and simple, reliable testing methods.

What is IDDSI Level 5 Called? The Minced & Moist Definition

IDDSI Level 5 is called Minced and Moist, designated by the color orange. This level is for individuals who have some basic chewing ability but cannot safely manage foods with larger or tougher textures. Minced and Moist food needs to be soft, moist, and cohesive, without thin liquids separating. For adults, particles must be no larger than 4mm in any dimension, roughly the width of a standard dinner fork's tines.

Key Characteristics of a Minced & Moist Diet

Softness: Easily mashed with a fork or tongue.
Moisture: Must be moist with no loose liquid. A sauce or gravy helps bind and add moisture.
Cohesion: Holds shape on a spoon but slides off easily, indicating it's not too sticky.
Minimal Chewing: Requires minimal chewing; no biting is needed.

Who Benefits from IDDSI Minced & Moist (Level 5)?

Individuals with dysphagia who struggle with chewing can benefit from a Minced and Moist diet. This includes those with difficulty chewing food into small pieces, pain or fatigue during chewing, oral health issues, or conditions like stroke, Parkinson's, or dementia. It's also suitable for those moving from a Level 4 pureed diet.

How to Safely Prepare and Test Minced & Moist Foods

To prepare Level 5 foods, cook ingredients until very tender using methods like steaming or stewing. Mince food to the required particle size (4mm for adults, 2mm for children) using a knife or food processor. Moisten the food with a thick, non-pouring sauce or gravy to bind it.

Test the food using the Fork Pressure Test, where it should separate easily through the tines, and the Spoon Tilt Test, where it should hold shape but slide off easily when tilted.

Foods Recommended and Avoided at Level 5

Suitable Minced & Moist Foods:

Finely minced meat, fish, or poultry with thick sauce.
Well-cooked and mashed vegetables.
Mashed or finely chopped soft fruits, with excess liquid drained.
Thick, smooth porridge or semolina without fluid separation.
Very soft rice or pasta with thick sauce.
Soft sponge cakes softened with custard.

Foods to AVOID:

Hard, tough, or chewy foods like steak, nuts, or raw vegetables.
Dry, crumbly items such as plain bread or dry biscuits.
Fibrous or stringy foods like pineapple or beans.
Foods with skins, husks, pips, or seeds (e.g., peas, grapes).
Mixed thin and thick textures.
Sticky foods like nut butter.

IDDSI Level 5, 4, and 6: A Comparison Table


Feature	IDDSI Level 4 (Pureed)	IDDSI Level 5 (Minced & Moist)	IDDSI Level 6 (Soft & Bite-Sized)
Texture	Smooth, thick, lump-free.	Soft, moist, small, soft lumps.	Soft, tender, bite-sized.
Lump Size (Adult)	None; smooth.	Max 4mm, easily mashed.	Max 15mm, chewable.
Chewing Required	None.	Minimal; no biting.	Soft chewing required.
Cohesion	Holds shape on spoon.	Cohesive but slides off.	Firm but tender; not sticky or crumbly.
Preparation	Blended smooth.	Finely minced with thick sauce.	Chopped or cooked until tender.

Ensuring a Balanced and Appealing Diet at Level 5

Maintaining proper nutrition and enjoyment is important on a texture-modified diet. A variety of food groups prepared to Level 5 standards should be included. Using colorful ingredients, herbs, and spices can make meals more appealing. Nutritional supplements or fortifying meals may be necessary, as advised by a dietitian. Commercially available Level 5 meals offer convenience. For more information and resources, visit the official IDDSI website.

Conclusion

IDDSI Level 5 is called Minced and Moist and is crucial for the safety of individuals with dysphagia who have chewing difficulties. By following guidelines for softness, moisture, and particle size, the risks of choking and aspiration are minimized. Using standard tests like the Fork Pressure and Spoon Tilt tests ensures consistent preparation. Implementing the Minced and Moist diet correctly supports nutrition and improves quality of life for those with swallowing difficulties.

Frequently Asked Questions

A Minced and Moist diet consists of foods that are soft, moist, and cohesive. For adults, food particles are no larger than 4mm and can be mashed with the tongue. The food should form a mound on a fork without liquid leaking and pass the Spoon Tilt Test without being sticky.

The two primary tests for Level 5 are the Fork Pressure Test and the Spoon Tilt Test. The Fork Pressure Test checks if the food can be easily mashed with a fork, while the Spoon Tilt Test ensures the food holds its shape on a spoon and slides off easily when tilted or flicked.

Individuals with dysphagia who have difficulty chewing or tire easily when chewing are often prescribed this diet. It is for those who can manage soft foods but require the texture to be minced and moistened for safety.

Foods to avoid include hard, dry, chewy, sticky, or fibrous items. This means no nuts, raw vegetables, hard bread, tough steak, or foods with skins, seeds, or pips.

The main difference is the texture. Level 4 Pureed is completely smooth and lump-free, requiring no chewing. Level 5 Minced and Moist contains small, soft lumps that require minimal chewing.

Yes, children can be prescribed a Level 5 diet. However, the particle size is smaller, with lumps no larger than 2mm instead of the 4mm for adults.

Yes. Using colourful ingredients, herbs, and spices can significantly improve the visual appeal and flavour of meals. Proper plating can also help to make the dining experience more pleasant.