Understanding Level 7 Easy to Chew
Level 7 Easy to Chew, often abbreviated as EC7, is a specific texture modification under the International Dysphagia Diet Standardisation Initiative (IDDSI). Unlike the standard Level 7 Regular diet, this category focuses on modifying food textures to be soft and tender, rather than restricting particle size. The primary goal is to provide a diet that is easier to chew for individuals with reduced chewing strength or endurance, such as the elderly or those recovering from illness or dental work. This modification ensures meals remain nutritious and enjoyable while minimizing discomfort.
The key characteristic of this diet is that food must be soft enough to be easily cut or broken apart with the side of a fork or spoon, or mashed with light pressure. The 'Fork Pressure Test' is a simple method used to verify this texture: a food sample is pressed with a fork until the tester's thumbnail blanches white. If the food completely squashes and does not return to its original shape, it passes the test. This standard ensures consistency and safety across all care settings.
Who Needs a Level 7 Easy to Chew Diet?
This diet is not for those with identified dysphagia (swallowing problems) that increase the risk of choking. It is specifically for individuals who have difficulty managing hard or chewy foods but have good oral and swallowing control. Potential candidates include:
- The Elderly: Aging can lead to weaker chewing muscles, tooth loss, or poorly fitting dentures, making softer foods more comfortable.
- Post-Operative Patients: Individuals recovering from oral or jaw surgery may need temporary relief from tough textures.
- Cancer Patients: Some treatments can cause mouth sores (mucositis) or dry mouth, which an easy-to-chew diet can help manage.
- Individuals with Fatigue: Those who tire easily during mealtime benefit from a diet that requires less physical effort to eat.
- Skill-Building Patients: It can also be used for individuals working towards advanced chewing skills under the guidance of a clinician.
Preparing Level 7 Easy to Chew Foods
To prepare meals that fit the Level 7 Easy to Chew standard, cooks should focus on cooking methods and techniques that tenderize ingredients and add moisture.
- Cook Vegetables Thoroughly: Steaming, boiling, or baking vegetables until very soft makes them mashable with a fork. Avoid raw or fibrous vegetables.
- Tenderize Meats: Slow cooking methods like stewing, braising, or using a pressure cooker can make meats exceptionally tender. Choose cuts that are naturally softer and avoid bone and gristle. Tender, flaky fish is also an excellent option.
- Add Moisture: Sauces, gravies, butter, or creamy dressings can significantly improve the moisture and ease of consumption. For example, add gravy to a shepherd's pie or sauce to pasta.
- Select Soft Grains and Starches: Soft-cooked cereals like porridge, well-cooked pasta, or the interior of a baked potato are suitable choices.
- Choose Soft Fruits: Ripe, soft fruits such as bananas, mangoes, or canned fruits like peaches and pears are perfect. Cooked or stewed fruits with skins and seeds removed also work well.
Comparison: Level 7 Easy to Chew vs. Level 6 Soft & Bite-Sized
While both diets cater to individuals with certain chewing issues, their defining characteristics are distinct, primarily concerning particle size and swallowing safety.
| Feature | Level 7 Easy to Chew (EC7) | Level 6 Soft & Bite-Sized (SB6) |
|---|---|---|
| Texture | Foods are soft and tender throughout. Hard, crunchy, or fibrous items are avoided. | Foods are soft, tender, and moist. The texture must hold its shape but be easily broken apart. |
| Particle Size | No restriction on food piece size. The individual can bite off pieces as they would with a normal diet. | Food pieces are restricted to a maximum size of 1.5 cm for adults and 8mm for children to minimize choking risk. |
| Swallowing Risk | Not intended for individuals with an identified increased risk of choking. Requires good oral motor control. | Suitable for individuals with mild to moderate dysphagia, where choking is a potential risk. The particle size restriction mitigates this. |
| Preparation | Focuses on using tenderizing cooking methods and selecting naturally soft foods. | Requires food to be cut or minced to specific particle sizes, in addition to being soft and moist. |
| Appropriate For | Individuals with chewing pain, fatigue, or dental issues who can control their bite size and eating pace. | Individuals with documented swallowing difficulties (dysphagia) or an identified choking risk. |
Conclusion
Level 7 Easy to Chew is a valuable texture modification within the IDDSI framework, designed to improve comfort and enjoyment for individuals with specific chewing challenges. By focusing on soft, tender, and moist foods while removing tough textures, it provides a safe and practical solution for people recovering from surgery, managing dental issues, or experiencing age-related changes. Adherence to the IDDSI standard, including the simple fork pressure test, helps ensure the consistency and safety of these meals. For anyone considering or preparing a diet of this type, it is crucial to consult with a healthcare professional, such as a Speech and Language Therapist or Dietitian, to confirm its suitability and ensure all nutritional needs are met without an increased risk of choking.
For more information, visit the official IDDSI website for a complete breakdown of their framework and testing methods: IDDSI.org.
Frequently Asked Questions
Is a Level 7 Easy to Chew diet the same as a mechanical soft diet?
While similar, a mechanical soft diet can vary in definition and may involve chopping or mincing foods. The IDDSI Level 7 Easy to Chew is a standardized term with specific testing methods to ensure the food is soft and tender, though it does not mandate a specific particle size restriction.
Can people with dentures eat a Level 7 Easy to Chew diet?
Yes, this diet is specifically designed to be suitable for those with chewing challenges, including those who wear dentures that may not fit perfectly or cause discomfort with tougher foods.
Can I still get enough nutrients on an easy to chew diet?
Yes. With careful planning, you can ensure a balanced intake of nutrients. Including a variety of soft proteins, fruits, vegetables, and enriched starches can help maintain good nutrition. A dietitian can help tailor a plan to meet individual needs.
What are some good snack ideas for a Level 7 Easy to Chew diet?
Excellent snack choices include soft fruits like bananas or peaches, yogurt, cottage cheese, milk puddings, and moist cakes or muffins. Smoothies can also be a great option for a nutritious, easy-to-consume snack.
How do you make meat suitable for Level 7 Easy to Chew?
Meat can be made tender by slow cooking, stewing, or braising. It can also be shredded or used in recipes like shepherd's pie or meatloaf. Always remove tough skin, gristle, and bone.
Are crispy or crunchy foods allowed on a Level 7 Easy to Chew diet?
No, crispy, crunchy, or crumbly foods are not allowed. The diet specifically excludes hard, tough, or chewy items that require significant chewing effort.
What should I do if I notice difficulty swallowing while on this diet?
If any swallowing difficulties occur, it is essential to contact a healthcare professional, such as a speech and language therapist. They can assess the situation and recommend a different diet texture if necessary.
