What is Level 7 Food Texture: An Expert Guide

According to the International Dysphagia Diet Standardisation Initiative (IDDSI), Level 7 represents regular-textured food, with an important subcategory known as 'Easy to Chew'. This specific texture is designed for individuals who can safely swallow but may experience difficulty or pain when chewing hard, tough, or chewy foods.

Quick Summary

This article explains Level 7 food texture, distinguishing between Regular and Easy to Chew categories within the IDDSI framework. It details who this diet is for, lists examples of suitable and unsuitable foods, and provides simple testing methods to ensure food safety.

Key Points

• IDDSI Classification: Level 7 is the highest category in the IDDSI framework, representing regular food texture.

• Easy to Chew Subcategory: The 'Easy to Chew' diet (EC7) is for individuals with chewing difficulties but no increased risk of choking.

• Soft and Tender Foods: Appropriate foods include soft, tender, and moist everyday items that can be broken apart with a fork or spoon.

• Foods to Avoid: Hard, tough, chewy, crunchy, fibrous, or sticky foods, as well as those with bones, seeds, or pips, should be avoided.

• Fork Pressure Test: A simple testing method involves pressing food with a fork; it should easily squash and not regain its shape.

• Distinction from Other Levels: Unlike Level 6 (Soft & Bite-Sized), Level 7 Easy to Chew does not restrict food particle size.

Understanding the IDDSI Framework

The International Dysphagia Diet Standardisation Initiative (IDDSI) was created to establish a global standard for classifying food textures and liquid thickness. This framework consists of eight levels, from Level 0 (Thin liquids) to Level 7 (Regular food), using a standardized system of names, numbers, and colors. This classification helps healthcare professionals, caregivers, and individuals communicate diet requirements clearly, reducing the risk of choking and other complications. Level 7, the highest level, encompasses foods of regular texture but includes a crucial subcategory known as 'Easy to Chew'.

What Defines Level 7 Food Texture?

Within the IDDSI framework, Level 7 is divided into two parts: Regular (RG7) and Regular Easy to Chew (EC7).

Level 7 Regular (RG7)

This is the standard diet for individuals with no chewing or swallowing difficulties. It includes all food textures and liquids, without any restrictions on size, shape, or consistency. People following this diet can safely handle hard, crunchy, and mixed-consistency foods, such as soups with pieces of meat and vegetables.

Level 7 Regular Easy to Chew (EC7)

This modified texture is for those who can swallow safely but need softer, more tender foods due to weakness, fatigue, or dental problems. While there are no restrictions on food piece size, certain textures are omitted to make eating more comfortable and efficient. Foods at this level can be easily broken apart with the side of a fork or spoon.

Who Needs a Level 7 Easy to Chew Diet?

This diet is suitable for several groups of people who do not have an increased risk of choking but have specific chewing-related challenges.

• Individuals with dental issues: Those with missing teeth, ill-fitting dentures, or sore gums find softer foods easier to manage.
• The elderly: As a person ages, chewing can become tiring or uncomfortable. An easy-to-chew diet reduces the physical effort required for meals.
• People recovering from illness or injury: For individuals regaining strength, this diet provides nourishment without demanding excessive energy expenditure on chewing.
• Individuals with jaw pain: Conditions affecting the jaw can make chewing a painful experience. The easy-to-chew diet bypasses this discomfort.

Suitable and Unsuitable Foods for Level 7 Easy to Chew

Suitable Foods

• Meats: Tender, slow-cooked meat that flakes easily, fish in sauce, and soft meatballs.
• Fruits: Ripe bananas, stewed fruits with skins removed, and soft tinned fruits like peaches or pears.
• Vegetables: Softly boiled or steamed vegetables without skins, such as carrots, potatoes, and cauliflower.
• Grains and Cereals: Porridge, well-cooked pasta, rice, and cereals that have been softened with milk.
• Dairy and Eggs: Yogurt, cottage cheese, and scrambled eggs.
• Baked Goods: Soft cakes and puddings softened with custard or cream.

Unsuitable Foods

• Hard and Dry Foods: Nuts, dry cereals, hard biscuits, and raw vegetables like carrots.
• Tough and Chewy Foods: Steak, crusty bread, dried fruit, and chewy sweets.
• Stringy and Fibrous Foods: Pineapple, rhubarb, and green beans.
• Crunchy and Crumbly Foods: Popcorn, crisps, and flaky pastry.
• Foods with Seeds or Bones: Foods with pips, small seeds, or bones.
• Sticky Foods: Peanut butter, marshmallows, and sticky rice cakes.

How to Test Food for Level 7 Easy to Chew

IDDSI provides simple and reliable testing methods to ensure food texture is safe. The primary test for Level 7 Easy to Chew is the Fork/Spoon Pressure Test.

1. Fork Separation: Place a piece of food on a plate. The food should be able to break apart easily with the side of a fork or spoon, without needing a knife.
2. Fork Pressure: Press down on the food with the tines of a fork until your thumbnail blanches white with pressure. The food should completely squash and not regain its original shape when the pressure is released.

Comparison: Level 7 Easy to Chew vs. Level 6 Soft & Bite-Sized

Feature	Level 7 Regular Easy to Chew (EC7)	Level 6 Soft & Bite-Sized
Food Texture	Soft and tender, normal everyday foods.	Soft and moist, but still requires some chewing.
Particle Size	No restrictions on size; food pieces can vary.	Bite-sized pieces (1.5cm for adults) are required.
Moisture	Foods should be adequately moist but do not need to be pureed.	Requires moistening with gravy or sauce; no separate thin liquid.
Chewing Ability	Requires the ability to bite and chew soft, tender foods without tiring.	Minimal chewing required; can be easily mashed with the tongue.
Swallowing	No underlying swallowing problems; choking risk is not increased.	May be prescribed for individuals with increased choking risk due to dysphagia.
Supervision	Generally no supervision needed at mealtimes.	Supervision may be required to monitor intake.

Conclusion

Level 7 food texture, specifically the Easy to Chew subcategory, is a vital part of the IDDSI framework, ensuring that individuals with chewing difficulties can eat safely and comfortably. By understanding the characteristics of this diet, identifying appropriate foods, and using simple testing methods, caregivers and healthcare providers can significantly improve the quality of life for those in their care. Always consult a healthcare professional for personalized guidance on diet modifications, especially if swallowing issues are present. For more information, please visit the International Dysphagia Diet Standardisation Initiative's official website.

Frequently Asked Questions

What is the primary difference between Level 7 Regular and Level 7 Easy to Chew?

The main difference is the texture of the food. Level 7 Regular includes all food textures, while Level 7 Easy to Chew specifically requires soft and tender foods that are easy to chew, but with no restrictions on piece size.

Who typically benefits from a Level 7 Easy to Chew diet?

People who benefit from this diet include those with dental issues like missing teeth, older adults with general chewing weakness, or individuals recovering from illness who need softer foods.

Are soups and stews allowed on a Level 7 Easy to Chew diet?

Yes, soups and stews are allowed, but the food pieces within them must be soft and tender enough to be broken apart with the side of a fork or spoon.

How can I test if a food is soft enough for a Level 7 Easy to Chew diet?

You can perform the Fork Pressure Test. Place the food on a plate and press down with a fork until your thumbnail blanches white. The food should easily squash and not return to its original shape.

Can mixed-consistency foods, like cereal with milk, be included in a Level 7 Easy to Chew diet?

Yes, mixed-consistency foods can be included, provided the solid components are soft and tender, and the individual has no swallowing problems.

What kind of fruits should be avoided on this diet?

Avoid fruits that are hard, have skins, pips, seeds, or a high water content that separates easily in the mouth, such as raw apples or oranges with pith.

Is a Level 7 Easy to Chew diet the same as a dysphagia diet?

A Level 7 Easy to Chew diet is part of the IDDSI framework used for dysphagia management, but it is specifically for those with chewing difficulties, not swallowing problems. Other levels (0-6) address varying degrees of swallowing impairment.