Understanding the IDDSI Framework
Before exploring what is level 7 regular IDDSI, it's crucial to understand the framework it is part of. The IDDSI framework is a global, standardized system designed to describe and categorize food textures and drink thicknesses for individuals with swallowing difficulties, or dysphagia. Developed by a board of international experts, its purpose is to improve patient safety by ensuring clear communication and consistent preparation of modified diets across all care settings and cultures. The framework consists of a continuum of 8 levels, numbered 0 to 7, each with a unique label, number, and color. Foods are categorized from Level 3 to 7, while drinks span Levels 0 to 4.
What is Level 7 Regular IDDSI?
IDDSI Level 7 – Regular is the final, and least restrictive, food texture in the IDDSI framework. It is intended for individuals who do not have chewing or swallowing problems that would increase their risk for choking. This level includes all normal, everyday foods with a wide variety of textures and sizes. Unlike the modified levels below it, Level 7 Regular has no restrictions on food piece size or specific textures, allowing for a complete and varied diet. It is the goal for many patients recovering from dysphagia to progress back to this level.
Key Characteristics of Level 7 Regular Foods
For a meal to be classified as Level 7 Regular, it must meet several criteria:
- Normal Everyday Foods: Any food item typically consumed by the general population is included.
- Varying Textures and Sizes: Food pieces can be of any size and possess diverse textures, including hard, crunchy, tough, or soft.
- Mixed Consistencies Allowed: This includes foods that contain both a solid and a liquid component, such as soup with vegetable pieces or cereal with milk. These are generally unsafe for individuals with dysphagia but are appropriate for Level 7.
- No Special Preparation Required: There is no need for specific mashing, pureeing, or mincing. Food is served as normal.
- Sufficient Chewing Ability: The individual must be able to bite off pieces of food and chew all textures without tiring easily.
The Subcategory: Level 7 Easy to Chew
Within Level 7, IDDSI also recognizes a subcategory called 'Regular Easy to Chew'. This was developed to cater to individuals who do not have a diagnosed swallowing problem (dysphagia) or an increased choking risk, but who may benefit from softer, more tender food choices. This could be due to weakened chewing muscles, dental issues, or as a recovery diet. The key difference is that while it is a subcategory of Level 7, it deliberately excludes hard, tough, chewy, or crunchy foods.
For the 'Easy to Chew' subcategory, the IDDSI Fork Pressure Test can be used to ensure the food's softness. When a fork is pressed onto the food, it should squash easily and deform, not regaining its shape when the pressure is released. This test helps caregivers ensure that meals are appropriately modified without restricting the size of food pieces, which is the primary control method for lower levels like Level 6.
Comparison of IDDSI Level 7 with Lower Levels
| Feature | Level 7: Regular | Level 6: Soft & Bite-Sized | Level 5: Minced & Moist |
|---|---|---|---|
| Chewing Required | Yes, for all textures | Yes, for soft pieces | Minimal |
| Particle Size | Not restricted, normal | Bite-sized (1.5cm for adults) | Small (4mm for adults) |
| Texture | All textures (soft, hard, tough, crunchy) | Soft, tender, moist throughout | Soft, moist, cohesive; small, visible lumps |
| Moisture | No restriction; mixed consistencies allowed | Moist with no thin liquid; thickened sauce | Moist, cohesive; no separate thin liquid |
| Testing Method | No specific test for Regular; Fork Pressure for Easy to Chew | Fork/Spoon Pressure Test | Fork Pressure Test and Spoon Tilt Test |
| Suitable For | No dysphagia or chewing issues | Mild-moderate dysphagia with adequate chewing | Moderate dysphagia, poor chewing |
The Role of Clinical Assessment and Preparation
Correctly identifying and preparing meals to the appropriate IDDSI level is a critical component of patient safety. The recommendation for an IDDSI level must always come from a qualified healthcare professional, such as a Speech-Language Pathologist (SLP) or a dietitian, following a comprehensive clinical assessment. For individuals on Level 7 Regular, the risks associated with eating are minimal. However, for those on the 'Easy to Chew' subcategory, attention to preparation is necessary to exclude harder food components. This may involve boiling or steaming vegetables until tender, choosing softer cuts of meat, and avoiding crunchy or chewy snacks. The global standardization and easy-to-use testing methods of the IDDSI framework enable care staff and family members to verify food consistency, further enhancing patient safety and quality of life.
Conclusion: The Importance of Accurate Diet Prescription
In summary, what is level 7 regular IDDSI is simply the classification for normal, everyday food, reserved for individuals with no functional deficits related to chewing or swallowing. It represents the pinnacle of recovery for many patients with dysphagia. The existence of the 'Easy to Chew' subcategory within Level 7 showcases the framework's detailed and person-centered approach, addressing nuanced needs without imposing unnecessary restrictions. The IDDSI framework as a whole, and Level 7 in particular, underscores the global effort to use clear, standardized terminology to enhance the safety and well-being of individuals with swallowing problems. The ultimate success of this initiative relies on consistent clinical assessment and careful meal preparation in line with the defined standards.
Learn more about the full scope of the framework at the official IDDSI website.
