What type of food does level 7 cover on the IDDSI chart?

October 28, 2025 •

5 min read

Over 590 million people worldwide are affected by dysphagia, a condition that makes swallowing difficult, highlighting the critical importance of standardized diets like the International Dysphagia Diet Standardisation Initiative (IDDSI). Understanding what type of food does level 7 cover on the IDDSI chart is essential for providing safe and comfortable meals for individuals who can manage regular foods with or without some slight texture modification.

Quick Summary

IDDSI Level 7 encompasses both 'Regular' and 'Easy to Chew' diets for individuals who have minimal to no swallowing problems, or require softer foods for easier chewing. It includes a wide range of food textures and sizes, from normal everyday meals to specific items that are soft and tender. Safe consumption depends on the individual's ability to bite, chew, and swallow effectively without a high risk of choking.

Key Points

Two Sub-Categories: IDDSI Level 7 includes both a 'Regular' diet for individuals with normal chewing and swallowing function, and an 'Easy to Chew' diet for those who need softer textures.
Easy to Chew Requires Softness: Foods on the Level 7 Easy to Chew diet must be soft and tender, easily separated with the side of a fork or spoon.
No Size Restrictions on Easy to Chew: Unlike lower IDDSI levels, Easy to Chew foods do not have a specific size restriction, but are only suitable for those who can regulate their own bite size.
Test with a Fork: The Fork/Spoon Pressure Test confirms if a food is soft enough for the Easy to Chew diet by ensuring it squashes easily under pressure.
Avoid Hard and Chewy Textures: For the Easy to Chew diet, avoid hard, dry, tough, chewy, fibrous, or crunchy foods, as well as items with pips, seeds, bones, or gristle.
Consult a Professional: The decision for any modified diet, including Level 7, should be based on a clinical assessment by a healthcare professional, like a speech-language therapist.

Demystifying IDDSI Level 7: Regular and Easy-to-Chew Foods

The IDDSI framework provides a standardized system for describing texture-modified foods and thickened liquids, crucial for individuals with dysphagia. Level 7, the final level, is for individuals who can safely manage a range of textures, although it is split into two important sub-categories: Regular and Easy to Chew. This guide will detail the food types included in both categories, offering practical insights and examples for caregivers and patients.

IDDSI Level 7 Regular: The Standard Diet

For most people without swallowing difficulties, Level 7 'Regular' is their standard diet. This category includes all normal, everyday foods of various textures, without any restrictions on size or texture. Individuals on this diet have strong chewing abilities and no increased risk of choking. They can eat hard, chewy, crispy, or crunchy foods, as well as those containing seeds, bones, or tough fibers. A person on the Level 7 Regular diet can handle a wide variety of foods, including:

Meats: Steaks, grilled chicken, tough cuts of meat.
Fruits and vegetables: Raw carrots, apples, and fibrous fruits like pineapple.
Grains: Crusty bread, crunchy toast, and dry cereals.
Mixed textures: Soup with chunky pieces, cereal with milk.

IDDSI Level 7 Easy to Chew: The Sub-Category for Softer Needs

The 'Easy to Chew' sub-category, also part of Level 7, is designed for individuals who require softer textures but have sufficient chewing strength to manage these foods safely. These individuals may have weaker chewing muscles due to age, fatigue, or dental issues, but do not have an identified choking risk. Crucially, while the texture is modified to be soft and tender, there are no restrictions on the size of food pieces. This differentiates it significantly from Level 6 (Soft and Bite-Sized), where food size is restricted.

Characteristics of Easy to Chew foods:

Soft and tender: Can be easily broken apart with the side of a fork or spoon.
Moist: Food is not dry, hard, or crumbly.
Minimal chewing effort: Requires chewing, but without tiring easily.

Examples of Level 7 Easy to Chew foods include:

Proteins: Meat cooked until tender (e.g., in a stew or casserole), tender flaked fish, eggs, and soft tofu.
Vegetables: Boiled or steamed vegetables cooked until soft, such as carrots, cauliflower, or mashed potatoes (with no crispy skin).
Fruits: Soft, ripe fruits like bananas, canned pears, or stewed apples.
Grains: Soft, well-cooked pasta, rice, and moist cake.

Food Testing Methods for Level 7 Easy to Chew

To ensure foods are appropriately soft, the IDDSI framework provides simple testing methods. For Level 7 Easy to Chew, the 'Fork/Spoon Pressure Test' is recommended. When pressing on the food with a fork until the thumbnail blanches white, the food should easily flatten and not return to its original shape. The 'Fork/Spoon Separation Test' confirms the food can be cut or separated easily with the side of the utensil. These tests should be performed at serving temperature, as food texture can change when it cools.

Key Differences and Risks

It is vital to distinguish between the Level 7 sub-categories and other IDDSI levels to prevent choking risks. A person on the Easy to Chew diet should not be given foods from the Regular diet that are hard, tough, or have fibrous bits. Furthermore, because Easy to Chew foods have no particle size restriction, they are unsuitable for anyone with an identified risk of choking, who would require a more modified diet like Level 6 (Soft and Bite-Sized).

TABLE: IDDSI Level 7 Comparison


Feature	Level 7 Regular	Level 7 Easy to Chew
Food Texture	All normal, everyday textures (hard, soft, crispy).	Soft or tender textures only.
Chewing Ability	Normal, strong chewing ability required.	Chewing ability for soft/tender foods, but may tire with harder textures.
Particle Size	No restrictions on food piece size.	No restrictions on food piece size.
Choking Risk	Not for individuals with increased choking risk.	Not for individuals with identified choking risk due to no particle size restrictions.
Example Food	Steak, raw apple, crusty bread.	Tender casserole meat, soft-cooked carrots, ripe banana.
Testing Method	Not applicable; for individuals with normal chewing/swallowing.	Fork/Spoon Pressure Test to confirm softness.

Conclusion

IDDSI Level 7 provides a standardized way to cater to individuals who can manage regular foods but may need softer textures. The distinction between the 'Regular' and 'Easy to Chew' sub-categories is crucial for patient safety. Caregivers and food service professionals must understand these differences, adhere to the simple testing protocols for Easy to Chew foods, and always consult with a healthcare professional, such as a speech-language therapist, for personalized dietary recommendations. Correct implementation ensures that individuals receive the nourishment they need safely and comfortably.

Frequently Asked Questions about IDDSI Level 7

How is IDDSI Level 7 different from Level 6? IDDSI Level 7 (Easy to Chew) has no particle size restrictions, whereas Level 6 (Soft and Bite-Sized) requires food to be cut to a maximum of 1.5 cm by 1.5 cm and must not be sticky. Level 7 Easy to Chew is for those who can regulate their bite size safely, while Level 6 is for those at higher choking risk.

Can a person on IDDSI Level 7 Easy to Chew eat toast? No, foods like toast are typically avoided on the Level 7 Easy to Chew diet. They are hard, crunchy, and dry, which are textures that should be avoided. A soft, moist alternative like a regular sandwich with a soft filling is more appropriate, though bread can sometimes be an exception depending on the individual's specific recommendation.

What types of bread are suitable for IDDSI Level 7? For the Level 7 Regular diet, any bread is suitable. For the Easy to Chew sub-category, soft, moist bread is appropriate, but dry or crusty breads should be avoided. Sandwiches with soft fillings are generally acceptable.

Are all vegetables on the Level 7 Easy to Chew diet cooked until soft? Yes, vegetables for the Easy to Chew diet must be steamed or boiled until tender enough to be easily squashed with a fork. Raw or stir-fried vegetables that remain firm are not suitable.

Can someone on IDDSI Level 7 Easy to Chew eat meat with gristle? No, tough or fibrous meats and meat with gristle should be avoided on the Easy to Chew diet. Meat must be cooked until very tender, such as in a stew or casserole, and should flake apart easily with a fork.

What drinks are associated with IDDSI Level 7? IDDSI Level 7 refers to foods, while drinks are classified in Levels 0 through 4. A person on a Level 7 diet may also need thickened liquids, and their healthcare provider will recommend the appropriate drink level based on their individual swallowing assessment.

Why is it important to test food at the correct temperature? It is important to test food at the temperature it will be served because the texture of food can change as it heats or cools. A food that meets the Easy to Chew criteria when hot may become hard or tough as it cools, potentially making it unsafe.

Frequently Asked Questions

The primary difference lies in the texture: Level 7 Regular includes all normal food textures, including hard and tough items, while Level 7 Easy to Chew is restricted to soft and tender foods that are easy to chew, with no restrictions on piece size.

The Level 7 Easy to Chew diet is for individuals who can manage soft and tender foods but may have difficulty with harder textures, often due to age, fatigue, or dental issues. It is not for those with an identified choking risk.

You can perform the Fork/Spoon Pressure Test. The food should flatten and hold its shape when pressed with a fork until the thumbnail blanches white. The food should also break apart easily with the side of a fork.

Soft, moist sandwiches with soft fillings are generally acceptable. Dry or crusty breads should be avoided, and any bread should be moist enough to chew easily. Clinician guidance is often advised for bread products.

Foods to avoid include nuts, raw vegetables, dried fruits, chewy sweets, crunchy cereals, tough meats, fibrous foods like pineapple, and items with seeds, bones, or gristle.

Mixed-consistency foods, such as cereal with milk or soup with soft vegetables, may be included. However, this should only be done with clinical guidance, and it is crucial that the solid parts are soft and safe for the individual.

IDDSI Level 7 focuses on food textures. A person on this food level may still require thickened liquids, and the appropriate liquid thickness level (0-4) is determined by a separate clinical assessment for swallowing safety.