Recipe Modifications for IDDSI

The International Dysphagia Diet Standardization Initiative (IDDSI) has laid out a framework for all foods to fit within a food or fluid level. Previously, recipes had been written to meet the criteria in the National Dysphagia Diet (NDD) - however, NDD was never fully supported by interdisciplinary providers like Speech Language Pathologists (SLP). 

Within IDDSI, any food or recipe can be manipulated to meet the texture and consistency requirements. Plus, as an extra assurance, all recipes can be tested to validate their consistency. 

Here are some key considerations for each level:

Regular - Easy to Chew (Level 7)

Soft & Bite Sized (Level 6)

Minced & Moist (Level 5)

Pureed (Level 4)


Reading a recipe:

When reading a recipe for IDDSI, look for a few key areas on the recipe:

  • IDDSI Symbols or Abbreviations
  • IDDSI testing methods
  • Special instructions for altering the texture of the food item


Recipe Rules for IDDSI:

  1. Follow the recipe
  2. Look at the texture of the food carefully, always complete the IDDSI testing/audit procedure(s) to verify the correct consistency
  3. Remember it's always acceptable to "level down" - for example, often ground meat will be offered for hard to chew recipes
  4. Use a sauce or gravy to add moisture to food items


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