Drinks
Thin
Flows like water. A person who is prescribed thin fluids can manage all drink consistencies, so no thickening is added.
IDDSI colour: White Drinks
Free tool for APDs and SPs
IDDSI framework levels 0 to 7
Select a level on the dysphagia diet continuum to see its name, descriptor, everyday examples and the IDDSI testing method. Drinks run from Level 0 (Thin) to Level 4 (Extremely Thick); foods run from Level 3 (Liquidised) to Level 7 (Regular or Easy to Chew). Educational reference only.
Educational reference only, not clinical advice.
The IDDSI framework is © the IDDSI and is free to use with attribution (iddsi.org). This tool summarises the framework for reference. Follow the current IDDSI descriptors and testing methods and your local dysphagia policy when modifying a diet or thickening a fluid.
Choose a level (0 to 7)
Levels 3 and 4 span both drinks and foods. Colours follow the official IDDSI colour for each level.
Drinks
Slightly Thick
Thicker than water and needs a little more effort to drink than thin fluids, but still flows through a straw or teat.
IDDSI colour: Grey Drinks
Drinks
Mildly Thick
Flows off a spoon quickly but slower than thin drinks. Some effort is needed to sip it through a standard straw.
IDDSI colour: Pink Drinks
Drinks and foods
Moderately Thick (drink) / Liquidised (food)
Can be drunk from a cup and needs effort to sip through a wide straw. Smooth with no lumps and no separation of liquid. As a food it is a smooth, liquidised texture that cannot be eaten with a fork because it drips slowly through the prongs.
IDDSI colour: Yellow Drinks and foods
Drinks and foods
Extremely Thick (drink) / Pureed (food)
Usually eaten with a spoon, not drunk from a cup and not sipped through a straw. Smooth with no lumps, holds its shape on a spoon and is not sticky. Liquid must not separate from the solid.
IDDSI colour: Green Drinks and foods
Foods
Minced & Moist
Soft and moist with small, soft lumps that are easy to squash with the tongue. Served with a smooth, thick sauce or gravy so it is cohesive and not runny.
IDDSI colour: Orange Foods
Foods
Soft & Bite-Sized
Soft, tender and moist throughout, with no thin liquid leaking from it. Served in bite-sized pieces so no knife is needed and the pieces can be broken up with a fork or spoon.
IDDSI colour: Blue Foods
Foods
Regular / Easy to Chew
Regular covers everyday foods of all textures with no restriction. Easy to Chew covers soft and tender everyday foods that still need chewing but not the size or texture limits of the lower levels. Both need the ability to chew safely.
IDDSI colour: Black Foods
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FAQ
IDDSI framework questions.
What is IDDSI?
IDDSI is the International Dysphagia Diet Standardisation Initiative. It describes a single, continuous framework of eight levels, numbered 0 to 7, that gives standard names, descriptors and testing methods for texture-modified foods and thickened drinks. It is used internationally to reduce confusion between services when a person has swallowing difficulties (dysphagia). Always follow the current IDDSI descriptors at iddsi.org and your local policy.
What is IDDSI Level 4?
Level 4 is Extremely Thick as a drink and Pureed as a food. It is usually eaten with a spoon rather than drunk from a cup or sipped through a straw. It is smooth with no lumps, holds its shape on a spoon and is not sticky, and the liquid must not separate from the solid. It is confirmed with the Fork Drip Test and the Spoon Tilt Test. Confirm against the current IDDSI descriptors.
What is IDDSI Level 5?
Level 5 is Minced and Moist. The food is soft and moist with small, soft lumps that are easy to squash with the tongue, served with a smooth thick sauce or gravy so it stays cohesive. Lumps are no bigger than 4 mm for adults or 2 mm for paediatric patients, checked with the Fork Pressure Test. Confirm against the current IDDSI descriptors.
What is IDDSI Level 7?
Level 7 has two forms. Regular covers everyday foods of all textures with no restriction. Easy to Chew (Level 7 EC) covers soft and tender everyday foods that still need chewing but not the size or texture limits of the lower levels. Both require the ability to chew safely, and neither restricts thin fluids unless that is separately prescribed. Confirm against the current IDDSI descriptors.
How do I test a thickened fluid?
Drinks at Levels 0 to 3 are checked with the IDDSI Flow Test. You draw 10 mL into a 10 mL slip-tip syringe, release the plunger for 10 seconds, then read how much liquid is left: less than 1 mL is Thin (0), 1 to 4 mL is Slightly Thick (1), 4 to 8 mL is Mildly Thick (2) and 8 to 10 mL is Moderately Thick (3). Thicker samples use the Fork Drip Test and Spoon Tilt Test instead. Always follow the current IDDSI method.
Where did IDDSI come from?
IDDSI was founded in 2013 by a group of volunteers from several countries and professions, including dietetics, speech pathology, nursing, medicine, food science and engineering. The framework was published in 2016 to standardise texture-modified diet and thickened-fluid terminology worldwide. The framework is the work of the IDDSI and is free to use with attribution at iddsi.org.
Every answer is an educational summary only. Follow the current IDDSI descriptors and testing methods at iddsi.org and your local dysphagia policy.