![]() Level 5 (Minced and Moist) Small lumps in the bolus (no larger than 4mm width and 15mm length for adults), can be eaten using spoon or fork. Should sit in a mound on top of the spoon/fork with minimal dripping through the fork. (Flow Test 10 ml remains in the syringe.) Spoon tilt test-should fall off the spoon in single spoonful. There should be no lumps, requires no chewing and the liquid should not separate. Cannot be taken through a straw, usually taken via spoon. Usually can be administered via spoon, however may also be eaten via fork. Level 4 (Pureed/Extremely Thick formerly Pudding Thick). This level can be taken from a spoon, but is too thin for a fork. This level takes a moderate effort to drink through a straw, but can be drunk from a cup. Level 3 (Moderately Thick formerly Honey Thick). Requires increased effort to drink from a straw. Flows off a spoon but is thicker than water. Level 2 (Mildly Thick formerly Nectar Thick). This may include formula or commercially available nutrition drinks such as Boost or Ensure. Level 1 (Slightly Thick) Thicker than water, but is not quite Mildly Thick (formerly Nectar Thick). ![]() Level 0 (Thin) is a liquid that flows like water. IDDSI involves 5 food consistency levels and 5 liquid levels. Some facilities allow a number of food items on one diet level that another facility adds into a different level. I’m sure you have probably been in a number of facilities that interpret Mechanical Soft, Dysphagia Soft, etc a little different than other facilities. IDDSI was created to replace the National Dysphagia Diet and to standardize food and liquid consistencies. The International Dysphagia Diet Standardisation Initiation is here and being utilized in many facilities.
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