The Ultimate IDDSI Transition Toolkit

Looking at switching to or furthering your International Dysphagia Diet Standardisation Initiative (IDDSI) implementation, but don't know where to start? Let's make it as simple as possible for you!

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This toolkit, created by Registered Dietitians specializing in IDDSI standards, includes 18 pages of clear steps, practical tips and essential resources for implementing IDDSI:

Helpful videos, documents & training tools
Tips for building your team of IDDSI champions
A guide to transitioning from NDD to IDDSI
Steps for implementation, testing & quality checks
A timeline guide to stay organized and on track

The Ultimate Guide to IDDSI
(International Dysphagia Diet Standardisation Initiative)

Since its release in 2015, the IDDSI Framework has provided globally recognized guidelines for safe, standardized diets for those with swallowing difficulties. These standards ensure consistency and safety across care settings, improving quality of life.

As a foodservice professional in senior living or healthcare, we know providing safe, quality care to your diners is your number one priority.

This resource hub is here to help your team succeed, with practical tools and guidance for smooth implementation and ongoing compliance.

Free On-demand Webinar | Preparing for IDDSI Enforcement
What Is IDDSI and Why Does it Matter?
The IDDSI Framework Explained

Implementing IDDSI In Your Organization
Using Software to Support IDDSI Implementation
The Human Side of IDDSI: Training Staff & Diet Change Acceptance

Preparing for IDDSI Enforcement: Survey Readiness & Implementation Strategies

Watch our on-demand webinar for a clear, practical roadmap for compliance. Global IDDSI Co-Chair Luis Riquelme and IDDSI LTC Chair & US Best Practices Member Noel Slaughter break down what surveyors look for, how to avoid citations and the steps you can take now to stay ahead.

Gain insider insights right from the leaders who have a pulse on the industry – so you can confidently prepare your team and stay compliant as enforcement expands.

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What is IDDSI and Why Does it Matter?

The International Dysphagia Diet Standardisation Initiative (IDDSI) was created to solve a critical problem: inconsistent texture standards that can lead to safety risks for individuals with swallowing difficulties.

Dysphagia affects 10-33% of older adults

Source: NIH

By providing clear, globally aligned guidelines, IDDSI improves patient and resident safety, supports staff training and ensures operational consistency across care settings. Its adoption is transforming how senior living and healthcare providers approach dysphagia diet standards, making it an essential framework for quality care.

Discover how to help residents accept texture-modified diet changes.

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The IDDSI Framework Explained

The 8 IDDSI Levels for Food & Liquids

There are 8 different IDDSI Levels, where liquids are measured from Levels 0-4 and foods are measured from Levels 3-7.

The IDDSI Liquid Levels are: Thin (Level 0), Slightly Thick (Level 1), Mildly Thick (Level 2), Moderately Thick (Level 3) and Extremely Thick (Level 4).

The IDDSI Food Textures are: Liquidised (Level 3), Pureed (Level 4), Minced & Moist (Level 5), Soft & Bite Size (Level 6) and Easy to Chew (Level 7).

Not all communities will offer all levels, depending on the population and needs of their patients or residents.

Click here to learn more about the IDDSI diet levels.

Updated Food Lists

IDDSI food lists are guides and not exhaustive rulebooks. They help classify foods by texture level and include:

Descriptions of each level
Who the level is for
Example foods for planning meals and snacks

You can download these free handouts under Consumer Resources on the IDDSI website.

Important:

Use the lists as educational tools, not definitive "yes/no" indexes.
Adapt for cultural preferences, regional availability and mixed dishes.
Always test foods or recipes to confirm compliance.

Pro Tip: Start with the "Foods to Avoid" section, then review the criteria and rationale for each level.

Level 7 Easy to Chew (EC7): What's New

Introduced in 2018, EC7 was created for individuals who don't have dysphagia but benefit from softer foods.

What EC7 Includes:

Naturally soft foods (e.g., cooked fish, canned fruit, pudding)
Foods softened by cooking (braising, stewing) or moistening

How It Differs:

No particle-size restriction – softness is the key factor
IDDSI testing methods ensure consistency:
- Break apart with side of fork/spoon
- Pass the IDDSI Fork Pressure Test

Why It Matters: EC7 helps reduce eating effort while keeping meals familiar and enjoyable.

Learn more about EC7 and its testing methods.

IDDSI Food & Liquid Testing Methods

Consistency is critical. IDDSI recommends a three-step testing process to validate textures before serving:

Spoon Tilt Test:
Ensures food holds shape but slides off easily.

Fork Drip Test:
Checks particle size and moisture for solids.

Flow Test:
Measures liquid thickness using a syringe.

Why test regularly? Even small variations in preparation can affect safety. Routine checks ensure compliance and protect residents.

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Implementing IDDSI in Your Organization

The Four Phases of Implementation

Assessment

Review current menus and workflows.
Identify gaps in compliance and equipment needs.

Training

Educate staff on IDDSI levels and IDDSI testing methods, and why they matter.
Align kitchen and care teams for consistent communication.

Get tips for supporting your staff through implementation.

Rollout

Update recipes and menus to meet IDDSI standards.
Begin testing foods and liquids daily before service.

Discover “go-live” resources and tips for a successful rollout.

Evaluation

Monitor compliance and resident feedback.
Adjust processes based on real-world challenges.

IDDSI Tools & Training Resources

Once you understand the ‘why’ and ‘how’ behind implementing IDDSI standards, the next step is putting that knowledge into action! That’s where our Ultimate IDDSI Transition Toolkit comes in: a comprehensive resource designed to guide your team through every stage of implementation.

Before you begin your own implementation journey, we encourage you to dowanload the toolkit and give your team the confidence and clarity they need to succeed.

Get the Toolkit Now

RELATED RESOURCE
Watch Calming 5 Common IDDSI Fears: Navigating the Solutions for Sustainable Implementation

And don’t forget to pay a visit to IDDSI.org, where you’ll find:

The IDDSI Framework, Detailed Level Definitions and the IDDSI Testing Methods
The news page for updates: Including monthly e‑bites, catalog releases, global event announcements, webinar highlights and stakeholder initiatives.
Resources and FAQs

Plus, don’t forget to check out the IDDSI YouTube channel for handy explainer videos.

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Using Software to Support IDDSI Implementation

Foodservice software can play a key role in supporting IDDSI implementation by streamlining menu planning, recipe management and texture modifications.

With built-in compliance tools and IDDSI tags, teams can ensure consistency across meals while reducing manual errors. This technology helps simplify training and quality checks, making the transition to IDDSI standards more efficient and reliable.

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The Human Side of IDDSI: Training Staff & Diet Change Acceptance for Diners

Supporting Resident Acceptance

Supporting resident diet changes under IDDSI requires balancing safety with personalization. While the framework provides clear guidelines for texture modified diets, individual tolerances – such as bread or transitional foods – should be assessed by the Speech Therapist and tailored by the interdisciplinary team. Solutions like MealSuite’s soaked bread recipes and IDDSI-safe dessert substitutes help facilities maintain variety and enjoyment while meeting compliance standards.

Making Pureed Meals Appealing

By molding foods into familiar shapes, adding color contrast and serving on attractive dishware, you can transform the dining experience from clinical to inviting. These simple steps not only enhance visual appeal but also help maintain dignity and enjoyment for residents who require texture modified diets.

View LinkedIn post

Source: Alexa Kirtley

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Ready to Strengthen Your IDDSI Program?

A safe, standardized approach to dysphagia diets isn’t just best practice – it’s essential for providing safe service to your residents and ensuring consistency across your team. By implementing IDDSI standards, you’re taking a proactive step toward better safety, quality and confidence in every meal.

Take the next step today:

Download Your IDDSI Transition Toolkit Watch the IDDSI Enforcement Webinar