IDDSI + NDD

Since 2008, Blossom Foods has offered menu items in three textures, Pureed, Ground, and Soft Chop based on the National Dysphagia Diet (NDD). In 2018, Blossom Foods adapted our menu items and textures to fit within the framework of IDDSI. With the introduction of the International Dysphagia Diet Standardization Initiative, IDDSI, food texture levels have been more clearly defined. From the chart below, you can see that the texture levels are now defined by level numerically.

Level 4 - Pureed: No lumps, liquid must not separate from solid, falls of spoon in a single spoonful when tilted and continues to hold its shape, cannot be sucked through straw, does not require chewing.

Pureed items should be consistent in smooth texture.

Level 5 – Minced & Moist: Can be eaten with fork or spoon, chopsticks with good hand control. Soft and moist with no separate thin liquid. Lumps are easy to squash with tongue. Biting is not required, minimal chewing, tongue force alone can be used to break soft small particles and is required to move the bolus.

Level 6 – Soft & Bite Sized: Can be eaten with fork or spoon, chopsticks. Can be mashed/broken down with pressure from fork, spoon or chopsticks, chewing is required before swallowing. Pieces should be soft, tender and moist throughout, “bite sized” pieces appropriate for size and oral processing skills. Must have adequate tongue force to keep pieces within the mouth during chewing, and to move the bolus for swallowing.

As more facilities implement the IDDSI framework, Blossom Foods is happy to assist in the implementation and demonstration/tasting of our menu items.

The National Dysphagia Diet: NDD was adapted in 2002. The levels for this diet included:

  • Level 1: Dysphagia Puree: Homogenous, very cohesive, pudding-like, requiring very little chewing ability.
  • Level 2: Dysphagia-Mechanical Altered: Cohesive, moist, semisolid foods, requiring some chewing.
  • Level 3: Dysphagia-Advanced: Soft foods that require more chewing ability.

Many facilities took the NDD framework and labeled their levels Puree, Ground, and Mechanical Soft or Soft Chop.

Blossom Foods offers it meals in the textures as described by these frameworks.

We are also introducing a Level 7 – Regular Texture line of Renal Meals.