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IDDSI – The Coming Standard For Dysphagia Diets

Updated: Jul 27, 2021

2019 has arrived and with it comes the approaching deadline for the conversion to IDDSI (the International Dysphagia Diet Standardisation Initiative).

IDDSI is an eight level consistency framework for both fluids and solid foods for the treatment of dysphagia, which will replace the current standards in Australia in May this year and April in the UK. As the aged care sector gears up for the coming change it’s worth reflecting on the condition of dysphagia itself and why the world needs the IDDSI framework. Editor’s Note: As of 1 February 2019, IDDSI has announced an additional Level 7 subcategory: Regular Easy to Chew. So, this is clearly still an evolving space!

Definition and prevalence of dysphagia

Worldwide over 590 million people, including 60% of the ageing population, will develop some form of dysphagia in their lifetime. Dysphagia describes a condition that affects the muscles involved in the swallowing of food, slowing down the swallowing motion which can cause both food and drink to enter the lungs rather than descending down the oesophagus. When food or liquid enters the lungs it is called ‘aspiration’, which can lead to the potentially fatal condition of aspirational pneumonia and the difficulty in swallowing and chewing food can result in malnutrition and dehydration.

The high rate of dysphagia among the elderly makes it a common disorder in aged care. Countries around the world have standardised levels of food and drink consistency for the treatment of dysphagia but they are not globally consistent. In Australia there are three levels of thickness for food and a seperate three for drink but in the UK and USA there are four different levels for food but each country uses distinctly different terminology. The lack of consistency in thickness levels and jargon makes it difficult for globalised efforts in the development of texture modified foodstuffs and treatment of dysphagia.


IDDSI was developed over three years to become the global standard for the treatment of dysphagia. It not only details the suitability and purpose of each texture thickness levels but provides new, more exact methods to test the thickness of prepared foods. The described rationale that accompanies each thickness level clarifies when it would be appropriate to use and

the clear descriptions makes the end result simple to envision. The clarity and depth of the global IDDSI format will reduce confusion in treating dysphagia patients, which will in turn reduce the risk of preventable illness and death.

With IDDSI set to launch in the coming months, the challenge of adapting existing systems and foods to the new IDDSI standards is a real and pressing concern. Like any change, it will take time to fully adjust to but work is well underway to ensure care providers using SoupedUp Catering software can be confident that textures will map seamlessly from the current standards to the new IDDSI standards. In addition, we are currently producing new IDDSI training videos to help care providers make the transition as smooth as possible.


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