One of the big differences that has come out of the new IDDSI standards in Australia is the removal of sandwiches from the menu. The previous texture A allowed for sandwiches without crusts or seeds provided they had a soft filling and were approved on a case by case basis. IDDSI has deemed bread to be high risk for all levels, apart from 7 Regular.
It begs the question, what has changed?
IDDSI’s new conservative approach stems from the mechanical actions required for a safe swallowing action. A person must be able to both bite and chew properly to eat bread safely and these two functions are compromised for people with dysphagia. IDDSI also makes mention of how bread doesn’t actually mash easily, despite its soft texture.
Bread is also technically fibrous. It may not be as severely fibrous as celery or rhubarb, but it’s still enough to require an increased chewing effort.
The ‘peanut effort’
In perhaps one of the strangest metrics in the culinary world, IDDSI points out that it takes about the same level of effort to chew bread safely as it does to chew a peanut. This ‘peanut effort’ has been deemed beyond the capability of people with dysphagia.
IDDSI notes that the condition of dry mouth also makes bread problematic, as it requires moisture to soften. Even with a moist mouth, it can create complications with swallowing, as the bolus formed takes on a sticky texture, which poses a choking risk for those with dysphagia.
If you are unsure on how to work with the IDDSI texture levels, our IDDSI video guides available as part of SoupedUp Training can help. The new IDDSI series covers ‘Food and fluid textures’ and ‘Testing methods’, as well as ‘A chef’s guide to preparing and presenting texture modified foods’.