IDDSI Level 3 Explained: Liquidized Foods & Honey Thick Drinks

The International Dysphagia Diet Standardization Initiative (IDDSI) has developed a global framework for classifying food textures and liquid thicknesses. This system helps ensure safe and appropriate nutrition for people with swallowing difficulties (dysphagia). We're focusing in on IDDSI Level 3: Liquidized foods and moderately thick beverages.

IDDSI Level 3 refers to foods that have been pureed or liquidized to a very smooth, pourable consistency. These foods flow easily off a spoon but are thicker than thin liquids. They can be drunk from a cup, sucked through a wide straw, or eaten with a spoon.

Characteristics:

1. Smooth texture: No lumps, fibers, bits of shell, skin, or husks
2. Pourable: Flows under its own weight
3. Cohesive: Holds together well
4. Not sticky in the mouth
5. No separate liquid or solid components

Testing IDDSI Level 3:

The IDDSI Flow Test is used to determine if a food meets Level 3 criteria. Using a 10ml syringe, the liquid should flow through leaving 1-4 ml in the syringe after 10 seconds.

 

Examples of Level 3 Foods:

• Smooth, blended soups (no chunks)
• Pureed meats with smooth gravy
• Well-blended fruit or vegetable purees
• Smooth yogurt (no bits)
• Liquidized cereals

While our previous discussion focused on liquidized foods, it's important to note that IDDSI Level 3 also includes beverages of a specific consistency. These are often referred to as "moderately thick" liquids.

Characteristics of Level 3 Beverages:

1. Thickness: Thicker than water and thin liquids, but still pourable
2. Flow rate: Flows slowly, similar to a thick milkshake or smoothie
3. Drinkability: Can be drunk from a cup or sucked through a wide straw
4. Cohesiveness: Holds together well when poured

Examples of Level 3 Beverages:

• Thick milkshakes
• Smooth, blended fruit smoothies (no seeds or pulp)
• Thickened juices
• Thickened milk
• Some liquid nutritional supplements (when appropriately thickened)

Understanding and implementing IDDSI Level 3 is crucial for ensuring safe and enjoyable nutrition for individuals with moderate dysphagia. This standardized level provides a clear framework for preparing both foods and beverages that are easy to swallow while minimizing choking and aspiration risks.

Key takeaways:

1. IDDSI Level 3 includes both liquidized foods and moderately thick beverages.
2. Consistency is smooth, pourable, and cohesive with no separate liquid or solid parts.
3. Proper preparation and testing are essential for safety.
4. Flavor and presentation remain important for meal satisfaction.