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International Dysphagia Diet Standardisation Initiative (IDDSI)

Changes to modified food and thickened drinks for people who have difficulty swallowing:  new words, labels, and instructions

This information is for adults and children who have difficulty swallowing (also known as dysphagia) and are taking modified food and/or thickened drinks. It is also for their carers.  

What is going to change?

From September 2019, Ireland will:

  • use new words to describe the modified food and thickened drinks, and these words may be different to what you are used to (see tables 1 and 2)
  • have new labels on thickening products to reflect the new words
  • have some changes to the instructions (number of scoops you use) to thicken drinks. 

What are the word changes?

The new words come from the International Dysphagia Diet Standardisation Initiative (IDDSI). Ireland will now describe modified food and thickened drinks in the same way as many other countries across the world.

The following tables show the changes to the names for food and drinks. Read the tables to see how your food and drink names will change to the new levels. For example, ‘Texture A: Soft’ food is now called ‘Level 6: Soft and Bite-Sized’.

Table 1: Old drink names and new drink names

Table 2: Old food names and new food names 

Will the foods and drinks that I am currently taking change?

There will be some changes:

  • Drink 'Grades' will be called 'Levels', and food textures will also be called ‘Levels’.
  • Drink thickness will change for Levels 2 and 3. IDDSI Level 2 drinks will be thinner than Grade 2 drinks and IDDSI Level 3 drinks will be thinner than Grade 3 drinks.
  • Labels on your thickening products may change. For example, there may be changes to the number of scoops you need or the size or type of scoop. The labels will have clear instructions explaining how to prepare your product. It is very important that you follow the new instructions carefully.

Please talk to your healthcare professional if you have any questions about the changes.

Are there any risks for me associated with this change?

There could be, so it is important that you are clear about the changes. As mentioned, the thickness of some drinks will change.

  • IDDSI Level 2 drinks will be thinner than Grade 2 drinks
  • IDDSI Level 3 drinks will be thinner than Grade 3 drinks

This means that if you move to Level 2 or Level 3 drinks you need to watch for any of the following signs:

  • Coughing during or after eating or drinking
  • Choking
  • ‘Wet’ or ‘gurgly’ sounding voice
  • Watering eyes
  • Unexplained increases in body temperature
  • Chest infection

Go to your GP if you have any of these signs and contact your speech and language therapist for a review.

What do I do with the products I am currently using?

You can continue to use these as normal until they are finished.  The changes only apply to new products that will be available from September 2019.

How can I find out more about these changes?

Your speech and language therapist, dietitian, nurse, doctor or pharmacist can tell you more about these changes.  

See the patient information leaflet below for more information.