The International Dysphagia Diet Standardisation Initiative

A standardized, global way of naming & describing texture modified foods & thickened liquids has been developed by an international body called IDDSI, catering to individuals with dysphagia of all ages, in all care settings, & across all cultures.

Australia will be adopting the IDDSI standard from May 1st 2019.

Between now & then Adult Speech Pathology & Nutrition Professionals Australia aim to update you on what has & hasn't changed in catering to modified diets & thickened fluids with a newsletter/ email each month until April. Each newsletter/ email will touch on 1 or 2 topics for each of the textures and will provide a step by step guide to the changes that you may need to think about. 

You will find a lot of information on the IDDSI website ( and there is an app for Apple and Android phones- just search for IDDSI in your app store.


Why do we need modified textures?

Dysphagia (dis-FAY-juh) means difficulty swallowing this can be food, drinks, saliva or medications. Left untreated or not properly managed, persons with dysphagia are at an increased risk of:
- Airway obstruction (choking)
- Aspiration pneumonia
- Unintentional weight loss
- Malnutrition
- Dehydration

Dysphagia can also impact on the person & their family socially & emotionally by contributing to
- Losing the enjoyment of eating or drinking
- Becoming embarrassed because of trouble eating & drinking
- Reducing the cultural or personal value of mealtimes

Modified diets can help mitigate the risks of dysphagia & bring enjoyment back to eating. A speech pathologist can assess a resident to provide clinical advice on what "level" of food & fluids is safest for them to consume. A dietitian can advise on the nutrition value of the recommended diet.


How will you know which food is appropriate for which IDDSI level?

Each level will have a "testing protocol" so if you are unsure what level a food falls into, you can test it for yourself.

The testing protocols will be explained in future emails as we discuss each each specific level of food and fluid.

THE REGULAR DIET (Level 7, Black)

The Regular Diet has not changed. It continues to include normal, everyday foods of various textures.a text block. You can use it to add text to your template.

There is no texture restriction at this level.

It can include foods that a hard, touch, chewy, fibrous, stringy, dry, crispy, crunchy or crumbly (or soft & easy to eat!)

It requires the ability to:
- Bite hard foods, and chew them for long enough to form a soft cohesive ball that is "swallow ready"
- Chew all food textures without tiring easily
- Remove bone or gristle from the mouth that cannot be swallowed easily


Good nutrition is one of the corner stones of healthy ageing, along with physical activity and social engagement. A lot of people are confused about what foods make up a healthy diet, but the Australian Guide to Healthy Eating can provide a good start.

Older people need more of certain nutrients, particularly protein and calcium, so a balanced diet is important. Eating a wide range of foods from all of the food groups is more likely to provide all of the essential nutrients. Fad diets that avoid whole food groups should be avoided.

It can be a challenge to provide all groups in an aged care menu, but a well planned menu that includes foods that residents like to eat can ensure that all residents can achieve the nutrition that they need. A texture modified diet will limit a resident's choices, and when appetite is also poor residents can struggle to eat the wide variety of foods that they have been used to.

Soft, minced and moist and smooth pureed diets must be planned at the same time as the regular menu, with suitable options identified at all meals and mid meals. All food groups must be considered, but the protein containing groups should be a focus. Protein is mainly found in the meats and alternatives and dairy foods.


Our new Meal Plans Manual is a benchtop guide to nutrition care and therapeutic or special diets when catering for older people.

It provides a summary of nutrition for an older person, information regarding menu planning as well as a meal plan for each of the various special diets that are likely to be encountered. 

Many of these special diets eg diabetic and texture modified diets are routinely provided from the main menu, but others will need to be catered for on an individual basis.

The meal plans provide a simple and practical guide that can be readily referred to at the time of serving meals.

Also included in this manual is information regarding standard serve sizes and a standard menu structure to ensure that residents are provided with ample opportunities to choose foods from each of the core food groups and to ensure that the organisation meets Best Practice and/ or Accreditation Guidelines.



Online e-learning Presentations

Have you attended NPA's Improving Nutrition in Aged Care Seminar? We are now offering the seminars as a series of online e-learning presentations.

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Resources for Aged Care

NPA has developed a set of resources and information for aged care homes.You can begin accessing  the NPA resources from our website now.

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