Soft and bite-sized food IDDSI Level 6

IDDSI is the International Dysphagia Diet Standardisation Initiative.

Why is this food texture needed?

It can be recommended for people who may have difficulties biting off pieces of food, chewing and swallowing but are able to chew bite-sized pieces down into little pieces that are safe to swallow. A moderate amount of chewing is required. The pieces are ‘bite-sized’ to reduce choking risk.

Food Examples

All Level 6 foods must be chopped into bite sized pieces (1.5cm x 1.5 cm (½ inch)) before eating.

Meat

• Cooked until tender and chopped so pieces are no longer than 1.5cmx1.5cm lump size.
• If you cannot serve soft and tender, serve as minced and moist

Fish

• Cooked soft enough to break and serve in pieces no larger than 1.5cmx1.5cm

Fruit

• soft and chopped to pieces no larger than 1.5cmx1.5cm pieces (drain any excess liquid).
• Do not use the fibrous parts of fruit (for example, the core or zest such as the white parts of an orange).
• Be extra careful if you are eating fruit with a high water content, where the juice separates from the solid in the mouth during chewing (for instance, fruits like watermelon or other melons).

Vegetables

• Vegetables steamed or boiled with final cooked size no larger than 1.5cmx1.5cm.
• Stir fried vegetables are too firm and are not suitable for this texture.

Cereal

• Served with pieces no bigger than 1.5cmx1.5cm, with their texture fully softened.
• Drain excess liquid before serving.

Dessert

• No ice-cream or jelly if a person requires thickened fluids (because these can change to thin fluid in the mouth)

Rice

• Requires a sauce to moisten it and hold it together.
• Rice should not be sticky or gluey and should not separate into individual grains when cooked and served.
• May require a thick, smooth, non-pouring sauce to moisten and hold the rice together

Meal Ideas

Breakfast

• Egg (scrambled, poached, boiled, fried).
• Baked beans or tinned tomatoes with soft white bread (no crusts).
• Fruits for example chopped banana, ripe peaches, melon, nectarines and strawberries.
• Porridge such as Ready Brek or instant oat cereal.
• Cereal wheat biscuits for example Weetabix soaked well in milk.

Main meal

• Well-cooked soft pasta and sauce.
• Boiled white rice (well cooked with plenty of thick sauce).
• Steamed, poached or baked fish for example cod, haddock in sauce.
• Plain, soft omelette with soft filling.
• Minced meat in thick gravy.
• Tender meat casserole with plenty of thick sauce or gravy.
• Lean tender pieces of meat for example for example chicken, turkey with plenty of thick gravy.
• Thick creamy soup.
• Fish pie.

Dessert

• Plain sponge cake, cake bars or sponge fingers with custard or cream – no fruit cake.
• Steamed plain pudding with custard or cream, for example sticky toffee pudding, vanilla sponge.
• Soft fruit - tinned or fresh, for example strawberries.
• Stewed fruit with yoghurt, ice cream, cream or evaporated milk.
• Thick and creamy yoghurt or fromage frais.
• Crème caramel.
• Egg custard.

Useful resources

The Caroline Walker Trust for information and guidance to encourage eating well.

Wiltshire Farm Foods for ready prepared, frozen Soft & Bite-sized texture meals that can be delivered to your home.

It’s made for you for ready prepared frozen Soft & Bite-sized texture meals that can be delivered to your home.

If you have any questions please speak to your Speech and Language Therapist directly or contact the Speech and Language Therapy department on 01223 216200.

References/sources of evidence

© The International Dysphagia Diet Standardisation Initiative 2019 (opens in a new tab) @ Licensed under the Creative Commons Attribution Sharealike 4.0 License.