Level 5 (Minced and Moist) Diet

Level 5 (Minced and Moist) Diet

Patient and Carer Information

Speech & Language Therapy

• Author ID: HD 
• Leaflet ref: SL 001
• Leaflet Ref: 8
• Version: Level 5 (Minced and Moist) Diet
• Last review: September 2025
• Expiry Date: September 2027

Why is a level 5 (minced and moist) diet needed?

A level 5 diet may be recommended for the following reasons:

• You may not be able to bite off pieces of food.
• You may find chewing difficult.
• You may have weakness of the muscles that control your swallowing meaning you are at risk of choking.
• You may be suffering from fatigue that means that you get tired before you have eaten enough.

Who decided I needed a level 5 (minced and moist) diet?

This was decided by your Speech & Language Therapist, who will have assessed how well you are able to chew and swallow.

How long do I need to have this type of diet?

You may be reviewed by a Speech & Language Therapist in the community, who will see if you can change the texture of your food, or this may be the safest option for you in the long term. 

If you have not been referred to the Community Speech & Language Therapy Team by the hospital, you can request this via your GP.

What is a level 5 (minced and moist) diet?

• Soft and moist but with no liquids leaking/dripping from the food
• Food can be easily mashed with just a little pressure from a fork
• Food is easily scooped onto a fork, with no liquid dripping and no crumbles falling off the fork
• Can be eaten with a spoon or a fork
• Biting is not required
• Minimal chewing is required
• Lumps no bigger than 4mm in size
• Lumps can be mashed with the tongue

How do I make level 5 (minced and moist) diet?

Finely mash, mince or chop meat, fish, fruit and vegetables to a 4mm lump size and serve in a thick, smooth, non-pouring gravy or sauce.

Cereal should be served thick with soft lumps smaller than 4mm. Any milk/fluid should not be separate from the cereal – drain any excess liquid before serving.

Rice requires a sauce to moisten and hold it together. It should not be sticky or gluey and should not separate into individual grains.  It may need to be mashed into a thick, non-pouring sauce or gravy.

How do I know my food is the right consistency?

Level 5 foods have lumps of no bigger than 4mm.  This is the gap between the prongs of a standard fork.

Level 5 foods hold their shape on a spoon and fall off easily if the spoon is tilted.

Level 5 foods should not be too sticky as this can cause them to stick to the cheeks, teeth, roof of the mouth or throat.

Foods to avoid

You should avoid bread, toast and sandwiches due to high risk of choking.  In addition, avoid the following:

• Mixed thick and thin textures: e.g. soup with pieces of meat or vegetables, cereal with milk
• Hard or dry food: e.g. nuts, raw vegetables, dry cakes, bread, dry cereal
• Tough or fibrous foods: e.g. steak, pineapple
• Chewy foods: e.g. lollies/toffees/sweets. Cheese chunks, marshmallows, chewing gum, sticky mashed potato, dried fruits, sticky foods
• Crispy textures: e.g. crackling, crisp bacon, cornflakes
• Crunchy foods: e.g. raw carrot, raw apple, popcorn
• Sharp or spiky foods: e.g. crisps
• Food with crumbly bits: e.g. dry cake, crumble, dry biscuits
• Pips or seeds: e.g. apple seeds, pumpkin seeds, white of an orange
• Foods with skins or outer shells: e.g. peas, grapes, chicken skin, salmon skin, sausage skin
• Foods with husks: e.g. corn, shredded wheat, bran
• Bone or gristle: e.g. chicken bones, fish bones, meat with gristle
• Round, long shaped foods: e.g. sausages, grapes
• Sticky or gummy foods: e.g. peanut butter, overcooked porridge, jelly, sticky rice
• Stringy foods: e.g. beans, rhubarb
• Floppy foods: e.g. lettuce, cucumber
• Foods where a crust forms during cooking or heating: e.g. on mashed potato, custard or a cheese topping
• Juicy foods: e.g. where juice separates from the food piece in the mouth, for example watermelon
• Foods with large or hard lumps: e.g. casserole pieces larger than 4mm, fruit, vegetable, meat or other food pieces larger than 4mm

Where can I find more information about level 5 foods?

Please ask your Speech & Language Therapist for more information, or you can visit the following website: www.IDDSI.org

Reference

“Complete IDDSI Framework Detailed Definitions”, International Dysphagia Diet Standardisation Initiative, 2017 www.iddsi.org

Images from IDDSI:

© The International Dysphagia Diet Standardisation Initiative 2019 @ https://iddsi.org/standards//framework. Licensed under the CreativeCommons Attribution Sharealike 4.0 License https://creativecommons.org/licenses/by-sa/4.0/legalcode. Derivative works extending beyond language translation are NOT PERMITTED.