Level 6 (Soft and Bite sized) Diet

Level 6 (Soft and Bite-sized) Diet

Patient and Carer Information

Speech & Language Therapy

Why is a Level 6 (Soft and Bite-sized) Diet Needed?

A level 6 diet may be recommended for the following reasons:

• You are not able to bite off pieces of food but are able to chew into pieces that are safe to swallow.
• You may have weakness of the muscles that control your swallowing meaning that you are at risk of choking.
• You may be suffering from fatigue that means you get tired before you have managed to eat enough.

Who decided I needed a level 6 (soft and bite-sized) 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 a referral via your GP.

What is a level 6 (soft and bite-sized) diet?

• Soft, tender and moist, with no thin liquid leaking/dripping from the food
• The ability to bite off a piece of food is not required
• The ability to chew bite-sized pieces so they are safe to swallow is required
• Bite-sized pieces are no more than 1.5cm x 1.5cm in size
• Food can be mashed/broken down with a fork if required
• A knife is not required to cut this food once served

How do I make a level 6 (soft and bite-sized) diet?

Meat, fish and vegetables should be cooked until soft and tender and then chopped or cut into pieces no larger than 1.5cm x 1.5cm. Stir-fried vegetables are too firm and should be avoided.

Do not use the fibrous parts of fruits (e.g. the white part of an orange) and be cautious with fruit with high water content where the juice separates from the solid in the mouth during chewing (e.g. melon).

Cereals should be fully softened and pieces no larger than 1.5cm x 1.5cm.  Drain off excess liquid before serving.

Rice requires a sauce to moisten it and hold it together. It should not be sticky or gluey and should not separate into individual grains when cooked and served.

How do I know if my food is the right consistency?

Level 6 foods have lumps no bigger than 1.5cm x 1.5cm – this is about the width of a standard dinner fork.

Level 6 foods are soft enough that they can be easily mashed with a fork.

Foods to avoid

• 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 i.e. pieces larger than 1.5cm x 1.5cm

Where can I find more information about level 6 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