What Is Level 7 in Food?

Introduction

When we think of food, we often consider flavor, culture, and nutrition. But for individuals with swallowing difficulties (dysphagia), food is not just about taste—it’s about safety. To ensure safe swallowing, global healthcare experts developed a standardized system called the IDDSI framework, which classifies food and drinks into various levels based on texture and thickness.

One of the key components of this system is Level 7.

What is level 7 in food?

So, what is Level 7 in food?
Level 7 refers to “Regular” or “Easy to Chew” foods, depending on the specific medical needs of the individual.

The origin and purpose of the IDDSI framework
What Level 7 means
Differences between Level 7 Regular and Level 7 Easy to Chew
Who needs Level 7 foods
Example foods and menus
How it compares to other IDDSI levels
Safety, preparation, and clinical implications

1. What Is the IDDSI Framework?

A. IDDSI Definition

The International Dysphagia Diet Standardisation Initiative (IDDSI) is a globally recognized framework that categorizes food and liquids into 8 levels (0 to 7) to help people with dysphagia (swallowing difficulties).

B. Why Was It Created?

Before IDDSI, there was no global consistency in terminology or standards. A food that was called “pureed” in one country might mean something different in another. This caused confusion for:

Patients
Caregivers
Clinicians
Food service providers

C. The 8 IDDSI Levels

Level	Type
0	Thin liquids
1	Slightly thick liquids
2	Mildly thick liquids
3	Moderately thick / Liquidised food
4	Extremely thick / Pureed
5	Minced & Moist
6	Soft & Bite-sized
7	Regular / Easy to Chew

2. Understanding Level 7 in Food

Level 7 is the highest level in the IDDSI food texture framework. It is divided into two subcategories:

Level 7: Regular
Level 7: Easy to Chew

Let’s break down both:

3. Level 7: Regular Food

Definition:

Level 7 Regular foods are normal, everyday foods that people eat without needing any modifications for texture or consistency.

Who Is It For?

Individuals with normal chewing and swallowing abilities
No dysphagia or food texture restrictions
Suitable for the general population

Key Features:

No restrictions on texture
Includes crunchy, crispy, hard, chewy, dry, and mixed consistency foods
Safe for individuals with fully functional oral motor skills

Examples:

Whole fruits and vegetables (like apples or raw carrots)
Meats like steak or fried chicken
Toast, crackers, chips
Nuts and seeds
Sandwiches with mixed textures

4. Level 7: Easy to Chew Food

Definition:

Level 7 Easy to Chew foods are soft-textured and easy to bite, chew, and swallow but not as modified as the lower levels (like Level 6 or Level 5).

Who Needs It?

People with mild swallowing issues
Elderly individuals with dental issues or weak chewing muscles
Patients transitioning from soft diets to regular ones
Individuals recovering from oral surgery or stroke

Key Features:

Foods should be tender and moist
Avoid hard, dry, stringy, tough, sticky, or crumbly textures
Foods should require minimal chewing but should still resemble regular food
Bite-sized pieces not required, but food should be soft enough to be easily broken down

Testing Guidelines:

Press the food with a fork: it should easily break with gentle pressure
Must not be sticky or hard
No tough skins (e.g., fruit peels) or bones

5. Comparison: Regular vs. Easy to Chew

Feature	Level 7 Regular	Level 7 Easy to Chew
Suitable for	Healthy individuals	People with mild chewing difficulty
Food texture	All textures	Only soft and tender
Crunchy or hard items	Allowed	Not allowed
Moisture level	Any	Moist foods preferred
Example	Fried chicken, nuts, toast	Soft-cooked vegetables, soft fish
Chewing effort required	Normal	Minimal

6. Examples of Level 7 Easy to Chew Foods

Proteins

Soft scrambled eggs
Tender cooked chicken (shredded or finely sliced)
Well-cooked tofu or paneer
Moist meatloaf or fish fillets
Soft dals or lentil patties

Carbohydrates

Soft chapati soaked in curry
Mashed potatoes or rice
Soft pasta with sauce
Oats or porridge

Vegetables

Steamed carrots or peas
Cooked spinach
Boiled potatoes

Fruits

Banana
Peeled peaches or pears
Stewed apples
Avocados

Snacks/Desserts

Soft cakes or muffins (without nuts)
Custard, yogurt, or soft kheer
Rice pudding
Soft cheese

7. Foods to Avoid at Level 7 Easy to Chew

Hard crusted bread (bagels, toast)
Nuts, seeds, popcorn
Raw vegetables (e.g., celery, carrot sticks)
Tough meats (steak, dry chicken)
Foods with stringy textures (pineapple, celery)
Sticky foods (peanut butter, toffee)
Mixed consistency items (soup with chunks)

8. How Level 7 Fits Into Clinical Nutrition

A. In Hospitals and Nursing Homes

Patients recovering from strokes, surgery, or neurological conditions may be prescribed Level 7 Easy to Chew diets before transitioning to regular meals.

B. In Speech and Swallow Therapy

Speech-language pathologists assess swallowing and recommend appropriate IDDSI levels. Level 7 is often a goal level for individuals in dysphagia recovery.

C. In Geriatric Care

Older adults with tooth loss, weak jaw muscles, or dementia are often placed on Level 7 Easy to Chew diets to reduce choking risk.

9. Preparing Level 7 Foods at Home

Tips:

Use slow-cooking methods (boiling, steaming, pressure cooking)
Ensure food is moist (add broths, gravies, or sauces)
Avoid over-frying or baking that causes dryness
Use a fork test to check softness

Sample Level 7 Easy to Chew Meal Plan:

Breakfast:

Mashed banana with oats and honey
Scrambled eggs
Herbal tea

Lunch:

Soft paneer curry
Cooked rice or soft chapati soaked in curry
Steamed carrots

Snack:

Yogurt with stewed apple

Dinner:

Moong dal khichdi
Soft-cooked mixed vegetables
Kheer (soft rice pudding)

10. Safety Concerns

Ensure food is not too dry or crumbly—it increases aspiration risk
Avoid items with hidden hard pieces (e.g., fruit stones, fish bones)
Serve foods at appropriate temperatures (extremely hot or cold foods may affect sensory swallowing)

11. Benefits of Level 7 Easy to Chew Diet

Promotes independence in eating
Improves nutrition for people with limited food options
Reduces choking incidents
Provides a more enjoyable food experience than lower levels like pureed diets

12. Level 7 and Quality of Life

Many patients on lower levels (pureed or minced food) feel disconnected from the joy of eating. Level 7 Easy to Chew foods look more like regular food and:

Encourage better appetite and mood
Help with social eating experiences
Improve overall dignity and satisfaction

13. Global Use and Adoption

The IDDSI framework, including Level 7, is now adopted in:

USA (endorsed by ASHA, Academy of Nutrition and Dietetics)
UK NHS services
Canada, Australia, India, and many more

Food service providers, hospitals, and aged care facilities use Level 7 labeling to ensure patient safety and standardization.

Conclusion: Why Level 7 Food Matters

Level 7 in the IDDSI framework stands for Regular and Easy to Chew foods. While regular food is meant for people with no swallowing problems, Easy to Chew is a carefully designed texture-modified diet that:

Supports safe swallowing
Improves nutritional intake
Enhances quality of life for elderly and dysphagia patients

From hospitals to home kitchens, understanding Level 7 helps caregivers and patients make better, safer food choices. It’s not just about eating—it’s about eating with dignity, comfort, and safety.