Texture Modification

Question 1

What is NDD?

Answer 1

National Dysphagia Diet, created in 2002

Question 2

What is IDDSI?

Answer 2

International Dysphagia Diet Standardisation Initiative, created in 2013

Question 3

Mention NDD levels!

Answer 3

Level 1: Dysphagia puree
Require little or no chewing ability

Level 2: Dysphagia Mechanically Altered
Require some chewing ability

Level 3: Dysphagia advanced (Mechanical soft)
Chopped or cut into small pieces
Should be well moistened

Question 4

Mention fluid modifications!

Answer 4

From NDD, there are 4 fluid modifications:

Thin liquids: watery

Nectar-thick liquids: pourable

Honey-thick liquids: slightly thicker than nectar, can be drizzled

Pudding-thick liquids: hold their shape, not pourable, eaten with a spoon

Question 5

How much levels on the IDDSI?

Answer 5

Eight levels

0: Thin
1: Slightly thick
2: Mildly thick
3: Moderately thick (liquidised border)
4: Extremely thick (pureed)
5: Minced & Moist —,
6: Soft & Bite-Sized | transitional foods
7: Regular _|

Question 6

Map NDD to IDDSI!

Answer 6

NDD IDDSI
Regular (7)Regular
Dysphagia adv. (6)Soft-bite
Dysphagia mech. (5)Minced&Moist
Puree (4)Pureed
Fluid Modifications. (3)Liquidised

Watery (0) Thin
Nectar (2) Mildly thick
Honey (3) Moderate thick
Spoon/pudding thick (4) Extremely thick

Question 7

What are solids in IDDSI?

Answer 7

Solids are defined across level 3 to 7:

Liquidized  —> (3) Moderately thick
Pureed
Minced & Moist
Soft & Bite
Regular

Question 8

Describe IDDSI levels!

Answer 8

Water: water-like

Slightly thick: flow through straw, syringe, or nipple

Mildly thick: sippable but requires effort

Moderate thick: drunk from cup, need effort for using a straw

Pureed: cannot be drunk from a cup

Minced&Moist: lumps mash with tongue pressure only

Soft&bite: chewing is required

Regular: food that start from one texture to another when moisture or temperature changed applied (ex: ice cream)