May 2025 IDDSI e-bite

Does a dysphagia diet have to be boring and unappetizing??   

The answer is NO, it does not and should not be this way.  In this month’s e-bite, we welcome our guest contributor, Professor Catriona Steele who shares her thoughts and wisdom on this topic.  

Variety is the spice of life! 

For many people, the idea of a diet comprised of pureed foods brings up images of bland, non-descript foods on a plate – all of a similar color and lacking in flavor and appeal – and often associated with institutional food such as that served in a cafeteria or worse, in prisons. Of course, our wonderful chef and food service colleagues tell us that this does not need to be the case, but the images prevail, and contribute to the negative sentiments that people express about recommendations for texture modified foods for people with dysphagia. I remember seeing a particularly horrifying advertisement as a young clinician for a device intended to help feed patients who were resistant at mealtime – it was a large syringe device – and the distributor suggested that one could load the device with the patient’s entire meal in layers – meat, potato, vegetables, and even dessert – and then place the nozzle in the patient’s mouth and push the plunger! 

Fast forward to 2015, when I had the privilege of sitting around a large table with other members of the IDDSI board, developing testing methods for liquids and arriving at the eureka moment of conceptualizing the IDDSI Framework as a continuum of 8 levels, with the food and drink levels overlapping in the middle at levels 3 and 4.  However, that was not the only eureka moment at that meeting… another was the realization that because the framework was a continuum, it would be possible to specify a RANGE of consistencies that were appropriate for a patient rather than a single level.  That is, if a clinician recommended a Level 5 minced and moist food texture on the one hand, and a Level 2 mildly thick drink consistency on the other, we realized that it was logical to assume that level 3 and level 4 items would also be suitable for the patient.  This realization became the basis for describing the clinician’s food and drink recommendations as boundaries of a recommended RANGE on the framework for a patient, and the basis for the IDDSI Functional Diet Scale (or IDDSI-FDS). 

Some of you may be familiar with other scales like the FOIS, DOSS or ASHA-NOMS, which describe the severity of a person’s dysphagia based on the diet textures that they are considered able to eat safely.  Those scales, although widely used, are not grounded in any particular conceptualization of diet texture levels. The IDDSI-FDS does the same thing – express the degree of diet texture restriction recommended for a patient, but conceptualized as a range of levels on the IDDSI Framework. The previous example of Level 5 minced and moist food with Level 2 mildly thick liquids would yield an IDDSI-FDS score of 4, meaning that there are four levels on the framework (2, 3, 4 and 5) that are appropriate for the patient.  For more examples, see the appendix to the article introducing the IDDSI-FDS (Steele et al., 2018). 

The reason this conceptualization of diet texture recommendation as a range is so revolutionary and so exciting, is that it opens up options for a variety of food textures on a patient’s menu.  And variety, as they say, is the spice of life!  This is a path towards improving meal enjoyment and quality of life for patients who need diet texture modification. 

Catriona M. Steele, PhD, CCC-SLP, SLP(C), Reg. CASLPO, F-ESSD, ASHA Honors 

Steele, C. M. et al. (2018). Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale.

https://doi.org/10.1016/j.apmr.2018.01.012 

Global Updates

Argentina: Join us for our Pre Congress activity about IDDSI: "Everything you need to know about IDDSI", from theory to practice. This is a full-day activity that will take place on August 21st, 2025, in the city of Córdoba, Argentina. For all the details on this Event go to: ARIRG Event

Canada: The CIRG brings you, Raspberry Fluff Dessert, an IDDSI Dessert Recipe suitable for all IDDSI Levels to enjoy! See the full recipe and more in the May Can-Do newsletter on the CIRG webpage

Italy: Dr. Carlo Pedrolli (IDDSI Board Member) presented on

“Nutrition in dysphagic people: IDDSI Framework” at the National Congress of SIGOT (Italian Geriatric Society in hospital and Community) in Modena (Italy) held May 21-23, 2025. 

United States: Happy National Speech-Language Hearing Month from the US IRG! FAQ's answered - read all the details in the May newsletter on the USIRG webpage

IDDSI Events

Early Bird Rates extended to June 15th, get your tickets now!

US IDDSI Symposium in beautiful Newport Beach, CA!

Friday, July 25th, 2025

For all the exciting details visit the US IDDSI Symposium Event page

Early Bird Registration is open for the UK IDDSI Academy Pilot in Bristol!

Tuesday, September 16th, 2025

Spaces are limited to 80 delegates so be sure to register before June 30th to get the Early Bird rate!

For more information and program highlights click here: UK IDDSI Academy Event

Early Bird Registration is open now!



Australia IDDSI Expo and Academy Pilot

Monday, October 20th and Tuesday, October 21st, 2025

Victoria Park, Brisbane, Australia

The Australian IDDSI Reference Group is delighted to showcase Australia's first IDDSI Expo together with IDDSI Global’s Academy Pilot course for 2 - one day events. The events will be held in Brisbane at Victoria Park Function Centre, 4km from Brisbane's City centre. Join us for either, or both days!

Early Bird rates are only in effect until August 15, 2025, so don't wait to register!

For all the exciting details on this event, go to the Australian IDDSI Event page here: Australia IDDSI Expo - Events - IDDSI

For more information on the Asia IDDSI Conference

visit the Asia Event webpage

IDDSI Translations

We are pleased to announce more IDDSI translations are up for review on the IDDSI website! 

We would like to extend our heartfelt thanks to the following for their ongoing hard work and dedication with the Türkiye IDDSI translations:



Emre CENGİZ, Selen SEREL ARSLAN, Numan DEMİR, Fatma ILGAZ, Ayşe Kübra SÖYLER, Ömer Faruk YAŞAROĞLU, Seren DÜZENLİ ÖZTÜRK, Rabia YILDIRIM, Serkan BENGİSU and Müşerrefe Nur KELEŞ

If you have any suggestions for webinar topics, we’d love to hear them! Head over to our Contact Us form, choose subject “Webinars”, and let us know what you’d like to see in the upcoming months. 

Upcoming Events:

• Argentina IDDSI Pre-Congress Course: "Everything you need to know about IDDSI" from theory to practice, in Cordoba, Argentina, August 21, 2025 Contenido Restringido – Asociación Argentina de Disfagia
• The 33rd World Congress of the IALP is coming to Malta August 24-28, 2025 - Innovation and inspiration in Communication Sciences and Disorders Congress Topics and Registration Information
• IDDSI Hands on seminar & pre-congress seminar for Japanese Society of Dysphagia Rehabilitation, Yokohama, Japan, Sep 18, 2025
• The 31st annual meeting of JSDR, Yokohama, Japan, Sep 19-20, 2025
• ESSD - European Society for Swallowing Disorders Conference, Athens, GR, Nov 7-11, 2025