Glasses of brightly colored juice with vegetables and fruits on the white table. IDDSI level 1, Slightly Thickened Liquids for Dysphagia

All About IDDSI Level 1 Liquids – Slightly Thick

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IDDSI Level 1 liquids, otherwise known as slightly thick liquids, are the first level of thickened liquids under the classification from the international dysphagia diet standardisation initiative.

Thickened liquids used to have 4 categories: thin, nectar thick, honey thick, and pudding thick. These categories were developed for the National Dysphagia Diet (NDD) in the early 2000’s. We now have 5 levels of thickened liquids under the IDDSI framework which was introduced in 2018.

Level 1 IDDSI liquids, slightly thickened, are most similar to the nectar thick NDD category.

Why Thickened liquids?

Thickened liquids are vital for some people with Dysphagia. Dysphagia is a medical term for difficulty swallowing. People who have trouble managing how fast thin liquids, like water, move may benefit from a thicker consistency to decrease risk of coughing and aspiration (liquid going down the air tube).

Depending on your ability to swallow comfortably and safely, you may need to increase the thickness of your liquids.

Being able to safely consume liquids is important for staying hydrated and keeping your nutrition at a healthy level. Having liquids at the right consistency and also using strategies to drink them safely can be helpful.

Drinking from a straw is a safe and helpful strategy for some but may be dangerous for other people Drinking from a cup, specifically a cup that controls the amount of liquid can be beneficial for others. A Provale cup is one option and comes in 2 different options depending on how much liquid you can manage in one sip.

Slightly Thick Liquids – IDDSI level 1

Slightly thick liquids have a small amount of a powdered or gel thickener added to a thin liquid like water or juice. Choosing a thickener product is a matter of trial and error, try different ones until you find one that you like.

These slightly thickened liquids should still flow easily through a straw but require a little bit more strength and effort than managing thin liquids.

Some liquids may be naturally slightly thick. These include:

  • fruit nectar
  • tomato juice
  • Some milks containing fat (dairy and non-dairy)
  • Some ice creams

Testing for the Right Thickness

The easiest way to test for the correct thickness of your liquids is to follow the flow test from the IDDSI.

Using a funnel (otherwise known as a 10 mL syringe without a needle), you add liquid to the 10mL mark with your finger plugging the hole at the bottom. Set a timer for 10 seconds, push start and remove your finger. At the end of 10 seconds there should be between 1mL and 4 mL of liquid left.

Most likely, there will be close to 1 mL left with slightly thick, level 1 liquids. For an example, visit the IDDSI YouTube Video of the flow-test.

Conclusion of IDDSI Level 1 Liquids – Slightly Thick

Slightly thick liquids, otherwise known as Level 1 on the IDDSI framework, are appropriate for some people with Dysphagia. Finding the right thickness for your liquids may require trial and error.

A Speech Therapist and Dietitian can help tremendously when finding the safest food and drink options for you. If you have questions send me a message by clicking the Contact link above!

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