Ensuring Safety whilst Eating


Have you ever considered that everything we do, or at least almost everything we do revolves around food? Whether it is spontaneously meeting someone you know, planning a small get together at home, or planning a party to celebrate special occasions – food is always there!


When planning such occasions, we make it a point to cater for everyone’s dietary requirements, likes and dislikes without hesitations… and rightly so. Apart from this, it is as important to consider that a person may also require changes in the consistencies of food and drinks. These changes may be necessary due to ageing or neurological conditions, such as Stroke or Parkinson’s Disease.


Changes in consistency may be recommended for a number of reasons, namely: due to inadequate or no dentition, dentures which are too big or too small, reduced chewing abilities, reduced strength in the muscles required for chewing and swallowing, and reduced ability to clear the mouth completely upon swallowing. A Speech Language Pathologist (SLP) may help in determining the safest food and drinks consistency through a swallowing assessment.  It is important to keep in mind that such consistency recommendations need to be adhered to in order to ensure safe eating and swallowing, to reduce the risk of choking and other complications which may arise, such as chest infections.


In Malta, caterers and healthcare professionals refer to a framework called International Dysphagia Diet Standardisation Initiative (IDDSI) - this is a universal language that clearly defines the different levels of consistencies of food and drink. Thus, one can follow the guidelines in this framework when preparing or ordering food for your loved ones who require such texture modified diets. There is no need to feel overwhelmed when catering for such diets – Always keep in mind that food can be presented in different consistencies, depending on the type of cooking used.


To give an example, meat can be served at: Regular consistency if cooked under a grill for a few minutes; Soft and Bite-sized consistency if cooked well (eg. stew) and cut into small biteable pieces; Minced and Moist consistency if meat is minced, cooked thoroughly and made moist throughout with gravy; and Puree/Liquidised consistency if blended smoothly without pieces. With regards to drinks, the individual may need to add thickener to their drinks in order for drinks to flow slowly to avoid coughing and chest infections in the long-run. If you require additional guidance regarding catering for your loved ones, you may speak to your caterer and SLP.


For more details on the IDDSI framework and definitions, click on the following link



Author: Sarah Bartolo [B.Sc (Hons) Communication Therapy] is a qualified Speech and Language Pathologist working with adults and children having communication and swallowing difficulties. Sarah is also a guest author on ( and a consultant at THREESIXO Consultancy (

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