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Level 1 National Dysphagia Diet

Medically reviewed by Last updated on Apr 2, 2024.

What is a level 1 National Dysphagia Diet?

A level 1 National Dysphagia Diet includes only pureed foods. Pureed foods should be smooth and free of lumps. Pureed foods require very little chewing. Your healthcare provider will tell you how long you need to follow this diet. He or she may also explain the International Dysphagia Diet Standardization Initiative (IDDSI). The IDDSI contains 8 levels, from the thinnest liquids and foods to the thickest. Pureed foods are on IDDSI level 4. Your provider may show you how to use IDDSI guidelines to test the thickness of your food or liquid.

What do I need to know about liquids?

Your healthcare provider will tell you how thick your liquids need to be. This depends on your ability to swallow. For the IDDSI system, liquids are levels 0 through 4. Your healthcare provider will tell you if you can have liquids from levels 0, 1, 2, or 3. Liquids can be thickened, if needed, with thickeners, flour, cornstarch, or potato flakes. Foods that are liquid at room temperature should also be thickened. These include frozen malts, yogurt, milk shakes, eggnog, ice cream, and gelatin.

How do I prepare pureed foods?

Which foods can I eat?

All foods listed below should be pureed to the same texture as pudding. Puree until there are no lumps or chunks.

Which foods should I avoid?

What other guidelines should I follow?

Where can I find more information about the IDDSI?

You can find official information about IDDSI levels and instructions for thickness testing by going to

When should I call my doctor?

Care Agreement

You have the right to help plan your care. Discuss treatment options with your healthcare provider to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.