Fluid diet - mildly thick level 2
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
To provide fluids of a mildly thick (IDDSI level 2) consistency for patients with dysphagia as recommended by a speech pathologist.
Mildly thick – level 2 is designed to be consumed from a cup. However, mild effort is required to take this thickness via a standard bore straw (standard bore straw = 5.3mm diameter). This thickness can be sipped, is lump free and pours quickly from a spoon but slower than thin fluids, such as water.
Refer to The International Dysphagia Diet Standardisation Initiative 2016 for approved IDDSI testing methods.1
IDDSI compliant – mildly thick – level 2 commercial products are labelled with a pink triangle identifier.*
Swallowing disorders as identified by a speech pathologist.
Care must be taken to ensure adequate fluid intake when thickened fluids replace thin fluids. Patients on this diet should be monitored regularly to ensure adequate fluid and nutritional intake.
Ensure the patient only receives fluids of the consistency recommended by the speech pathologist.
Suitable for use in paediatrics when combined with an age-appropriate diet (if indicated).
Specific menu planning guidelines
|Hot main dishes
|All. But wet dish sauces need to be assessed as compliant diet by a speech pathologist
|Wet dishes with thin sauces
|All, only if a small amount is served on food (max 40ml serving)
|Starchy vegetables / pasta / rice
|Thickened to mildly thick – level 2 consistency or deemed already suitably thick and assessed as compliant for this diet by a speech pathologist
Salad ingredients and vegetables that produce minimal juice when eating, e.g., carrot, lettuce
Salad dressing needs to be assessed as compliant by a speech pathologist
Salad ingredients and vegetables that produce juice, e.g., pineapple, orange, tomato
All cereals served with milk thickened to mildly thick – level 2 consistency
Cereal where the milk is fully absorbed into the cereal, e.g., semolina. These products are to be assessed as compliant for this diet by a speech pathologist
|Cereal where the milk is not fully absorbed into the cereal
|Hot breakfast choices
All, except those listed as not allowed
Drained canned fruit
Fresh fruit that produces minimal juice when eaten, e.g., banana, apple
Undrained canned fruit
Fresh fruit where juice is produced when eaten, e.g., orange, watermelon, passionfruit, pineapple
|All, but sauces need to be assessed as compliant by a speech pathologist
|Transitional desserts, meaning desserts that change to a liquid in the mouth, e.g., unthickened ice-cream, jelly
|Milk and cheese
Milk thickened to mildly thick – level 2 consistency
|Must be thickened to mildly thick – level 2 consistency
|Nutritional supplements that are thickened to, or which meet mildly thick – level 2 consistency
|Celebratory foods / special occasions
*©The International Dysphagia Diet Standardisation Initiative 2019 licensed under the Creative Commons Attribution ShareAlike 4.0 License. Derivative works extending beyond language translation are NOT PERMITTED.
- International Dysphagia Diet Standardisation Initiative. Complete IDDSI Framework Detailed definitions. IDDSI; 2019. [cited 19 August 2022].