IDDSI Q&A: IDDSI and Gravy

Roche Dietitians is doing a series of Q&A about IDDSI from our clients, partners, and IDDSI Community Group on LinkedIn. We welcome your questions about IDDSI. To submit a question, type your question in the comment section below. To view the other Q&As, visit our blog.

Question:

“I am wondering how you handle gravy related to IDDSI. Do you recommend placing it on meats? Staff are used to putting gravy on everything from the old dysphagia standards.

I did find this gravy information on information on IDDSI.org

“Dual consistency foods in which the liquid component is thin (Level 0) and easily separates from the solid component are not appropriate for people with dysphagia. If both the solid and liquid components of a dual consistency item fall within the range of diet textures that have been recommended for a patient, the patient may be able to handle that item.  For example, if a Level 4 pureed food item is served with a level 3 sauce, such as a creamy mashed potato with moderately thick gravy, then a patient whose diet texture prescription spans a range containing both levels 3 and 4 on the framework may be able to handle both components of this item.  Clinical evaluation of a patient’s ability to handle specific mixed or dual consistency items should be performed before recommending that these items be included on a diet.”

Answer:

Technically, if an individual is able to tolerate mixed consistency, we can thicken gravy to the level of thickness they can tolerate per their thickened liquid diet order. However, through my experience with planning menus for several communities and writing a diet manual, this is not practical on a menu planning basis.

So, when pureeing, I’m now integrating gravy into the foods, as appropriate to the recipe. For most recipes, I don’t think it would be appealing to thicken gravy to IDDSI Pureed (Level 4) and have it sitting on top.  I think about minced and moist foods in the same way, as I feel it is more appealing to incorporate the gravy into minced foods rather than having a thickened gravy sit on top. But, we can accommodate individual preferences when someone has orders and can tolerate thinner liquids/sauces/gravies, and mixed consistencies.