Pearl Barley Water Thickened | IDDSI Level 3 Care Food Recipe

IDDSI Level 3 | 60 minutes (including soaking) | Easy

Why Pearl Barley Water

Pearl barley water (薏米水) is a staple traditional health drink in Hong Kong, prized for its cooling and dampness-clearing properties — especially valued in the humid summer months. In its natural state it is IDDSI Level 0 (thin liquid), posing aspiration risk for people with dysphagia. Thickening to Level 3 (mildly thick — flows slowly when a cup is tilted) preserves the health benefits whilst greatly reducing aspiration risk.

Ingredients (2–3 servings)

• 50g pearl barley (raw)
• 800ml water
• 15g rock sugar (adjust to taste)
• Food-grade thickener as needed (e.g. Resource ThickenUp Clear or equivalent)

Method

Making the barley water

1. Soak pearl barley in cold water for 30 minutes, then drain.
2. Add 800ml fresh water. Bring to the boil over high heat, then reduce to a gentle simmer for 30 minutes.
3. Strain out the barley grains (reserve for another use). Retain the clear liquid.
4. Stir in rock sugar until dissolved.
5. Allow to cool to room temperature — thickeners perform more consistently in cooler liquids.

Thickening to Level 3

6. Add approximately 1.5g of thickener per 100ml of barley water (follow manufacturer’s guidance for your specific product).
7. Whisk briskly for 20–30 seconds, then rest for 1 minute to allow viscosity to stabilise.
8. Perform the syringe test to confirm Level 3.

Texture Test (IDDSI Syringe Test)

10ml syringe test (Level 3 standard):

• Draw 10ml of thickened barley water into a 10ml syringe.
• Hold vertically and allow liquid to flow freely for 10 seconds.
• Level 3 correct: 1–4ml flows out (mildly thick).
• More than 4ml flows: add more thickener and retest.
• Less than 1ml flows: liquid has reached Level 4 — dilute slightly with plain barley water and retest.

Sourcing in Hong Kong

• Pearl barley: Available in Wellcome, PARKnSHOP, and wet market grain stalls. Choose intact, dry grains without mould.
• Thickener: Resource ThickenUp Clear (Nestlé) is available at selected Wellcome stores, health pharmacies, and online retailers. Your hospital speech therapist can advise on approved brands.

Safety Note

After thickening, serve immediately or refrigerate and consume within 24 hours. Refrigeration may alter viscosity — re-test before serving. Always strain out barley grains before serving to a person with dysphagia; the grains are solid pieces not appropriate for a Level 3 drink.

Nutrition

Approximately 60 kcal per serving with small amounts of protein and dietary fibre. Pearl barley supports dampness clearance according to traditional Chinese health principles — particularly relevant in Hong Kong’s humid climate. Elderly individuals with impaired kidney function should consult their doctor or dietitian before consuming regularly.