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Review
. 2013 Aug 24;1(4):280-291.
doi: 10.1007/s40141-013-0024-z. eCollection 2013.

The Need for International Terminology and Definitions for Texture-Modified Foods and Thickened Liquids Used in Dysphagia Management: Foundations of a Global Initiative

Julie A Y Cichero, Catriona Steele, Janice Duivestein, Pere Clavé, Jianshe Chen, Jun Kayashita, Roberto Dantas, Caroline Lecko, Renee Speyer, Peter Lam, Joseph Murray
Review

The Need for International Terminology and Definitions for Texture-Modified Foods and Thickened Liquids Used in Dysphagia Management: Foundations of a Global Initiative

Julie A Y Cichero et al. Curr Phys Med Rehabil Rep. .

Abstract

Conservative estimates suggest that dysphagia (difficulty swallowing) affects approximately 8 % of the world's population. Dysphagia is associated with malnutrition, dehydration, chest infection and potentially death. While promising treatments are being developed to improve function, the modification of food texture and liquid thickness has become a cornerstone of dysphagia management. Foods are chopped, mashed or puréed to compensate for chewing difficulties or fatigue, improve swallowing safety and avoid asphyxiation. Liquids are typically thickened to slow their speed of transit through the oral and pharyngeal phases of swallowing, to avoid aspiration of material into the airway and improve transit to the esophagus. Food texture and liquid modification for dysphagia management occurs throughout the world. However, the names, the number of levels of modification and characteristics vary within and across countries. Multiple labels increase the risk to patient safety. National standardization of terminology and definitions has been promoted as a means to improve patient safety and inter-professional communication. This article documents the need for international standardized terminology and definitions for texture-modified foods and liquids for individuals with dysphagia. Furthermore, it documents the research plan and foundations of a global initiative dedicated to this purpose.

Keywords: Deglutition; Deglutition disorders; Diet; Dysphagia; Texture-modified food; Thickened liquids.

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Conflict of interest statement

J.A.Y. Cichero has received payment for participation in expert panels, speaking at conferences and reimbursement for travel expenses from Nestlé Health Sciences. C. Steele has received payment for participation in expert panels, speaking at conferences and reimbursement for travel expenses from Nestlé Health Sciences. J. Duivestein has received payment for participation in expert panels, speaking at conferences and reimbursement for travel expenses from Nestlé Health Sciences. P. Clavé reports grants, personal fees and non-financial support from Fresenius Kabi, grants, personal fees and non-financial support from Nutricia, grants, personal fees and non-financial support from Nestlé Health Science, outside the submitted work; in addition, Dr. Clavé has a patent IMAGE + PHYSIOLOGY issued and is President of the European Society for Swallowing Disorders and Councilor of Dysphagia Research Society. J. Chen has received payment for participation in expert panels, speaking at conferences and reimbursement for travel expenses from Nestlé Health Sciences. J. Kayasgita has received reimbursement for travel expenses from Nestlé Health Sciences. R. Dantas has received payment for participation in expert panels, speaking at conferences and reimbursement for travel expenses from Nestlé Health Sciences. C. Lecko has received payment for participation in expert panels, speaking at conferences and reimbursement for travel expenses from Nestlé Health Sciences. R. Speyer has received reimbursement for travel expenses from Nestlé Health Sciences and is secretary of the European Society of Swallowing Disorders. P. Lam has received payment for participation in expert panels, speaking at conferences and reimbursement for travel expenses from Nestlé Health Sciences. J. Murray has received payment for participation in expert panels, speaking at conferences and reimbursement for travel expenses from Nestlé Health Sciences.

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