Systematic Review and Evidence Based Recommendations on Texture Modified Foods and Thickened Fluids for Adults (≥18 years) with Oropharyngeal Dysphagia
e-SPEN Journal
Andersen, U. T., Beck, A. M., et al. (2013).
e-SPEN Journal, 8(4), e127-e134.
This systematic review investigates the effects of texture modified food and thickened fluid on managing acute or chronic oropharyngeal dysphagia in adults in hospital or community settings.
Danish Society for Clinical Nutrition and Metabolism (DAPEN)
2000-2010
Randomized controlled trials; systematic reviews; meta-analysis; cohort studies
16
<div>For decreasing the likelihood of getting aspiration pneumonia in adults with chronic dysphagia, nine studies investigating the effects of texture modified foods and/or thickened fluids found that using the "chin down" procedure when consuming thin fluids resulted in fewer cases of aspiration pneumonia. The texture of foods or thickness of liquids was not found to prevent pneumonia. Individual counselling and prescribed diet modifications were not found to be better than self-chosen food consistency in reducing aspiration pneumonia risk. For adults with acute dysphagia, individual counselling combined with follow up on the use of texture modified food and thickened fluids reduced the risk of aspiration pneumonia.</div>
<div>For increasing dietary intake in adults with chronic dysphagia, three studies found that special made and nutritionally enriched texture modified foods (e.g., pureed and minced) and thickened liquids (e.g., nectar, honey, or pudding consistency) increased overall dietary intake. The evidence does not indicate that serving 5 meals rather than 3 increases intake for elderly adults. The authors reported a lack of evidence regarding diet modifications for improving intake for adults with acute dysphagia. One study reported that special made and nutritionally enriched modified food and thickened fluid increased the nutritional status (e.g., weight, BMI) of elderly adults with chronic dysphagia. Four studies investigating fluid intake found that thickened fluids do not increase intake in adults with acute or chronic dysphagia.</div>
<div>For adults with dysphagia secondary to dementia, Parkinson's disease, or acute or chronic stroke, two studies investigating the effect of thickened fluids with different textures found that modified fluid of honey or pudding consistency reduced aspiration.</div>
