Second Update of a Systematic Review and Evidence-Based Recommendations on Texture Modified Foods and Thickened Liquids for Adults (Above 17 Years) With Oropharyngeal Dysphagia
Clinical Nutrition ESPEN
Hansen, T., Beck, A. M., et al. (2022).
Clinical Nutrition ESPEN, 49, 551-555.
This updated systematic review investigates the effects of texture diet modification and fluid thickening on a variety of outcomes (i.e., survival, quality of life, occurrence of aspiration risk and pneumonia, dehydration, nutritional status, and mealtime performance) and the relationship between these interventions with patient preferences and intervention adherence in adults, 17 years and older, with oropharyngeal dysphagia in acute or chronic care settings.
No funding received
January 1, 2015 to May 19, 2021
Randomized controlled trials and systematic reviews (including Cochrane reviews)
3
Three randomized controlled trials (RCTs) investigating the effects of thickened liquids (TL) in adults with oropharyngeal dysphagia (OD) demonstrated a non-significant decrease in risk of death at 3-month follow-up (RR=0.91; 95% CI=0.51-1.62 for nectar TL; RR=0.92; 95% CI=0.51-1.66 for honey TL). TL showed a non-significant decrease in the risk of pneumonia for nectar TL (RR=0.81; 95% CI=0.40-1.65) and a non-significant increase in risk for honey TL (RR=1.58; 95% CI=0.89-2.80). At 3-month follow-up, the use of TL resulted in a decrease in quality of life, increased risk of hydration, increased risk of weight loss, and decreased preferences. The authors conclude that "there is no convincing evidence that TL ... prevents death or pneumonia nor improves quality of life, nutritional status, or oral intake in individuals with OD" (p. 554) and caution "that clinicians only use TL after careful consideration as a compensatory strategy" (p. 552). Additional research on TL is warranted.
This systematic review identified no studies investigating texture-modified diet (TMD), thus no conclusions can be made regarding the efficacy of TMD on outcomes in adults with oropharyngeal dysphagia. Future research on TMD is warranted.
