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Recommendations Summary

UWL: Collaboration for Modified Texture Diets 2009

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.


  • Recommendation(s)

    UWL: Collaboration for Modified Texture Diets

    The Registered Dietitian (RD) should collaborate with the speech-language pathologist and other healthcare professionals to ensure that older adults with dysphagia receive appropriate and individualized modified texture diets.  Older adults consuming modified texture diets report an increased need for assistance with eating, dissatisfaction with foods, and decreased enjoyment of eating, resulting in reduced food intake and weight loss.

    Rating: Strong
    Conditional

    • Risks/Harms of Implementing This Recommendation

      • Patient denial or misclassification of the necessary dysphagia diet may result in aspiration pneumonia due to poor swallowing function

    • Conditions of Application

      • These recommendations apply to older adults with dysphagia consuming modified texture diets.
      • Facilities may not have access to a speech-language pathologist.
      • Food service staff should be trained to prepare and serve foods according to modified texture diet guidelines.

    • Potential Costs Associated with Application

      • Modified texture diets may include specialized preparation techniques, special foods and liquids that may be costly.

    • Recommendation Narrative

      • Seven studies were evaluated regarding the use of modified texture diets in older adults with dysphagia. 
      • People consuming modified texture diets report an increased need for assistance with eating, dissatisfaction with foods, and decreased enjoyment of eating, resulting in decreased food intake and weight loss (Ekberg et al, 2002; Nowson et al, 2003; Colodny, 2005; Wright et al, 2005; Foley et al, 2006; Lorefalt et al, 2006).
      • Recognition of the social and psychological burden of dysphagia, an individualized treatment approach and the provision of eating assistance may contribute to increased food intake and weight maintenance or weight gain (Rypkema et al, 2004).
      • Interventions may include but are not limited to:  standard high-energy diet change or protein-energy supplements in malnutrition, swallowing therapy, rehydration, better positioning, and individualizing meal timing (Rypkema et al, 2004).

    • Recommendation Strength Rationale

      • Conclusion Statement in support of these recommendations received Grade I.

    • Minority Opinions

      Consensus reached.