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Dysphagia. 2017 Apr;32(2):293-314. doi: 10.1007/s00455-016-9758-y. Epub 2016 Dec 2.

Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework.

Cichero JA1,2, Lam P3,4,5, Steele CM3,6,7, Hanson B3,8, Chen J3,9, Dantas RO3,10, Duivestein J3,11,12, Kayashita J3,13, Lecko C3,14, Murray J3,15, Pillay M3,16,17, Riquelme L3,18,19, Stanschus S3,20.

Author information

1
International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia. j.cichero@uq.edu.au.
2
School of Pharmacy, Pharmacy Australia Centre of Excellence (PACE), The University of Queensland, 20 Cornwall St, Brisbane, QLD, 4102, Australia. j.cichero@uq.edu.au.
3
International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia.
4
Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada.
5
Peter Lam Consulting, Vancouver, BC, Canada.
6
Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
7
Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
8
Department of Mechanical Engineering, University College London, London, UK.
9
Zhejiang Gongshang University, Hangzhou, China.
10
Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
11
Access Community Therapists, Vancouver, BC, Canada.
12
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
13
Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan.
14
National Health Service Improvement, London, UK.
15
Ann Arbor Veterans Affairs, Ann Arbor, MI, USA.
16
Speech Pathology, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa.
17
Manchester Metropolitan University, Manchester, UK.
18
Department of Speech-Language Pathology, New York Medical College, Valhalla, NY, USA.
19
Barrique Speech-Language Pathology at Center for Swallowing & Speech-Language Pathology, New York Methodist Hospital, Brooklyn, NY, USA.
20
Swallowing and Speech Pathology, Hospital zum Heiligen Geist, Kempen, Germany.

Abstract

Dysphagia is estimated to affect ~8% of the world's population (~590 million people). Texture-modified foods and thickened drinks are commonly used to reduce the risks of choking and aspiration. The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded with the goal of developing globally standardized terminology and definitions for texture-modified foods and liquids applicable to individuals with dysphagia of all ages, in all care settings, and all cultures. A multi-professional volunteer committee developed a dysphagia diet framework through systematic review and stakeholder consultation. First, a survey of existing national terminologies and current practice was conducted, receiving 2050 responses from 33 countries. Respondents included individuals with dysphagia; their caregivers; organizations supporting individuals with dysphagia; healthcare professionals; food service providers; researchers; and industry. The results revealed common use of 3-4 levels of food texture (54 different names) and ≥3 levels of liquid thickness (27 different names). Substantial support was expressed for international standardization. Next, a systematic review regarding the impact of food texture and liquid consistency on swallowing was completed. A meeting was then convened to review data from previous phases, and develop a draft framework. A further international stakeholder survey sought feedback to guide framework refinement; 3190 responses were received from 57 countries. The IDDSI Framework (released in November, 2015) involves a continuum of 8 levels (0-7) identified by numbers, text labels, color codes, definitions, and measurement methods. The IDDSI Framework is recommended for implementation throughout the world.

KEYWORDS:

Deglutition; Deglutition disorders; Dysphagia diet; Food and fluid standards; Swallowing; Texture-modified food; Thickened fluid

PMID:
27913916
PMCID:
PMC5380696
DOI:
10.1007/s00455-016-9758-y
[Indexed for MEDLINE]
Free PMC Article

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