Dysphagia and Texture-Modified Diets: Nutritional Adequacy, Dignity and the Evidence That Is Missing
DOI:
https://doi.org/10.5281/zenodo.22278529Keywords:
Dysphagia, Texture-modified diet, Thickened fluids, Nutritional adequacy, Mealtime experienceAbstract
Two syntheses of the same intervention point in opposite directions. A meta-analysis of 16 randomised trials in 1,812 adults with
dysphagia concluded that texture-modified diets increase dietary intake of energy and protein, while thickened fluids reduced
aspiration risk with an odds ratio of 0.59 (95% CI 0.44 to 0.79). A systematic review of 35 studies found that consumption of
texture-modified diets was associated with poorer intake than regular diets, significantly so for energy and calcium, and
concluded that nutrition intake was compromised. The comparator differs between them, which explains the divergence without
resolving it. A further difficulty is that adequacy is commonly inferred from planned provision rather than verified at the point of
consumption, so a diet may meet its texture and nutritional targets on paper while delivering less in practice.
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