Search Results (7)

Dysphagia is a common clinical condition, especially among older adults, associated with an increased risk of malnutrition, aspiration, and respiratory complications. A key therapeutic approach involves modifying liquid consistency using thickening agents to achieve safer swallowing. Although rotational rheometry offers accurate viscosity characterization, its complexity and cost limit routine application in clinical or domestic settings. This study evaluates and correlates different methods for measuring the viscosity of thickened liquids, comparing rheological data with empirical techniques such as the Ford cup, Bostwick consistometer, and Line-Spread Test (LST). Several thickeners were tested—guar gum, xanthan gum, a guar/xanthan blend, maltodextrin-based mixtures, and a commercial thickener—across a range of concentrations, temperatures, and preparation times. The results demonstrate that simple methods, particularly the Bostwick consistometer and LST, show strong correlations with rheometer measurements within the International Dysphagia Diet Standardisation Initiative (IDDSI) Level 2 (mildly thick) and Level 3 (moderately thick) ranges. However, limitations were observed at extreme viscosities, where certain methods lacked sensitivity or operational feasibility. These findings support the potential of empirical tools for practical viscosity screening in dysphagia management, especially where rheometry is unavailable. This work provides evidence-based guidance for clinicians, caregivers, and food service professionals seeking safe, reproducible, and standardized approaches to fluid consistency assessment. Full article

Oropharyngeal dysphagia is a common condition among older adults and individuals with neurological disorders, necessitating the use of texture-modified foods (TMFs) to ensure safe swallowing; however, reheating often leads to syneresis and structural breakdown, compromising both functionality and patient acceptability. This study aimed to evaluate the efficacy of single and binary hydrocolloid systems for improving the thermal and structural stability of moulded carrot purée formulated to meet International Dysphagia Diet Standardisation Initiative (IDDSI) Level 4 standards. The main methods involved preparing purées with various hydrocolloid combinations, assessing gel strength, shape retention, and syneresis following steaming, and validating results using commercial moulds. Thermoreversible methylcellulose (Benecel™ A4M) was the most effective single-component system, while binary blends of A4M with locust bean gum (LBG)—specifically B2 (1.5% A4M + 0.5% LBG) and B3 (1.5% A4M + 1% LBG)—demonstrated superior structural integrity, with height retention of 80 ± 2% (B2) and 85 ± 2% (B3), and reduced syneresis (~22 ± 1% and ~19 ± 3%, respectively; p < 0.05), both meeting IDDSI requirements. In contrast, formulations containing agar, xanthan, or carboxymethylcellulose exhibited poorer shape fidelity, likely due to matrix-disrupting interactions. These findings indicate that A4M-LBG blends offer a practical solution for producing reheatable, visually recognisable meals for individuals with moderate-to-severe dysphagia. Full article

Background/Objective: The International Dysphagia Diet Standardisation Initiative (IDDSI) and the Japanese Dysphagia Diet 2021 (JDD2021) are prominent systems that classify thickened beverages for dysphagia management. We herein aim to establish a correspondence between these systems through systematic viscosity measurements. Methods: We analyzed 49 thickened beverage samples using an E-type viscometer, IDDSI flow test, and JDD syringe test. Results: Receiver operating characteristic analysis revealed the following viscosity cutoffs for IDDSI levels: 0–1 at 72.0 mPa·s (area under the curve [AUC] 0.94), 1–2 at 112.0 mPa·s (AUC 0.95), and 2–3 at 303.0 mPa·s (AUC 0.97). Multiple regression analysis revealed that beverage characteristics, including fat, sodium content, and settling time, significantly influenced viscosity (R² = 0.803). The findings established that IDDSI Level 0 corresponds to a thinner viscosity than JDD Stage 1 and Stage 1 (0–72 mPa·s), Level 1 to Stage 1 (72–112 mPa·s), Level 2 to Stages 1–2 (112–303 mPa·s), and Level 3 to Stage 3 (>303 mPa·s). Moreover, the measurement methods had high correlations (r = 0.83–0.93, p < 0.001). Conclusions: The comprehensive map between IDDSI and JDD2021 classifications developed from the results of this study enables healthcare providers to translate between the classification systems, improving dysphagia management internationally while supporting evidence-based care and global research. Full article

Diet modification is a common compensation strategy to promote swallowing safety in patients with swallowing difficulties. The International Dysphagia Diet Standardisation Initiative (IDDSI) guideline provides qualitative descriptions on texture-modified food and thickened liquid. This study aimed to establish quantitative textural and rheological data on different IDDSI levels based on common Chinese ingredients and dishes. Textural and rheological properties of 226 samples of various food textures and 93 samples of various liquid consistencies were obtained using a texture profile analysis (TPA) and viscometer, respectively. The establishment of such quantitative data can be used for future texture-modified food product development and research purposes. Full article

To delay impacts of aging, optimal nutritional status is essential. Several factors can reduce food intake, such as isolation, income, and cognitive/physical decline. Additionally, chewing and swallowing difficulties, or dysphagia, often disrupt the ability to consume life-long favorite dishes. Food and liquids could require modification of texture or consistency to ensure a comfortable or safe swallow. The food industry, foodservices facilities, and caregivers need quality control benchmarks to provide adequate nourishment and meet these new feeding challenges. The International Dysphagia Diet Standardisation Initiative (IDDSI) is proposing the IDDSI framework and testing methods to describe food used in nutritional care plans to circumvent dysphagia and improve communication among caregivers. This systematic review assesses the validity and reliability of the IDDSI testing methods using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN). Two publications presented content validity whereas 19 publications looked at construct validity or reliability for the IDDSI testing methods. One study was conducted in older adults presenting dysphagia. This review concludes that there is insufficient evidence to recommend the IDDSI testing methods. Further research, conducted with robust methodological design and reporting, is needed to develop and assess nutritious adapted food for frail older populations. Full article

Medication lubricants are thick liquids or gels that are designed to aid swallowing of solid oral dosage forms. Tablets and capsules are placed within a spoonful of the product for swallowing. The aim of this study was to describe and compare commercially available medication lubricants in terms of textural suitability for patients with dysphagia. Twelve medication lubricants were characterised according to the International Dysphagia Diet Standardisation Initiative (IDDSI) framework. Apparent viscosity, yield stress, thickness consistency, and various texture features were compared. Gloup Forte was the only medication lubricant classified as IDDSI level 4 (pureed/extremely thick) at room (24 °C) temperature. Four other Gloup products were IDDSI level 3 (liquidised/moderately thick) at room temperature but testing at 4 °C or pouring from the container instead of using the pump dispenser resulted in classification as IDDSI level 4. The IDDSI Flow test would have classified MediSpend and Slo Tablets as IDDSI level 3, but their very low yield stress led to these fluids flowing too quickly through the prongs of a fork and so these were classified as <3. Severo was IDDSI level 2. Heyaxon and the two versions of Magic Jelly tested contained lumps, and Swallow Aid had exceptionally high viscosity, hardness, adhesiveness, and gumminess, classifying them as IDDSI Level 7 (“regular textures”) and therefore as unsuitable for people with dysphagia according to IDDSI. This study provides valuable information to help with the selection of a safe medication lubricant with appropriate thickness level suited to each individual with dysphagia. Full article

Riluzole 5 mg/mL oral suspension is the only licensed liquid medicine to treat Amyotrophic Lateral Sclerosis (ALS) orally. As more than 80% of ALS patients develop dysphagia, an oral liquid formulation provides an important therapeutic option. The Riluzole 5 mg/mL oral suspension is administered by means of the graduated oral dosing syringe included in the medicine package. Its concentration (5 mg/mL) is consistent with a small and easy to measure volume (10 mL) to deliver the prescribed 50-mg dose twice daily. This work had a dual objective. The first was to evaluate the texture of the Riluzole 5 mg/mL oral suspension according to the International Dysphagia Diet Standardisation Initiative (IDDSI) flow test. Results of this experiment indicated that Riluzole 5 mg/mL oral suspension would basically fall under the “mildly thick” IDDSI descriptors. This is an important feature because thick fluids facilitate a safer swallow in patients with dysphagia. As a second objective, we evaluated for scientific purposes the compatibility of Riluzole 5 mg/mL oral suspension with some of the most common food thickeners available on the market. Intimate mixtures of the Riluzole 5 mg/mL oral suspension with thickeners were evaluated for appearance, pH, Riluzole assay and Riluzole related substances immediately after preparation and after two hours at room temperature. Riluzole 5 mg/mL oral suspension resulted to be compatible with all the marketed thickeners tested. Full article