Modifying Food Textures for Dysphagia Management: Do the Benefits Outweigh the Risk?

​Modified diets are commonly used to help manage the risks of aspiration and pneumonia. But an article published in BMC Geriatrics on July 20, 2018, suggests there is little evidence that the benefits outweigh the risks associated with thickened fluids and modified-texture food in older adults who suffer from oropharyngeal dysphagia. According to the article, 15% to 30% of long-term care residents receive modified-texture food, and up to 25% of long-term care residents use thickened fluids as a method for preventing aspiration and its effects in those with oropharyngeal dysphagia—a common affliction in older adults and in those with neurological and neurodegenerative diseases. The authors of the article note there is no "convincing evidence" that supports the use of modified-texture foods and thickened fluids to prevent aspiration pneumonia. According to one study referenced in the article, half of participants aspirated on all three interventions (chin-down posture with thin fluids, and nectar-thickened and honey-thickened fluids in a head-neutral position), and one-quarter did not aspirate on any of the interventions. Other studies have found similar results.