Characterizing Gelatin-Based Desserts Using International Dysphagia Diet Standardisation Initiative Testing Methods

Abstract

Purpose: Gelatin-based desserts are a popular method to promote liquid consumption for individuals with dysphagia. Unique characteristics of these desserts in the United States pose a challenge for appropriate presentation to patients in relation to their clinically approved International Dysphagia Diet Standardisation Initiative (IDDSI) level. The purpose of this study was to determine the constancy of IDDSI level and transitional food status for 16 nationally available gelatin-based desserts based on preparation (premade and ready-to-make) and formulation (regular and sugar-free). Method: Three semiblinded raters used IDDSI testing methods to assign an IDDSI level and transitional food rating immediately, 15 min, and 60 min after removing from the refrigerator. Results: The majority (89.6%) of the samples were rated as Level 7 Easy to Chew, across all time intervals, with good interrater agreement (Mann–Whitney U Test, immediately U = 101.0, p = .934; 15 min U = 101.0, p = .934; 60 min U = 94.5, p = .711). Approximately a quarter of samples were categorized as a transitional food, though 4% could not be categorized using current IDDSI characteristics. Conclusions: Overall, this study presents that the current characteristics and physiological rationale may overestimate the skills required for gelatin-based desserts and inappropriately classify them as nontransitional foods. As with all products, individual gelatin-based desserts should be tested at the time of presentation to the patient. However, clinical evaluation should further determine the appropriateness of the dessert for each patient.