The Nutritional Challenges in Dysphagia: Not Only a Matter of Nutrients

Abstract

Oropharyngeal dysphagia can significantly affect food ingestion. Texture-modified foods and thickened fluids are proposed to alleviate this difficulty. The nutritional density of adapted foods is often insufficient to maintain adequate nutritional intakes. The current scientific knowledge relies on a weak correlation between clinical assessment and meals consumed by patients as well as few clinical trials to support the efficacy of any treatment. The negative organoleptic perceptions associated with dysphagia diets further exacerbate undernutrition and malnutrition. Over the years, scientist in food science, nutritionists, psychologists and other health professionals have proposed parameters when formulating novel foods for the treatment of dysphagia. Beyond the nutritional composition of adapted foods for the treatment of dysphagia, this chapter will present multidimensional factors affecting food intake, sensory evaluations, rheological parameters as well as the available research to date with respect to optimizing nutritional treatment of dysphagia. To date, extrapolation to everyday food formulations remains a real challenge. To ensure success, thorough, individualized nutritional care plans need to be implemented and monitored regularly. An international knowledge transfer database must be considered to help document the innovations proposed in texture-modified foods and thickened fluids in order to benefit patients of all ages and origins.