We are a group of volunteers from diverse professions including nutrition & dietetics, medicine, speech pathology, occupational therapy, nursing, patient safety, engineering, food science & technology from around the world who came together to develop international standardised terminology and definitions for texture modified foods and thickened liquids for persons with dysphagia.
- To develop a standardised way of naming and describing texture modified foods and thickened liquids for people with dysphagia across the lifespan
- Our process is intended to be person-focused, rather than profession focused. We seek to develop a global terminology that will ‘work’ for all cultures and that will be accompanied by practical and valid measurement techniques that will facilitate use by persons with dysphagia, caregivers, clinicians, food service professionals and industry partners.
- To seek a common language that can be used for technical, cultural, professional and non-professional uses. We believe this should be a living document, changing as needs change.
In recent years, a number of countries have worked to develop dysphagia diet standards at regional or national levels. Unfortunately all these standards use different terminology, labels, numbers and levels which adds to the confusion for individuals and caregivers as well as health professionals and researchers. An individual with dysphagia that is on a modified texture diet may find that his/her diet may be called one thing in hospital, which may be different in the rehabilitation facility or may be different from the label used in another province or even country. The development of international standards will address this particular issue.
Developing a common dysphagia diet language
The IDDSI committee came together in 2013 with a goal of developing international standardized terminology and descriptors for dysphagia diets that would meet the needs of individuals with dysphagia across the age span, across all care setting and across all cultures. The outcome of the committee’s work is the creation of the International Dysphagia Diet Framework. In addition, food and drink descriptors along with instructions for easy, reliable and accessible methods to test different foods and drinks were completed here.
Dysphagia (swallowing disorder) is broadly estimated to affect 8% of the general population. This is 580 million people worldwide. Persons with dysphagia might experience trouble with: swallowing food or drinks, chewing, sucking, controlling saliva, taking medication, or protecting the airway from choking. Dysphagia can occur at any time during the lifespan and may be short or long term. The most common causes of dysphagia are related to underlying medical or physical conditions. There are a number of significant consequences related to dysphagia including life-threatening chest infection (or pneumonia), malnutrition or dehydration. Having a swallowing disorder greatly impacts an individual’s quality of life.
There are a number of strategies and treatments used to help improve the safety, efficiency and enjoyment of the individual with dysphagia.
One of the most common ways of managing dysphagia is the provision of texture modified foods (chopped, minced, pureed) and thickened liquids (thin and various thicknesses). These modified foods and drinks are provided to help reduce the risk of choking or having material entering the lungs airway and may be commonly referred to as a dysphagia diet.
Due to the enormous variation in types of foods and drinks as well as their properties, it is challenging to categorize foods and drinks to ensure universal understanding of the types of foods and drinks that would best meet the needs of an individual with dysphagia. Confusion and miscommunication regarding diet textures and drink consistencies has resulted in increased risk of illness and even death.
The IDDSI Framework and supporting descriptor and testing methods documents were completed and published in November 2015, and can be seen here.
In response to the global community, the IDDSI board has agreed to lead and coordinate IDDSI implementation, which is described in more detail here.