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Dysphagia
Published in: Dysphagia 2/2017

Open Access 01-04-2017 | Original Article

Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework

Authors: Julie A. Y. Cichero, Peter Lam, Catriona M. Steele, Ben Hanson, Jianshe Chen, Roberto O. Dantas, Janice Duivestein, Jun Kayashita, Caroline Lecko, Joseph Murray, Mershen Pillay, Luis Riquelme, Soenke Stanschus

Published in: Dysphagia | Issue 2/2017

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Abstract

Dysphagia is estimated to affect ~8% of the world’s population (~590 million people). Texture-modified foods and thickened drinks are commonly used to reduce the risks of choking and aspiration. The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded with the goal of developing globally standardized terminology and definitions for texture-modified foods and liquids applicable to individuals with dysphagia of all ages, in all care settings, and all cultures. A multi-professional volunteer committee developed a dysphagia diet framework through systematic review and stakeholder consultation. First, a survey of existing national terminologies and current practice was conducted, receiving 2050 responses from 33 countries. Respondents included individuals with dysphagia; their caregivers; organizations supporting individuals with dysphagia; healthcare professionals; food service providers; researchers; and industry. The results revealed common use of 3–4 levels of food texture (54 different names) and ≥3 levels of liquid thickness (27 different names). Substantial support was expressed for international standardization. Next, a systematic review regarding the impact of food texture and liquid consistency on swallowing was completed. A meeting was then convened to review data from previous phases, and develop a draft framework. A further international stakeholder survey sought feedback to guide framework refinement; 3190 responses were received from 57 countries. The IDDSI Framework (released in November, 2015) involves a continuum of 8 levels (0–7) identified by numbers, text labels, color codes, definitions, and measurement methods. The IDDSI Framework is recommended for implementation throughout the world.
Appendix
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Metadata
Title
Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework
Authors
Julie A. Y. Cichero
Peter Lam
Catriona M. Steele
Ben Hanson
Jianshe Chen
Roberto O. Dantas
Janice Duivestein
Jun Kayashita
Caroline Lecko
Joseph Murray
Mershen Pillay
Luis Riquelme
Soenke Stanschus
Publication date
01-04-2017
Publisher
Springer US
Published in
Dysphagia / Issue 2/2017
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-016-9758-y

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