Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework
Identifieur interne : 000761 ( Pmc/Checkpoint ); précédent : 000760; suivant : 000762Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework
Auteurs : Julie A. Y. Cichero ; Peter Lam ; Catriona M. Steele ; Ben Hanson [Royaume-Uni] ; Jianshe Chen [République populaire de Chine] ; Roberto O. Dantas [Brésil] ; Janice Duivestein ; Jun Kayashita [Japon] ; Caroline Lecko [Royaume-Uni] ; Joseph Murray [États-Unis] ; Mershen Pillay [Afrique du Sud, Royaume-Uni] ; Luis Riquelme [États-Unis] ; Soenke Stanschus [Allemagne]Source :
- Dysphagia [ 0179-051X ] ; 2016.
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.
The online version of this article (doi:10.1007/s00455-016-9758-y) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1007/s00455-016-9758-y
PubMed: 27913916
PubMed Central: 5380696
Affiliations:
- Afrique du Sud, Allemagne, Brésil, Japon, Royaume-Uni, République populaire de Chine, États-Unis
- Michigan, État de New York
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PMC:5380696Le document en format XML
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<institution>Ann Arbor Veterans Affairs,</institution>
</institution-wrap>
Ann Arbor, MI USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Michigan</region>
</placeName>
<wicri:cityArea>Ann Arbor</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Pillay, Mershen" sort="Pillay, Mershen" uniqKey="Pillay M" first="Mershen" last="Pillay">Mershen Pillay</name>
<affiliation><nlm:aff id="Aff1">International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD Australia</nlm:aff>
<wicri:noCountry code="subfield">QLD Australia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff15"><institution-wrap><institution-id institution-id-type="GRID">grid.16463.36</institution-id>
<institution>Speech Pathology, School of Health Sciences,</institution>
<institution>University of KwaZulu-Natal,</institution>
</institution-wrap>
Westville Campus, Durban, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Westville Campus, Durban</wicri:regionArea>
<wicri:noRegion>Durban</wicri:noRegion>
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<affiliation wicri:level="1"><nlm:aff id="Aff16"><institution-wrap><institution-id institution-id-type="GRID">grid.25627.34</institution-id>
<institution></institution>
<institution>Manchester Metropolitan University,</institution>
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Manchester, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Manchester</wicri:regionArea>
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</author>
<author><name sortKey="Riquelme, Luis" sort="Riquelme, Luis" uniqKey="Riquelme L" first="Luis" last="Riquelme">Luis Riquelme</name>
<affiliation><nlm:aff id="Aff1">International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD Australia</nlm:aff>
<wicri:noCountry code="subfield">QLD Australia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="Aff17"><institution-wrap><institution-id institution-id-type="GRID">grid.260917.b</institution-id>
<institution>Department of Speech-Language Pathology,</institution>
<institution>New York Medical College,</institution>
</institution-wrap>
Valhalla, NY USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">État de New York</region>
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<wicri:cityArea>Valhalla</wicri:cityArea>
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<affiliation wicri:level="2"><nlm:aff id="Aff18"><institution-wrap><institution-id institution-id-type="GRID">grid.415436.1</institution-id>
<institution>Barrique Speech-Language Pathology at Center for Swallowing & Speech-Language Pathology,</institution>
<institution>New York Methodist Hospital,</institution>
</institution-wrap>
Brooklyn, NY USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">État de New York</region>
</placeName>
<wicri:cityArea>Brooklyn</wicri:cityArea>
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</author>
<author><name sortKey="Stanschus, Soenke" sort="Stanschus, Soenke" uniqKey="Stanschus S" first="Soenke" last="Stanschus">Soenke Stanschus</name>
<affiliation><nlm:aff id="Aff1">International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD Australia</nlm:aff>
<wicri:noCountry code="subfield">QLD Australia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff19">Swallowing and Speech Pathology, Hospital zum Heiligen Geist, Kempen, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Swallowing and Speech Pathology, Hospital zum Heiligen Geist, Kempen</wicri:regionArea>
<wicri:noRegion>Kempen</wicri:noRegion>
<wicri:noRegion>Kempen</wicri:noRegion>
<wicri:noRegion>Kempen</wicri:noRegion>
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<series><title level="j">Dysphagia</title>
<idno type="ISSN">0179-051X</idno>
<idno type="eISSN">1432-0460</idno>
<imprint><date when="2016">2016</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><p>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.</p>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1007/s00455-016-9758-y) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Dysphagia</journal-id>
<journal-id journal-id-type="iso-abbrev">Dysphagia</journal-id>
<journal-title-group><journal-title>Dysphagia</journal-title>
</journal-title-group>
<issn pub-type="ppub">0179-051X</issn>
<issn pub-type="epub">1432-0460</issn>
<publisher><publisher-name>Springer US</publisher-name>
<publisher-loc>New York</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27913916</article-id>
<article-id pub-id-type="pmc">5380696</article-id>
<article-id pub-id-type="publisher-id">9758</article-id>
<article-id pub-id-type="doi">10.1007/s00455-016-9758-y</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Cichero</surname>
<given-names>Julie A. Y.</given-names>
</name>
<address><phone>+61 733461900</phone>
<email>j.cichero@uq.edu.au</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff2">2</xref>
<bio><sec id="FPar1"><title>Julie A. Y. Cichero</title>
<p>Ph.D.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Lam</surname>
<given-names>Peter</given-names>
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<address><email>peter.lam@iddsi.org</email>
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<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff3">3</xref>
<xref ref-type="aff" rid="Aff4">4</xref>
<bio><sec id="FPar2"><title>Peter Lam</title>
<p>R.D., C.F.E.</p>
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</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Steele</surname>
<given-names>Catriona M.</given-names>
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<address><email>catriona.steele@iddsi.org</email>
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<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff5">5</xref>
<xref ref-type="aff" rid="Aff6">6</xref>
<bio><sec id="FPar3"><title>Catriona M. Steele</title>
<p>Ph.D.</p>
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<given-names>Ben</given-names>
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<address><email>ben.hanson@ucl.ac.uk</email>
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<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff7">7</xref>
<bio><sec id="FPar4"><title>Ben Hanson</title>
<p>Ph.D.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Chen</surname>
<given-names>Jianshe</given-names>
</name>
<address><email>jschen@zjgsu.edu.cn</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff8">8</xref>
<bio><sec id="FPar5"><title>Jianshe Chen</title>
<p>Ph.D.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Dantas</surname>
<given-names>Roberto O.</given-names>
</name>
<address><email>rodantas@fmrp.usp.br</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff9">9</xref>
<bio><sec id="FPar6"><title>Roberto O. Dantas</title>
<p>Ph.D.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Duivestein</surname>
<given-names>Janice</given-names>
</name>
<address><email>jduivestein@cw.bc.ca</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff10">10</xref>
<xref ref-type="aff" rid="Aff11">11</xref>
<bio><sec id="FPar7"><title>Janice Duivestein</title>
<p>M.R.Sc., OT/PT.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Kayashita</surname>
<given-names>Jun</given-names>
</name>
<address><email>kayashita@pu-hiroshima.ac.jp</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff12">12</xref>
<bio><sec id="FPar8"><title>Jun Kayashita</title>
<p>Ph.D.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Lecko</surname>
<given-names>Caroline</given-names>
</name>
<address><email>caroline.lecko@nhs.net</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff13">13</xref>
<bio><sec id="FPar9"><title>Caroline Lecko</title>
<p>R.N.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Murray</surname>
<given-names>Joseph</given-names>
</name>
<address><email>joe.murray@va.gov</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff14">14</xref>
<bio><sec id="FPar10"><title>Joseph Murray</title>
<p>Ph.D.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Pillay</surname>
<given-names>Mershen</given-names>
</name>
<address><email>pillaym1@uksn.ac.za</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff15">15</xref>
<xref ref-type="aff" rid="Aff16">16</xref>
<bio><sec id="FPar11"><title>Mershen Pillay</title>
<p>D.Ed.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Riquelme</surname>
<given-names>Luis</given-names>
</name>
<address><email>luisslp@aol.com</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff17">17</xref>
<xref ref-type="aff" rid="Aff18">18</xref>
<bio><sec id="FPar12"><title>Luis Riquelme</title>
<p>Ph.D.</p>
</sec>
</bio>
</contrib>
<contrib contrib-type="author"><name><surname>Stanschus</surname>
<given-names>Soenke</given-names>
</name>
<address><email>soenke.stanschus@gmx.de</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff19">19</xref>
<bio><sec id="FPar13"><title>Soenke Stanschus</title>
<p>M.A.</p>
</sec>
</bio>
</contrib>
<aff id="Aff1"><label>1</label>
International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD Australia</aff>
<aff id="Aff2"><label>2</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.1003.2</institution-id>
<institution>School of Pharmacy, Pharmacy Australia Centre of Excellence (PACE),</institution>
<institution>The University of Queensland,</institution>
</institution-wrap>
20 Cornwall St, Brisbane, QLD 4102 Australia</aff>
<aff id="Aff3"><label>3</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.17091.3e</institution-id>
<institution>Faculty of Land and Food Systems,</institution>
<institution>University of British Columbia,</institution>
</institution-wrap>
Vancouver, BC Canada</aff>
<aff id="Aff4"><label>4</label>
Peter Lam Consulting, Vancouver, BC Canada</aff>
<aff id="Aff5"><label>5</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.231844.8</institution-id>
<institution>Toronto Rehabilitation Institute,</institution>
<institution>University Health Network,</institution>
</institution-wrap>
Toronto, ON Canada</aff>
<aff id="Aff6"><label>6</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.17063.33</institution-id>
<institution>Rehabilitation Sciences Institute, Faculty of Medicine,</institution>
<institution>University of Toronto,</institution>
</institution-wrap>
Toronto, ON Canada</aff>
<aff id="Aff7"><label>7</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.83440.3b</institution-id>
<institution>Department of Mechanical Engineering,</institution>
<institution>University College London,</institution>
</institution-wrap>
London, UK</aff>
<aff id="Aff8"><label>8</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.413072.3</institution-id>
<institution></institution>
<institution>Zhejiang Gongshang University,</institution>
</institution-wrap>
Hangzhou, China</aff>
<aff id="Aff9"><label>9</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.11899.38</institution-id>
<institution>Medical School of Ribeirão Preto,</institution>
<institution>University of São Paulo,</institution>
</institution-wrap>
Ribeirão Preto, Brazil</aff>
<aff id="Aff10"><label>10</label>
Access Community Therapists, Vancouver, BC Canada</aff>
<aff id="Aff11"><label>11</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.17091.3e</institution-id>
<institution>Faculty of Medicine,</institution>
<institution>University of British Columbia,</institution>
</institution-wrap>
Vancouver, BC Canada</aff>
<aff id="Aff12"><label>12</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.412155.6</institution-id>
<institution>Department of Health Sciences,</institution>
<institution>Prefectural University of Hiroshima,</institution>
</institution-wrap>
Hiroshima, Japan</aff>
<aff id="Aff13"><label>13</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.451052.7</institution-id>
<institution></institution>
<institution>National Health Service Improvement,</institution>
</institution-wrap>
London, UK</aff>
<aff id="Aff14"><label>14</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.413800.e</institution-id>
<institution></institution>
<institution>Ann Arbor Veterans Affairs,</institution>
</institution-wrap>
Ann Arbor, MI USA</aff>
<aff id="Aff15"><label>15</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.16463.36</institution-id>
<institution>Speech Pathology, School of Health Sciences,</institution>
<institution>University of KwaZulu-Natal,</institution>
</institution-wrap>
Westville Campus, Durban, South Africa</aff>
<aff id="Aff16"><label>16</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.25627.34</institution-id>
<institution></institution>
<institution>Manchester Metropolitan University,</institution>
</institution-wrap>
Manchester, UK</aff>
<aff id="Aff17"><label>17</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.260917.b</institution-id>
<institution>Department of Speech-Language Pathology,</institution>
<institution>New York Medical College,</institution>
</institution-wrap>
Valhalla, NY USA</aff>
<aff id="Aff18"><label>18</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.415436.1</institution-id>
<institution>Barrique Speech-Language Pathology at Center for Swallowing & Speech-Language Pathology,</institution>
<institution>New York Methodist Hospital,</institution>
</institution-wrap>
Brooklyn, NY USA</aff>
<aff id="Aff19"><label>19</label>
Swallowing and Speech Pathology, Hospital zum Heiligen Geist, Kempen, Germany</aff>
</contrib-group>
<pub-date pub-type="epub"><day>2</day>
<month>12</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>2</day>
<month>12</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="ppub"><year>2017</year>
</pub-date>
<volume>32</volume>
<issue>2</issue>
<fpage>293</fpage>
<lpage>314</lpage>
<history><date date-type="received"><day>2</day>
<month>8</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>8</day>
<month>11</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s) 2016</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.</license-p>
</license>
</permissions>
<abstract id="Abs1"><p>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.</p>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1007/s00455-016-9758-y) contains supplementary material, which is available to authorized users.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Deglutition</kwd>
<kwd>Deglutition disorders</kwd>
<kwd>Swallowing</kwd>
<kwd>Dysphagia diet</kwd>
<kwd>Texture-modified food</kwd>
<kwd>Thickened fluid</kwd>
<kwd>Food and fluid standards</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© Springer Science+Business Media New York 2017</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
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<li>Allemagne</li>
<li>Brésil</li>
<li>Japon</li>
<li>Royaume-Uni</li>
<li>République populaire de Chine</li>
<li>États-Unis</li>
</country>
<region><li>Michigan</li>
<li>État de New York</li>
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<country name="États-Unis"><region name="Michigan"><name sortKey="Murray, Joseph" sort="Murray, Joseph" uniqKey="Murray J" first="Joseph" last="Murray">Joseph Murray</name>
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