In Vivo Behavior of Transitional Foods as Compared to Purees: A Videofluoroscopic Analysis

Area of Science:

• Clinical Nutrition
• Swallowing Disorders
• Medical Food Technology

Background:

• Texture-modified diets are crucial for individuals with dysphagia.
• Medically tailored transitional foods (TFs) offer a potential alternative to pureed consistencies.
• The safety and efficacy of TFs during swallowing require further investigation.

Purpose of the Study:

• To compare the oropharyngeal swallowing physiology of patients with dysphagia consuming TFs versus pureed solids.
• To assess the safety and performance of TFs in a clinical setting.

Main Methods:

• Retrospective chart review of 31 long-term acute care inpatients with acute respiratory failure.
• Videofluoroscopic swallow studies (VFSS) were conducted using both pureed and transitional solid foods (Savorease Therapeutic Foods).
• Swallow function was evaluated using the Modified Barium Swallow Impairment Profile (MBSImP) framework.

Main Results:

• No statistically significant differences were found in MBSImP component scores or overall oral/pharyngeal composite scores between pureed and transitional solids.
• While most patients performed similarly, some showed better oral/pharyngeal residue with TFs, and others better bolus preparation/swallow initiation with pureed solids.
• No instances of airway invasion were observed for either texture.

Conclusions:

• High-dissolving transitional solids do not appear to increase swallowing risk compared to pureed textures.
• TFs may serve as a safe intermediate texture to facilitate progression to more challenging consistencies in medically complex patients with dysphagia.
• This study supports the integration of TFs into dysphagia evaluation, recommendations, and treatment protocols.