Defining Breakfast in Dysphagia Care: Standards, Safety, and Nutrition

Breakfast research typically emphasizes the consequences of skipping the meal rather than the benefits of regular intake, and key terms and metrics remain inconsistently defined. Definitions differ across countries and study designs, which complicates the implementation of recommendations and can materially change nutritional assessments, as illustrated by comparisons of two practical definitions applied to a hospital menu. Evidence for breakfast in clinical populations with dysphagia is limited, despite the high risk of malnutrition and the routine dilution of foods that lowers nutritional density. Recent hospital nutrition guidance mentions breakfast only briefly and provides little direction on composition, timing within the morning window, or texture. We therefore advocate clear, uniform definitions of breakfast; dysphagia-specific breakfast guidance with explicit energy and macronutrient targets, with particular attention to protein; adoption of the International Dysphagia Diet Standardisation Initiative framework for food texture and liquid thickness; and a multidisciplinary approach involving dietitians, speech-language pathologists, and nurses to deliver safe swallowing alongside adequate nutrition.