Determination of the international dysphagia diet standardization initiative level of commercially available oral nutritional supplements

Abstract

Background/objective

The International Dysphagia Diet Standardization Initiative (IDDSI), a global multi-disciplinary non-profit framework, has created a standardized communication code to describe foods and liquids for individuals with dysphagia. For liquids, four levels have been determined (Level 0: Thin 1; Level 1: Slightly thick; Level 2: Mildly thick; Level 3: Moderately thick; Level 4: Extremely thick). The implementation of the IDDSI terminology is still in progress. Thus, most commercially available oral nutritional supplements lack an IDDSI identification label. The objective of the present work was to characterize oral nutritional supplements in terms of IDDSI, to facilitate its implementation.

Methods

Several supplements commercially available were tested and categorized according to the IDDSI system for liquids. Supplements in powder form were prepared according to manufacturers’ instructions. The IDDSI Flow Test was performed with specified syringes according to standard methodology.

Results

In total, 40 products from seven companies (Abbott, Medella, Nestle Health Science, Nutricia, Nutrisens, and Nutrimedica) were assessed, including different flavors from the same product line. Most products were classified at IDDSI 0 and 1 levels. Compact product forms were classified at the IDDSI 2 level, while soups and creams were classified at the IDDSI 3 or 4 level.

Conclusions

Patients with dysphagia and malnutrition can choose from various products classified according to the IDDSI classification to meet their nutritional needs.