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Introduction: Oral feeding safety is necessary to provide nutrition, hydration, and eating pleasure for patients with dysphagia. Commercial thickeners are prescribed for these patients to change food viscosity and may alter the proper preparation of modified food. Objective: Analyze composition, employed terminology, preparation instructions, recommended amount and weight of provided measuring spoons, nutritional information, and viscosity of 7 commercial thickeners. Methods: The sample comprised all thickeners from different brands available in Brazil, named A to G. Products were submitted to viscosity analysis using viscometer and the International Dysphagia Diet Standardization Initiative (IDDSI) test. Samples were prepared with mineral water (25°C) and with the amount of thickener recommended to obtain intermediate viscosity (level 2) according to the manufacturer’s instructions. Results: Products B, C, and E presented similar composition. Manufacturer’s information about the amount and preparation procedure, time, temperature, and base liquid was incomplete. Viscosity tests revealed that thickener C was basically solid while D displayed results out of the desired viscosity level. Conclusions: The study showed differences in components and viscosity, beyond the lack of label details. There was no established correlation between viscosity classifications provided by National Dysphagia Diet and IDDSI.

COVID-19 reached pandemic level in March 2020 and the number of confirmed cases continues to increase worldwide. The clinical course of the disease has not yet been fully characterized, and some specific symptoms related to smell, taste, and feeding behavior require further examination. The present study aimed to assess the presence of symptoms related to the feeding behavior occurred during and/or after COVID-19 in adults residing in Portugal and to link them to disease severity using a multivariate approach. Data were collected from May to September 2020, through a questionnaire answered online containing questions about general and specific symptoms before, during and after COVID-19. 362 participants were included: 201 were symptomatic, being 15 hospitalized and 186 non-hospitalized. Cluster analysis grouped the non-hospitalized participants as mild and severe cases. For these patients, the most frequent symptoms related to the feeding process were smell disorders in 40% and 62%, taste disorders in 37% and 60%, and dry mouth, in 23% and 48% of mild and severe cases, respectively. Dry mouth was significantly associated with difficulty to swallow, pain during swallow, choking when eating or drinking, and preference for mushy/pasty foods (p<0.01; Chi-squared test). Among the severe cases, the incidence of coughing during the meal (31%), difficulty (19%) and pain during swallow (17%), preference for mushy/pasty foods (10%) and choking when eating or drinking (6%) were clinically relevant and may indicate the presence of swallowing disorders. This group also showed a higher frequency of general symptoms, such as fever, headache, abdominal pain, tiredness, diarrhea, nausea, and shortness of breath (p<0.05; Chi-squared test). Smell disorders, taste disorders and dry mouth were the most frequent symptoms related to the feeding behavior for both mild and severe cases. Dry mouth was significantly associated with swallowing difficulties and future research should investigate it as a frequent symptom and as a predictive of the presence of eating and swallowing disorders in COVID-19 cases.

This study aims to investigate the knowledge of speech therapists about characteristics of food used in the management of dysphagia. This was a quantitative descriptive study, performed using an online questionnaire (SurveyMonkey ® ) about the desirable food and beverages attributes to facilitate deglutition in dysphagia rehabilitation: texture, viscosity, temperature, taste, and moisture. Participants were separated into two groups, experts in dysphagia and no experts in dysphagia. Differences between the two groups were compared using the Freeman-Halton extension of the Fisher exact probability test and chi-square test. From 1,072 respondents, 752 were included and 572 were experts in dysphagia. The speech therapist expert in dysphagia answered correctly about the texture and viscosity, while no experts answered correctly only about viscosity. The other attributes, temperature, taste, and moisture, were incorrectly answered by both groups. The speech therapists demonstrated reduced knowledge regarding the characteristics of foods most indicated for patients with dysphagia. Sensory Studiesresult in G1 (29.19%) and the worst result in G2 (12.77%). For the results of temperature variable, it was possible to observe a better result for G1 when compared to G2, but still presenting a high error rate (70.81%) when the inadequate responses ("warm," "room temperature," and "temperature does not interfere") are added. The low index "cold" responses could indicate the lack of knowledge of the professionals regarding the advantages offered by the use in clinical practice and in the prescription of cold food for patients with dysphagia.As for temperature, the taste characteristic did not obtain assertive results in this research. The literature confirms the benefits of the sour taste for the swallowing process (Chee et al., 2005;Kajii et al., 2002;Pelletier & Lawless, 2003) such as reduced risk of laryngotracheal penetration (Pelletier & Lawless, 2003), positive influence on the pharyngeal transit time and increased perception of the bolus, but the alternative "sour" obtained extremely low responses, being 11.71% for G1 and 2.22% for G2. The great majority of participants opted for the answer "taste does not interfere," demonstrating that they do not know the influence of taste on the dynamics of swallowing. The results indicate that the professionals who work with dysphagia are not using this characteristic in their clinical practice or in the prescription of food.The last analyzed characteristic, moisture, presented similar results between the two groups, both of which selected the answer "moisture does not interfere" in its majority, G1 68.54% and G2 71.11%. According to the researched literature, moist foods are beneficial for oral and pharyngeal transit and contribute with the oral fluid intake (Cichero, 2016;Vivanti et al., 2009). Only 31.29% of G1 and 28.88% of G2 indicated moist trait.Since swallowing mechanism is dependent upon bolus characteristics (Logemann, 2007), knowledge about the influence of texture, viscos...

Introduction: this study aimed to verify the ability of speech therapists to identify, sort and name the different consistencies used in neurogenic oropharyngeal dysphagia (NOD) management, and to compare the results with the terms proposed by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: this research was approved by the ethics committee. Sixty speech therapists who work with NOD patients sorted 5 commercial foods from thinnest to thickest to match IDDSI levels 0 to 4, and then used a term to designate each consistency. Results: most subjects (76.66%) sorted the foods properly. Terminologies were divergent at all levels. For level 0, practitioners assigned 3 different terms. For level 1, 24 different terms were reported; for level 2 there were 25 terms, 23 terms for level 3, and 18 terms for level 4. Level 0 (IDDSI-thin) was designated by most participants as liquid; level 1 (IDDSI-slightly thick) was referred to as semi-thickened liquid; level 2 (IDDSI-mildly thick) as thickened liquid; level 3 (IDDSI-moderately thick) as honey; and level 4 (IDDSIextremely thick) as pasty by most subjects. A reduced number of participants used terms in accordance with IDDSI. Level 0 was appropriately named by 5 subjects (8.33%); levels 1, 2 and 4 by 2 practitioners each (3.33%); and level 3 by 1 professional (1.66%). None of the subjects named all 5 IDDSI levels correctly. Discussion/Conclusion: most practitioners progressed consistencies properly. There was a diversity of terminologies used for the same consistency at all levels, with no standardization.