The greatest contribution to oral fluid intake was from food, not beverages. Designing menus and food services that promote and encourage the enjoyment of fluid dense foods, in contrast to thickened beverages, may present an important way to improve fluid intakes of those with dysphagia. Supplemental enteral or parenteral fluid may be necessary to achieve minimum calculated fluid requirements.

Thickened fluids and texture-modified foods are provided for the therapeutic treatment of dysphagia. Review of the literature indicated that numerous labels are applied to a small number of food textures and fluid thickness levels. The consequences of inconsistent terminology affect patient safety and the efficiency of communication. A joint project of the Dietitians Association of Australia and The Speech Pathology Association of Australia Limited (Speech Pathology Australia) was undertaken to develop consensus standards for number of levels, labels and definitions of thickened fluids and texture-modified foods within the Australian context. A project officer and multidisciplinary advisory committee were appointed by competitive process to carry out and oversee the project. The project determined that there were 39 different labels in use for thickened fluids and 95 different labels in use for texture-modified foods used in Australia. Dietitians and speech pathologists demonstrated overwhelming support for a standardised labelling and terminology system (99.2% of respondents). A national consultative process encompassing the views of more than 580 clinicians helped to formulate the final standards. A scale for modified fluids and a scale for texture-modified foods were developed and consensus was achieved between the Dietitians Association of Australia and Speech Pathology Australia. The standards are now recommended for use throughout Australia.

Aim:  To determine preferences for meals and snack of long‐stay patients and hospitalised patients with increased energy and protein requirements. Methods:  Using consistent methodology across two tertiary teaching hospitals, a convenience sample of adult public hospital inpatients with increased energy and protein requirements or longer stays (seven days or more) were interviewed regarding meal and snack preferences. Descriptive reporting of sample representativeness, preferred foods and frequency of meals and between meal snacks. Results:  Of 134 respondents, 55% reported a decreased appetite and 28% rated their appetite as ‘poor’. Most felt like eating either nothing (42%) or soup (15%) when unwell. The most desired foods were hot meal items, including eggs (31%), meat dishes (20%) and soup (69%). Of items not routinely available, soft drink (7.6%) and alcohol (6.7%) were most commonly desired during admission. Almost half (49%) reported difficulty opening packaged food and a majority (81%) indicated finger foods were easy to eat. Conclusion:  Appetites during admission were frequently lower than usual. Responses encourage consideration of eggs, meat dishes and soups for long‐stayers or those with high‐energy, high‐protein needs. Easy to consume but not routinely offered, between meal items, such as soup, juice, cake, soft drink or Milo could be explored further to enhance oral intakes.

Children from food insecure households are more likely to have substandard food and nutritional intakes, and experience developmental delays, behaviour issues and increased use of health services. In Australia, screening for household food insecurity (HFI) within health services is not undertaken routinely, limiting opportunities to optimise nutrition and healthcare. This research aimed to (a) identify the prevalence, potential determinants and outcomes of HFI among paediatric outpatients in two Queensland hospitals; and (b) identify questions suitable for screening households at risk of HFI. A cross-sectional survey collected data from caregivers of children attending paediatric appointments at two hospitals in Brisbane, Australia (n = 148).Sociodemographic, health and household-related characteristics were collected, and food security status was assessed using four HFI measures. Chi-square, independent t-tests, ANOVA and logistic regression explored associations between HFI and health-related characteristics. A potential HFI screener was identified based on the most frequently endorsed questions from any HFI measure, and its validity was assessed through calculation of sensitivity and specificity. Prevalence of HFI was 41%, with 16% experiencing very low food security. Households with a child of 'fair/poor' health had 5.59 times greater odds of being food insecure than being food secure, compared to households with a child of 'excellent/good' health (aOR 5.59, 95% CI: 1.3-23.5). HFI was also positively associated with household chaos (p = .006).A combination of two questions was identified as a possible screening tool, with a sensitivity of 96% and a specificity of 90%. This study demonstrated HFI may be highly prevalent in a paediatric outpatient population, which may result in difficulties in being able to follow nutrition prescriptions. A highly sensitive and specific two-question screening tool was identified and may assist practitioners in paediatric healthcare settings in identifying clients who are at risk of HFI. K E Y W O R D Schildren, food insecurity, health outcomes, paediatric primary care, screening tool | 1539 KERZ Et al.