Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trials

Objectives: To determine and explore the effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake in adults with dysphagia. Participants: Adults with dysphagia. Design: A meta-analysis of randomized controlled trials (RCTs). Methods: We conducted a comprehensive li...

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Main Authors: Yu-Hao Chu, Jane C-J Chao
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:The Journal of Nutrition, Health and Aging
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Online Access:http://www.sciencedirect.com/science/article/pii/S1279770725000090
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author Yu-Hao Chu
Jane C-J Chao
author_facet Yu-Hao Chu
Jane C-J Chao
author_sort Yu-Hao Chu
collection DOAJ
description Objectives: To determine and explore the effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake in adults with dysphagia. Participants: Adults with dysphagia. Design: A meta-analysis of randomized controlled trials (RCTs). Methods: We conducted a comprehensive literature search in EMBASE, Cochrane Library, Ovid-Medline, CINAHL, Web of Science, PubMed, and reference lists until November 2023. Quality of the included studies was assessed by the Cochrane Risk of Bias Assessment tool 2.0. Data analysis was performed using Comprehensive Meta-analysis 3.0 for pooled Hedges’ g and odds ratios (ORs) with corresponding confidence interval (CI) adopting a random-effects model. A X2- based test using Cochran’s Q (P < 0.10) and I2 statistics evaluated heterogeneity. Results: In total, 16 RCTs from among 3,854 studies retrieved from the literature search with 1812 adults with dysphagia were included in this meta-analysis. Texture-modified diets revealed a significant small effect on increasing energy intake (g: 0.37, 95% CI = 0.05–0.68) and a medium effect on increasing protein intake (g: 0.56, 95% CI = 0.13–0.99). Thickened fluids revealed a significantly reduced risk of aspiration (OR: 0.59, 95% CI = 0.44–0.79), and thickened fluids combined with water protocol revealed a significant large effect on increasing fluid intake (g: 3.96, 95% C = 0.75–7.16). Conclusions: The findings of this meta-analysis demonstrated that texture-modified diets increase dietary intake of energy and protein for adults with dysphagia. In addition, thickened fluids reduced the risk of aspiration while thickened fluids combined with water protocol increased fluid intake in adults with dysphagia.
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spelling doaj-art-2817c9b6439441caae85b0e4555b3f4f2025-08-20T02:10:13ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882025-04-0129410048610.1016/j.jnha.2025.100486Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trialsYu-Hao Chu0Jane C-J Chao1School of Nutrition and Health Sciences, Taipei Medical University, Taipei, TaiwanSchool of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan; TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan; Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Corresponding author.Objectives: To determine and explore the effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake in adults with dysphagia. Participants: Adults with dysphagia. Design: A meta-analysis of randomized controlled trials (RCTs). Methods: We conducted a comprehensive literature search in EMBASE, Cochrane Library, Ovid-Medline, CINAHL, Web of Science, PubMed, and reference lists until November 2023. Quality of the included studies was assessed by the Cochrane Risk of Bias Assessment tool 2.0. Data analysis was performed using Comprehensive Meta-analysis 3.0 for pooled Hedges’ g and odds ratios (ORs) with corresponding confidence interval (CI) adopting a random-effects model. A X2- based test using Cochran’s Q (P < 0.10) and I2 statistics evaluated heterogeneity. Results: In total, 16 RCTs from among 3,854 studies retrieved from the literature search with 1812 adults with dysphagia were included in this meta-analysis. Texture-modified diets revealed a significant small effect on increasing energy intake (g: 0.37, 95% CI = 0.05–0.68) and a medium effect on increasing protein intake (g: 0.56, 95% CI = 0.13–0.99). Thickened fluids revealed a significantly reduced risk of aspiration (OR: 0.59, 95% CI = 0.44–0.79), and thickened fluids combined with water protocol revealed a significant large effect on increasing fluid intake (g: 3.96, 95% C = 0.75–7.16). Conclusions: The findings of this meta-analysis demonstrated that texture-modified diets increase dietary intake of energy and protein for adults with dysphagia. In addition, thickened fluids reduced the risk of aspiration while thickened fluids combined with water protocol increased fluid intake in adults with dysphagia.http://www.sciencedirect.com/science/article/pii/S1279770725000090DysphagiaThickened fluidTexture-modified dietDietary nutrient intakeFluid intakeAspiration
spellingShingle Yu-Hao Chu
Jane C-J Chao
Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trials
The Journal of Nutrition, Health and Aging
Dysphagia
Thickened fluid
Texture-modified diet
Dietary nutrient intake
Fluid intake
Aspiration
title Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trials
title_full Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trials
title_fullStr Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trials
title_full_unstemmed Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trials
title_short Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trials
title_sort effectiveness of diet modification on dietary nutrient intake aspiration and fluid intake for adults with dysphagia a meta analysis of randomized controlled trials
topic Dysphagia
Thickened fluid
Texture-modified diet
Dietary nutrient intake
Fluid intake
Aspiration
url http://www.sciencedirect.com/science/article/pii/S1279770725000090
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