Transitional Foods and Their Effects on Swallowing Safety and Efficiency: An Exploratory Study.

Abstract

Transitional foods are foods that start as one texture and change to another with minimal chewing required. While transitional foods have been promoted for pharyngeal swallowing dysfunction, their effects on swallowing safety and efficiency are not well understood. The aims of this study were to characterize differences in swallowing efficiency and safety between transitional, pureed, and regular food textures. This was a retrospective study of consecutive outpatient adults who underwent flexible endoscopic evaluation of swallowing (FEES) at a multidisciplinary dysphagia clinic. FEES were used to obtain measures of swallowing safety and efficiency and were included if containing at least one trial of transitional, pureed, and regular food textures. FEES were blindly analyzed by pairs of raters. Multilevel statistical models were used to compare differences in outcome measures across textures. A total of 219 swallowing trials were analyzed. A greater number of swallows was required for pureed compared to transitional foods (p = 0.011). There was a greater amount of epiglottic residue (p < 0.05) and oropharyngeal residue (p < 0.0001) for pureed and regular foods compared to transitional foods (p < 0.05). There was also a greater amount of hypopharyngeal residue for pureed compared to transitional foods (p < 0.0001). Differences in swallowing safety could not be determined. Transitional foods were associated with better swallowing efficiency than pureed and regular food textures in this heterogeneous sampling of dysphagic adults. Future research should prospectively assess the effects of transitional foods on swallowing safety and efficiency in specific dysphagic populations.