The Effects of Adding Particles in Texture Modified Food on Tongue Strength and Swallowing Function in Patients with Oropharyngeal Dysphagia: A Proof of Concept Study

Texture Modified Food (TMF) is commonly used for individuals with oropharyngeal dysphagia (OD), but often results in poor adherence, malnutrition, and reduced quality of life. Since IDDSI levels 3 and 4 do not allow particles, food is usually offered as a fully smooth puree. However, little is known about the impact of adding small particles on swallowing function.

This proof-of-concept study examined whether adding carrot particles (2 mm and 4 mm) to a smooth puree affects tongue strength, swallowing safety, and efficiency. Ten adult patients with OD consumed three types of bolus: a smooth carrot puree (IDDSI 4), one with small particles, and one with larger particles. Measurements were taken using the IOPI and FEES, and analyzed using the PAS and Pooling scores.

Results showed no significant differences in tongue pressure, aspiration, or pharyngeal residue between the three boluses. Aspiration was observed only with the smooth bolus. The addition of particles was therefore considered safe in this setting.

This study suggests that TMF containing structure can be safely used and may offer benefits for taste experience and nutritional quality. Further research is needed to better understand the role of particles in dysphagia diets and to inform clinical practice.

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