APNED vs. IDDSI Flashcards
What does APNED stand for
Association professionnelle des nutritionnistes exprets en dysphagie
What is the mandate of APNED?
- To share expertise
- Encourage the exchange of ideas and experiences of clinical practices in the area of dysphagia.
APNED modified textures from most permissive to most restrictive?
-Tender, Soft, Minced, Pureed
APNED liquids from most permissive to most restrictive?
-Clear, Nectar, Honey, Pudding
What does “more restrictive” include?
The lower restrictions plus additional restrictions
–> If an item is not allowed on a less restrictive diet, then automatically it would not be allowed on a more restrictive diet
Tender?
- A regular menu
- Everything allowed except hard or raw foods
- Most vegetables are cooked
Permitted foods tender?
- Firm food
- Crunchy fod
- Sticky food (Soft PB ok, but not crunchy PB)
Not permitted foods tender?
- Hard, raw vegetables
- Nuts
- Hard, dried fruits
When is soft ideal?
-Chewing is posible, but more difficults
Permitted foods soft?
- Partially firm food, that can be separated by a fork
- Tourtiere, meat pie, hashbrowns, quiche
Not permitted foods soft?
- Grilled or tough meat or in lage pieced
- Sticky food (peanut butte)
When is minced diet ideal?
- Minimal chewing required
- Food can be re-shaped or re-formed
Permitted foods on minced diet?
- Finely sliced food (<5 mm) with obligatory sauce
- Meat loaf, small pasta and ground meats
Not permitted foods on the minced diet?
- Crust (meat pie, quiche)
- Grilled sausage
When is the pureed diet ideal?
- When there is no chewing necessary
- Can be reshaped or reformed
Permitted foods on puree?
- Smooth puree
- Fish puree, meat puree
What is not permitted on puree?
Any puree with texture
Clear fluids?
- Regular liquids
- No change require
i. e. water, coffee, tea, fruit juice, milk
Clear fluids on bostwich?
24 cm/30 sec
Nectar fluids?
- Can be taken with a glass or straw
- Slowly flows from spoon
i. e. Cold tomato jice, eggnog, yoplait drink
Nectar fluids on boswitch?
14 cm/30 seconds
Honey fluid?
- Can be taken with a spoon, but doesnt hold shape
- Too thick with a straw
i. e. tomato sauce, yogurt, honey
Honey fluid on boswitch?
8 cm/30 seconds
Pudding liquids?
Very thick liquid, must be taken with spoon
i.e. pudding, firm yogurt
Pudding liquid on boswitch?
4 cm/30 seconds
What does IDDSI stand for?
International Dysphagia Diet Standardisation Initiative
Objectives of IDDSI?
- Standardize naming and descriptions of texture modified foods an thickened liquids
- Develop person focused global terminology for people of all cultures
- Seek common language that can be used for technical, cultural, professional and non-professional uses
Why do we need to learn IDDS?
- Due to a possible transition into the IDDSI system in Quebec in the future
- DC supports IDDSI
IDDSI Foods from more permissive to more restrictive?
-Regular, soft & bite-sized, minced & moist, pureed, liquidized
IDDSI liquids from more permissive to more restrictive?
Thin, slightly thick, mildly thick, moderately thick, extremely thick
Which foods are transitional foods in IDDSI ? (3)
-Regular, Soft & Bite Size, Minced & Moist
Regular foods?
- Normal, everyday foods of various textures an sizes
- Any method can be used to eat these foods
Normals sizes of regular foods for pediatric and adults?
- Pediatric: Larger or smaller than 8 mm
- Adult: Larger or smaller than 15 mm
Normal textures of regular foods?
- hard, crunchy, soft, chewy, fibrous, stringy, dry, crispy
- Food with seeds, husks bone
What is soft and bite sized foods?
- Can be eaten with a fork, spoon or chopsticks
- Can be mashed/broken down with a fork
- No knife or chewing required
- Soft, tender, moist foods with no separate thin liquids
Bite sized pieces of foods in “soft and bite-sized” in Pediatric and Adults?
Pediatric: <8 mm
Adults: <15 mm
Permitted foods on “soft and bite sized”?
- Soft, tender meats <15 mm
- Steamed, boiled vegetables
- Mashed or cut fruit
- Crumbly textures
No permitted foods on “Soft and bite sized”?
- Firm meat, fish and bones
- Hard, raw, stir-fried vegetables
- Mixed thin/thick textures
- Regular dry break
What is 15 mm equal to?
Adult thumbnail or standard fork
What is the fork pressure test in “soft & bite sized”?
- Pressure from fork held on its side can “cut” foods
- When a sample is pressed with the base of a fork, the sample is squashed and does not return to it’s original shape
What is minced and moist?
- Food can be eaten with a fork or a spoon
- Can be scooped & shaped on a plate
- Lumps are easy to squash with tongue
- Minimal chewing required
- Soft, moist foods with no separate thin liquid
Permitted foods on minced and moist?
- Finely minced, chopped and mashed foods <4 mm
- Extremely thick, smooth or non-pouring sauce or gravy
Not permitted foods on minced and moist?
- Particles larger than 2mm
- Similar restrictions to level 6 soft and bite size
Fork pressure test in minced and moist?
- When pressed with fork, particles should be easily separated and come through the prongs
- Easily mashed with little pressure
What is roughly 4mm?
Similar width of the pongs between a standard fork
What are transitional foods?
- Foods that start as one texture, and then finish as another texture
- Specifically, when moisture is applied o changes in texture occur
Rationale for transitional food?
- Minimal chewing required
- Tongue pressure sufficient to break food down after change in state
- Developmental teaching or rehab of chewing skills
Examples of transitional foods?
- ice chips
- cie crea
- Wafers
- waffle cones
- Potato crisps
- Shortbread
Fork pressure test with transitional foods?
After moisture or temperature is applies, sample can be easily deformed and doesn’t recover it’s shape
Pureed/Extremely thick?
- Usually eaten with a spoon
- Cannot be drink from a cup or straw
- Does not require chewing
- Can be piped, layered or molder
- No lump, not sticks
- Liquids must not separate from solid
Fork drip test in pureed?
-Small amount may flow through and form tail below fork, but does not flow or drip continuously
Spoon tilt test in pureed?
Cohesive enough to hold it’s shape on spoon. Not firm or sticky, with little food left on spoon when tilted
What is the liquidized/moderately thick?
- Can be drunk from a cup
- Some effort is required to suck through standard bore straw
- Cannot be piped, layered or molded
- Cannot be eater with a fork
- Can be eaten with a spoon
- No oral processing or chewing required
- Smooth texture
Example of liquidized/moderately thick?
- Sauces, gravies
- Fruit syrup
- Runny pureed fruit
Fork drip test in liquidize?
- Drips slowly in dollops through prongs of fork
- Prongs of fork do not leave clear patten on surface of test liquid
- Spreads out if spilled onto flat surface-
IDDSI flow test for liquidized?
-When the test liquid flow through 10 ml slip tip syringe it leaves >8 ml in the syringe after 10 seconds
Mildly thick liquids?
- Flows off a spoon
- Sippable, pours quickly from spoon but slower than thin drinks
- Effort required to drink through standard bore straw
IDDSI flow test in mildly thick?
-When test liquid flows through 10 ml slip tup syringe and leaves 4-8 ml after 10 seconds
Slightly thick ?
- Thicker tha wate
- Requires a little more effort to drink than thin liquids
- Flows through straw or syringe
- Similar to thickness of anti-regurgitations infant formula
IDDSI flow test for slightly thick?
-When test liquid flows through 10 ml slip tip syringe and leaves 1-4 ml after 20 seconds
Thin?
- Flows like water
- Fast flow
IDDSI flow test for thin?
-When test liquid flows through 10 ml slip tip syringe is leaves no residue after 10 seconds
APNED tender/Soft, IDDSI?
Regular
APNED Tender, Soft, Minced, IDDSI?
Soft & Bite Sized
Ice cream?
Regularon IDDSI
