**6. Conclusion**

Dysphagia is a condition affecting dietary intake. Although often underestimated, chronic undernutrition can exacerbate frailty and can lead to poor physical condition, declined immune system, sarcopenia and pneumonia. In view of the current literature, nutritional content, texture and consistency as well as appearance of texture-modified foods should be improved. An assortment of foods and fluids should be investigated to reflect more realistic food intake patterns. Above all, a personalized nutritional intervention is essential to prevent health decline.

Eating is indispensable to subsistence in addition to being a critical part of the social aspect of life. New texture-modified foods should be developed with the involvement of individuals affected by dysphagia to improve taste, textural profiles and overall acceptability. Clinical trials should improve documentation of the dysphagia severity level, nutritional intervention (foods/fluids offered) and food intake prescribed, nutrient density, satisfaction of meals and adaptation to patients nutritional needs. Research done to date, although essential to understanding this complex health issue, is still theoretical and lacks integration of expertise. We must improve clients/patients consultation. A large number of foods and fluids are required to build an nutritious and appealing menu which is an essential element to improve intakes. An open-sourced international clinical database for nutritional interventions in dysphagia, similar to existing food composition databases [181–184], would be a valuable tool to build a strong resource base. While archiving details of various food or fluids formulations, nutritional values and rheological parameters (when available), this compendium would support knowledge transfer and benefit food/pharmaceutical industries, researchers, clinicians as well as clients.

Finally, clinicians and research teams must continue to progress in bridging the knowledge gap between the foods used to evaluate dysphagia severity (with and without barium), the foods and the fluids available for nutritional interventions

and recommendations for the development of commercial foods available for oropharyngeal dysphagia treatment.
