Aspiration Pneumonia

To the Editor: Mandell and Niederman (Feb. 14 issue)1 suggest that for patients with swallowing disorders, particularly after stroke, a mechanical soft diet with thickened liquids may be helpful in the prevention of aspiration pneumonia. An early behavioral intervention by speech and language therapists in patients with acute stroke and swallowing disorders, including dietary modification if it is determined to be appropriate, reduces the risk of chest infections.2 Although convincing evidence that modified diets prevent pneumonia in adults with chronic dysphagia is lacking,3 the modification of diets for this purpose has become widespread in recent years. Modified diets worsen quality . . .