Journal of Huntington’s Disease 5 (2016) 15–17 DOI 10.3233/JHD-150176 IOS Press 15 Short Communication Long-Term use of Modified Diets in Huntington’s Disease: A Descriptive Clinical Practice Analysis on Improving Dietary Enjoyment Bronwyn Moorhouse a,* and Caroline A. Fisher b,c a Department of Speech Pathology and Brain Disorders Program, Royal Talbot Rehabilitation Centre, Austin Health, Kew, Melbourne, Australia b Psychology Department, Royal Melbourne Hospital, Melbourne Health, Melbourne, Australia c The Melbourne Clinic, Richmond, Melbourne, Australia Keywords: Diet, dysphagia, Huntington’s disease, nutrition, patient-centred care, patient-focused care, swallowing Dysphagia is a very common occurrence in Huntington’s disease (HD). As such, many people with HD require texture modified diets. This com- mentary discusses the implications for individuals living long-term on modified diets – including the loss of sensory stimulation and dietary enjoyment. Clinical practice analyses of two interventions aimed at promoting dietary satisfaction and involvement in food preparation for those with HD are described and parameters for future research are discussed. Problems with swallowing (dysphagia) are com- mon in Huntington’s disease (HD), throughout the illness [1–3]. Dysphagia in HD contributes to a number of issues including inadequate mastication, difficulties with bolus formation and oral transit, delayed swallow initiation and reduced pharyngeal motility leading to increased risk of aspiration [4], a common cause of death in advanced HD [5]. Dyspha- gia is also implicated in difficulties with substantial weight loss in HD [5]. Recent best practice clinical * Correspondence to: Dr. Bronwyn Moorhouse, Brain Dis- orders Program, Royal Talbot Rehabilitation Centre, Austin Health, 1 Yarra Boulevard Kew, 3101, Australia. Tel.: +61 613 9490 4582; Fax: +61 613 94907501; E-mail: bronwyn.moorhouse @austin.org.au. guidelines have been developed to optimise mealtime assistance in those with HD [3]. The guidelines advise that once swallowing difficulties have developed, often in the middle stages of the disease, recommen- dations should be provided by speech and language pathologists about modifying the consistency of food and the viscosity of fluids, to optimise swallow safety. The guidelines also highlight the importance of positioning, food placement and behavioural and environmental strategies in reducing choking and aspiration, particularly in the later stages of the ill- ness [3]. Given that those with HD often live for 15 to 20 years following symptom onset [6], they may require texture modified diets for many years. While clinically the need for diet modification in HD is clear, relatively little analysis has been undertaken into the impact of long-term ingestion of minced or pur´ eed diets. Recent dietetics research has indicated that staff involved with the ordering, prepa- ration and mealtime assistance of texture modified foods held concerns about the sensory experience for individuals eating these foods [7]. Concerns included the food being unappealing and that it could lead to “taste fatigue”. Suggestions to improve the experi- ence included maintaining vibrant but natural colours ISSN 1879-6397/16/$35.00 © 2016 – IOS Press and the authors. All rights reserved