Enabling equitable and inclusive travel experiences for dysphagia patients: a call to action for the aviation industry

Dysphagia, or difficulty in swallowing, can be the result of several etiologies such as stroke, neuromuscular disorders, head and neck injuries, or extrinsic compression of the esophagus. Patients with dysphagia are at severe risk of sequelae, such as aspiration and malnutrition, which present a severe risk of mortality. There is a significant need of implementing dysphagia -appropriate menu in commercial airlines. Among the general US population, there is a prevalent increase in dysphagia, which creates a substantial accessibility gap in commercial aviation food service. We reviewed publicly available in-flight menu options from the three largest U.S. carriers (American, United, and Delta) and classified items using the International Dysphagia Diet Standardization Initiative (IDDSI) framework. Across economy-accessible menu items identified online, 56 (American), 67 (United), and 51 (Delta) items were classified to be concentrated in thin liquids (IDDSI 0-1) and regular/easy-to-chew foods (IDDSI 6-7), with no clearly identifiable mildly/moderately thick liquid options (IDDSI 2-3) based on posted descriptions.