Additionally, 54% of patients on a texture modified diet were recommended a nutritional supplement, compared with 24% of patients on a regular diet.79 Conversely, Germain et al80 compared patients consuming a modified diet with greater food choices to patients consuming a ‘standard’ (more restricted) modified diet over a 12-week period. They found significantly greater nutritional intake in patients consuming the expanded option diet. Additionally, they observed a significant weight gain in the patients consuming the expanded option diet at the end of 12 weeks.