Comparison of mechanical analyses and tongue pressure analyses during squeezing and swallowing of gels

Relationship between maximal isometric tongue pressure and limit of fracture force of gels in tongue squeezing

BACKGROUND

There is no clear objective indicator for selecting soft foods that are required for food bolus formation in older people with impaired oral function.

OBJECTIVE

This study aimed to investigate the relationship between maximal isometric tongue pressure (MITP) and the mechanical properties of gels that can be crushed by the tongue.

METHODS

This study included 65 healthy participants aged 22-96 (young group; 15 males, 15 females; older dentate group; 7 males, 8 females; older edentulous group; 10 males, 10 females). MITP was measured by the balloon-probe device. Agar gel with 10 different kinds of fracture force from 10N to 100N was used. The limit of fracture force of gels (LFFG) that were crushed by the tongue was measured by the up-and-down method. In the older edentulous group, two items were measured with and without dentures. Spearman's rank correlation coefficient was used to evaluate the relationship between MITP and LFFG in each group (p < .05).

RESULTS

There were positive correlations between MITP and LFFG in all groups (overall groups: rs  = .66, young group: rs  = .46, older dentate group: rs  = .61, older edentulous group with dentures: rs  = .60, older edentulous group without dentures: rs  = .47).

CONCLUSION

MITP and LFFG were positively correlated in young, older dentate and older edentulous groups, suggesting that MITP has the potential to be an objective indicator of the range of mechanical properties of soft food that can be crushed by the tongue.

In situ quantitative assessment of food oral processing parameters: A review of feasible techniques and devices

Oral processing is a combination of various actions, the detailed description of which has always been the subject of relevant research. By means of imaging technology and sensory evaluation, more knowledge of oral processing have been accumulated. Presently, the advances in sensory technology have added quantitative parameters to the qualitative description of oral processing, which also enriched the specifics of each action. Previous studies have shown that oral processing includes lip closure, dental occlusion, masticatory muscles activity, tongue movement, and swallowing, whose processing contains rich information such as the movement of organ and the intensity of organ contacts. "Quantification" was taken in this review as the basic feature of in situ detection information, the relevant parameters and feasible methods for the quantitative description of each activity was recorded in detail. In addition, basic problems and feasible optimization schemes of the existing in situ detection device are also proposed in the hope of promoting the development of in situ detection device thus providing available information for the description of oral processing.

A review of the impact of food design on the mealtimes of people with swallowing disability who require texture-modified food

Texture-modified foods are a common component of interventions provided to people with dysphagia (swallowing disorders) to maintain their respiratory health, nutritional health and to reduce the risk of aspiration-related illness or choking on food. However, the unsightly and unappetizing appearance of texture-modified foods may negatively impact on the mealtime experience and acceptance of texture-modified foods of persons with dysphagia. The aim of this review was to determine what is known about the impact of specific elements of food design ‐ food structure and visual appeal ‐ on the mealtime experiences of people with dysphagia. This review of 35 studies presents evidence on how the physical characteristics of texture-modified foods for people with dysphagia can be considered during food production, formulation or service to improve their mealtime experience. Overall, the visual appeal, texture, taste, aroma, temperature, mealtime environment and mealtime assistance all impact upon mealtime experiences and should be considered carefully in the design of a person’s mealtime plan and food-related dysphagia interventions to improve their mealtime-related quality of life. Further research needs to include the views of people with dysphagia, particularly those with lifelong conditions, who might require texture-modified food for an extended period over their lifespan.

Effect of fracture properties of gels on tongue pressure during different phases of squeezing and swallowing

To provide appropriate foods for elderly people with eating difficulties, it is necessary to take account of the ability of compensatory mastication such as tongue squeezing. However, the biomechanics of tongue squeezing is still unclear. The aim of present study is to investigate the effect of the initial mechanical properties of gels on the change in tongue pressure production during squeezing and swallowing. As test sample, nine kinds of gels with three fracture force and three fracture strain were prepared. Tongue pressure during squeezing and swallowing gels was measured by using an ultra-thin tongue pressure sensor with five measuring points attached on the hard palate in seven healthy participants, and analyzed at four phases; Initial squeeze, Middle squeeze, Last squeeze, and Swallowing. The maximal magnitude of tongue pressure was increased for gels with higher fracture force at most measuring points and was decreased for gels with higher fracture strain at some measuring points on the median line during Initial and Middle squeezing. However, no influence by fracture force and strain was found in magnitude during Last squeezing and Swallowing. The duration of tongue pressure increased for gels with higher force at most measuring points during Middle squeezing, although no influence by strain was found during each phase. The results clearly show how the initial fracture properties of gels influence on tongue pressure production during each phase of food oral processing, which clarified one aspect of squeezing with tongue, as the compensatory mastication.

Rheology and soft tribology of thickened dispersions aiming the development of oropharyngeal dysphagia-oriented products

Dysphagia is a swallowing disorder that mainly affects elderly but can be minimized by thickening of liquid foods. Flaxseed gum (FG) was studied as a potential alternative thickener for dysphagia patients in comparison to commercial thickeners based on xanthan gum (XG) and modified starch (MS). Rheological and tribological responses of biopolymer-based thickening solutions (0.75–3% w/w) incorporated in different food matrices (water, orange-flavoured soy juice and skim milk) were recorded and correlated. In general, the increase in gums concentration led to increases in viscosity, viscoelastic properties and lubricating capacity. An opposite behavior was observed for the MS-based products, since an increase in concentration led to a lower increase in viscosity and viscoelastic properties but caused a decrease in the lubricating capacity. These results indicated that associating tribology to rheology is crucial to further define formulations with pleasant swallowing characteristics.

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Modified starch-based (MS) has lower thickening and lubricant capacities than gums.

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Higher MS concentrations increased viscosity, while decreased lubrication.

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Flaxseed gum & xanthan-based solutions are better thickeners and lubricants than MS.

Coordination of tongue pressure production, hyoid movement, and suprahyoid muscle activity during squeezing of gels

OBJECTIVE

The aim of this study was to evaluate tongue movement and its biomechanical effects during squeezing, one of the oral strategies for processing soft foods, by tongue pressure sensors, videofluorography, and surface electromyography.

DESIGN

Fifteen healthy men (mean age, 31.0 ± 4.1 years) without dysphagia were recruited. A 0.1-mm-thick pressure sensor sheet with five measuring points, videofluorography, and surface electromyography were used for synchronous measurements of tongue pressure, hyoid movement, and suprahyoid muscles activity, respectively, while squeezing 5 mL of gels. Amplitude, duration, area, and their sequential order during initial squeezing were analyzed. Differences in hyoid position at the onset, peak, and offset of hyoid movement were also analyzed.

RESULTS

At the beginning of initial squeezing, tongue pressure at the middle area of the hard palate, hyoid movement, and suprahyoid muscle activity appeared simultaneously, followed by tongue pressure at the anterior area and then at the posterior area. When the hyoid was in an elevated position, the amplitude of suprahyoid muscle activity and tongue pressure peaked. At the end of initial squeezing, the hyoid position at the offset of hyoid excursion was superior to that at the onset. All evaluation items of tongue pressure, hyoid movement, and suprahyoid muscle activity were modulated according to the texture of gels.

CONCLUSIONS

During initial squeezing, tongue pressure, hyoid movement, and suprahyoid muscle activity were coordinated while being modulated by the food texture. At the end of initial squeezing, the hyoid was maintained in an elevated position, which might be beneficial for subsequent squeezing.

Perception and measurement of food texture: Solid foods

There is still a gap between instrumental measurement and sensory evaluation because of the complexity of food texture in spite of many efforts. In sensory evaluation, the terms describing the texture should be well understood by panelists, which poses a problem of establishing lexicons and training panelists. In the instrumental measurement, more efforts are required to understand the large deformation and fracture behavior of foods. The texture profile analysis (TPA) proposed by Alina Szczesniak, Malcolm Bourne, and Sherman has been applied to many foods, and was useful to develop the understanding of textures. But sometimes confusion of the interpretation of TPA parameters appeared. Many new techniques have been introduced to quantify TPA parameters. Recent efforts to fill the gap between sensory evaluation and instrumental measurements, human measurements, or physiological measurements have been introduced. This endeavor is an effort of synthesizing the dentistry and biomedical approach, sensory and psychological approach, and material science approach, and therefore, the collaboration among these disciplines is necessary. This manuscript mainly discusses texture studies for solid foods.

PRACTICAL APPLICATIONS

To fill the gap between the sensory evaluation and the instrumental measurement of texture, it is necessary to examine the physical change of foods during the oral processing. This will give us the designing principle of palatable and safe foods.

Effect of bolus volume and flow time on temporospatial coordination in oropharyngeal pressure production in healthy subjects

The effects of bolus volume and flow time on the sequential coordination of tongue pressure (TP) and pharyngeal pressure (PP), which are important in the biomechanics of swallowing, are unclear. In this study, we measured TP and PP simultaneously in 10 healthy adults at multiple points during dry swallowing and the swallowing of 5 ml and 15 ml of liquids with different viscosities, and investigated changes in the timing of the onset, peak, and offset of these pressures. TP was measured using a sensor sheet system with five measuring points on the hard palate, and PP was measured using a manometry catheter with four measuring points. The order and correlations of sequential events, such as onset, peak, and offset times of pressure production, at each pressure measuring point were analyzed on the synchronized waveforms. We found that the differences between the TP and PP onset times decreased when the bolus volume was larger. The change in bolus volume had very little effect on peak time or offset time. The flow time of the bolus affected the appearance of onset and peak time for both TP and PP. A time difference between TP and PP emerged as the flow time increased, with TP starting to appear before PP. This may be the first detailed analysis of pressure-flow dynamics that treats the mouth and pharynx as a single functional unit. We believe that our analysis is an important step toward extending future research to include a wider range of age groups and dysphagia patients.

A comparison of the lubrication behavior of whey protein model foods using tribology in linear and elliptical movement

Lubrication is an important factor in the sensory evaluation of food products. Tribology provides a theoretical framework and instrumental methods for evaluating frictional properties between two moving surfaces and the lubrication behavior of products between these surfaces. Relating frictional measurements to sensory properties detected during oral processing requires careful and pertinent choices in surface materials and testing conditions. The aims of this study were to investigate: (a) differences in lubrication behavior of a range of food textures and (b) the differences between linear and elliptical movement and added saliva to understand the contribution of food structure to friction. Six whey protein model food samples, ranging in texture from fluid to semisolid to soft solid, were analyzed using a pin on disk tribometer to determine the coefficient of friction (COF) across a range of sliding speeds. The samples were analyzed in their initial form and post-oral processing (n = 4) in both linear and elliptical movements. Elliptical movement slightly decreased coefficients of friction and extended the shape of the friction curve. Increases in test food viscosity decreased the COF but differences in viscosity were not apparent when test foods were mixed with saliva. Data correction for viscosity shifted the friction curves horizontally, indicating that lubrication had a greater impact upon friction than viscosity. This study provides initial insights for further comparison of linear and elliptical movement with a variety of sample compositions.

PRACTICAL APPLICATIONS

Sensory perception of smoothness and creaminess are often major contributors to overall hedonic food liking and are a major reason why products high in fat and sugar are more highly preferred over other foods. These parameters are influenced by friction and lubrication between the tongue, palate, teeth, food products, and saliva during oral processing. Tribology provides an instrumental method to evaluate friction between moving surfaces that mimic oral surfaces and the lubrication behavior of foods. Trends in frictional measurements can be correlated with sensory ratings of the same foods to better understand why preferences exist for certain foods or food compositions and how to effectively improve the acceptability and enjoyment of healthier foods.