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Kongjaroen A, Gamonpilas C, Methacanon P. Effects of dispersing media on the rheological and tribological properties of basil seed mucilage-based thickened liquids. J Texture Stud 2024; 55:e12852. [PMID: 38952166 DOI: 10.1111/jtxs.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/04/2024] [Accepted: 06/15/2024] [Indexed: 07/03/2024]
Abstract
The development of thickening powders for the management of dysphagia is imperative due to the rapid growth of aging population and prevalence of the dysphagia. One promising thickening agent that can be used to formulate dysphagia diets is basil seed mucilage (BSM). This work investigates the effects of dispersing media, including water, milk, skim milk, and apple juice, on the rheological and tribological properties of the BSM-thickened liquids. Shear rheology results revealed that the thickening ability of BSM in these media in ascending order is milk < skim milk ≈ apple juice < water. On the other hand, extensional rheology demonstrated that the longest filament breakup time was observed when BSM was dissolved in milk, followed by skim milk, water, and apple juice. Furthermore, tribological measurements showed varying lubrication behavior, depending on the BSM concentration and dispersing media. Dissolution of BSM in apple juice resulted in the most superior lubrication property compared with that in other dispersing media. Overall, this study provides insights on BSM's application as a novel gum-based thickening powder in a range of beverages and emphasizes how important it is for consumers to have clear guidance for the use of BSM in dysphagia management.
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Affiliation(s)
- Akapong Kongjaroen
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Khlong Luang, Thailand
| | - Chaiwut Gamonpilas
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Khlong Luang, Thailand
| | - Pawadee Methacanon
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Khlong Luang, Thailand
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Li L, Zhou TQ, Wang YQ, Zhang Q, Yan JN, Wang C, Lai B, Zhang LC, Wu HT. Rheological characterization of chia seed gum as a thickening agent used for dysphagia management. Int J Biol Macromol 2024; 275:133413. [PMID: 38945723 DOI: 10.1016/j.ijbiomac.2024.133413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/11/2024] [Accepted: 06/23/2024] [Indexed: 07/02/2024]
Abstract
Dysphagia has emerged as a serious health issue facing contemporary society. Consuming thickened liquids is an effective approach for improving the swallowing safety for dysphagia patients. The thickening effect of chia seed gum (CSG), a novel thickener, in different dispersing media (water, orange juice, and skim milk) was investigated. Moreover, the potential application of CSG for dysphagia management was evaluated by comparison with xanthan gum (XG) and guar gum (GG). The thickened liquids prepared with 0.4 %-1.2 % (w/v) CSG, XG, and GG could be classified into levels 1-4, 2-4, and 1-3, respectively, according to the International Dysphagia Diet Standardization Initiative (IDDSI) framework. All the thickened liquids displayed shear-thinning characteristics that facilitated safe swallowing. The viscosities (η50) of CSG dissolved in water (0.202-1.027 Pa·s) were significantly greater than those of CSG dissolved in orange juice (0.070-0.690 Pa·s) and skim milk (0.081-0.739 Pa·s), indicating that CSG had a greater thickening effect in water than in orange juice and skim milk. Compared with those prepared with GG, the thickened liquids prepared with CSG and XG exhibited greater viscoelasticity, better water-holding capacity, and more compact networks. The findings suggested that CSG can be used as a potential thickener for thickening liquid foods to manage dysphagia.
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Affiliation(s)
- Lin Li
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Tian-Qi Zhou
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Yu-Qiao Wang
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Qian Zhang
- College of Food Science and Engineering, Jilin University, Changchun 130062, China
| | - Jia-Nan Yan
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Ce Wang
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Bin Lai
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
| | - Li-Chao Zhang
- Institutes of Biomedical Sciences, Shanxi University, Taiyuan 030006, China
| | - Hai-Tao Wu
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China.
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Venkat S. Improving swallowing function with thickening agents in post-stroke oropharyngeal dysphagia: a real-world experience. Curr Med Res Opin 2024; 40:1163-1170. [PMID: 38864410 DOI: 10.1080/03007995.2024.2365406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 06/04/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION Post-stroke dysphagia (PSD) is a widely prevalent and possibly life-threatening consequence that may lead to aspiration pneumonia, malnutrition, dehydration, and higher mortality risk. Recommending thickened fluids (TF) is a longstanding practice in the management of dysphagia. Augmenting liquid viscosity with a xanthan gum-based thickener benefits patients with PSD by aiding in the enhancement of bolus control, facilitating improved coordination in the swallowing mechanism, and lowering the risk of aspiration. Despite the widespread use of TF, limited high-quality evidence supports its benefits in PSD. CASE REPORT This manuscript presents the clinical experience with four varied cases of PSD. A comprehensive approach to management with TF decreased the risk of aspiration pneumonia and facilitated effective management of dietary recommendations both during hospitalization and after discharge (all Cases). In addition, TF maintained nutrition and hydration in patients with multiple hospital admissions (Case 2), maintained hydration in those unable to engage in swallow rehabilitation due to complex medical conditions (Cases 2, 3, and 4), and those who needed slow and longer recovery due to long-term risk of silent aspiration (Cases 2, 3, and 4). In one case (Case 4), the use of TF was extended for more than two years post-stroke with no reported incidence of chest infection. CONCLUSION In routine clinical practice, a comprehensive management approach with xanthan gum-based TFs reduces the risk of aspiration and aspiration pneumonia in patients with PSD while maintaining nutritional and hydration and improving swallowing function based on formal instrumental assessments. This clinical experience highlights the pivotal role of instrumental assessment, patient education, and informed decision-making to optimize outcomes with TF.
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Gi Chun Y, Jeong Kim Y, Young Lee I, Young Jeon E, Kim BK. Relationship between rheological properties, sensory perception, and overall acceptability of thickened liquids for dysphagia in young and old healthy individuals. Food Res Int 2024; 188:114511. [PMID: 38823884 DOI: 10.1016/j.foodres.2024.114511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 06/03/2024]
Abstract
This study investigated the relationship between rheological properties, sensory perception, and overall acceptability in healthy young and old groups for dysphagia thickened liquids. Unflavored (UTL) and flavored (FTLP) thickened liquids were prepared using tap water or pomegranate juice at 10 different viscosity levels. The rheological properties were then evaluated via syringe flow test and line spread test (LST). When the apparent viscosity levels of UTL and FTLP were similar, the syringe test and LST results were also similar, indicating consistent flow behavior. Sensory perception evaluations showed that the young group better distinguished viscosity differences between stages compared to the old group. Regarding overall acceptability, the old group preferred samples with higher apparent viscosity than the young group. Principal component analysis and k-means cluster analysis were used to explore correlations between variables and classify thickened liquids into four groups. This can serve the foundation for standardized texture grades of dysphagia thickened liquids, considering rheological characteristics and sensory profiles.
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Affiliation(s)
- Yong Gi Chun
- Research Group of Food Processing, Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Republic of Korea
| | - Yun Jeong Kim
- Research Group of Food Processing, Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Republic of Korea; Department of Food Biotechnology, University of Science and Technology, Daejeon 34113, Republic of Korea
| | - In Young Lee
- Research Group of Food Processing, Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Republic of Korea
| | - Eun Young Jeon
- Research Group of Food Processing, Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Republic of Korea
| | - Bum-Keun Kim
- Research Group of Food Processing, Korea Food Research Institute, Wanju-gun, Jeollabuk-do 55365, Republic of Korea; Department of Food Biotechnology, University of Science and Technology, Daejeon 34113, Republic of Korea.
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5
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Wang K, Cheng Z, Qiao D, Xie F, Zhao S, Zhang B. Polysaccharide-dextrin thickened fluids for individuals with dysphagia: recent advances in flow behaviors and swallowing assessment methods. Crit Rev Food Sci Nutr 2024:1-25. [PMID: 38556920 DOI: 10.1080/10408398.2024.2330711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
The global aging population has brought about a pressing health concern: dysphagia. To effectively address this issue, we must develop specialized diets, such as thickened fluids made with polysaccharide-dextrin (e.g., water, milk, juices, and soups), which are crucial for managing swallowing-related problems like aspiration and choking for people with dysphagia. Understanding the flow behaviors of these thickened fluids is paramount, and it enables us to establish methods for evaluating their suitability for individuals with dysphagia. This review focuses on the shear and extensional flow properties (e.g., viscosity, yield stress, and viscoelasticity) and tribology (e.g., coefficient of friction) of polysaccharide-dextrin-based thickened fluids and highlights how dextrin inclusion influences fluid flow behaviors considering molecular interactions and chain dynamics. The flow behaviors can be integrated into the development of diverse evaluation methods that assess aspects such as flow velocity, risk of aspiration, and remaining fluid volume. In this context, the key in-vivo (e.g., clinical examination and animal model), in-vitro (e.g., the Cambridge Throat), and in-silico (e.g., Hamiltonian moving particles semi-implicit) evaluation methods are summarized. In addition, we explore the potential for establishing realistic assessment methods to evaluate the swallowing performance of thickened fluids, offering promising prospects for the future.
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Affiliation(s)
- Kedu Wang
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, China
- Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, College of Food Science, Southwest University, Chongqing, China
| | - Zihang Cheng
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, China
- Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, College of Food Science, Southwest University, Chongqing, China
| | - Dongling Qiao
- Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, College of Food Science, Southwest University, Chongqing, China
| | - Fengwei Xie
- Department of Chemical Engineering, University of Bath, Bath, UK
- School of Engineering, Newcastle University, Newcastle upon Tyne, UK
| | - Siming Zhao
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, China
| | - Binjia Zhang
- Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, College of Food Science, Southwest University, Chongqing, China
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Al Zahabi K, Hassan L, Maldonado R, Boehm MW, Baier SK, Sharma V. Pinching dynamics, extensional rheology, and stringiness of saliva substitutes. SOFT MATTER 2024; 20:2547-2561. [PMID: 38407364 DOI: 10.1039/d3sm01662e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Saliva substitutes are human-made formulations extensively used in medicine, food, and pharmaceutical research to emulate human saliva's biochemical, tribological, and rheological properties. Even though extensional flows involving saliva are commonly encountered in situations such as swallowing, coughing, sneezing, licking, drooling, gleeking, and blowing spit bubbles, rheological evaluations of saliva and its substitutes in most studies rely on measured values of shear viscosity. Natural saliva possesses stringiness or spinnbarkeit, governed by extensional rheology response, which cannot be evaluated or anticipated from the knowledge of shear rheology response. In this contribution, we comprehensively examine the rheology of twelve commercially available saliva substitutes using torsional rheometry for rate-dependent shear viscosity and dripping-onto-substrate (DoS) protocols for extensional rheology characterization. Even though most formulations are marketed as having suitable rheology, only three displayed measurable viscoelasticity and strain-hardening. Still, these too, failed to emulate the viscosity reduction with the shear rate observed for saliva or match perceived stringiness. Finally, we explore the challenges in creating saliva-like formulations for dysphagia patients and opportunities for using DoS rheometry for diagnostics and designing biomimetic fluids.
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Affiliation(s)
- Karim Al Zahabi
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA.
| | - Lena Hassan
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA.
| | - Ramiro Maldonado
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA.
| | | | - Stefan K Baier
- Motif FoodWorks Inc., Boston, MA 02210, USA
- School of Chemical Engineering, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Vivek Sharma
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA.
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7
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Kongjaroen A, Methacanon P, Gamonpilas C. Effects of barium sulfate on rheological properties and IDDSI flow consistency of liquid stimuli prepared using commercial thickening powders. J Texture Stud 2023; 54:835-844. [PMID: 37340614 DOI: 10.1111/jtxs.12784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/22/2023]
Abstract
During videofluoroscopic swallowing study (VFSS), barium sulfate (BaSO4 ) is commonly added into food samples as a radiopaque contrast media for bolus visualization and examination. Accordingly, the consistency and flow behavior of barium stimuli can differ significantly from their non-barium counterparts. Such differences may have a subsequent impact on the validity of VFSS. Therefore, in this study, effects of barium sulfate on the shear and extensional rheological properties and IDDSI (International Dysphagia Diet Standardization Initiative) flow consistency of liquids prepared using various commercial thickening powders were investigated. Results showed that all barium stimuli exhibited shear thinning behavior but with significantly higher shear viscosity compared to the non-barium counterparts. A shift factor of viscosity at shear rate 50 s-1 with values in range of 1.21-1.73 could be used to describe the increase in the viscosity for samples thickened with gum-based thickeners. However, the change in the viscosity was not invariant for the stimuli prepared starch-based thickener. The addition of BaSO4 had a negative impact on extensional properties of samples by demonstrating a faster filament rupture. The extent of impact on the decrease in filament breakup time was more pronounced in xanthan > guar gum ≈ tara gum-based thickeners. Based on the IDDSI flow test, no significant effect of BaSO4 was found on the gum-based thickeners, whereas there was a marked effect in the starch-based sample. These results can be used beneficially to assist clinicians in the dysphagia diagnosis for matching rheological properties of the barium stimuli to enhance effectiveness dysphagia interventions.
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Affiliation(s)
- Akapong Kongjaroen
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Khlong Luang, Pathumthani, Thailand
| | - Pawadee Methacanon
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Khlong Luang, Pathumthani, Thailand
| | - Chaiwut Gamonpilas
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Khlong Luang, Pathumthani, Thailand
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8
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Martínez-Padilla LP. Rheology of liquid foods under shear flow conditions: Recently used models. J Texture Stud 2023. [PMID: 37726094 DOI: 10.1111/jtxs.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/17/2023] [Accepted: 08/30/2023] [Indexed: 09/21/2023]
Abstract
Proper modeling of flow or viscosity curves as a function of shear rate is a useful tool in any engineering activity. The rheology of foods depends on the composition, processing to which they have been subjected and the state of dispersion in which they are found. Liquid foods are complex biosystems, that show non-Newtonian behavior under flow conditions. This review presents models used in recent decades to describe the experimental rheological behavior of various liquid foods, ranging from Newtonian fluids to the most complex. Some non-Newtonian parameters such as those of the Ostwald-de Waele, Bingham, Herschel-Bulkley, Casson, Cross, and Carreau models are summarized. Examples of thixotropic behavior described by the Weltman and Abu-Jdayil models are also presented. In each model, explanations based on the composition and dispersion state of the food are made. This is useful in innovative processing technologies and for scientists new to the field of food rheology. An attempt is made to exemplify and group the expected behavior for most fluid foods, including some for a dysphagia diet, depending on their composition or the dispersed system formed, which will be useful for professionals who wish to compare reported rheological parameters with those obtained experimentally.
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Affiliation(s)
- Laura Patricia Martínez-Padilla
- Laboratorio de Propiedades Reológicas y Funcionales en Alimentos, FES Cuautitlán, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Brito-de la Fuente E, Muñiz-Becerá S, Ascanio G. Lipid emulsions in clinical nutrition: Enteral and parenteral nutrition. ADVANCES IN FOOD AND NUTRITION RESEARCH 2023; 105:301-342. [PMID: 37516466 DOI: 10.1016/bs.afnr.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Abstract
Clinical nutrition emulsions are important products that can be life-saving for many patients suffering from gastrointestinal tract disorders, swallowing impairment, cancer, liver diseases, and many other clinical conditions. The transfer of lipids to the human body can be either intravenously (Parenteral Nutrition, PN) or through the gastrointestinal tract (Enteral Nutrition, EN). PN emulsions are considered pharmaceuticals and thus regulated accordingly. On the other hand, EN emulsions are classified as Food for Specific Medical Purposes (FSMP) and do not follow pharmaceutical regulations. Regarding product design, PN emulsions must follow theoretical emulsion formulation and production aspects, but special requirements regarding droplet size distribution must be followed to comply with national pharmacopeia monographs. Furthermore, a full clinical program on clinical evidence to prove safety and efficacy must be provided for marketing approval. On the contrary, EN emulsions require limited clinical evidence to substantiate health or clinical benefits. A short introduction to clinical nutrition with a focus on lipid emulsions is presented in this chapter. Furthermore, a general overview of the composition and main ingredients of clinical nutrition lipid emulsions is reviewed. Main clinical aspects are also mentioned here, highlighting the difficulties of clinically proving the efficacy of these products. The manufacturing and control of clinical nutrition emulsions are also reviewed, focusing on PN products and the main regulatory requirements related to the safety of these intravenous emulsions. Finally, stability and physicochemical properties are reviewed, and examples of commercially available products are used to illustrate these properties linked to the stability of these products. Lipids in clinical nutrition is a moving field and we do hope this chapter may remain a valuable source to understand newly emerging research on this topic.
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Affiliation(s)
- Edmundo Brito-de la Fuente
- Instituto de Ciencias Aplicadas y Tecnología, Universidad Nacional Autónoma de México, Circuito Exterior S/N, Ciudad Universitaria, Mexico City, Mexico.
| | - Sahylin Muñiz-Becerá
- Instituto de Ciencias Aplicadas y Tecnología, Universidad Nacional Autónoma de México, Circuito Exterior S/N, Ciudad Universitaria, Mexico City, Mexico
| | - Gabriel Ascanio
- Instituto de Ciencias Aplicadas y Tecnología, Universidad Nacional Autónoma de México, Circuito Exterior S/N, Ciudad Universitaria, Mexico City, Mexico
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10
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Gallegos C, Turcanu M, Assegehegn G, Brito-de la Fuente E. Rheological Issues on Oropharyngeal Dysphagia. Dysphagia 2023; 38:558-585. [PMID: 34216239 DOI: 10.1007/s00455-021-10337-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
There is an increasing proof of the relevance of rheology on the design of fluids for the diagnosis and management of dysphagia. In this sense, different authors have reported clinical evidence that support the conclusion that an increase in bolus viscosity reduces the risks of airway penetration during swallowing. However, this clinical evidence has not been associated yet to the definition of objective viscosity levels that may help to predict a safe swallowing process. In addition, more recent reports highlight the potential contribution of bolus extensional viscosity, as elongational flows also develops during the swallowing process. Based on this background, the aim of this review paper is to introduce the lecturer (experts in Dysphagia) into the relevance of Rheology for the diagnosis and management of oropharyngeal dysphagia (OD). In this sense, this paper starts with the definition of some basic concepts on Rheology, complemented by a more extended vision on the concepts of shear viscosity and elongational viscosity. This is followed by a short overview of shear and elongational rheometrical techniques relevant for the characterization of dysphagia-oriented fluids, and, finally, an in-depth analysis of the current knowledge concerning the role of shear and elongational viscosities in the diagnosis and management of OD (shear and elongational behaviors of different categories of dysphagia-oriented products and contrast fluids for dysphagia assessment, as well as the relevance of saliva influence on bolus rheological behavior during the swallowing process).
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Affiliation(s)
- Crispulo Gallegos
- Product and Process Engineering Center, Fresenius Kabi Deutschland GmbH, Daimlerstrasse 22, 61352, Bad Homburg, Germany.
| | - Mihaela Turcanu
- Product and Process Engineering Center, Fresenius Kabi Deutschland GmbH, Daimlerstrasse 22, 61352, Bad Homburg, Germany
| | - Getachew Assegehegn
- Product and Process Engineering Center, Fresenius Kabi Deutschland GmbH, Daimlerstrasse 22, 61352, Bad Homburg, Germany
| | - Edmundo Brito-de la Fuente
- Product and Process Engineering Center, Fresenius Kabi Deutschland GmbH, Daimlerstrasse 22, 61352, Bad Homburg, Germany
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Giura L, Urtasun L, Astiasaran I, Ansorena D. Application of HPP for the Development of a Dessert Elaborated with Casein and Cocoa for a Dysphagia Diet. Foods 2023; 12:foods12040882. [PMID: 36832957 PMCID: PMC9957160 DOI: 10.3390/foods12040882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
In this study, the application of high-pressure processing (HPP) for optimizing the texture of a cocoa dessert rich in casein and developed for people with dysphagia was investigated. Different treatments (250 MPa/15 min; 600 MPa/5 min) and protein concentrations (10-15%) were combined and evaluated for choosing the optimum combination leading to an adequate texture. The selected formulation was a dessert containing 4% cocoa and 10% casein and subjected to 600 MPa for 5 min. It showed a high nutritional value (11.5% protein) and high antioxidant capacity, which was slightly affected by the HPP processing. The rheological and textural properties showed that HPP had a clear effect on the dessert structure. The loss tangent decreased from 2.692 to 0.165, indicating the transition from a liquid to a gel-like structure, which is in a suitable range for dysphagia foods. During storage (14 and 28 days at 4 °C), progressive significant changes in the structure of the dessert were observed. A decrease in all rheological and textural parameters occurred, except for the loss of tangent, which increased its value. In any case, at 28 days of storage, samples maintained the weak gel-like structure (0.686 loss tangent) that is acceptable for dysphagia management.
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Affiliation(s)
- Larisa Giura
- Centro de Investigación en Nutrición, Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, IDISNA—Instituto de Investigación Sanitaria de Navarra, Universidad de Navarra, 31008 Pamplona, Spain
- National Centre for Food Technology and Safety (CNTA), Crta-Na 134-km 53, 31570 San Adrian, Spain
| | - Leyre Urtasun
- Centro de Investigación en Nutrición, Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, IDISNA—Instituto de Investigación Sanitaria de Navarra, Universidad de Navarra, 31008 Pamplona, Spain
| | - Iciar Astiasaran
- National Centre for Food Technology and Safety (CNTA), Crta-Na 134-km 53, 31570 San Adrian, Spain
| | - Diana Ansorena
- National Centre for Food Technology and Safety (CNTA), Crta-Na 134-km 53, 31570 San Adrian, Spain
- Correspondence:
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12
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Gamonpilas C, Kongjaroen A, Methacanon P. The importance of shear and extensional rheology and tribology as the design tools for developing food thickeners for dysphagia management. Food Hydrocoll 2023. [DOI: 10.1016/j.foodhyd.2023.108603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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13
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Ozola L, Shengjuler D, Galoburda R, Kruma Z, Straumite E, Kampuse S. Development and Characteristics of Plant-Based Product Prototypes for Oro-Pharyngeal Dysphagia Diet. Foods 2023; 12:foods12030474. [PMID: 36766006 PMCID: PMC9914909 DOI: 10.3390/foods12030474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
Patients with dysphagia diseases require food with acceptable textural characteristics. Additionally, due to the consumption of smaller portions, these patients receive insufficient amounts of nutrients. Therefore, this study aimed to develop plant-based purée as a meal for an oro-pharyngeal dysphagia (OD) diet, enriched with proteins, fiber and antioxidant vitamins. The suitability of three protein sources-soy protein isolate, whey protein isolate and brown pea protein concentrate-was tested through evaluation of their effect on the rheological properties of protein-enriched plant-based purées for OD diets. Based on the rheological analysis, whey protein was selected for incorporation into the new product formulations. Two prototypes of soups and two prototypes of desserts produced in this study demonstrated acceptable textural properties and high nutritional value.
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14
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Malafronte L, Yilmaz-Turan S, Dahl L, Vilaplana F, Lopez-Sanchez P. Shear and extensional rheological properties of whole grain rye and oat aqueous suspensions. Food Hydrocoll 2022. [DOI: 10.1016/j.foodhyd.2022.108319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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15
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Kongjaroen A, Methacanon P, Seetapan N, Fuongfuchat A, Gamonpilas C, Nishinari K. Effects of dispersing media on the shear and extensional rheology of xanthan gum and guar gum-based thickeners used for dysphagia management. Food Hydrocoll 2022. [DOI: 10.1016/j.foodhyd.2022.107857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Calmarza-Chueca F, Sánchez-Gimeno AC, Raso-Pueyo J, Arbones-Mainar JM, Caverni-Muñoz A, Sanz-Arque A, Sanz-Paris A. Rheological Properties and Stability of Thickeners for Clinical Use. Nutrients 2022; 14:nu14173455. [PMID: 36079712 PMCID: PMC9460253 DOI: 10.3390/nu14173455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
The adaptation of liquids for patients with dysphagia requires precision and individualization in the viscosities used. We describe the variations of viscosity in water at different concentrations and evolution over time of the three compositions of commercial thickeners that are on the market (starch, starch with gums, and gum). By increasing the concentration in water, the viscosity of gum-based thickeners increases linearly, but it did not reach pudding texture, whereas the viscosity of the starch-based thickeners (alone or mixed with gums) rapidly reaches very thick textures. We modeled the viscosity at different concentrations of the four thickeners using regression analysis (R2 > 0.9). We analyzed viscosity changes after 6 h of preparation. The viscosity of gum-based thickeners increased by a maximum of 6.5% after 6 h of preparation, while starch-based thickeners increased by up to 43%. These findings are important for correct handling and prescription. Gum-based thickeners have a predictable linear behavior with the formula we present, reaching nectar and honey-like textures with less quantity of thickener, and are stable over time. In contrast, starch thickeners have an exponential behavior which is difficult to handle, they reach pudding-like viscosity, and are not stable over time.
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Affiliation(s)
| | - Ana Cristina Sánchez-Gimeno
- Food Technology, Faculty of Veterinary, AgriFood Institute of Aragon (IA2), Zaragoza University, C/Miguel Servet, 177, 50013 Zaragoza, Spain
| | - Javier Raso-Pueyo
- Food Technology, Faculty of Veterinary, AgriFood Institute of Aragon (IA2), Zaragoza University, C/Miguel Servet, 177, 50013 Zaragoza, Spain
| | - José Miguel Arbones-Mainar
- Aragón Health Research Institute, 50009 Zaragoza, Spain
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Instituto Aragones de Ciencias de la Salud (IACS), University Hospital Miguel Servet, 50009 Zaragoza, Spain
- Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
| | | | - Alejandro Sanz-Arque
- Department of Endocrinology and Nutrition, Miguel Servet Hospital, 50009 Zaragoza, Spain
| | - Alejandro Sanz-Paris
- Department of Endocrinology and Nutrition, Miguel Servet Hospital, 50009 Zaragoza, Spain
- Aragón Health Research Institute, 50009 Zaragoza, Spain
- Correspondence:
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17
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Baixauli R, Bolivar-Prados M, Ismael-Mohammed K, Clavé P, Tárrega A, Laguna L. Characterization of Dysphagia Thickeners Using Texture Analysis-What Information Can Be Useful? Gels 2022; 8:gels8070430. [PMID: 35877515 PMCID: PMC9323126 DOI: 10.3390/gels8070430] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 02/04/2023] Open
Abstract
Besides shear viscosity, other texture parameters (adhesiveness or cohesiveness) might be relevant for safe swallowing in people suffering from oropharyngeal dysphagia. Shear viscosity is assessed through protocols developed using a viscometer or a rheometer. In contrast, protocols and instruments (capillary break-up rheometer) to assess adhesiveness and cohesiveness are less common and much less developed. Other equipment such as texture analyzers can provide useful information on food properties. Here, we aimed to explore different texture analyzer settings (type of test, probe, and protocol) to characterize four commercial dysphagia thickeners at the shear viscosity levels recommended by manufacturers. Among the tests used (extrusion or penetration) with the different probes (disc, cone and shape holder, sphere, or cylinder), cone extrusion provided information about adhesivity, disc extrusion about sample cohesiveness, and sphere about penetration and sample elasticity. The test speeds used influenced the results, but only one speed is needed as the different speeds provided the same fluid information; for easiness, it is proposed to use 1 mm/s. Comparing the texture analyzer results with viscosity values obtained at different shears, the texture analyzer parameters reflected information that differ from shear viscosity. This information could be relevant for the therapeutic effect of thickening products and food characterization.
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Affiliation(s)
- Raquel Baixauli
- Institute of Agrochemistry and Food Technology (IATA, CSIC), 46980 Valencia, Spain; (R.B.); (A.T.)
| | - Mireia Bolivar-Prados
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain; (M.B.-P.); (K.I.-M.); (P.C.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), 08304 Barcelona, Spain
| | - Kovan Ismael-Mohammed
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain; (M.B.-P.); (K.I.-M.); (P.C.)
| | - Pere Clavé
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, 08304 Mataró, Spain; (M.B.-P.); (K.I.-M.); (P.C.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), 08304 Barcelona, Spain
| | - Amparo Tárrega
- Institute of Agrochemistry and Food Technology (IATA, CSIC), 46980 Valencia, Spain; (R.B.); (A.T.)
| | - Laura Laguna
- Institute of Agrochemistry and Food Technology (IATA, CSIC), 46980 Valencia, Spain; (R.B.); (A.T.)
- Correspondence:
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18
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Yang Y, Xu J, Sang TT, Wang HY. A review and evidence based recommendations on starch- and gum-based thickeners for dysphagic patients. JOURNAL OF FOOD MEASUREMENT AND CHARACTERIZATION 2022. [DOI: 10.1007/s11694-022-01418-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Mirazimi F, Saldo J, Sepulcre F, Gràcia A, Pujola M. Enriched puree potato with soy protein for dysphagia patients by using 3D printing. FOOD FRONTIERS 2022. [DOI: 10.1002/fft2.149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Farnaz Mirazimi
- Departament d'Enginyeria Agroalimentària i Biotecnologia Universitat Politècnica de Catalunya ‐ Campus del Baix Llobregat Castelldefels Catalonia Spain
| | - Jordi Saldo
- Animal and Food Science Department Centre d'Innovació, Recerca i Transferència en Tecnologia dels Aliments (CIRTTA) XaRTA, TECNIO Universitat Autònoma de Barcelona Facultat de Veterinària Cerdanyola del Vallès Catalonia Spain
- CEPROBI‐IPN Yautepec Morelos Mexico
| | - Francesc Sepulcre
- Departament d'Enginyeria Agroalimentària i Biotecnologia Universitat Politècnica de Catalunya ‐ Campus del Baix Llobregat Castelldefels Catalonia Spain
| | | | - Montserrat Pujola
- Departament d'Enginyeria Agroalimentària i Biotecnologia Universitat Politècnica de Catalunya ‐ Campus del Baix Llobregat Castelldefels Catalonia Spain
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20
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Ohie K, Chiba H, Kumagai S, Yoshida T, Tasaka Y. A method for evaluating time-resolved rheological functionalities of fluid foods. J Texture Stud 2022; 53:444-452. [PMID: 35338484 PMCID: PMC9544376 DOI: 10.1111/jtxs.12679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/13/2022] [Accepted: 03/23/2022] [Indexed: 11/27/2022]
Abstract
We have developed an effective method for evaluating time-resolved rheological functionalities of swallowed foods using ultrasonic spinning rheometry (USR). USR can obtain variations over time in the rheological properties of fluids despite the fluids being in heterogeneous and non-equilibrium conditions. In addition, USR can evaluate time variations of shear-thinning property changing in a few seconds. Demonstrations were conducted with typical thickener solutions: starch, guar gum, and xanthan gum-based solutions, with alpha-amylase as a digestive enzyme. The flow curve of the starch-based solutions lowered with time, and a few minutes after addition of the amylase, the viscosity dropped to one-hundredth of the original value. In contrast, the guar gum and xanthan gum-based solutions maintained the original viscosities as generally known. Applying the power law fitting to series of these flow curves, the time variation of the shear thinning property is quantitatively characterized by the plots on typical K-n space, where K and n are parameters in the model, consistency index and power law exponent. The qualitative characteristics of the thickeners are successfully quantified in the K-n space, and this will be a practical tool for evaluating the time-resolved rheological properties of swallowed foods.
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Affiliation(s)
- Kohei Ohie
- Laboratory for Flow Control, Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Haruko Chiba
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Satomi Kumagai
- Nutrition Management Center, Hokkaido University Hospital, Sapporo, Japan
| | - Taiki Yoshida
- National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology, Tsukuba Central 3, 1-1-1, Umezono, Tsukuba, Japan
| | - Yuji Tasaka
- Laboratory for Flow Control, Faculty of Engineering, Hokkaido University, Sapporo, Japan
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21
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Himashree P, Sengar AS, Sunil CK. Food thickening agents: Sources, chemistry, properties and applications - A review. Int J Gastron Food Sci 2022. [DOI: 10.1016/j.ijgfs.2022.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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On the assessment of shear and extensional rheology of thickened liquids from commercial gum-based thickeners used in dysphagia management. J FOOD ENG 2022. [DOI: 10.1016/j.jfoodeng.2021.110820] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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23
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Panraksa P, Zhang B, Rachtanapun P, Jantanasakulwong K, Qi S, Jantrawut P. ‘Tablet-in-Syringe’: A Novel Dosing Mechanism for Dysphagic Patients Containing Fast-Disintegrating Tablets Fabricated Using Semisolid Extrusion 3D Printing. Pharmaceutics 2022; 14:pharmaceutics14020443. [PMID: 35214175 PMCID: PMC8879151 DOI: 10.3390/pharmaceutics14020443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/16/2022] Open
Abstract
With the ability to fabricate personalized dosage forms and considerably shorter manufacturing time, semisolid extrusion (SSE) 3D printing has rapidly grown in popularity in recent years as a novel, versatile manufacturing method that powers a wide range of applications in the pharmaceutical field. In this work, the feasibility of using SSE 3D printing to fabricate fast-disintegrating tablets (FDTs) that are pre-filled in dosing syringes was evaluated. The novel design approach, ‘tablet-in-syringe’, was aimed to ease the oral drug administration and improve the dosing accuracy for dysphagic patients. The effect of varying polymer (hydroxypropyl methylcellulose E15) concentrations and printing parameters (e.g., extrusion rate) on dimensional accuracy, physicochemical properties, disintegration time, and content uniformity of 3D-printed FDTs was studied. An overall comparison of results demonstrated that the best FDT formulation among those developed was with a polymer:drug ratio (w/w) of 1:30, printed at extrusion rate of 3.5 μL/s. The diameter of printed filaments of this formulation was observed to be similar to the nozzle diameter (22G), proving that good printing accuracy was achieved. This FDTs also had the fastest disintegration time (0.81 ± 0.14 min) and a drug (phenytoin sodium, as the model drug) content uniformity that met pharmacopeial specifications. Although the flow characteristics of the dissolved formulation still need improvement, our findings suggested that the novel ‘tablet-in-syringe’ could potentially be considered as a promising fast-disintegrating drug delivery system that can be personalized and manufactured at—or close to—the point of care for dysphagic patients using SSE.
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Affiliation(s)
- Pattaraporn Panraksa
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Bin Zhang
- School of Pharmacy, University of East Anglia, Norwich NR4 7TJ, UK;
| | - Pornchai Rachtanapun
- Division of Packaging Technology, Faculty of Agro-Industry, School of Agro-Industry, Chiang Mai University, Chiang Mai 50100, Thailand; (P.R.); (K.J.)
- Cluster of Agro Bio-Circular-Green Industry (Agro BCG), Chiang Mai University, Chiang Mai 50100, Thailand
| | - Kittisak Jantanasakulwong
- Division of Packaging Technology, Faculty of Agro-Industry, School of Agro-Industry, Chiang Mai University, Chiang Mai 50100, Thailand; (P.R.); (K.J.)
- Cluster of Agro Bio-Circular-Green Industry (Agro BCG), Chiang Mai University, Chiang Mai 50100, Thailand
| | - Sheng Qi
- School of Pharmacy, University of East Anglia, Norwich NR4 7TJ, UK;
- Correspondence: (S.Q.); or (P.J.); Tel.: +44-1603592925 (S.Q.); +66-53944309 (P.J.)
| | - Pensak Jantrawut
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand;
- Cluster of Agro Bio-Circular-Green Industry (Agro BCG), Chiang Mai University, Chiang Mai 50100, Thailand
- Correspondence: (S.Q.); or (P.J.); Tel.: +44-1603592925 (S.Q.); +66-53944309 (P.J.)
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Sethupathy P, Priyadarshini SR, Moses JA, Anandharamakrishnan C. Matrix‐dependent oral processing, oro‐sensory perception, and glycemic index of chocolate bars. J FOOD PROCESS PRES 2021. [DOI: 10.1111/jfpp.16067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Priyanka Sethupathy
- Computational Modeling and Nanoscale Processing Unit National Institute of Food Technology, Entrepreneurship and Management (NIFTEM) ‐ Thanjavur Ministry of Food Processing Industries Government of India Thanjavur India
| | - S. R. Priyadarshini
- Computational Modeling and Nanoscale Processing Unit National Institute of Food Technology, Entrepreneurship and Management (NIFTEM) ‐ Thanjavur Ministry of Food Processing Industries Government of India Thanjavur India
| | - Jeyan A. Moses
- Computational Modeling and Nanoscale Processing Unit National Institute of Food Technology, Entrepreneurship and Management (NIFTEM) ‐ Thanjavur Ministry of Food Processing Industries Government of India Thanjavur India
| | - Chinnaswamy Anandharamakrishnan
- Computational Modeling and Nanoscale Processing Unit National Institute of Food Technology, Entrepreneurship and Management (NIFTEM) ‐ Thanjavur Ministry of Food Processing Industries Government of India Thanjavur India
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25
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Comparing rheological, tribological and sensory properties of microfibrillated cellulose dispersions and xanthan gum solutions. Food Hydrocoll 2021. [DOI: 10.1016/j.foodhyd.2021.107052] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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26
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Funami T, Nakauma M. Correlation of human perception in swallowing with extension rheological and tribological characteristics in comparison with shear rheology. J Texture Stud 2021; 53:60-71. [PMID: 34841545 DOI: 10.1111/jtxs.12648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/18/2021] [Accepted: 11/18/2021] [Indexed: 12/28/2022]
Abstract
Correlation was investigated between instrumental characteristics obtained by extension rheological or tribological measurements and human perception while swallowing using aqueous solutions of xanthan gum and locust bean gum. Extension viscosity and the friction coefficient were measured using a capillary breakup rheometer and a rotation tribometer, respectively, as in our previous study. Results were compared with shear viscosity to clarify novelty and advantage of these mechanical parameters. It was indicated that perceived cohesiveness correlated the highest with the maximum extension viscosity immediately after the onset of extensional flow, perceived spinnability correlated with extension viscosity in high Hencky strain region, and perceived sliminess correlated with the friction coefficient at the critical point between the boundary lubrication and the mixed lubrication. These correlations were discussed and tried to validate considering biomechanics of human swallowing and food-human interactions.
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27
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Calmarza-Chueca F, Cristina-Sánchez-Gimeno A, Perez-Nogueras J, Caverni-Muñoz A, Sanz-Arque A, Arbones-Mainar JM, Sanz-Paris A. Institutionalized elderly are able to detect small viscosity variations in thickened water with gum-based thickeners: should texture classifications be reviewed? BMC Geriatr 2021; 21:647. [PMID: 34798812 PMCID: PMC8603478 DOI: 10.1186/s12877-021-02599-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 10/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of dysphagia is very high in institutionalized elderly. Knowledge of the rheological and sensory characteristics of the various thickeners in elderly is limited, although it has been seen that there are differences between the rheological behaviors of gum-based thickeners with different composition. Moreover, we have not found sensory studies of viscosity in institutionalized elderly. Our hypothesis was that viscosity ranges established by the scientific societies, such as the National Dysphagia Diet Task Force (NDD), seem to be very wide and individuals might be able to detect small differences within the same texture range. The objectives of our study were 1) comparing the rheological characteristics of two commercial gum-based thickeners with different composition, dissolved in water under standard conditions, and 2) perform a sensory analysis (with both adults and institutionalized elderly) to detect different viscosities within the same texture (nectar and honey). METHODS Two commercial thickeners based on gums (NC and RC) were studied analyzing their viscosity in water with different concentrations (shear rate: 50 s- 1; temperature: 22-25 °C). A sensory analysis involving 26 elderly and 29 adult controls was carried out to evaluate whether differences within nectar and honey textures among gum-based thickeners could be distinguished. RESULTS As the shear rate increases, viscosity decreases (non-Newtonian and pseudoplastic behavior). At the same concentration, each thickener produces a different viscosity (p < 0.05). Institutionalized elderly detected viscosity differences in nectar range of 49.9 (2.5) mPa·s (p < 0.05) and 102.2 (4.7) mPa·s (p < 0.0001). They also detected viscosity differences in honey texture range of 134.6 (9.7) mPa·s (p < 0.05) y 199.3 (9.2) mPa·s (p < 0.0001). Their caregivers also detected viscosity differences in both viscosity ranges (p < 0.0001) and with greater intensity than the elderly in honey texture (p: 0.016). CONCLUSIONS Our results suggest that the accepted viscosity ranges by NDD for the different textures might be too wide because institutionalized elderly and their caregivers are able to discern small differences in viscosity in nectar and honey textures. Gum-based thickeners with different composition showed differences in viscosity capacity, so they are not interchangeable.
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Affiliation(s)
| | - Ana Cristina-Sánchez-Gimeno
- Food Technology, Faculty of Veterinary, Zaragoza University, AgriFood Institute of Aragon (IA2), C/ Miguel Servet, 177, 50013, Zaragoza, Spain
| | | | | | - Alejandro Sanz-Arque
- Aragón Health Research Institute/ Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Spain
| | - José Miguel Arbones-Mainar
- Aragón Health Research Institute/ Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Spain.,Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, University Hospital Miguel Servet, Instituto Aragones de Ciencias de la Salud (IACS), 50009, Zaragoza, Spain.,Center for Biomedical Research in Network Physiopathology Obesity and Nutrition (CIBERObn), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Alejandro Sanz-Paris
- Department of Endocrinology and Nutrition, Miguel Servet Hospital, Zaragoza, Spain. .,Aragón Health Research Institute/ Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Spain.
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Funami T, Nakauma M. Instrumental characteristics from extensional rheology and tribology of polysaccharide solutions. J Texture Stud 2021; 52:567-577. [PMID: 34605034 DOI: 10.1111/jtxs.12638] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022]
Abstract
Instrumental characteristics from extensional rheology and tribology for aqueous xanthan gum (XG) and locust bean gum (LBG) solutions were studied in the presence or absence of simulated saliva. Extensional viscosity was calculated from the filament shrinkage behavior using a capillary breakup extensional rheometer, whereas the friction coefficient was measured using a set-up consisting of polydimethylsiloxane substrate and a glass ball bearing on a rotational rheometer. Increase in extensional viscosity was detected immediately after initiation of extensional flow, particularly XG, and also immediately before the filament rupture, particularly LBG. Extensional viscosity tended to decrease with increased addition of simulated saliva for XG, while to increase for LBG. In both cases, effect of cations in the saliva was greater than that of mucin. From the shape of the Stribeck curve (i.e., dependence of the friction coefficient on the entrainment speed) and comparison of the friction coefficient itself, lubricity of XG was greater than that of LBG. Simulated saliva added decreased the friction coefficient for each polysaccharide through functions of cations rather than mucin. Extensional viscosity and tribological measurements revealed mechanical properties of polysaccharide solutions which cannot be determined or quantified by shear viscosity alone.
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29
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Tackling older adults’ malnutrition through the development of tailored food products. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.06.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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30
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Wong LY, Ng ML, Tong ETS. How Accurate Are the Consistency Labels Used in Hong Kong? An Objective Study of the Consistency of Thickened Liquids Using International Dysphagia Diet Standardisation Initiative and Consistometric Measurements. Folia Phoniatr Logop 2021; 74:167-175. [PMID: 34348310 DOI: 10.1159/000518480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 07/13/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The present study objectively examined the consistency (thickness) of labels that are used in Hong Kong for the population with dysphagia using an International Dysphagia Diet Standardisation Initiative (IDDSI) flow test and Bostwick consistometric measurements. METHODS Liquids were prepared by thickening water to achieve 4 consistency labels (slightly thick, mildly thick, medium thick, and extra thick) according to manufacturer's instructions, employing 2 types of thickening products that are used in Hong Kong, i.e., starch based and gum based. For each consistency label prepared using each thickening product, the IDDSI flow test and consistometric measurements were obtained and compared. RESULTS The results showed that the actual thickness of liquids was highly dependent on the type of thickener (starch based vs. gum based) used. Thickened liquids prepared using the starch-based thickener were generally thinner than the actual value at a lower concentration. CONCLUSION Though prepared strictly following the manufacturer's instructions, the thickened liquids fail to faithfully correlate with the standardized norms established according to the IDDSI framework and the objective consistometric measurement using a Bostwick consistometer. Therefore, caution must be exercised when administering a thickened diet following the manufacturer's instructions for patients with dysphagia.
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Affiliation(s)
- Long Yat Wong
- Speech Science Laboratory, Faculty of Education, University of Hong Kong, Hong Kong, China
| | - Manwa L Ng
- Speech Science Laboratory, Faculty of Education, University of Hong Kong, Hong Kong, China
| | - Eric T S Tong
- Hong Kong Sheng Kung Hui Welfare Council, Hong Kong, China
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31
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Effect of xanthan gum co-extruded with OSA starch on its solubility and rheological properties. Lebensm Wiss Technol 2021. [DOI: 10.1016/j.lwt.2021.111588] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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32
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Methacanon P, Gamonpilas C, Kongjaroen A, Buathongjan C. Food polysaccharides and roles of rheology and tribology in rational design of thickened liquids for oropharyngeal dysphagia: A review. Compr Rev Food Sci Food Saf 2021; 20:4101-4119. [PMID: 34146451 DOI: 10.1111/1541-4337.12791] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 01/02/2023]
Abstract
In today's market environment, an aging society is recognized as one of the megatrends in the world. The demographic change in the world population age structure has driven a huge demand in healthcare products as well as services that include the technological innovation for the health and wellness of the elderly. Dysphagia or swallowing difficulty is a common problem in the elderly as many changes in swallowing function come with aging. The presence of a strong relationship between swallowing ability, nutritional status, and health outcomes in the elderly leads to the importance of dysphagia management in the population group. Modification of solid food and/or liquid is a mainstay of compensatory intervention for dysphagia patients. In this regard, texture-modified foods are generally provided to reduce risks associated with choking, while thickened liquids are recommended for mitigating risks associated with aspiration. In this review, we discuss thickened liquids and other issues including the importance of their rheological and tribological properties for oropharyngeal dysphagia management in the elderly. The review focuses on both commercial thickeners that are either based on modified starch or xanthan gum and other potential polysaccharide alternatives, which have been documented in the literature in order to help researchers develop or improve the characteristic properties of thickened liquids required for safe swallowing. Furthermore, some research gaps and future perspectives, particularly from the nutrition aspect related to the interaction between thickeners and other food ingredients, are suggested as such interaction may considerably control the rate of nutrient absorption and release within our body.
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Affiliation(s)
- Pawadee Methacanon
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Klong Luang, Pathumthani, Thailand
| | - Chaiwut Gamonpilas
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Klong Luang, Pathumthani, Thailand
| | - Akapong Kongjaroen
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Klong Luang, Pathumthani, Thailand
| | - Chonchanok Buathongjan
- Advanced Polymer Technology Research Group, National Metal and Materials Technology Center (MTEC), NSTDA, Klong Luang, Pathumthani, Thailand
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Giura L, Urtasun L, Belarra A, Ansorena D, Astiasarán I. Exploring Tools for Designing Dysphagia-Friendly Foods: A Review. Foods 2021; 10:1334. [PMID: 34200551 PMCID: PMC8229457 DOI: 10.3390/foods10061334] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 02/08/2023] Open
Abstract
Dysphagia is a medical condition that affects normal swallowing. To prevent the risk of aspiration or choking, thickened fluids and texture-modified foods have been used for dysphagia management with the goal of slowing down the flow of liquids and protecting the airway. This article summarizes the available information about the rheological and textural parameters, the characterization of the most-used thickeners and the application of alternative texture modification technologies that are crucial to developing safe dishes for people who suffer from swallowing difficulties. Regarding rheological and textural measurements, fundamental and empirical methods are described.
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Affiliation(s)
- Larisa Giura
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, Instituto de Investigación Sanitaria de Navarra, Universidad de Navarra, IDISNA, C/Irunlarrea s/n, 31008 Pamplona, Spain; (L.G.); (I.A.)
- National Centre for Food Technology and Safety (CNTA)—Technology and Knowledge for Food Sector Competitiveness, Navarre, Crta-Na 134-km 53, 31570 San Adrian, Spain (L.U.); (A.B.)
| | - Leyre Urtasun
- National Centre for Food Technology and Safety (CNTA)—Technology and Knowledge for Food Sector Competitiveness, Navarre, Crta-Na 134-km 53, 31570 San Adrian, Spain (L.U.); (A.B.)
| | - Amanda Belarra
- National Centre for Food Technology and Safety (CNTA)—Technology and Knowledge for Food Sector Competitiveness, Navarre, Crta-Na 134-km 53, 31570 San Adrian, Spain (L.U.); (A.B.)
| | - Diana Ansorena
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, Instituto de Investigación Sanitaria de Navarra, Universidad de Navarra, IDISNA, C/Irunlarrea s/n, 31008 Pamplona, Spain; (L.G.); (I.A.)
| | - Icíar Astiasarán
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, Instituto de Investigación Sanitaria de Navarra, Universidad de Navarra, IDISNA, C/Irunlarrea s/n, 31008 Pamplona, Spain; (L.G.); (I.A.)
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Guo Q. Understanding the oral processing of solid foods: Insights from food structure. Compr Rev Food Sci Food Saf 2021; 20:2941-2967. [PMID: 33884754 DOI: 10.1111/1541-4337.12745] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/17/2021] [Accepted: 03/03/2021] [Indexed: 01/25/2023]
Abstract
Understanding the relationship between the structure of solid foods and their oral processing is paramount for enhancing features such as texture and taste and for improving health-related factors such as management of body weight or dysphagia. This paper discusses the main aspects of the oral processing of solid foods across different categories: (1) oral physiology related to chewing, (2) in-mouth food transformation, (3) texture perception, and (4) taste perception, and emphasis is placed on unveiling the underlying mechanisms of how food structure influences the oral processing of solid foods; this is exemplified by comparing the chewing behaviors for a number of representative solid foods. It highlights that modification of the texture/taste of food based on food structure design opens up the possibility for the development of food products that can be applied in the management of health.
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Affiliation(s)
- Qing Guo
- College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.,National Engineering Research Center for Fruit and Vegetable Processing, China Agricultural University, Beijing, China.,Key Laboratory of Fruits and Vegetables Processing of Ministry of Agriculture and Rural Affairs, China Agricultural University, Beijing, China
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35
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de O S Schmidt H, Komeroski MR, Steemburgo T, de Oliveira VR. Influence of thickening agents on rheological properties and sensory attributes of dysphagic diet. J Texture Stud 2021; 52:587-602. [PMID: 33760237 DOI: 10.1111/jtxs.12596] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 12/11/2022]
Abstract
Dysphagia is the difficulty during the progression of the bolus from the mouth to the stomach. Modifying the texture of the food is a fundamental factor for safe swallowing in patients with dysphagia since inadequate consistency can result in complications. To personalize and develop diets for dysphagia, understanding, and controlling the rheological and sensory properties of thickeners is useful. This review examines the different types of thickeners used to modify the texture of foods, as well as their influence on rheological properties and sensory attributes to efficiently manage the diet in dysphagia. The study discusses characteristics such as: hardness, viscosity, viscoelasticity, as well as sensory attributes related to rheology. The thickeners xanthan gum, methylcellulose, carboxymethylcellulose, guar gum, linseed, and chia, carboxymethylated curdlan, and konjac glucomannan were reviewed in this work. Sensory evaluations of different foods have already been carried out on some products such as: meats, carrots, soups, pates, and timbales with their modified textures. The sensory attributes measured among hydrocolloids are strongly correlated with rheological parameters. Dysphagic diets should have less hardness and adherence, but with adequate cohesiveness to facilitate chewing, swallowing to protect from aspiration and reduction of residues in the oropharynx. The use of a single type of thickener may not be ideal, their mixtures and synergistic effect can improve the viscous and elastic characteristics of foods, to obtain safe food to swallow and to improve the sensory interest of dysphagic patients. Personalized recommendations with follow-up on swallowing approaches, respecting patient's individuality, explaining thickening agents' differences would be pertinent.
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Affiliation(s)
- Helena de O S Schmidt
- Institute of Food Science and Technology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Marina Rocha Komeroski
- Institute of Food Science and Technology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Thaís Steemburgo
- Nutrition Department, Postgraduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Viviani Ruffo de Oliveira
- Nutrition Department, Postgraduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
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36
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Yasuda T, Shimokasa K. A proposed method of evaluating the yield stress of a thickened liquid using a simplified inclined plane test. J Texture Stud 2021; 53:307-314. [PMID: 33580713 DOI: 10.1111/jtxs.12590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
Managing the thickening index of food is important for dysphagia and helps in recognizing the static and dynamic rheological properties of the thickening agent. One dynamic property is the viscosity under a shear rate of 50 s-1 , and one static property is the yield stress at a shear rate of 0 s-1 . The purpose of this study is to design a simplified inclined plane test to identify the yield stress of a thickened liquid by observing flow behavior on an inclined plate. The yield angle (stress) is defined as the inclination angle of the plate just before the thickened liquid flows. The concentrations (yield stresses, yield angles) of a thickening agent containing xanthan gum are 1.0 (1.2, 3°), 1.5 (5.6, 13°), 2.0 (7.5, 26°), 2.5 (12.5, 26°), and 3.0 (19.1, 42°) wt% (Pa, degrees). We measured the time course of the displacement of the downstream edge (DDE) of the thickened liquid on the inclined plate. The discrete inclination angles were in the range of 0° to 42°. The DDE after 10 s was more than 4.5 mm for all concentrations of the thickening agent at an inclination greater than the yield angle of the plate. We confirmed that the yield angle identifies the yield stress for the thickened liquid via the DDE using the simplified inclined plane test with discrete inclination angles.
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Affiliation(s)
- Toshitaka Yasuda
- Department of Electronic Engineering, Tokyo National College of Technology, Tokyo, Japan
| | - Kenji Shimokasa
- Course of System Engineering, Division of Industrial Technology, Tsukuba University of Technology, Ibaraki, Japan
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37
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Herranz B, Criado C, Pozo-Bayón MÁ, Álvarez MD. Effect of addition of human saliva on steady and viscoelastic rheological properties of some commercial dysphagia-oriented products. Food Hydrocoll 2021. [DOI: 10.1016/j.foodhyd.2020.106403] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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38
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Vieira J, Andrade C, Santos T, Okuro P, Garcia S, Rodrigues M, Vicente A, Cunha R. Flaxseed gum-biopolymers interactions driving rheological behaviour of oropharyngeal dysphagia-oriented products. Food Hydrocoll 2021. [DOI: 10.1016/j.foodhyd.2020.106257] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Theocharidou A, Ahmad M, Petridis D, Vasiliadou C, Chen J, Ritzoulis C. Sensory perception of guar gum-induced thickening: Correlations with rheological analysis. Food Hydrocoll 2021. [DOI: 10.1016/j.foodhyd.2020.106246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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40
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Application of food texture to moderate oral processing behaviors and energy intake. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.10.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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41
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Hadde EK, Chen J. Texture and texture assessment of thickened fluids and texture-modified food for dysphagia management. J Texture Stud 2020; 52:4-15. [PMID: 33155674 DOI: 10.1111/jtxs.12567] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/26/2020] [Accepted: 11/02/2020] [Indexed: 12/19/2022]
Abstract
Thickened fluids and texture-modified foods are commonly used in the medical management of individuals who suffer from swallowing difficulty (known as dysphagia). However, how to reliably assess texture properties of such food systems is still a big challenge both to industry and to academic researchers. This article aims to identify key physical parameters that are important for objective assessment of such properties by reviewing the significance of rheological or textural properties of thickened fluids and texture-modified foods for swallowing. Literature reviews have identified that dominating textural properties in relation to swallowing could be very different for thickened fluids and for texture-modified foods. Important parameters of thickened fluids are generally related with the flow of the bolus in the pharyngeal stage, while important parameters of texture-modified foods are generally related with the bolus preparation in the oral stage as well as the bolus flow in the pharyngeal stage. This review helps to identify key textural parameters of thickened fluids and texture-modified foods in relation to eating and swallowing and to develop objective measuring techniques for quality control of thickened fluids and texture-modified foods for dysphagia management.
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Affiliation(s)
- Enrico K Hadde
- Lab of Food Oral Processing, School of Food Science and Biotechnology, Zhejiang Gongshang University, Zhejiang, Hangzhou, China
| | - Jianshe Chen
- Lab of Food Oral Processing, School of Food Science and Biotechnology, Zhejiang Gongshang University, Zhejiang, Hangzhou, China
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Patel S, McAuley WJ, Cook MT, Sun Y, Hamdy S, Liu F. The Swallowing Characteristics of Thickeners, Jellies and Yoghurt Observed Using an In Vitro Model. Dysphagia 2020; 35:685-695. [PMID: 31707519 PMCID: PMC7351813 DOI: 10.1007/s00455-019-10074-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/24/2019] [Indexed: 02/03/2023]
Abstract
Drinks and foods may be thickened to improve swallowing safety for dysphagia patients, but the resultant consistencies are not always palatable. Characterising alternative appetising foods is an important task. The study aims to characterise the in vitro swallowing behaviour of specifically formulated thickened dysphagia fluids containing xanthan gum and/or starch with standard jellies and yoghurt using a validated mechanical model, the "Cambridge Throat". Observing from the side, the model throat can follow an experimental oral transit time (in vitro-OTT) and a bolus length (BL) at the juncture of the pharynx and larynx, to assess the velocity and cohesion of bolus flow. Our results showed that higher thickener concentration produced longer in vitro-OTT and shorter BL. At high concentration (spoon-thick), fluids thickened with starch-based thickener showed significantly longer in vitro-OTT than when xanthan gum-based thickener was used (84.5 s ± 34.5 s and 5.5 s ± 1.6 s, respectively, p < 0.05). In contrast, at low concentration (nectar-like), fluids containing xanthan gum-based thickener demonstrated shorter BL than those of starch-based thickener (6.4 mm ± 0.5 mm and 8.2 mm ± 0.8 mm, respectively, p < 0.05). The jellies and yoghurt had comparable in vitro-OTT and BL to thickeners at high concentrations (honey-like and spoon-thick), indicating similar swallowing characteristics. The in vitro results showed correlation with published in vivo data though the limitations of applying the in vitro swallowing test for dysphagia studies were noted. These findings contribute useful information for designing new thickening agents and selecting alternative and palatable safe-to-swallow foods.
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Affiliation(s)
- Simmi Patel
- Department of Clinical and Pharmaceutical Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | - William J McAuley
- Department of Clinical and Pharmaceutical Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | - Michael T Cook
- Department of Clinical and Pharmaceutical Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | - Yi Sun
- Department of Engineering and Computer Science, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | - Shaheen Hamdy
- GI Sciences, Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Salford Royal Hospital, Salford, M6 8HD, UK
| | - Fang Liu
- Department of Clinical and Pharmaceutical Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK.
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43
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Marconati M, Ramaioli M. The role of extensional rheology in the oral phase of swallowing: an in vitro study. Food Funct 2020; 11:4363-4375. [PMID: 32373829 DOI: 10.1039/c9fo02327e] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Swallowing disorders deteriorate significantly the quality of life and can be life-threatening. Texture modification using shear thinning food thickeners has been proven to be effective in the management of dysphagia. Some studies have recently considered the positive role of cohesiveness, but there is still an insufficient understanding of the effect of the rheological properties of the liquid bolus on the dynamics of bolus transport, particularly when elasticity and extensional properties are combined with a shear thinning behaviour. This study combines steady shear, SAOS and capillary breakage extensional rheometry with an in vitro method to characterize the oral transport of viscoelastic liquids. Bolus velocity and bolus length were measured from exit in vitro experiments using image analysis and related to shear and extensional properties. A theory describing the bolus dynamics shows that the elastic and extensional properties do not influence significantly the oral transit dynamics. Conversely, in vitro results suggest that the extensional properties can affect the transition from the oral to the pharyngeal phase of swallowing, where thin, viscoelastic liquids lead to a fast transit, lower oral post-swallow residues and more compact bolus with a smoother surface, which may suggest a lower risk of fragmentation. This mechanistic explanation suggests that the benefit of the extensional properties of thin viscoelastic liquids in the management of dysphagia should be further evaluated in clinical trials.
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Affiliation(s)
- Marco Marconati
- Department of Chemical and Process Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, GU2 7XH, UK
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44
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45
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Vieira J, Oliveira F, Salvaro D, Maffezzolli G, de Mello J, Vicente A, Cunha R. Rheology and soft tribology of thickened dispersions aiming the development of oropharyngeal dysphagia-oriented products. Curr Res Food Sci 2020; 3:19-29. [PMID: 32914117 PMCID: PMC7473376 DOI: 10.1016/j.crfs.2020.02.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
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. Modified starch-based (MS) has lower thickening and lubricant capacities than gums. Higher MS concentrations increased viscosity, while decreased lubrication. Flaxseed gum & xanthan-based solutions are better thickeners and lubricants than MS.
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Affiliation(s)
- J.M. Vieira
- Department of Food Engineering, Faculty of Food Engineering, University of Campinas (UNICAMP), 13083-862, Campinas, SP, Brazil
- Centre of Biological Engineering (CEB), University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - F.D. Oliveira
- Department of Food Engineering, Faculty of Food Engineering, University of Campinas (UNICAMP), 13083-862, Campinas, SP, Brazil
| | - D.B. Salvaro
- Laboratory of Materials (LabMat), Department of Mechanical Engineering, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - G.P. Maffezzolli
- Laboratory of Materials (LabMat), Department of Mechanical Engineering, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - J.D.B. de Mello
- Laboratory of Materials (LabMat), Department of Mechanical Engineering, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - A.A. Vicente
- Centre of Biological Engineering (CEB), University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - R.L. Cunha
- Department of Food Engineering, Faculty of Food Engineering, University of Campinas (UNICAMP), 13083-862, Campinas, SP, Brazil
- Corresponding author.
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46
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Savouré T, Dornier M, Vachoud L, Collignan A. Clustering of instrumental methods to characterize the texture and the rheology of slimy okra (Abelmoschus esculentus) suspensions. J Texture Stud 2020; 51:426-443. [PMID: 31955423 DOI: 10.1111/jtxs.12505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/04/2020] [Accepted: 01/11/2020] [Indexed: 01/13/2023]
Abstract
Okra (Abelmoschus esculentus) is one of the ingredients widely used in African gastronomy because of the unique slimy texture it gives to sauces. However, processing and formulation can affect the textural and rheological properties of these sauces, leading to unacceptable quality for the African consumer. The aim of this study was to select the instrumental measurements best enabling (a) characterization of the rheology and texture of slimy sauces prepared from okra and (b) monitoring its evolution during the preservation process. Thirty-seven slimy suspensions (sauces and purées) were measured with 16 rheological and textural parameters. A principal component analysis revealed that flow consistency index K and flow behavior index n were well correlated with visco-elastic, adhesive, and shear thinning properties, and that stringiness was well correlated with elongational, cohesive, and ductile properties. These two sets of measurement methods are sufficient to characterize their rheological and textural properties, and necessary to discriminate them according to their process and formulation.
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Affiliation(s)
- Timoty Savouré
- AS Food International, Grenoble, France.,Qualisud, Univ Montpellier, CIRAD, Montpellier SupAgro, Université d'Avignon, Université de La Réunion, Montpellier, France
| | - Manuel Dornier
- Qualisud, Univ Montpellier, CIRAD, Montpellier SupAgro, Université d'Avignon, Université de La Réunion, Montpellier, France
| | - Laurent Vachoud
- Qualisud, Univ Montpellier, CIRAD, Montpellier SupAgro, Université d'Avignon, Université de La Réunion, Montpellier, France
| | - Antoine Collignan
- Qualisud, Univ Montpellier, CIRAD, Montpellier SupAgro, Université d'Avignon, Université de La Réunion, Montpellier, France
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47
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Ben Tobin A, Mihnea M, Hildenbrand M, Miljkovic A, Garrido-Bañuelos G, Xanthakis E, Lopez-Sanchez P. Bolus rheology and ease of swallowing of particulated semi-solid foods as evaluated by an elderly panel. Food Funct 2020; 11:8648-8658. [DOI: 10.1039/d0fo01728k] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Preparation of a bolus is a complex process with both food comminution and degree of lubrication with saliva playing an important role in a safe swallow.
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Affiliation(s)
- Aarti Ben Tobin
- Agriculture and Food
- CSIRO Commonwealth Scientific and Industrial Research Organisation
- Brisbane
- Australia
| | - Mihaela Mihnea
- Agriculture and Food
- Bioeconomy and Health
- RISE Research Institutes of Sweden
- Gothenburg
- Sweden
| | - Marie Hildenbrand
- Agriculture and Food
- Bioeconomy and Health
- RISE Research Institutes of Sweden
- Gothenburg
- Sweden
| | - Ana Miljkovic
- Agriculture and Food
- Bioeconomy and Health
- RISE Research Institutes of Sweden
- Gothenburg
- Sweden
| | | | - Epameinondas Xanthakis
- Agriculture and Food
- Bioeconomy and Health
- RISE Research Institutes of Sweden
- Gothenburg
- Sweden
| | - Patricia Lopez-Sanchez
- Agriculture and Food
- Bioeconomy and Health
- RISE Research Institutes of Sweden
- Gothenburg
- Sweden
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48
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Hadde EK, Cichero JAY, Zhao S, Chen W, Chen J. The Importance of Extensional Rheology in Bolus Control during Swallowing. Sci Rep 2019; 9:16106. [PMID: 31695062 PMCID: PMC6834566 DOI: 10.1038/s41598-019-52269-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/10/2019] [Indexed: 11/16/2022] Open
Abstract
Thickened fluids are commonly used in the medical management of individuals who suffer swallowing difficulty (known as dysphagia). Previous studies have shown that the rheological properties of a liquid affect the flow behavior of the bolus in swallowing, such as pharyngeal transit time. While there is no doubt that shear rheology is a highly important factor for bolus flow, it is suspected that extensional properties of a liquid bolus also plays an important role in swallowing, due to elongation of the bolus as it flows through the oropharynx. Our aim in this work was to observe the effect of extensional viscosity on pharyngeal transit time and elongation of the bolus during swallowing. Eight samples of thickened liquid barium that were shear-controlled, but varied in extensional viscosity and two samples that were extensional-controlled, but varied in shear viscosity were swallowed by eight healthy individuals. Data were collected under lateral view of videofluoroscopy swallow study (VFSS); measures of pharyngeal transit time and the ratio of the length to the width of the bolus on the frame of Upper Esophageal Sphincter (UES) opening were taken from the VFSS recordings. It was observed that the pharyngeal transit time generally increases when the fluids are thickened to higher IDDSI consistency. Additionally, higher extensional viscosity fluids reduced the elongation of the bolus during swallowing, thus potentially reducing the risk of post-swallow residue due to bolus breakage. This study confirmed the relevance of the extensional viscosity of the bolus in swallowing.
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Affiliation(s)
- Enrico Karsten Hadde
- School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China.
| | | | - Shaofeng Zhao
- The 1st Affiliated Hospital of Soochow University, Suzhou, China
- The Eight Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Wei Chen
- School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
| | - Jianshe Chen
- School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China
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Hanson B, Jamshidi R, Redfearn A, Begley R, Steele CM. Experimental and Computational Investigation of the IDDSI Flow Test of Liquids Used in Dysphagia Management. Ann Biomed Eng 2019; 47:2296-2307. [PMID: 31218485 PMCID: PMC6838027 DOI: 10.1007/s10439-019-02308-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 06/11/2019] [Indexed: 11/26/2022]
Abstract
The International Dysphagia Diet Standardisation Initiative (IDDSI) flow test, using a standard 10-mL syringe, is being adopted in many countries for clinical measurement of the consistency of drinks. The working hypothesis is that thickening drinks to retard flow can be advantageous for individuals who struggle to cope with thin drinks. This study assesses how the IDDSI test relates to rheology and clinical knowledge of physiological flows during swallowing. With no pre-existing analytical solution for internal flow through the syringe, a computational model was designed, incorporating rheometry data from a variety of Newtonian and non-Newtonian liquids. The computational model was validated experimentally across the range of liquids but the technique showed limitations in simulating dripping and cohesiveness. Gum-based liquids which were strongly shear-thinning (0.12 < n < 0.25) showed plug-flow characteristics with 90% of the shear occurring in only 22% of the radial dimension. Shear rates were maximal at the nozzle outlet (> 60 times higher than the barrel) and reached 7400/s for the thinnest gum-based liquid. Shear rheology data alone was unable to describe the flow of these drinks. The flow conditions in the test varied according to the type and consistency of liquid, relating to the desired clinical effect.
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Affiliation(s)
- Ben Hanson
- UCL Mechanical Engineering, Torrington Place, London, WC1E 7JE, UK.
| | - Rashid Jamshidi
- UCL Chemical Engineering, Torrington Place, London, WC1E 7JE, UK
| | - Andrew Redfearn
- UCL Mechanical Engineering, Torrington Place, London, WC1E 7JE, UK
| | - Ryan Begley
- UCL Mechanical Engineering, Torrington Place, London, WC1E 7JE, UK
| | - Catriona M Steele
- Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, #12-101, Toronto, ON, M5G 2A2, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON, Canada
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50
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Krishnaraj P, Anukiruthika T, Choudhary P, Moses JA, Anandharamakrishnan C. 3D Extrusion Printing and Post-Processing of Fibre-Rich Snack from Indigenous Composite Flour. FOOD BIOPROCESS TECH 2019. [DOI: 10.1007/s11947-019-02336-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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