The Food Colloid Principle in the Design of Elderly Food

Understanding the health benefits and technological properties of β-glucan for the development of easy-to-swallow gels to guarantee food security among seniors

The world's population is growing rapidly and the number of elderly people with undernutrition and malnutrition is increasing. Common health problems among seniors are cardiovascular, inflammatory, gastrointestinal, and cognitive disorders, cancer, diabetes, psychological and dental problems. The food industry is trying to meet the demands of an aging society, but these efforts are not sufficient. New strategies are needed, and they demand foods development with modified textures that are easy to swallow, such as gels suitable for seniors. Depending on the specific needs of the elderly, bioactive compounds with health benefits should be included in food systems. Novel foods may play an important role in the prevention, maintenance, and treatment of age-related diseases. One of the most studied bioactive compound is β-glucan, a polysaccharide with approved health claims confirmed by clinical trials, such as "β-glucan contributes to the maintenance of normal blood cholesterol levels" and "the consumption of β-glucan from oats or barley contributes to the reduction of postprandial glucose spikes." In this review, the health benefits, and technological properties of β-glucan for the development of senior-friendly ready-to-swallow gels were described. In addition, some patents and studies conducted in connection with the development of the gel systems were collected.

Designing of texture modified fruit juices using food hydrocolloids: Storage influence on viscosity

Elderly individuals require special dietary considerations due to various physiological dysfunctions (such as dysphagia, constipation, etc.) and specific nutritional needs. Dysphagia, the difficulty associated with swallowing can lead to some challenges in containing and transitioning of food or liquids within the mouth, increasing the risk of aspiration pneumonia. Thickening fluid is an effective method for alleviating swallowing difficulties. It works by slowing down the flow of liquids during swallowing, thus reducing the risk of aspiration into the airway. The purpose of this research is to develop texture-modified (TM) fruit juices to cater to the needs of elderly individuals with impaired swallowing abilities. To achieve this goal, we created TM fruit juices thickened with hydrocolloids, specifically guar gum (GG), xanthan gum (XG), and starch (S), at different concentrations. The thickened liquids, classified at three National Dysphagia Diet levels, were stored at 4 °C for three months. Physicochemical analyzes of the fruit juices were performed before and after storage. The sensory differences and flow behaviors of orange juice samples containing ascending concentrations of all studied thickeners were investigated at the end of the three-month storage. The results indicated significant changes in the physicochemical properties of the samples, depending in the type of fruit, the hydrocolloid used, and the storage period. Sensory evaluation revealed that orange juices containing starch were more preferred compared to other samples. Therefore, using orange juice thickened with easily swallowed, and less viscous starch will be a safer option for the elderly and individuals with swallowing difficulties.

Properties of Yoghurt Fortified in Lactoferrin with Effect of Storage Time

The stability of fortified yoghurts during refrigerated storage is important for industry and the consumer. The aim of the study was to evaluate the nutritional value, microbiological quality, organoleptic properties, and structure of natural yoghurts made with the addition of lactoferrin during refrigerated storage. In this study, we produced natural yoghurts fortified in lactoferrin, using YC-X11 yoghurt starter culture based on Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus. Physicochemical (acidity, nutritional value and structure) as well as microbiological and organoleptic changes occurring during 28-days refrigerated storage were determined. Storage research made it possible to determine the direction of changes taking place in the products. The analysed parameters did not differ statistically significantly between the control yoghurts and those with the addition of lactoferrin. Textural and rheological studies also shown that the addition of lactoferrin did not significantly change the structure of the yoghurt. The yoghurts were characterized by high sanitary and hygienic quality during the whole refrigerated storage. Lactoferrin has a positive effect on the durability of the product.

Formulation of Ready-to-Eat Soup for the Elderly: Nutritional Composition and Storage Stability Study

Lack of appetite is a common problem in elderly people which could lead to the risk of malnutrition. Soup-based product formulation and supplementation for the elderly is an interesting and convenient way to maintain nutritional status. Hence, this study aims to develop ready-to-eat (RTE) soup and instant soup powder using common agricultural commodities. The results indicated that among all formulations, the F7 formula comprised brown rice (15 g), pumpkin (32.5 g), sweetcorn (12.5 g), red tilapia (17.5 g), rice bran oil (1.0 g), and water (21.5 g) with energy ratio (C:P:F) of 58:23:20 receiving the highest sensory scores. The selected formulation (F7) was also transformed into instant powder and both RTE soup and instant powder were evaluated for nutritional composition and storage stabilities at 5 °C and 25 °C, respectively. The nutritional composition analyses indicate that 100 g of RTE soup consists of 13.8 g carbohydrates, 4.9 g proteins, 1.8 g fats, and 1.5 g dietary fibers; the soup is also a rich source of antioxidants and β-carotene. Storage studies suggested that the content of β-carotene and antioxidant activity of both (ready-to-eat and instant powder) types of soup decreased with increasing storage time, while a slight increase in yeast and mold count (<50 cfu/g) was noted. Most importantly, no pathogenic bacteria were detected in ready-to-eat and instant soup during the storage study of 6 weeks at 5 °C and 6 months at 25 °C, respectively. In terms of the high nutritional composition and functional value of the product, 4 weeks of storage at 5 °C and 4 months of storage at room temperature were suggested for ready-to-eat and instant powder soup product, respectively.

Recent progress in emulsion gels: from fundamentals to applications

Emulsion gels, also known as gelled emulsions or emulgels, have garnered great attention both in fundamental research and practical applications due to their superior stability, tunable morphology and microstructure, and promising mechanical and functional properties. From an application perspective, attention in this area has been, historically, mainly focused on food industries, e.g., engineering emulsion gels as fat substitutes or delivery systems for bioactive food ingredients. However, a growing body of studies has, in recent years, begun to demonstrate the full potential of emulsion gels as soft templates for designing advanced functional materials widely applied in a variety of fields, spanning chemical engineering, pharmaceutics, and materials science. Herein, a concise and comprehensive overview of emulsion gels is presented, from fundamentals to applications, highlighting significant recent progress and open questions, to scout for and deepen their potential applications in more fields.

Understanding relations between rheology, tribology, and sensory perception of modified texture foods

The aim of this work was to examine relations between instrumental and sensory parameters in a texture modified food matrix, with and without saliva. Nine pureed carrot samples (eight thickened and a control) were developed with starch (0.4 and 0.8% wt/wt), xanthan (0.2 and 0.4% wt/wt) or starch-xanthan blends that met International Dysphagia Diet Standardisation Initiative (IDDSI) Level 4 guidelines using fork and spoon tests. Rheological and tribological tests were conducted on the food and simulated bolus prepared by adding fresh stimulated saliva to the food (1:5, saliva:food) to mimic oral processing. Perceived sensory properties were identified using a temporal dominance of sensations (TDS) test (n = 16) where panelists were given a list of nine attributes. The area under the curve was extracted from TDS curves for each attribute/sample and this was correlated with rheological (viscosity at 10 s^-1 , G', G″, and tan δ at 1 Hz) and tribological (friction coefficient in three regimes) data. The viscosity of the control sample decreased after adding hydrocolloids (except Starch_0.8%) and with saliva incorporation. G' and G″ either increased or were similar for xanthan and blends and decreased for starch-thickened samples. Hydrocolloid addition increased friction for all samples and was higher with saliva addition. Sensory results showed that samples with starch were perceived as thick and grainy while xanthan was perceived as smooth and slippery. A greater number of sensory attributes correlated with viscoelastic parameters compared to friction coefficients. Correlations were highest with the saliva added samples, further highlighting the importance of including saliva during instrumental testing.

Formulation and Cost-Effectiveness of Fluid Gels as an Age-Appropriate Dosage Form for Older Adults with Dysphagia

Dysphagia is associated with increased dependency and treatment costs, whereby patients resort to extemporaneous compounding that may further increase the number of adverse events and medical errors. In the management of dysphagia, increasing the bolus viscosity of medication such as fluid gels can be practiced. This study aimed to prepare and characterize the fluid gels as well as to estimate the cost of using fluid gels and compare it to the conventional practice of extemporaneous preparation of thickened liquid. Fluid gels were formulated using gellan gum and determined for physicochemical characteristics and in vitro drug release profile. The cost-based price of the fluid gel was estimated and compared to the cost of administering standard medication as well as administering thickened liquid using thickening powder. Fluid gels exhibited good physicochemical properties with the viscosity within nectar and honey consistency. A similar dissolution profile to the reference was observed for the 0.5% w/v gellan gum fluid gel and exhibiting the Higuchi release model. The price for 100 mL unit of 50 mg/mL paracetamol/acetaminophen and 20 mg/mL ibuprofen fluid gel was estimated to be about USD2.30 and USD2.37, respectively. A dose of 1000 mg paracetamol and 400 mg ibuprofen fluid gel was estimated to be about USD0.46 and USD0.47, respectively, which is lower than the cost of administering the same dose using extemporaneous thickened liquid. Fluid gels could be a cost-effective formulation for delivering medication in patients with dysphagia and can be developed on a profitable scale.

Effect of the rheological properties of the liquid carrier on the in vitro swallowing of solid oral dosage forms

Solid oral dosage forms (SODF) are the most popular oral drug delivery forms, but they can be difficult to swallow, especially for patients suffering from swallowing disorders. This study investigated the dynamics of different combinations of liquid carriers and SODF during the oral phase of swallowing using an in vitro model. The rheological properties of the carriers were characterized using shear and extensional rheometry, and their effect on bolus velocity, bolus shape, post-swallow residues, and SODF position within the bolus was evaluated. The latter has been identified as a novel and promising variable to discriminate between alternative formulations. When swallowed with water, capsules and tablets did not impact significantly the velocity of the bolus, but they lagged behind the liquid bolus, suggesting that low viscosity Newtonian fluids are not efficient carriers for SODF. Increasing the viscosity of the carrier at high shear rates improved the ability of the liquid to transport the SODF but also increased the amount of post-swallow residues. At equivalent shear viscosity, elastic and extensional properties of carriers influenced positively the position of the SODF in the bolus. Capsules and tablets were transported toward the front of these boluses, during the oral phase of swallowing, which is considered beneficial to avoid SODF sticking to the mucosa in the following stages of swallowing. Thin elastic liquids appear as an interesting option to promote safe swallowing of capsules and tablets. Clinical studies are, however, necessary to confirm this positive effect in healthy and dysphagic patients.

Texture-Modified Food for Dysphagic Patients: A Comprehensive Review

Food texture is a major food quality parameter. The physicochemical properties of food changes when processed in households or industries, resulting in modified textures. A better understanding of these properties is important for the sensory and textural characteristics of foods that target consumers of all ages, from children to the elderly, especially when food product development is considered for dysphagia. Texture modifications in foods suitable for dysphagic patients will grow as the numbers of elderly citizens increase. Dysphagia management should ensure that texture-modified (TM) food is nutritious and easy to swallow. This review addresses how texture and rheology can be assessed in the food industry by placing particular emphasis on dysphagia. It also discusses how the structure of TM food depends not only on food ingredients, such as hydrocolloids, emulsifiers, and thickening and gelling agents, but also on the applied processing methods, including microencapsulation, microgels as delivery systems, and 3D printing. In addition, we address how to modify texture for individuals with dysphagia in all age groups, and highlight different strategies to develop appropriate food products for dysphagic patients.

Molar mass effect in food and health

It is demanded to supply foods with good quality for all the humans. With the advent of aging society, palatable and healthy foods are required to improve the quality of life and reduce the burden of finance for medical expenditure. Food hydrocolloids can contribute to this demand by versatile functions such as thickening, gelling, stabilising, and emulsifying, controlling texture and flavour release in food processing. Molar mass effects on viscosity and diffusion in liquid foods, and on mechanical and other physical properties of solid and semi-solid foods and films are overviewed. In these functions, the molar mass is one of the key factors, and therefore, the effects of molar mass on various health problems related to noncommunicable diseases or symptoms such as cancer, hyperlipidemia, hyperglycemia, constipation, high blood pressure, knee pain, osteoporosis, cystic fibrosis and dysphagia are described. Understanding these problems only from the viewpoint of molar mass is limited since other structural characteristics, conformation, branching, blockiness in copolymers such as pectin and alginate, degree of substitution as well as the position of the substituents are sometimes the determining factor rather than the molar mass. Nevertheless, comparison of different behaviours and functions in different polymers from the viewpoint of molar mass is expected to be useful to find a common characteristics, which may be helpful to understand the mechanism in other problems.

Changes in the Physicochemical Parameters of Yoghurts with Added Whey Protein in Relation to the Starter Bacteria Strains and Storage Time

Simple Summary

Addition of whey proteins to yoghurt may be a good solution that could be routinely applied in the dairy industry to offer consumers a new functional product, with health-promoting properties. Conducting a comprehensive analysis of yoghurts made using two different starter cultures, with and without the addition of various levels of whey proteins, we found that the quality of yoghurts with WPC, including sensory quality, can be satisfactory for even 28 days of storage. The use of whey protein concentrate determined both the physicochemical (i.e., lactic acid content, proximate chemical composition, water holding capacity, water activity, firmness, consistency, cohesive strength and colour parameters) and sensory quality of the yoghurts. The additive had a significant effect on potential acidity, inhibiting the increase in the amount of lactic acid in yoghurts during storage, and also reduced syneresis. We suggest that using WPC on a larger scale will create new opportunities on the food market.

Abstract

The stability of the physicochemical characteristics of yoghurts during refrigerated storage is important for industry and the consumer. In this study we produced plain yoghurts with the addition of health-promoting whey protein concentrate (WPC), using two different starter cultures based on Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus. Physicochemical changes (acidity, nutritional value, water activity, water-holding capacity, texture, and colour, including whitening and yellowing indices) as well as sensory changes occurring during 28-day refrigerated storage were determined. Starter cultures were found to significantly (p ≤ 0.05 and p ≤ 0.01) influence the water-holding capacity, firmness, consistency, cohesive strength and colour parameters of the curd. Use of whey protein concentrate affected both the physicochemical and sensory quality of the yoghurts. The additive had a significant effect on potential acidity, inhibiting the increase in lactic acid in the yoghurts during storage, and also reduced syneresis. However, it decreased the lightness of curd and negatively affected its sensory characteristics, primarily flavour. Moreover, nearly all parameters changed significantly with the passage of storage time (in most cases negatively). The exceptions were total protein and fat content. The changes, however, were not severe and remained at a level acceptable to tasters. Addition of 1% or 2% whey protein to yoghurt may be a good solution that can be routinely applied in the dairy industry to offer consumers a new functional product. A comprehensive assessment of the physicochemical and sensory changes occurring during refrigerated storage of yoghurts manufactured with the addition of WPC and using different cultures is crucial for modelling such a product.

Influence of the particle size and hydrocolloid type on lipid digestion of thickened emulsions

Hydrocolloids are used as stabilizing agents in order to enhance the physical stability of emulsions during their storage. However, they can also play an important role in nutrient release and bioavailability. In this context, the aim of this research was to study the effect of the emulsion type and thickener type on the physical-structural changes and free fatty acid release during in vitro digestion. Oil-in-water emulsions were prepared with different particle sizes (CE: conventional emulsions and NE: nanoemulsions) and thickening agents (starch and xanthan gum). The experimental conditions of homogenization used allowed food emulsions to be obtained at the microscale and nanoscale, with particle sizes ranging among 3.2-3.4 μm and 78-107 nm for CE and NE, respectively. The addition of thickening agents (XG and ST) modified the physical properties of emulsions (particle size, zeta potential and stability) slightly, and thickened samples with similar viscosity were obtained. The kinetics of FFAs released during the in vitro intestinal digestion showed no significant differences (p > 0.05) in the digestion rate among samples; however, emulsion and thickener types decreased the final extent of free fatty acids, being more evident for those samples with starch. Xanthan gum kept the particle size of nanoemulsions stable during the oral and gastric phases, which promoted the release of FFAs during the intestinal phase. Therefore, xanthan gum could be used as a thickening agent of nanoemulsions exerting a minor impact on their lipid bioaccessibility.

The role of extensional rheology in the oral phase of swallowing: an in vitro study

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.

Role of fluid cohesiveness in safe swallowing

In patients with dysphagia, it has been a practice to thicken fluid food to prevent aspiration-the transport of a bolus into the trachea instead of the oesophagus. In these patients, aspiration is a risk behaviour and is closely related to pneumonia (caused by the aspiration of oral bacteria into the lungs). Since excessive thickening of fluids can cause adverse effects, such as lowering the palatability of food, subsequent reduction of liquid intake, dehydration and malnutrition, identifying the optimum thickening level is vital. Thickening might not only increase fluid viscosity, but could also modify its cohesiveness, which is another key factor affecting aspiration. Even though cohesiveness is more of a concept than a well-defined measurable parameter, this property describes the degree of coherency provided by the internal structure of a material against its fractional breakup. In fluids, this concept is less explored than in solids, powders and granules, and during the last decade few scientists have tackled this topic. Although the role of cohesiveness in the swallowing of heterogeneous solid foods is briefly overviewed, the aim of the present paper is to introduce the concept of cohesiveness for a relatively homogeneous fluid bolus and its effect on swallowing. Cohesiveness is highly correlated with the extensibility and yield stress of the fluid, suggesting that a high cohesiveness could have an important role in preventing aspiration.

Relating Food Engineering to Cooking and Gastronomy

Modern consumers are increasingly eating meals away from home and are concerned about food quality, taste, and health aspects. Food engineering (FE) has traditionally been associated with the industrial processing of foods; however, most underlying phenomena related to FE also take place in the kitchen during meal preparation. Although chemists have positively interacted with acclaimed chefs and physicists have used foods as materials to demonstrate some of their theories, this has not been always the case with food engineers. This review addresses areas that may broaden the vision of FE by interfacing with cooking and gastronomy. Examples are presented where food materials science may shed light on otherwise empirical gastronomic formulations and cooking techniques. A review of contributions in modeling of food processing reveals that they can also be adapted to events going on in pots and ovens, and that results can be made available in simple terms to cooks. Industrial technologies, traditional and emerging, may be adapted to expand the collection of culinary transformations, while novel equipment, digital technologies, and laboratory instruments are equipping the 21st-century kitchens. FE should become a part of food innovation and entrepreneurship now being led by chefs. Finally, it is suggested that food engineers become integrated into gastronomy's concerns about safety, sustainability, nutrition, and a better food use.

Challenges to assumptions regarding oral shear rate during oral processing and swallowing based on sensory testing with thickened liquids

For people with dysphagia, or difficulty swallowing, thickened liquids are used to slow bolus flow to make them easier to control. For these liquids, the oral shear rate of 50 s^-1 has been adopted as the standard at which viscosity measurements are taken. However, there is evidence to suggest that other shear rates may be more appropriate to model the processes in the mouth and throat. This research compared the sensory and rheological properties of xanthan gum, guar gum, and carboxymethyl cellulose thickened liquids that had been matched for apparent viscosity at 50 s^-1 to assess the validity of the current shear rate standard. Properties of gums were observed at various viscosity levels based on the International Dysphagia Diet Standardisation Initiative (IDDSI) framework. Textural sensory characteristics of samples were quantified using magnitude estimation scaling and a trained descriptive panel, while rheological measurements were taken at shear rates of 1 to 1000 s^-1. Perceived slipperiness of the gums was found to be driven by thickness level at low viscosity levels, but affected by the shear thinning behavior of the gums at higher viscosity levels. Although the liquids had been matched for apparent viscosity at 50 s^-1, panelists could distinguish both the perceived viscosities of the gums and their ease of swallowing, suggesting that 50 s^-1 is neither appropriate to model the oral nor pharyngeal shear rates. A single oral shear rate could not be predicted from the data, and it is proposed that panelists evaluated oral viscosity using different methods at different viscosity levels. Based on the sensory data, the pharyngeal shear rate during swallowing appears to lie above 50 s^-1.

Perception and measurement of food texture: Solid foods

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

PRACTICAL APPLICATIONS

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

Clinical applications of IDDSI framework for texture recommendation for dysphagia patients

Dysphagia is a highly prevalent eating and swallowing disorder among elderly people, impacting negatively on the health and well-being of those afflicted. With increasing populations of elderly people, food industries are under growing pressure to produce appropriately texture-modified food for safe consumption by these vulnerable populations. Recently published International Dysphagia Diet Standardisation Initiative (IDDSI) framework provides a new global guideline on texture modification and standardization for dysphagia patients. This work was designed to test the feasibility of IDDSI framework for clinical applications by assessing the correlation between swallowing capability of dysphagia patients and the IDDSI texture levels. Altogether 26 elderly subjects were recruited and assessed for their dysphagia grades using the Water Drinking Test. Subjects were provided with fluid samples constituted at different consistencies from a commercial product and swallowing performance (time of swallowing, number of swallows, and number of coughs) was monitored and recorded. Correlations among swallowing capability parameters were observed. Most importantly, results from this work clearly demonstrated that the severity of dysphagia by water-based swallow tests correlates positively with the IDDSI fluid thickness aimed at reducing dysphagia symptoms in those patients, confirming the reliability and feasibility of IDDSI framework for clinical applications.

PRACTICAL APPLICATIONS

Swallowing disorder or dysphagia occurs commonly among many elderly people and imposes negative impacts on their health and well-being. Medical professionals can diagnose eating and swallowing capability in a qualitative manner, but have difficulty in making diet recommendation because of the lack of texture guidance. This work confirmed the feasibility of IDDSI framework for clinical and bedside applications. The correlation between the capability grades of swallowing and IDDSI texture levels established in this work provides a useful measure for such applications.

Oral processing of emulsion systems from a colloidal perspective

This review discusses recent understanding of the oral destabilization of food emulsions from a colloidal perspective.