Instrumental texture assessment of IDDSI texture levels for dysphagia management. Part 2: Texture modified foods

An oral gel suitable for swallowing: The effect of micronization on the gel properties and microstructure of κ-carrageenan

κ-Carrageenan (κ-Car) is an important material for preparing food gels and hydrogels. However, κ-Car gel has issues with high hardness and low water-holding capacity. Modification strategy of micronization is proposed for the first time to explore its influence on texture properties and gelling process of κ-Car gel, and to investigate the feasibility of κ-Car as a food matrix with low strength. κ-Car undergoing 60 min of micronization, the d(0.9) decreased by 79.33 %, SBET and Vtotal increased by 89.23 % and 95.27 %. The swelling rate and degree of gelling process increased significantly, and the microstructure changed from loose large pores to dense small pores resembling a "honeycomb". Importantly, the hardness of gel-60, Milk-60 and PNS-60 decreased by 72.52 %, 49.25 % and 81.37 %. In addition, WHC of gel-60, Milk-60 and PNS-60 was improved. IDDSI tests showed that κ-Car gels, milk gels and PNS gels can be categorized as level 6 (soft and bite-sized), except for PNS-60, which belongs to level 5 (crumbly and moist). Furthermore, the texture and bitter masking effect of milk gels and PNS gels were improved. In conclusion, this study demonstrated that micronization can be a novel approach to improve the gel properties of κ-Car, laying the groundwork for developing dysphagia foods.

IDDSI-compliant recipes containing oral contrast agents for radiological dysphagia diagnostics

Videofluoroscopic swallowing study (VFSS), alongside flexible endoscopic evaluation of swallowing, represents the gold standard for diagnosing swallowing disorders and to determine severity, pathophysiology, and effective interventions, including texture modification. The clinical swallowing examination and assessment supplements these instrumental methods and serves as the basis for the modules of swallowing diagnostics. The adaptation of food and drink consistencies in dysphagia management has become widespread. For valid results of a VFSS with respect to confirming swallowing safety and efficiency of different liquid and food consistencies and textures, the use of uniform recipes containing radio-opaque contrast media is important. Our goal was to identify recipes that would produce consistencies that conform to the liquid and food levels of 0-7, as defined by the International Dysphagia Diet Standardization Initiative (IDDSI), with barium- and iodine-based contrast media, xanthan gum-based thickeners, and other edible components, which also show sufficient contrast on VFSS. In this study, we determined the different recipes using IDDSI testing methods and explored their radiological characteristics using a Philips MultiDiagnost Eleva fluoroscopy system and two different fluid contrast agents: barium- (Micropaque®) and iodine-based (Telebrix®). All recipes showed sufficient contrast on fluoroscopy and could be visualized in the amounts used for swallowing examinations. They were practical and easy to implement in terms of production and availability of the components. The homogeneity of the recipes diminished with higher IDDSI levels, which represent transitional food, but appeared still sufficient for fluoroscopic examination. The opacity did not significantly differ between the barium- and iodine-based contrast media.

Salmon protein gel enhancement for dysphagia diets: Konjac glucomannan and composite emulsions as texture modifiers

The growing prevalence of dysphagia among the aging population presents a significant challenge. Many highly nutritious foods, like salmon, are often unsuitable for the elderly due to their firm texture when heated. To address this concern, a combination of salmon myofibrillar protein (SMP), Konjac glucomannan (KGM), and different emulsion fillers-such as oil droplets, octenyl succinic anhydride (OSA)-modified potato starch emulsion, and high methoxylated pectin (HMP) emulsions-was selected to enhance the network of salmon protein gels with the aims to create potential applications as dysphagia-friendly foods. The International Dysphagia Dietary Standardization Initiative (IDDSI) test indicated that all gel samples were classified as level 5. The OSA-SMP-KGM gel exhibited notably higher cohesiveness (P < 0.05), reduced adhesion, and enhanced mouthfeel. The OSA-SMP-KGM gel exhibited a smooth surface and excellent water retention (92.4 %), rendering it suitable for individuals with swallowing difficulties, particularly those prone to experiencing dry mouth. The yield stress of OSA-SMP-KGM gel was 594.14 Pa and stable structure was maintained during chewing and swallowing (γe/γv = 62.5). This study serves as a valuable reference for developing salmon-based products that are not only highly nutritious but also fulfill the criteria for a desirable swallowing texture.

Development and characterization of emulsion gels prepared via gliadin-based colloidal particles and gellan gum with tunable rheological properties for 3D printed dysphagia diet

Dysphagia, a condition characterized by difficulty swallowing, has emerged as a threat to health. Herein, we investigated the feasibility of preparing a novel 3D-printed dysphagia diet using emulsions and gellan gum. A gel network was facilitated by the inclusion of gellan gum, which also helped to reduce the size of the oil droplets. Emulsion gels (with 0.3 %-0.5 % gellan gum) were stable at 25 °C for 30 days and tolerated a high ionic concentration of 800 mmol L-1. Emulsion gels remained stable after heat treatment and centrifugation. The excellent stability of the emulsion gels was related to the three-dimensional network developed by the gellan gum. The rheological results validated the solid-state behavior, shear thinning behavior and structural recovery of emulsion gels. Emulsion gels with 0.3 %-0.5 % gellan gum were suitable for 3D printing since they had high printing accuracy, self-support, and smooth surface texture. International Diet Standardization Initiative (IDDIS) tests have shown that emulsion gels can be classified as a level 3-5 dysphagia diet. In addition, the bioaccessibility of astaxanthin increased 1.7 times after being encapsulated by emulsion gels. Overall, these results demonstrate the potential of emulsion gels in the development of novel 3D-printed diets for dysphagia and bioactive protection.