Differences in chewing behaviors between healthy fully dentate young and older adults assessed by electromyographic recordings

Chewing and its influence on swallowing, gastrointestinal and nutrition-related factors: a systematic review

The study aimed to evaluate the hypothesis that chewing is a mechanical and physiological contributor to swallowing, physiologic/pathologic processes of the gastrointestinal tract (GIT), and nutrition-related factors. A search strategy was applied to three different databases to investigate if chewing function in adults affects the swallowing, physiologic/pathologic processes of the GIT, and nutrition-related factors compared to controls with no exposure. The included studies were evaluated for methodological quality and risk of bias and certainty of evidence. The results showed 71 eligible studies. Overall, the results showed that 46 studies supported the hypothesis while 25 refuted it. However, the GRADE analysis showed low to very low certainty of the evidence to support the hypothesis that chewing is an important contributor in the swallowing process, and physiologic/pathologic processes in the GIT. The GRADE analysis also showed a moderate to very low certainty of the evidence to suggest that chewing function contributes to nutrition-related parameters. The overall results of the current study showed that a majority (64.7%) of the studies (46 out of 71) supported the hypothesis. However, robust studies with proper design, adequate sample size, and well-defined outcome parameters are needed to establish conclusive evidence.

Lip and tongue pressure and the functionality of oro-facial structures in healthy individuals

BACKGROUND

With the ageing process changes in the musculature of oro-facial structures take place, consequently there is a reduction in the strength and mobility of the lips, tongue and cheeks.

OBJECTIVE

The aim of this study was to correlate oro-facial structures and chewing and swallowing functions among a group of senior citizens and young adults and check the influence of lip and tongue pressure of these functions.

METHODS

This is an observational, cross-sectional and analytical study. Thirty seniors with an average age of 67.13 years and 30 young adults with an average age of 22.03 years participated in the study. The Oro-facial Myofunctional Assessment Protocol with Scores for the Elderly and the Oro-facial Myofunctional Assessment Protocol with Expanded Scores were also used. The evaluation of the force of pressure of the lips and tip and dorsum of the tongue was carried out using the Biofeedback device Pró-Fono: Lip and Tongue Pressure.

RESULTS

Young adults had a higher evaluation score for the aspect/posture of the face, cheeks, lips, mentalis muscle, tongue, mobility of lips, tongue, jaw and cheeks, chewing and swallowing functions, total time and chewing strokes, and tip pressure and dorsum of tongue. According to the Structural Equation Modelling, a direct relationship was found between the tongue dorsum pressure force and the swallowing function.

CONCLUSION

With healthy ageing changes occurring in the appearance, posture and mobility of the lips, tongue, jaw and cheeks, with the seniors and reduced performance of chewing and swallowing functions.

Chewing and Swallowing Patterns for Different Food Textures in Healthy Subjects

Aims

This study aimed to determine the patterns of chewing and swallowing in healthy subjects with different food textures.

Methods

This cross-sectional study included 75 subjects who were asked to video record themselves while chewing different food samples of varying textures, including sweet and salty food. The food samples were coco jelly, gummy jelly, biscuit, potato crisp, and roasted nuts. A texture profile analysis test was used to measure the hardness, gumminess, and chewiness of the food samples. Chewing patterns were investigated by measuring the chewing cycle prior to the first swallow (CS1), the chewing cycle until the last swallow (CS2), and the accumulation of chewing time from the first chewing to the last swallowing (STi). Swallowing patterns were evaluated by calculating the swallowing threshold, which is the chewing time/duration prior to the first swallow (STh). The number of swallows for each food sample was also recorded.

Results

There was a statistically significant difference in the CS2 of potato crisps, as well as the STi of coco jelly, gummy jelly, and biscuits between male and female subjects. A significant positive correlation was found between hardness and STh. There was a significant negative correlation between gumminess and all chewing and swallowing parameters, as well as chewiness and CS1. This study also found s significant positive correlation between dental pain, CS1, CS2, and STh of gummy jelly, as well as dental pain and CS1 of biscuits.

Conclusions

Females require longer chewing time for harder foods. Food hardness is positively related to the chewing duration prior to the first swallow (swallowing threshold/STh). Food chewiness has a negative correlation with the chewing cycle prior to the first swallow (CS1). Food gumminess is inversely related to all the chewing and swallowing parameters. Dental pain is associated with an increased chewing cycle and swallowing time of hard foods.

Masticatory function in elderly compared to young adults

PURPOSE

To characterize the masticatory function of the elderly and to compare total amount of time, masticatory strokes and total mastication score among the elderly and young adults.

METHODS

It is an observational, cross-sectional and analytical study. A total of 50 individuals participated, 25 elderly (mean age 66 years) and 25 young adults (mean age 22 years). The evaluation of mastication was performed by standardized filming of the usual mastication of a wheat flour biscuit. The masticatory type (alternated bilateral, simultaneous bilateral, preferential unilateral, chronic and anterior), masticatory score, total masticatory time and the total number of masticatory strokes were verified and compared between the elderly and young adults.

RESULTS

The predominant masticatory pattern in the young adults was the alternated bilateral mastication (52%), while, in the elderly, the simultaneous bilateral mastication predominated (48%). The use of dental prostheses had a significant influence on the total mastication score; elderly presented greater masticatory time and greater amount of masticatory strokes; however, the total masticatory score was lower for this group.

CONCLUSION

The use of dental prosthesis has a significant influence on masticatory function. When compared to young adults, the elderly had a greater amount of time and masticatory strokes and a lower total mastication score.

The Test of Masticating and Swallowing Solids (TOMASS): Normative data for two crackers available in the Scandinavian and international markets

PURPOSE

To establish normative data of crackers common in the Scandinavian and international markets for use in the Test of Masticating and Swallowing Solids (TOMASS), and to investigate possible sex and age effects on masticatory performances.

METHOD

234 healthy participants (>20 years of age) were asked to either ingest the Göteborgskex Guld Marie™ cracker (n = 234) or to ingest both a Guld Marie cracker and a Tuc Original™ cracker (n = 115). Quantifiable measures of masticatory performance (number of bites, number of chewing cycles, number of swallows, and total time) were observed during TOMASS for each participant, directly on-site or by video recording.

RESULT

There were no significant differences in masticatory performances between the crackers. Significant age effects were observed for all masticatory measurements, except for the number of swallows. The results showed insufficient support for an effect of sex, and that results obtained on-site and from video recordings were highly correlated.

CONCLUSION

These findings suggest that similar masticatory performance is to be expected when performing TOMASS using the evaluated crackers. The age of the participant affects TOMASS performance, but the effect of sex is considerably smaller.

Virtual Reality as a Tool to Study the Influence of the Eating Environment on Eating Behavior: A Feasibility Study

In this manuscript, we describe a new approach to study the effect of the eating environment on food intake and eating behavior using virtual reality technology. Fifteen adults consumed pizza rolls in two virtual reality (VR) environments: a restaurant and a table in an empty room. The participants' food intake, eating parameters (e.g., masticatory parameters and eating rate), and their sensory evaluation of the test food was measured. The participants' sense of presence (the feeling of being in the virtual environment) and markers of arousal were also measured. There was no statistical significant difference in food intake or the sensory evaluation of the test food. In the restaurant condition, participants used fewer masticatory cycles before swallowing but there was no effect on eating rate or maximum bite force. Participants experienced a greater sense of presence when they were in the pizza restaurant scene. Moreover, their heart rate and skin temperature were higher in the restaurant condition. This study suggests that VR could be developed as a new tool to study the effect of the eating environment on food intake and eating behavior.

A description of an 'obesogenic' eating style that promotes higher energy intake and is associated with greater adiposity in 4.5year-old children: Results from the GUSTO cohort

Recent findings confirm that faster eating rates support higher energy intakes within a meal and are associated with increased body weight and adiposity in children. The current study sought to identify the eating behaviours that underpin faster eating rates and energy intake in children, and to investigate their variations by weight status and other individual differences. Children (N=386) from the Growing Up in Singapore towards Healthy Outcomes (GUSTO) cohort took part in a video-recorded ad libitum lunch at 4.5years of age to measure acute energy intake. Videos were coded for three eating behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min) and measures of eating microstructure: eating rate (g/min), total oral exposure (min), average bite size (g/bite), chews per gram, oral exposure per bite (s), total bites and proportion of active to total mealtime. Children's BMIs were calculated and a subset of children underwent MRI scanning to establish abdominal adiposity. Children were grouped into faster and slower eaters, and into healthy and overweight groups to compare their eating behaviours. Results demonstrate that faster eating rates were correlated with larger average bite size (r=0.55, p<0.001), fewer chews per gram (r=-0.71, p<0.001) and shorter oral exposure time per bite (r=-0.25, p<0.001), and with higher energy intakes (r=0.61, p<0.001). Children with overweight and higher adiposity had faster eating rates (p<0.01) and higher energy intakes (p<0.01), driven by larger bite sizes (p<0.05). Eating behaviours varied by sex, ethnicity and early feeding regimes, partially attributable to BMI. We propose that these behaviours describe an 'obesogenic eating style' that is characterised by faster eating rates, achieved through larger bites, reduced chewing and shorter oral exposure time. This obesogenic eating style supports acute energy intake within a meal and is more prevalent among, though not exclusive to, children with overweight. Clinical Trial Registry Number: NCT01174875; https://clinicaltrials.gov/.

Fruit form Influences Postprandial Glycemic Response in Elderly and Young Adults

OBJECTIVES

This study compared the effects of consuming different forms (bite size, puree) and two fruit types (guava, papaya) on glycemic response (GR) in elderly and young adults.

DESIGN

This study was conducted using a randomized, crossover design.

PARTICIPANTS

Nineteen healthy participants (9 elderly, 10 young adults) were recruited from the general public in Singapore.

INTERVENTION

Participants consumed glucose (reference food) on three occasions and test fruits (guava bites, guava puree, papaya bites, and papaya puree) on one occasion each.

MEASUREMENTS

Blood glucose was analyzed prior to consuming the test food, at 15, 30, 45, 60, 90 and 120 minutes after food consumption.

RESULTS

The incremental area under the blood glucose response curve (iAUC) over 120 minutes for all the treatments was significantly lower than glucose (all P < 0.001). All fruit forms and types studied were low glycemic index (GI) (guava bites: 29; papaya bites: 38; papaya puree: 42; guava puree: 47), albeit a significant difference in GI between the treatments was found (P = 0.003). Elderly exhibited significantly greater GR than young participants (P = 0.019).

CONCLUSION

Although fruit form influences GR in the elderly and young adults, all fruit types and forms studied were found to be low GI. This study indicates that fruits are a valuable source of nutrient irrespective of the form of delivery in elderly and young adults. This study was registered at www.anzctr.org.au as ACTRN12614000655640.