Rheological characterisation of thickened milk components (protein, lactose and minerals)

Hadde, Enrico Karsten; Nicholson, Timothy M.; Cichero, Julie A. Y.; Deblauwe, C.

doi:10.1016/j.jfoodeng.2015.06.016

Cited by 32 publications

(30 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The variations observed suggest some instability in the product for reasons that are unknown. However, recent studies have shown that the viscosity of milk products varies based on protein and fat content [16, 17]. Given fact that the Enfamil AR™ specialty formulas involve elements designed to reduce acid reflux and/or provide caloric fortification, it is tempting to speculate that protein or fat content may be contributing to increased viscosity.…”

Section: Discussionmentioning

confidence: 99%

Understanding the Viscosity of Liquids used in Infant Dysphagia Management

et al. 2016

View full text Add to dashboard Cite

When assessing swallowing in infants, it is critical to have confidence that the liquids presented during the swallow study closely replicate the viscosity of liquids in the infant's typical diet. However, we lack research on rheological properties of frequently used infant formulas or breastmilk, and various forms of barium contrast media used in swallow studies. The aim of the current study was to provide objective viscosity measurements for typical infant liquid diet options and barium contrast media. A TA-Instruments AR2000 Advanced Rheometer was used to measure the viscosity, five standard infant formulas, three barium products and two breastmilk samples. Additionally, this study measured the viscosity of infant formulas and breastmilk when mixed with powdered barium contrast in a 20% weight-to-volume (w/v) concentration. Study findings determined that standard infant formulas and the two breastmilk samples had low viscosities, at the lower end of the National Dysphagia Diet (NDD) thin liquid range. Two specialty formulas tested had much thicker viscosities, close to the NDD nectar-thick liquid range lower boundary. The study showed differences in viscosity between two 60% w/v barium products (Liquid E-ZPaque® and E-Z-Paque® powder); the powdered product had a much lower viscosity, despite identical barium concentration. When E-Z-Paque® powdered barium was mixed in a 20% w/v concentration using water, standard infant formulas or breastmilk, the resulting viscosities were at the lower end of the NDD thin range, and only slightly thicker than the non-barium comparator liquids. When E-Z-Paque® powdered barium was mixed in a 20% w/v concentration with the two thicker specialty formulas (Enfamil AR 20kcal and 24 kcal), unexpected alterations in their original viscosity occurred. These findings highlight the clinical importance of objective measures of viscosity as well as objective data on how infant formulas or breastmilk may change in consistency when mixed with barium.A modified barium swallow (MBS) is considered the gold standard for the evaluation of deglutition disorders. During a pediatric MBS, a commonly used approach is to mix barium Corresponding Author: Jackie Frazier, M.A, 13123 East 16th Avenue, Box 030, Aurora, CO 80045, USA, Phone: (720) 777-6810, Jacqueline.Frazier@childrenscolorado.org. HHS Public Access Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript contrast with the child's typical diet to facilitate optimal cooperation. In addition, to maximize confidence that the MBS represents the child's typical swallow function, it is critical that the viscosity of the food or liquid presented be as close as possible to the viscosity of the child's typical diet. While accurate knowledge of the influence of liquid viscosity on deglutition is important for all children with dysphagia, it is particularly critical in young infants who must meet their nutrition and hydration needs exclusively through liquid intake. Yet, the field currently lacks information regarding the viscosi...

show abstract

Section: Discussionmentioning

confidence: 99%

Understanding the Viscosity of Liquids used in Infant Dysphagia Management

et al. 2016

View full text Add to dashboard Cite

show abstract

“…For example infant formula needs significantly longer to thicken and results in a higher final viscosity [54*]; concern was a reported of the lack of guidance [55]. Thickening occurs more slowly at refrigerated temperature (5°C) and even more slowly for refrigerated milk, which may require 45-60 minutes [56] and reaches a higher final viscosity, increasing with fat content [57*] and protein content [58]. Serving temperature is important: viscosity of thickened water at 40 .…”

Section: Current Practice and Standardisation Approaches Internationallymentioning

confidence: 99%

A review of diet standardization and bolus rheology in the management of dysphagia

Hanson

2016

Current Opinion in Otolaryngology & Head and Neck Surgery

View full text Add to dashboard Cite

Purpose: Texture modification is a widespread practice as a strategy for the management of dysphagia and can be very effective in individual cases. However, it is often performed in a qualitative, subjective manner and practices vary internationally according to multiple sets of national guidelines. This paper aims to identify best practice by reviewing the theory and practice of texture modification, focussing on recent advances. Recent findings:Instrumental assessment of texture modification in-vivo is challenging, but studies including rheology and perception have indicated that fluid viscosity is only one of many factors affecting texture modification in practice. Systematic reviews have identified a historical lack of high-quality clinical evidence, but recent controlled studies are beginning to identify positive and negative aspects of thickened fluids. Research and practice to date have been limited by the lack of control and standardisation of foods and drinks. However in 2015 a notfor-profit organisation, the International Dysphagia Diet Standardisation Initiative, has published a framework for texture modification from thin liquids to solid foods based on all the existing documentation and guidance, and the -limited-available clinical evidence. Summary:Rheology exists in the lab, however normal practice is often subjective or lacking control and standardisation. In the near future, cohesion of practice and the availability of practical standardisation tools may increase awareness and use of rheology. KeywordsDysphagia, Swallowing, Rheology, Viscosity, Texture modification Key points •The relationships between rheology and swallowing are beginning to be characterised using oral pressure sensing and videofluoroscopy, together with careful control of bolus rheology.• It is becoming clearer that viscosity alone is not sufficient to categorise texture modification.• Literature to date shows a trend for reduced aspiration with increased thickness of liquids, and increased residue with some thicker consistencies, however evidence is scarce.• An inconsistent approach to definition of texture modification techniques has been limiting the collation of a coherent evidence base.• A new international standard (IDDSI) has been created, drawing on available evidence and including practical objective measures.

show abstract

“…For the preparation of thickened samples, they used three types of commercial thickeners containing maize starch, guar gum (GG), and XG marketed in Australia, and the thickened samples were prepared with very high concentrations (12.6–17.5%) at room temperature (20C) to measure shear stress–shear rate values. In particular, little information is available on the dynamic rheological properties of thickened PBB determined by small‐deformation oscillatory measurements, which allow the observation of the viscoelastic properties of thickened fluids without disturbing the structure of the fluid during measurement (Hadde, Nicholson, & Cichero, ; Hadde, Nicholson, Cichero, & Deblauwe, ). The thickened PBB is a cold fluid stored at refrigerator temperature that is commonly served to patients for providing hydration in addition to protein and calcium (Claes et al, ).…”

Section: Introductionmentioning

confidence: 99%

Rheological characterization of thickened protein‐based beverages under different food thickeners and setting times

Kim

Yoo

2018

Journal of Texture Studies

View full text Add to dashboard Cite

Food thickeners have been commonly used in the preparation of various thickened fluids with desirable rheological properties for dysphagic patients to elicit an optimal swallow response. However, among various thickened fluids, there is limited rheological information on cold thickened protein-based beverage (PBB) (e.g., whole milk, skim milk, and soybean milk) prepared with various xanthan gum (XG)-based thickeners. Our flow and dynamic rheological results showed that the flow and viscoelastic properties of the thickened PBB samples prepared with different food thickeners were dependent on the PBB type, thickener type, and setting time. These rheological results presented in this study will provide both thickener manufacturers and clinicians with valuable information for thickened PBB products with desirable rheological properties for safe and easy swallowing. New knowledge of the different rheological characterizations of thickened PBB can be practically applied to develop the commercial dysphagia thickeners suitable for PBB in food industry.

show abstract

Rheological characterisation of thickened milk components (protein, lactose and minerals)

Cited by 32 publications

References 20 publications

Understanding the Viscosity of Liquids used in Infant Dysphagia Management

Understanding the Viscosity of Liquids used in Infant Dysphagia Management

A review of diet standardization and bolus rheology in the management of dysphagia

Rheological characterization of thickened protein‐based beverages under different food thickeners and setting times

Contact Info

Product

Resources

About