Shear and extensional rheological characterization of thickened fluid for dysphagia management

Hadde, Enrico Karsten; Chen, J.

doi:10.1016/j.jfoodeng.2018.10.007

Cited by 76 publications

(73 citation statements)

References 32 publications

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“…6). Results for TUC and PEO are close to the values reported in literature 14,34 and the apparent extensional viscosity of the cereal extracts are within the range of 2 to 4% PEO (Fig. 6).…”

Section: Extensional Rheologysupporting

confidence: 88%

“…Under the IDDSI framework, thickened beverages are classified via a simple gravity discharge test 13 . This flow test has already been considered by several authors [14][15][16][17] , but a relationship between the liquid rheology and the IDDSI scale has not yet been comprehensively investigated. While there is general agreement that texture modified liquids reduce aspiration, but the mechanistic reasons why this occurs are still debated.…”

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confidence: 99%

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

Marconati

Ramaioli

2020

Food Funct.

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Swallowing disorders deteriorate significantly the quality of life and can be lifethreatening. Texture modification using shear thinning food thickeners have proven 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 elastic liquids. Bolus velocity and bolus length were measured from in vitro experiments using image analysis and related to the 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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Section: Extensional Rheologysupporting

confidence: 88%

mentioning

confidence: 99%

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

Marconati

Ramaioli

2020

Food Funct.

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“…Likewise, the cohesiveness of the fluid is related to its maximum extensional viscosity. [36] Therefore, and according to the results obtained in the present study, the apparent viscosity could be used as a standard measure for the DOPs.…”

Section: Apparent Viscositysupporting

confidence: 56%

Textural characteristics of safe dishes for dysphagic patients: a multivariate analysis approach

Ibáñez

Gómez

Merino

et al. 2019

International Journal of Food Properties

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Twenty-four safe dishes for cerebral palsy dysphagic patients and four commercial dysphagia-oriented food products for dysphagia were studied in order to determine their textural characteristics. Apparent viscosity measured at 25, 50, and 100 s −1 and extrusion force analyzed at 1, 2, 5, and 10 mm/s were evaluated. Using clustering techniques, samples were divided into three categories. Apparent viscosity at 50 s −1 and extrusion force at 5 and 10 mm/s could be enough to characterize the safe dishes for dysphagic patients.

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“…This categorization results from the analysis of the consistency of thickened foods using simple and easy methods to quantify the movement of these foods based on their flow rate as thin (level 0, flows like water), slightly thick (level 1, slightly thicker than water), mildly thick (level 2, flows off a spoon), moderately thick (level 3, will not hold its shape on a spoon), and extremely thick (level 4, holds shape on spoon) to represent the thickening of the drinks (Nishinari et al, 2019;Ong, Steele, & Duizer, 2018). However, for the development of a new thickener formulation that ensures a suitable and quantifiable product, a complete rheological analysis under shear and extensional forces, applying different magnitudes of forces (as for example flow curves and oscillatory rheology) or shear rates/frequencies is essential to guarantee the safety of the new product for dysphagia patients (Hadde & Chen, 2019). This is because oral and pharyngeal flow is complex and thus, the in vivo behaviour of a material cannot be fully characterised by any metric.…”

Section: Introductionmentioning

confidence: 99%

Flaxseed gum-biopolymers interactions driving rheological behaviour of oropharyngeal dysphagia-oriented products

et al. 2021

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Viscosity-modified diet through thickeners is used as a strategy to circumvent swallowing problems by oropharyngeal dysphagia patients. Most commercial products present xanthan and starch in their formulations, but flaxseed gum (FG) is a potential thickener for liquid food that provides additional health benefits. FG was mixed either with modified starch (MS) and/or xanthan gum (XG), varying biopolymers' concentration according to a central composite rotational design in which rheological and colour properties in water were the evaluated responses. All formulations showed a shear time-independent and shear-thinning behaviour, mainly influenced by XG and MS concentrations. In oscillatory measurements, the formulations presented a prevailing elastic character attributed to MS and mainly to XG, which despite the lower concentration in which it was incorporated, exerted a similar influence on this rheological property. However, the increase of FG concentration was the most significant factor influencing viscosity, but also favoured an increase of both viscoelastic moduli mainly G'. Analysis of the microstructure disclosed different network structures as a result of biopolymers interactions, which was related to rheological behaviour giving insights to design new thickeners for dysphagia management. In addition, the amount of glucose released after in vitro digestion was evaluated and compared to a commercial MS-based thickener. Interestingly, the commercial formulation showed a glucose release significantly higher than the proposed FG/MS/XG-based formulations. These results open the opportunity to tailor the rheological characteristics of food systems by adding and combining natural ingredients, improving technological and nutritional properties.

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Shear and extensional rheological characterization of thickened fluid for dysphagia management

Cited by 76 publications

References 32 publications

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

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

Textural characteristics of safe dishes for dysphagic patients: a multivariate analysis approach

Flaxseed gum-biopolymers interactions driving rheological behaviour of oropharyngeal dysphagia-oriented products

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