Textural Changes by Mastication and Proper Food Texture for Patients with Oropharyngeal Dysphagia

Abstract

Bolus texture is a key factor for safe swallowing in patients with dysphagia since an improper texture may result in aspiration and/or pharyngeal residue. This article discusses swallowing bolus texture from two key aspects: the textural change of solid food by mastication and the current standardized definition of food texture in Japan. When swallowing a liquid bolus, the texture is mostly maintained from ingestion to swallow onset. For solid food, however, the food is crushed by chewing and mixed with saliva before swallowing; the texture of the ingested food is modified to an easily swallowable form at swallow onset by mastication. Understanding the mechanism of mastication and its assessment are therefore important in deciding the proper diet for dysphagic patients. As standardized criteria for classifying the texture of food and liquid are essential as well, this report also describes the Japanese Dysphagia Diet 2013 that is commonly used as the standardized index for dysphagic diets in Japan.

Rheological and Textural Properties of Apple Pectin-Based Composite Formula with Xanthan Gum Modification for Preparation of Thickened Matrices with Dysphagia-Friendly Potential

“…In addition to the rheological characterization, TPA provides other important measurements of a dysphagia-friendly matrix (DFM). In this study, TPA is conducted by applying a vertical pressing force to mimic the human oral chewing process, and the setup and protocols follow those recommended by the Japanese Ministry of Health and Welfare in Japanese [ 60 ], first revealed by Funami [ 18 ] and, thereafter reviewed and discussed by Matsuo and Fujishima [ 61 ]. The characterization utilizes the standard parameters of hardness, adhesiveness, and cohesiveness.…”

Association between Weight Loss and Food Form in Older Individuals Residing in Long-Term Care Facilities: 1-Year Multicenter Longitudinal Study

“…Each facility's registered dietitian calculated the average daily total oral energy intake (kcal/day) for each resident in the previous week, with reference to the amount of food offered and uneaten. Regarding the food form, a diet corresponding to the 2013 Japanese dysphagia diet classification codes of the Japanese Society of Dysphagia Rehabilitation was considered a dysphagia diet [15,16]. Food forms not requiring any other processing or special preparation beyond the normal or that used processing or special preparation as standard (e.g., chopping or thickening with starch) were considered a regular diet.…”

Development of the Sakiika transport test: A practical screening method for patients with oral-phase dysphagia

“…When solid food requiring mastication is ingested, the first movement observed is stage I transport [17,18]. In stage I transport, food ingested in the midline at the maximal jaw opening is pulled backward by the tongue, lifted upwards by elevation of the tongue surface, and pushed laterally against the occlusal surfaces of the molars by the rotation of the tongue.…”