Texture and texture assessment of thickened fluids and texture‐modified food for dysphagia management

Abstract

Thickened fluids and texture‐modified foods are commonly used in the medical management of individuals who suffer from swallowing difficulty (known as dysphagia). However, how to reliably assess texture properties of such food systems is still a big challenge both to industry and to academic researchers. This article aims to identify key physical parameters that are important for objective assessment of such properties by reviewing the significance of rheological or textural properties of thickened fluids and texture‐modified foods for swallowing. Literature reviews have identified that dominating textural properties in relation to swallowing could be very different for thickened fluids and for texture‐modified foods. Important parameters of thickened fluids are generally related with the flow of the bolus in the pharyngeal stage, while important parameters of texture‐modified foods are generally related with the bolus preparation in the oral stage as well as the bolus flow in the pharyngeal stage. This review helps to identify key textural parameters of thickened fluids and texture‐modified foods in relation to eating and swallowing and to develop objective measuring techniques for quality control of thickened fluids and texture‐modified foods for dysphagia management.

Food polysaccharides and roles of rheology and tribology in rational design of thickened liquids for oropharyngeal dysphagia: A review

“…Many clinicians and researchers are completely aware that thickening liquids used for dysphagia management need to be characterized and described more carefully in terms of their rheological characteristics rather than by using simple terms such as thick or thin. As such, many articles describing concepts such as viscosity, density, yield stress, shear rates, shear stress, Newtonian and non‐Newtonian fluids, and bolus cohesion are increasingly mentioned and discussed for thickened liquids and commonly appear in the recent literature (Barbon & Steele, 2018; Burbidge et al., 2016; Cichero & Murdoch, 2006; Hadde & Chen, 2020; Sopade et al., 2007; Sopade, Halley, Ciehero, Ward, Hui, & Teo, 2008; Sopade, Halley, Ciehero, Ward, Liu, & Varliveli, 2008). Although the aforementioned IDDSI guideline does not include liquid viscosity in its description, an investigation of the rheological property of thickened liquids is essential not only to classify the level or consistency of the liquids but also to provide any information to relate to consumer's texture perception.…”

Instrumental and sensory techniques to characterize the texture of foods suitable for dysphagic people: A systematic review

“…Therefore, rheometric methods are rarely used in the food industry and even less in the clinical setting of OD. Other methods, such as the Bostwick Consistometer Test (BCT) or the Line Spread Test (LST), are often used for their greater simplicity in comparison to the abovementioned ones (Hadde & Chen, 2021). BCT has been successfully applied to evaluate the rheological properties of 30 thickened beverages for OD treatment (Germain et al., 2006).…”

Microwave treatment to modify textural properties of high protein gel applicable as dysphagia food

“…About 16.1% of the population in the United States are estimated to experience dysphagia disorder (Adkins et al, 2020). Dysphagia disorder limits the functionality of chewing and swallowing in patients who are mostly elderlies, therefore most foods with their common texture might not be suitable and safe for dysphagic people (Hadde & Chen, 2020). Some standards have defined the appropriate properties of dysphagia food and recommended textural and rheological criteria for this reason.…”

“…Considering the criteria defined by the above‐mentioned standard, the most critical points for a dysphagia food with appropriate texture are, one, it must require minimum energy for processing a ready‐to‐swallow bolus (which could be correlated to hardness and adhesiveness parameters of texture), this is very important because harder and more adhesive texture takes more time and energy to process which may cause tiring for the consumer with this disease, therefore reduces the portion size of meals which in long term ends to malnutrition and insufficient energy intake; second, it must be cohesive enough during oral processing and swallowing (which could be correlated to cohesiveness parameter). This is important because liquid exertion from the bolus or separation of particles from it makes difficulties to oral processing of the bolus and increases the risk of choking or entering liquid or food particles into the esophagus (IDDSI, 2019; Kwong & Tse, 2020; Sungsinchai et al, 2019; Hadde & Chen, 2020).…”