The Criteria of Thickened Liquid for Dysphagia Management in Japan

Watanabe, Emi; Yamagata, Yoshie; Fujitani, Junko; Fujishima, Ichiro; Takahashi, Koji; Uyama, Risa; Ogoshi, Hiro; Kojo, Akiko; Maeda, Hiroshi; Ueda, Kôichiro; Kayashita, Jun

doi:10.1007/s00455-017-9827-x

Cited by 38 publications

(29 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Liquids are thickened by a xanthan gum-based thickener and are divided into three categories: mildly, moderately, and extremely thick ( Figure 11 ) [ 41 ]. Mildly thick liquids flow quickly by tilting the spoon and leave a thin trace of residue in the cup after poured.…”

Section: Proper Modification Of Food Texture For Oropharyngeal Dysmentioning

confidence: 99%

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

Matsuo

Fujishima²

2020

Nutrients

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Proper Modification Of Food Texture For Oropharyngeal Dysmentioning

confidence: 99%

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

Matsuo

Fujishima²

2020

Nutrients

Self Cite

View full text Add to dashboard Cite

show abstract

“…Several food textural and rheological properties, such as elasticity, hardness, gumminess, springiness, creaminess, crispness, brittleness, chewiness, adhesiveness, and cohesiveness, are used to describe the behaviour of solid food boluses. The Japanese Society for Dysphagia Rehabilitation considers hardness (under 15,000 N/m 2 ), adhesiveness (under 1000 J/m 2 ), and cohesiveness (between 0.2 and 0.9) as being the most significant [59]. A future step in our investigation would be a rigorous study on these rheological properties of food in order to describe the textures of recipes with more precision.…”

Section: Discussionmentioning

confidence: 99%

Triple Adaptation of the Mediterranean Diet: Design of A Meal Plan for Older People with Oropharyngeal Dysphagia Based on Home Cooking

Costa

Carrión

Puig-Pey³

et al. 2019

Nutrients

View full text Add to dashboard Cite

Background: Oropharyngeal dysphagia (OD) and malnutrition are highly prevalent in older patients that are discharged from general hospitals (47% and 30%, respectively). Aims: To develop a nutritional plan for these patients involving a triple adaptation of their traditional diet: (a) rheological adaptation (texture and viscosity) for safe deglutition, (b) nutritional adaptation (water, calories, and proteins), and (c) organoleptic adaptation to improve compliance. Methods: Two fluid viscosities (250 and 800 mPa·s) were selected according to previous studies on optimal viscosities in older patients. The British Dietetic Association food texture classification based on common clinical practice selected two food textures (thick purée and fork-mashable. Two levels of calorie protein enrichment were selected according to previous studies using the Mini Nutritional Assessment (MNA®). Results: The daily caloric-protein and hydric needs were established at 1750 kcal, 70 g protein, and 1750 mL water in patients with MNA® ≥ 17; and, 2037 kcal, 90 g protein, and 2000 mL water/day in malnourished patients. Sixteen weekly menus (296 recipes) were developed while using two textures, two levels of viscosity, two nutritional phenotypes (normal/at-risk vs. malnourished), and two seasons of the year (spring/summer-autumn/winter) based on Mediterranean cuisine. Conclusion: This concept paper demonstrates that traditional Mediterranean cooking can be adapted to meet the rheological, nutritional, and hydration needs of older patients with OD. The recipes that we have developed meet the needs of patients with varying degrees of OD and malnutrition are reproducible in patient’s homes and they could have a major impact on the clinical outcomes of these patients.

show abstract

“…25 With respect to dysphagia diets, formulations are classified as either foods or pharmaceuticals, and vary considerably in trace element content. 26,27 For example, the copper content of dysphagia diet A is 0.03 mg per pack. In Japan, dysphagia diet is provided for older patients who cannot eat normal meals in order to prevent aspiration, ensure caloric intake and restore or maintain pleasure of eating.…”

Section: Discussionmentioning

confidence: 99%

Copper Deficiency Anemia in Older Patients with Swallowing Disorders: A Case Report

Tanabe

Iwaisako

2019

Curr Res Nutr Food Sci

View full text Add to dashboard Cite

BackgroundTrace element deficiency is most commonly a result of long-term intravenous nutrition; however, it can also develop on rare occasions in people who are fed orally. The present study aimed to investigate the development of copperdeficiency anemia in older patients who were provided with dysphagia diets because of swallowing disorders. MethodsThe study included 34 patients who were provided with dysphagia diet A for at least three months at Higashiyama Sanatorium for the Elderly in Kyoto, Japan. ResultsSix patients had hemoglobin levels below 10.0 g/dL before being placed on a dysphagia diet; however, this number increased to 17 during this study. Univariate analysis showed the factors associated with anemia onset to be serum copper level and dysphagia diet administration duration, whereas multivariate analysis showed only serum copper level to be significant. Receiver operating characteristic analysis showed the serum copper level cut-off value to be 13 μg/dL with respect to development of anemia (sensitivity: 100%; specificity: 59%). In addition, oral copper supplementation for two months improved anemia in all 15 cases who were followed up. ConclusionsPatients receiving dysphagia diet are at risk of developing copper deficiency anemia. Copper supplementation is recommended for all older patients being prescribed this type of diet, and special attention is required in this respect.

show abstract

The Criteria of Thickened Liquid for Dysphagia Management in Japan

Cited by 38 publications

References 9 publications

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

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

Triple Adaptation of the Mediterranean Diet: Design of A Meal Plan for Older People with Oropharyngeal Dysphagia Based on Home Cooking

Copper Deficiency Anemia in Older Patients with Swallowing Disorders: A Case Report

Contact Info

Product

Resources

About