The Effect of Oral Processing on the Viscosity of Thickened Drinks for Patients With Dysphagia

Vallons, Katleen J. R.; Oudhuis, Lizette; Helmens, Harold J.; Kistemaker, C.

doi:10.5535/arm.2015.39.5.772

Cited by 21 publications

(13 citation statements)

References 18 publications

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“…To measure the difference in "real" oral breakdown, Vallons, Oudhuis, Helmens, and Kistemaker (2015) measured the viscosity of water samples thickened with several commercial dysphagia products. The samples were measured after being spat out.…”

Section: Approaches To Studying the Impact Of Saliva On Rheological Properties In Relation To Sensory Perceptionmentioning

confidence: 99%

Saliva matters: Reviewing the role of saliva in the rheology and tribology of liquid and semisolid foods. Relation to in-mouth perception

2021

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In recent years, the dynamic aspects of the oral perception of food have increasingly been taken into account in food texture characterization. At the same time, the experimental settings of instrumental measurements have also been emulating "oral contexts" more closely. The aspects related to in-mouth handling that have been incorporated into food studies include using saliva as a key material. Semisolid (or liquid) food does not usually need mastication but undergoes more subtle processes involving the tongue and palate, among other buccal structures, in which saliva is omnipresent. Creaminess, mouthfeel and astringency are central sensory sensations for which oral handling and consequently, saliva is pivotal. The present review examines the experimental considerations involved in using saliva in the rheology and tribology of liquid and semisolid foods. It also analyses some instrumental parameters that have been related to sensory attributes of liquid and semisolid foods.

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Section: Approaches To Studying the Impact Of Saliva On Rheological Properties In Relation To Sensory Perceptionmentioning

confidence: 99%

Saliva matters: Reviewing the role of saliva in the rheology and tribology of liquid and semisolid foods. Relation to in-mouth perception

2021

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“…Increased salivary flow rate, correlated to masseter muscle activity (sEMG measured) during bolus formation, helps break down the bolus's structure [20]. After 10 seconds' oral processing, viscosity of expectorated boluses of gum-or starchthickened water decreased by 70% and 35% respectively [21]. This was attributed to the effect of alpha-amylase, but a general dilution effect may also have contributed [18].…”

Section: Research In Swallowing and Rheologymentioning

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

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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.

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“…Despite the fact that all guidelines for the preparation of dysphagic meals are only referred to food viscosity before it is introduced into the mouth, it is also important to take into account that the mixing of saliva with foodstuff may change its rheological properties. Although few analyses regarding viscosity and thickening after the mixing with saliva have been performed ( 19 , 21 , 55 ), these findings must be taken into account in dietary prescriptions for dysphagia.…”

Section: Discussionmentioning

confidence: 99%

“…Oral processing of food (especially if prolonged as in the case of patients suffering from dysphagia) still leads to a reduction in viscosity even when gum-based thickeners are used. These aspects should be considered in the management of dysphagia therapy, to prevent patients receiving food with inappropriate consistency, taking into account the physician's instructions ( 19 – 21 ).…”

Section: Introductionmentioning

confidence: 99%

Optimizing Texture Modified Foods for Oro-pharyngeal Dysphagia: A Difficult but Possible Target?

et al. 2018

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Dysphagia is a swallowing disorder characterized by the difficulty in transferring solid foods and/or liquids from the oral cavity to the stomach, imparing autonomous, and safe oral feeding. The main problems deriving from dysphagia are tracheo-bronchial aspiration, aspiration pneumonia, malnutrition and dehydration. In order to overcome dysphagia-induced problems, over the years water and food thickening has been used, focusing specifically on viscosity increase, but limited results have been obtained. Elastic components and their effects on the cohesiveness on the bolus should be taken into account in the first place. We provide an analysis of dysphagia and suggest possible corrections to the protocols which are being used at present, taking into account rheological properties of food and the effect of saliva on the bolus. We reckon that considering such aspects in the dysphagia management market and healthcare catering would result in significant clinical risk reduction.

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The Effect of Oral Processing on the Viscosity of Thickened Drinks for Patients With Dysphagia

Cited by 21 publications

References 18 publications

Saliva matters: Reviewing the role of saliva in the rheology and tribology of liquid and semisolid foods. Relation to in-mouth perception

Saliva matters: Reviewing the role of saliva in the rheology and tribology of liquid and semisolid foods. Relation to in-mouth perception

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

Optimizing Texture Modified Foods for Oro-pharyngeal Dysphagia: A Difficult but Possible Target?

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