Watanabe Emi, Yamagata Yoshie, Fujitani Junko, Fujishima Ichiro, Takahashi Koji, Uyama Risa, Ogoshi Hiro, Kojo Akiko, Maeda Hiroshi, Ueda Koichiro, Kayashita Jun
Department of Molecular Nutrition, Institution of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Department of Health Sciences, Prefectural University of Hiroshima, 1-1-71 Ujina-Higashi, Minami-ku, Hiroshima, 734-8558, Japan.
Dysphagia. 2018 Feb;33(1):26-32. doi: 10.1007/s00455-017-9827-x. Epub 2017 Aug 30.
In Japan, the viscosity of thickened liquids is different among hospitals and nursing homes. In order to standardize viscosity of thickened liquids, the dysphagia diet committee of the Japanese Society of Dysphagia Rehabilitation developed the Japanese Dysphagia Diet 2013 (JDD2013). To decide on a definition of thickened liquids, the committee reviewed categories from other countries. Especially, the criteria of the USA and Australia were used as references. The definition had three levels: mildly thick, moderately thick, and extremely thick. Then a sensory evaluation by health care workers was carried out to decide the viscosity range of each level, and a draft document was made. After collecting public comments, follow-up experiments using thickened water with thickeners using xanthan gum were performed, and the JDD2013 (Thickened Liquid) was determined. The JDD2013 (Thickened Liquid) evaluated the drinking properties, visual properties, and viscosity values of each level. The shear rate of 50 s was adopted to measure the viscosity with a cone and plate type viscometer to duplicate the measurement criteria used by the USA. We also set the values of the JDD2013 with the Line Spread Test to promote the use of guidelines in clinical practice. We believe the JDD2013 standards help hospitals and other settings that care for people with dysphagia to use the same thickness level and the same labels. In the future, the JDD2013 levels will be compared with new international guidelines to help with international understanding of the JDD2013 levels.
在日本，不同医院和养老院中增稠液体的黏度存在差异。为规范增稠液体的黏度，日本吞咽障碍康复学会的吞咽障碍饮食委员会制定了《2013年日本吞咽障碍饮食标准》（JDD2013）。为确定增稠液体的定义，该委员会参考了其他国家的分类。尤其以美国和澳大利亚的标准作为参考依据。该定义分为三个级别：轻度增稠、中度增稠和极度增稠。随后，医护人员进行了感官评估以确定每个级别的黏度范围，并形成了一份文件草案。在收集公众意见后，使用添加了黄原胶增稠剂的增稠水进行了后续实验，最终确定了JDD2013（增稠液体）标准。JDD2013（增稠液体）对每个级别的饮用特性、视觉特性和黏度值进行了评估。采用50秒的剪切速率，使用锥板式黏度计测量黏度，以复制美国使用的测量标准。我们还通过线条扩散试验设定了JDD2013的数值，以促进该指南在临床实践中的应用。我们相信，JDD2013标准有助于医院及其他护理吞咽障碍患者的机构使用相同的厚度级别和相同标签。未来，JDD2013的级别将与新的国际指南进行比较，以促进国际上对JDD2013级别的理解。
