Clinical Nutrition Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Stomatology Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Eur J Clin Nutr. 2019 Jul;73(7):989-996. doi: 10.1038/s41430-019-0389-x. Epub 2019 Jan 14.
BACKGROUND/OBJECTIVES: Oropharyngeal dysphagia (OD) is a common problem in elderly population that negatively affects the oral intake and body composition resulting in clinical complications as malnutrition and dehydration. The aim of this study was to design, implement, and evaluate the effect of texture-modified foods and thickened drinks diet, with nectar or pudding viscosity and controlled bolus volume in older adults with OD on body composition and oral intake.
SUBJECTS/METHODS: Randomized clinical trial, simple blind. Patients ≥ 65 years, admitted at a national institute, who had a confirmed diagnosis of OD were included. A texture-modified foods and thickened drinks diet, with nectar or pudding viscosity and controlled bolus volume, was compared to isocaloric standard treatment for 12 weeks. Body composition was evaluated by bioelectrical impedance, muscular functionality was evaluated by handgrip strength, and daily energy and protein intake by 24-h recall and evaluated by Food Processor Nutrition Analysis® software.
Twenty participants were included per group, with mean age 76 years. After 12 weeks, the consumption of energy (29 ± 10 to 40 ± 15 kcal/kg, p = 0.009) and protein (1.3 ± 0.6 to 1.8 ± 0.7 g/kg, p = 0.03), as well as phase angle (4.4 ± 1.8 to 5.5 ± 2.5°, p = 0.05), body weight (56 ± 10 to 60 ± 10 kg, p < 0.001), and handgrip strength (18 ± 11 to 21 ± 13 kg, p = 0.004) increased in the intervention group. In control group there were no changes.
The dietary intervention improved oral intake, weight, handgrip strength, and phase angle, which can prevent or limit the nutritional complications associated with the OD.
背景/目的：口咽吞咽困难（OD）是老年人群中的常见问题，会对口腔摄入和身体成分产生负面影响，导致临床并发症，如营养不良和脱水。本研究旨在设计、实施和评估对老年 OD 患者采用调整食物质地和增稠饮料饮食（具有花蜜或布丁稠度和控制的团注量）对身体成分和口腔摄入的影响。
研究对象/方法：这是一项随机临床试验，采用简单盲法。纳入在国立机构住院且经确诊为 OD 的年龄≥65 岁患者。将调整食物质地和增稠饮料饮食（具有花蜜或布丁稠度和控制的团注量）与等热量标准治疗进行比较，为期 12 周。采用生物电阻抗评估身体成分，采用握力评估肌肉功能，通过 24 小时回顾法评估每日能量和蛋白质摄入，并使用 Food Processor Nutrition Analysis®软件进行评估。
每组纳入 20 名参与者，平均年龄为 76 岁。12 周后，能量（29±10 至 40±15 kcal/kg，p=0.009）和蛋白质（1.3±0.6 至 1.8±0.7 g/kg，p=0.03）的摄入量以及相位角（4.4±1.8 至 5.5±2.5°，p=0.05）、体重（56±10 至 60±10 kg，p<0.001）和握力（18±11 至 21±13 kg，p=0.004）在干预组中增加。在对照组中没有变化。
饮食干预改善了口腔摄入、体重、握力和相位角，这可以预防或限制与 OD 相关的营养并发症。
