Department of Physical Medicine and Rehabilitation, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10326, Republic of Korea.
Department of Food and Nutrition Service, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
BMC Geriatr. 2020 Nov 23;20(1):493. doi: 10.1186/s12877-020-01890-4.
Increasing viscosity can reduce the risk of aspiration into the airway, but excessively thickened food may require more force and effort. We assumed that semi-solid foods with similar viscosities will behave differently in the oropharynx and there might exist the possibility that properties other than viscosity may have clinical relevance. This study aimed to find out the texture of semi-solid foods that affects the effort of pharyngeal swallow in the older adults.
Nine kinds of semi-solid foods not requiring mastication were selected for texture profile analysis (TPA), and included whipped cream, mayonnaise, soft tofu, mango pudding, boiled mashed pumpkin, boiled mashed potatoes, boiled mashed sweet potatoes, red bean paste, and peanut butter. Hardness, adhesiveness and cohesiveness of each food were measured three times by using the rheometer. A blinded sensory test using a 9-point hedonic scale was also conducted in eighteen older adults people to investigate how much effort was required to swallow food, and how much of the food remained in the pharynx after swallowing. The correlation between texture and sensory outcome was statistically analyzed.
Foods that belonged to the same viscosity category showed different texture values, and the participants also rated different scores respectively. Only adhesiveness among three properties was significantly correlated with the sensory test. (r = 0.882, p = 0.002 for difficult to swallow, r = 0.879, p = 0.002 for sense of residue).
Adhesiveness was the most important property of the semi-solid foods, requiring most efforts in pharyngeal swallow in the older adults. If we select and provide food having low adhesiveness value in the same viscosity category, there might be the possibility to make it easier to swallow in older adults.
增加食物黏度可以降低吸入气道的风险，但过于浓稠的食物可能需要更多的力量和努力。我们假设具有相似黏度的半固态食物在口咽部的表现会有所不同，可能存在除黏度以外的其他特性与临床相关的可能性。本研究旨在找出影响老年人咽部吞咽费力的半固态食物质地。
选择 9 种不需要咀嚼的半固态食物进行质地剖面分析（TPA），包括鲜奶油、蛋黄酱、软豆腐、芒果布丁、煮烂的南瓜、煮烂的土豆、煮烂的红薯、红豆沙和花生酱。使用流变仪三次测量每种食物的硬度、粘性和内聚性。18 名老年人还进行了一项盲感测试，使用 9 分愉悦量表来调查吞咽食物需要多少努力，以及吞咽后食物在咽部残留多少。统计分析质地和感官结果之间的相关性。
属于同一黏度类别的食物表现出不同的质地值，参与者也分别给出不同的评分。只有三种特性中的粘性与感官测试显著相关。（吞咽困难的评分 r=0.882，p=0.002；残留感的评分 r=0.879，p=0.002）。
粘性是半固态食物最重要的特性，在老年人的咽部吞咽中需要最大的努力。如果我们选择和提供具有相同黏度类别、低粘性值的食物，可能会使老年人更容易吞咽。
