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机构化老年人能够检测到含有树胶增稠剂的增稠水中的小粘度变化:是否应该重新审查质地分类?

Institutionalized elderly are able to detect small viscosity variations in thickened water with gum-based thickeners: should texture classifications be reviewed?

机构信息

Department of Endocrinology and Nutrition, Miguel Servet Hospital, Zaragoza, Spain.

Food Technology, Faculty of Veterinary, Zaragoza University, AgriFood Institute of Aragon (IA2), C/ Miguel Servet, 177, 50013, Zaragoza, Spain.

出版信息

BMC Geriatr. 2021 Nov 19;21(1):647. doi: 10.1186/s12877-021-02599-8.


DOI:10.1186/s12877-021-02599-8
PMID:34798812
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8603478/
Abstract

BACKGROUND: The prevalence of dysphagia is very high in institutionalized elderly. Knowledge of the rheological and sensory characteristics of the various thickeners in elderly is limited, although it has been seen that there are differences between the rheological behaviors of gum-based thickeners with different composition. Moreover, we have not found sensory studies of viscosity in institutionalized elderly. Our hypothesis was that viscosity ranges established by the scientific societies, such as the National Dysphagia Diet Task Force (NDD), seem to be very wide and individuals might be able to detect small differences within the same texture range. The objectives of our study were 1) comparing the rheological characteristics of two commercial gum-based thickeners with different composition, dissolved in water under standard conditions, and 2) perform a sensory analysis (with both adults and institutionalized elderly) to detect different viscosities within the same texture (nectar and honey). METHODS: Two commercial thickeners based on gums (NC and RC) were studied analyzing their viscosity in water with different concentrations (shear rate: 50 s; temperature: 22-25 °C). A sensory analysis involving 26 elderly and 29 adult controls was carried out to evaluate whether differences within nectar and honey textures among gum-based thickeners could be distinguished. RESULTS: As the shear rate increases, viscosity decreases (non-Newtonian and pseudoplastic behavior). At the same concentration, each thickener produces a different viscosity (p < 0.05). Institutionalized elderly detected viscosity differences in nectar range of 49.9 (2.5) mPa·s (p < 0.05) and 102.2 (4.7) mPa·s (p < 0.0001). They also detected viscosity differences in honey texture range of 134.6 (9.7) mPa·s (p < 0.05) y 199.3 (9.2) mPa·s (p < 0.0001). Their caregivers also detected viscosity differences in both viscosity ranges (p < 0.0001) and with greater intensity than the elderly in honey texture (p: 0.016). CONCLUSIONS: Our results suggest that the accepted viscosity ranges by NDD for the different textures might be too wide because institutionalized elderly and their caregivers are able to discern small differences in viscosity in nectar and honey textures. Gum-based thickeners with different composition showed differences in viscosity capacity, so they are not interchangeable.

摘要

背景:在机构化老年人中,吞咽困难的患病率非常高。尽管已经观察到不同组成的胶基增稠剂的流变行为存在差异,但对老年人中各种增稠剂的流变和感官特性的了解有限。此外,我们还没有发现针对机构化老年人的粘度感官研究。我们的假设是,科学学会(如国家吞咽障碍饮食工作组(NDD))确定的粘度范围似乎非常宽,个体可能能够在同一质地范围内检测到微小差异。我们的研究目的是 1)比较两种具有不同组成的商业胶基增稠剂在标准条件下溶解在水中的流变特性,2)进行感官分析(包括成年人和机构化老年人),以检测同一质地(花蜜和蜂蜜)内的不同粘度。

方法:研究了两种基于胶的商业增稠剂(NC 和 RC),分析了它们在不同浓度(剪切速率:50 s;温度:22-25°C)下在水中的粘度。一项涉及 26 名老年人和 29 名成年对照组的感官分析表明,胶基增稠剂在花蜜和蜂蜜质地之间的差异是否可以区分。

结果:随着剪切速率的增加,粘度降低(非牛顿和假塑性行为)。在相同浓度下,每种增稠剂产生不同的粘度(p<0.05)。机构化老年人检测到花蜜范围内 49.9(2.5)mPa·s(p<0.05)和 102.2(4.7)mPa·s(p<0.0001)的粘度差异。他们还检测到蜂蜜范围内 134.6(9.7)mPa·s(p<0.05)和 199.3(9.2)mPa·s(p<0.0001)的粘度差异。他们的护理人员也在这两个粘度范围内检测到了粘度差异(p<0.0001),并且在蜂蜜质地方面的检测强度大于老年人(p:0.016)。

结论:我们的结果表明,NDD 为不同质地接受的粘度范围可能太宽,因为机构化老年人及其护理人员能够辨别花蜜和蜂蜜质地中粘度的微小差异。不同组成的胶基增稠剂在粘度能力上存在差异,因此它们不能互换。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e2/8603478/a2413c85aae2/12877_2021_2599_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e2/8603478/bb9608b501c7/12877_2021_2599_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e2/8603478/42dd0c95e547/12877_2021_2599_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e2/8603478/a2413c85aae2/12877_2021_2599_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e2/8603478/bb9608b501c7/12877_2021_2599_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e2/8603478/42dd0c95e547/12877_2021_2599_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48e2/8603478/a2413c85aae2/12877_2021_2599_Fig3_HTML.jpg

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引用本文的文献

[1]
Measuring Viscosity and Consistency in Thickened Liquids for Dysphagia: Is There a Correlation Between Different Methods?

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[2]
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[3]
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[4]
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本文引用的文献

[1]
Dysphagia screening in residential care settings: A scoping review.

Int J Nurs Stud. 2021-2

[2]
Is IDDSI an Evidence-Based Framework? A Relevant Question for the Frail Older Population.

Geriatrics (Basel). 2020-10-21

[3]
Prevalence and risk factors of dysphagia among nursing home residents in eastern China: a cross-sectional study.

BMC Geriatr. 2020-9-17

[4]
Therapeutic Effect, Rheological Properties and α-Amylase Resistance of a New Mixed Starch and Xanthan Gum Thickener on Four Different Phenotypes of Patients with Oropharyngeal Dysphagia.

Nutrients. 2020-6-23

[5]
Effect of a gum-based thickener on the safety of swallowing in patients with poststroke oropharyngeal dysphagia.

Neurogastroenterol Motil. 2019-8-11

[6]
Experimental and Computational Investigation of the IDDSI Flow Test of Liquids Used in Dysphagia Management.

Ann Biomed Eng. 2019-6-19

[7]
Challenges to assumptions regarding oral shear rate during oral processing and swallowing based on sensory testing with thickened liquids.

Food Hydrocoll. 2018-11

[8]
Comparative study of IDDSI flow test and line-spread test of thickened water prepared with different dysphagia thickeners.

J Texture Stud. 2018-9-21

[9]
The anatomy and physiology of normal and abnormal swallowing in oropharyngeal dysphagia.

Neurogastroenterol Motil. 2017-5-25

[10]
Sensory and rheological characteristics of thickened liquids differing concentrations of a xanthan gum-based thickener.

J Texture Stud. 2017-5-25

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