Chen Muxi, Cheng Yi, Hu Wen, Wang Mengyan, Duan Juan, Shi Lei
Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China.
West China School of Clinical Medicine, Sichuan University, Chengdu, China.
PLoS One. 2025 Jan 30;20(1):e0317196. doi: 10.1371/journal.pone.0317196. eCollection 2025.
This study aimed to investigate the textural characteristics of foods preferred by elderly Chinese individuals and their suitability based on the International Dysphagia Diet Standardization Initiative (IDDSI) framework. The goal was to provide objective data to support the development of safe and nutritious diets tailored to the swallowing abilities of the elderly.
A cross-sectional observational study was conducted, using web-scraping technology to identify 26 commonly preferred food ingredients among elderly individuals across seven regions of China. These foods were prepared and evaluated according to IDDSI levels 0-7. Texture analysis was performed to measure hardness, cohesiveness, and adhesiveness, with statistical tests including chi-square analysis and multiple linear regression used to explore the relationships between these textural properties and IDDSI levels.
As IDDSI levels increased, the hardness of various food categories generally showed an upward trend, with significant increases observed in fruits, vegetables, grains, and tubers at IDDSI levels 6-7 (p≤0.05). Cohesiveness varied without a clear linear trend, showing significant changes at specific IDDSI levels for meats, grains, and tubers (p≤0.05). Adhesiveness initially increased and then decreased across the IDDSI spectrum, with the most significant fluctuations occurring in mixed beans, fruits, and grains at levels 5-7 (p≤0.05). Regression analysis revealed that cohesiveness had the most substantial impact on IDDSI levels (coefficient = -5.224, p≤0.05), followed by adhesiveness (coefficient = -0.021, p≤0.05), and hardness (coefficient = 0.002, p≤0.05).
The findings underscore the importance of considering the textural properties of foods when designing diets for elderly individuals with dysphagia. The study provides empirical evidence supporting the IDDSI framework and offers a predictive model that can assist in the development of customized diets, ensuring both safety and nutritional adequacy. Future research should focus on refining food preparation methods to better meet the specific needs of this population.
本研究旨在根据国际吞咽障碍饮食标准化倡议（IDDSI）框架，调查中国老年人偏爱的食物的质地特征及其适用性。目标是提供客观数据，以支持制定适合老年人吞咽能力的安全且营养丰富的饮食。
开展了一项横断面观察性研究，使用网络爬虫技术在中国七个地区的老年人中识别出26种常见的偏爱的食物成分。这些食物按照IDDSI的0 - 7级标准进行制备和评估。进行质地分析以测量硬度、内聚性和粘附性，并使用包括卡方分析和多元线性回归在内的统计检验来探究这些质地特性与IDDSI级别之间的关系。
随着IDDSI级别的升高，各类食物的硬度总体呈上升趋势，在IDDSI 6 - 7级时，水果、蔬菜、谷物和块茎类食物的硬度显著增加（p≤0.05）。内聚性变化无明显线性趋势，在肉类、谷物和块茎类食物的特定IDDSI级别出现显著变化（p≤0.05）。粘附性在整个IDDSI范围内先升高后降低，在5 - 7级时，杂豆类、水果和谷物中的波动最为显著（p≤0.05）。回归分析显示，内聚性对IDDSI级别影响最大（系数 = -5.224，p≤0.05），其次是粘附性（系数 = -0.021，p≤0.05），硬度（系数 = 0.002，p≤0.05）。
研究结果强调了为吞咽障碍老年人设计饮食时考虑食物质地特性的重要性。该研究提供了支持IDDSI框架的实证证据，并提供了一个预测模型，可协助制定定制化饮食，确保安全性和营养充足性。未来的研究应专注于改进食物制备方法，以更好地满足这一人群的特定需求。
