评估吞咽困难的老年人的吞咽能力：高蛋白、低碳水化合物奶昔配方与商业配方的比较
Evaluating swallowing capacity in older adults with dysphagia: high protein, low carbohydrate smoothie formulas versus commercial formula.
作者信息
Mongkolsucharitkul Pichanun, Pinsawas Bonggochpass, Watcharachaisoponsiri Thareerat, Suta Sophida, Pumeiam Sureeporn, Ophakas Suphawan, Surawit Apinya, Ongard Sunun, Keskool Phawin, Thitisakulchai Poungkaew, Srichayet Phisamai, Mayurasakorn Korapat
机构信息
Siriraj Population Health and Nutrition Research Group (SPHERE), Research Group and Research Network Division, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
Department of Otolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
出版信息
BMC Geriatr. 2025 Jul 2;25(1):456. doi: 10.1186/s12877-025-06126-x.
BACKGROUND
Dysphagia is a common problem in older adults that can lead to nutritional deficiencies. Oral nutritional supplements (ONS) are products used for oral nutrition support as an alternative nutritional therapy, specifically manufactured for the older individuals at risk of dysphagia. This study aimed to develop four high protein (23-34% energy ratio) and low carbohydrate (25-38% energy ratio) smoothie formulas (white sesame (WS) vs. white sesame and low carbohydrate (WSLC) vs. black sesame and low carbohydrate (BSLC) vs. chicken shitake (CS); 1 kcal/ml) for the older people with dysphagia and to assess their effect on swallowing capacity compared to widely used commercial formula (Ensure).
METHODS
A cross-sectional study involved 63 participants aged 65 years or over. Subjects were divided into asymptomatic (n = 32, aged 72.9 ± 5.66 year) or symptomatic swallowing difficulty (n = 31, aged 75.0 ± 6.48 year) groups based on swallowing screening questionnaires. Swallowing capacity was assessed using Fiberoptic Endoscopic Evaluation of Swallowing (FEES), performed by experienced physicians, for three drinks (WS, CS vs. Ensure) in a blinded, randomly crossover sequence.
RESULTS
Spare retention of a food bolus in each formula had been identified in the asymptomatic (47-66%) and symptomatic (61-71%) groups. WS had fewer premature spills than Ensure in the symptomatic group, but not in the asymptomatic group (5 ± 0.03 vs. 4.7 ± 0.12, p < 0.05), while CS had fewer premature spills than Ensure in both groups.
CONCLUSIONS
The findings suggest that smoothie drinks, particularly WS (51-350 centipoise), may offer a viable alternative to commercial formula (1-50 centipoise) for older adults with dysphagia, potentially reducing premature spillage. The findings provide useful preliminary insights into the potential of these formulas to support safer swallowing. Further research, including longer-term studies, would help to more fully explore their nutritional benefits, safety, and applicability across broader populations.
TRIAL REGISTRATION
Clinical Trial ID NCT04901182, https//clinicaltrials.gov/ct2/show/NCT04901182 (25/05/2021).
背景
吞咽困难是老年人常见的问题，可导致营养缺乏。口服营养补充剂（ONS）是用于口服营养支持的产品，作为一种替代营养疗法，专门为有吞咽困难风险的老年人制造。本研究旨在为吞咽困难的老年人开发四种高蛋白（能量比23 - 34%）和低碳水化合物（能量比25 - 38%）的奶昔配方（白芝麻（WS）、白芝麻和低碳水化合物（WSLC）、黑芝麻和低碳水化合物（BSLC）、香菇（CS）；1千卡/毫升），并与广泛使用的商业配方（安素）相比，评估它们对吞咽能力的影响。
方法
一项横断面研究纳入了63名65岁及以上的参与者。根据吞咽筛查问卷，受试者被分为无症状组（n = 32，年龄72.9 ± 5.66岁）或有症状的吞咽困难组（n = 31，年龄75.0 ± 6.48岁）。由经验丰富的医生采用纤维内镜吞咽评估（FEES）对三种饮品（WS、CS与安素）进行吞咽能力评估，采用盲法、随机交叉顺序。
结果
在无症状组（47 - 66%）和有症状组（61 - 71%）中均发现每种配方食物团块的残留情况。在有症状组中，WS的过早溢出比安素少，但在无症状组中并非如此（5 ± 0.03对4.7 ± 0.12，p < 0.05），而在两组中CS的过早溢出都比安素少。
结论
研究结果表明，对于吞咽困难的老年人，奶昔饮品，特别是WS（51 - 350厘泊），可能是商业配方（1 - 50厘泊）的可行替代品，有可能减少过早溢出。这些发现为这些配方支持更安全吞咽的潜力提供了有用的初步见解。进一步的研究，包括长期研究，将有助于更全面地探索它们在更广泛人群中的营养益处、安全性和适用性。
试验注册
临床试验标识符NCT04901182，https//clinicaltrials.gov/ct2/show/NCT04901182（2021年5月25日）。
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