Measuring the Rheological and Textural Properties of Thick Purees Used to Manage Patients with Swallowing Disorders

Texture-modified diets are the first-line compensatory strategy for older patients with swallowing and mastication disorders. However, the absence of a common protocol to assess textural properties inhibits their standardization and quality control and, thus, patient safety. This study aimed to (a)...

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Detalles Bibliográficos
Autores: Ismael-Mohammed, Kovan, Bolivar-Prados, Mireia, Laguna Cruañes, Laura, Clavé, Pere
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/334455
Acceso en línea:http://hdl.handle.net/10261/334455
Access Level:acceso abierto
Palabra clave:Dysphagia
Viscosity
Textural properties
Rheometer
Texture analyzer
Texture C
Thick puree
Descripción
Sumario:Texture-modified diets are the first-line compensatory strategy for older patients with swallowing and mastication disorders. However, the absence of a common protocol to assess textural properties inhibits their standardization and quality control and, thus, patient safety. This study aimed to (a) assess the rheological and textural properties of ten thick purees (Texture C, British Dietetic Association), (b) understand the effect of oral processing, and (c) measure the properties of the ready-to-swallow bolus after oral processing in healthy adults. Shear viscosity at 50 s−1 and 300 s−1 and textural properties (maximum force, cohesiveness, and adhesiveness) of boluses of ten thick purees were analyzed with a rheometer and a texture analyzer before and after oral processing (ready-to-swallow) in five healthy volunteers. Viscosity varied by 81.78% at 50 s−1 (900–4800 mPa·s) among purees before oral processing. Maximum force varied by 60% (0.47–1.2 N); cohesiveness, 18% (0.66–0.82), and adhesiveness, 32% (0.74–1.1 N·s). The high variability of viscosity was also present in ready-to-swallow boluses, 70.32% among purees. Oral processing significantly reduced viscosity in most purees (French omelet, zucchini omelet, turkey stew, red lentils, noodles, and hake fish) and also significantly reduced maximum force (7–36%) and adhesiveness (17–51%) but hardly affected cohesiveness (<5%). All thick purees met the qualitative textural descriptors for Level C texture. However, all ten purees showed significant differences in all parameters measured instrumentally and were affected differently by oral processing. This study demonstrates the need to use instrumental quality control using standardized protocols and SI units to narrow the variability and provide the optimal values for patients with dysphagia who require texture-modified diets.