Dysphagia and improvement of nutritional status: Techno-functional characteristics of commercial thickeners
DOI:
https://doi.org/10.33448/rsd-v10i5.15244Keywords:
Deglutition; Food thickener; Viscosity; Gums; Starch.Abstract
Dysphagia is characterized by a dysfunction in the swallowing process, which impairs safe and autonomous oral feeding. To minimize the negative effects, modified texture foods and thickened drinks are used. This study aimed to compare the viscosities of commercial food thickeners when dissolved in liquid preparations. Three starch-based thickeners were used to thicken five preparations (water, orange juice, milk, thickened milk, and coffee). Nutritional information, microscopy, pH, swelling power, and solubility of the granules and the viscosity of the preparations as a function of time and temperature were evaluated. All thickeners had a high percentage of carbohydrates, sodium, and the presence of modified starch. The thickeners promoted changes in the pH of the preparations and the presence of modified corn starch showed an increase in solubility and swelling power. About temperature variations, lower values increased viscosity, and viscosity increased with rest, probably due to the continuous hydration of the thickening agent. The greater the consistency you want to achieve, the greater quantities of product need to be added. The thickened food preparations showed different viscosities, depending on the food matrix, temperature, time and the amount of product added.
References
Adeleye, B., & Rachal, C. (2007). Comparison of the Rheological Properties of Ready-to-Serve and Powdered Instant Food-Thickened Beverages at Different Temperatures for Dysphagic Patients. Journal of the American Dietetic Association, 107(7), 1176–1182. https://doi.org/10.1016/j.jada.2007.04.011
Andersen, U. T., Beck, A. M., Kjaersgaard, A., Hansen, T., & Poulsen, I. (2013). Systematic review and evidence based recommendations on texture modified foods and thickened fluids for adults (≥18 years) with oropharyngeal dysphagia. E-SPEN Journal, 8(4), e127–e134. https://doi.org/10.1016/j.clnme.2013.05.003
Barros, S. L., Santos, N. C., Melo, M. O. P., Nascimento, A. P. S., Sousa, F. M., Santos, R. M. S. & Figueirêdo, D. V. P. (2020). Qualidade físico-química e textural de geleias elaborados com morango, pimenta e maltodextrina. Research, Society and Development, 9(1), e153911868. http://dx.doi.org/10.33448/rsd-v9i1.1868
Barros, S. P., Manzano, F. M. & Silva, L. B. C. (2008) Manual de técnicas e receitas para espessamento de alimentos: utilização de diferentes amidos espessantes, Bauru: USP, 19p.
Bemiller, J. N. (1997). Starch modification: challenges and prospects. Starch/Stärke, 49(4), 127-131. https://doi.org/10.1002/star.19970490402
Cichero, J. A. (2013). Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety. Nutrition Journal, 12(54). https://doi.org/10.1186/1475-2891-12-54
Clerici, M. T. P. S. (2012). Physical and/or Chemical Modifications of Starch by Thermoplastic Extrusion. Thermoplastic Elastomers. https://doi.org/10.5772/34318
Dobak, S. & Kelly, D. (2020). Tough Pill to Swallow: Postextubation Dysphagia and Nutrition Impact in the Intensive Care Unit. Nutrition in Clinical Pratice, 36(1), 80-87. https://doi.org/10.1002/ncp.10602
Ellul, M. A., Benjamin, L., Singh, B., Lant, S., Michael, B. D., Easton, A., Kneen, R., Defres, S., Sejvar, J., & Solomon, T. (2020). Neurological associations of COVID-19. The Lancet. Neurology, 19(9), 767–783. https://doi.org/10.1016/S1474-4422(20)30221-0
Ertekin, C. & Aydogdu, I. (2003). Neurophysiology of swallowing. Clinical Neurophysiology, 114(12), 2226-2244. https://doi.org/10.1016/S1388-2457(03)00237-2
Fernández, L., Cabrera, N., Fernández, D., & Olcese, L. (2020). Disfagia en tiempos de COVID-19 Dysphagia in COVID-19 times. Rev. Otorrinolaringol.Cir. Cabeza Cuello 2020;, 80, 385–394.
Garcia, J. M., Chambers, E., Matta, Z. & Clark, M (2005). Viscosity Measurements of Nectar- and Honey-thick Liquids: Product, Liquid, and Time Comparisons. Dysphagia, 20(4), 325–335. https://doi.org/10.1007/s00455-005-0034-9
Kim, C‐Y. & Yoo, B. (2018). Rheological characterization of thickened protein‐based beverages under different food thickeners and setting times. Journal of Texture Studies, 49(3), 293– 299. https://doi.org/10.1111/jtxs.12332
Lima, M. S. de, Sassi, F. C., Medeiros, G. C. de, Ritto, A. P., & Andrade, C. R. F. de. (2020). Evolução funcional da deglutição em pacientes com COVID-19 internados em UTI. CoDAS, 32(4), e20200222. https://doi.org/10.1590/2317-1782/20192020222
Logemann, J. A. (2007). Swallowing disorders. Best Practice and Research in Clinical Gastroenterology, 21(4), 563–573. https://doi.org/10.1016/j.bpg.2007.03.006
Lotong, V., Chun, S. S., Chambers IV, E., & Garcia, J. M. (2003). Texture and flavor characteristics of beverages containing commercial thickening agents for dysphagia diets. Journal of Food Science, 68(4), 1537–1541. https://doi.org/10.1111/j.1365-2621.2003.tb09680.x
Matta, Z., Chambers IV, E., Garcia, J. M., & Helverson, J. M. G. (2006). Sensory Characteristics of Beverages Prepared with Commercial Thickeners Used for Dysphagia Diets. Journal of the American Dietetic Association, 106(7), 1049–1054. https://doi.org/10.1016/j.jada.2006.04.022
Moreno, C., García, M. J. & Martinez, C. (2006). Grupo de Estudio de la Alimentación del Mayor. Situation and adequacy analysis of dysphagia diets at a regional hospital. Nutrición Hospitalaria, 21(1), 26-31.
Moret-Tatay, A., Rodríguez-García, J., Martí-Bonmatí, E., Hernando, I., & Hernández, M. J. (2015). Commercial thickeners used by patients with dysphagia: Rheological and structural behaviour in different food matrices. Food Hydrocolloids, 51, 318–326. https://doi.org/10.1016/j.foodhyd.2015.05.019
National Dysphagia Diet Task Force (2002). National Dysphagia Diet: Standardization for Optimal Care. Chicago: American Dietetic Association, 47p.
Phua, J., Weng, L., Ling, L., Egi, M., Lim, C. M., Divatia, J. V., Shrestha, B. R., Arabi, Y. M., Ng, J., Gomersall, C. D., Nishimura, M., Koh, Y., & Du, B. (2020). Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. The Lancet Respiratory Medicine, 8(5), 506–517. https://doi.org/10.1016/S2213-2600(20)30161-2
Schmidt, H. & Oliveira, V. R. (2015). Avaliação reológica e sensorial de espessantes domésticos em diferentes líquidos como alternativa na disfagia. Brazilian Journal of Food Technology, 18(1). https://doi.org/10.1590/1981-6723.3714
Silva, G. D. O., Takizawa, F. F., Pedroso, R. A., Franco, C. M. L., Leonel, M., Sarmento, S. B. S., & Demiate, I. M. (2006). Características físico-químicas de amidos modificados de grau alimentício comercializados no Brasil. Ciencia e Tecnologia de Alimentos, 26(1), 188–197. https://doi.org/10.1590/S0101-20612006000100030
Silva, J. M., Junior, B. D., Vieira, V. B., Klososki, S. J., Barão, C. E., Pinheiro, K. H. & Pimentel, T. C. (2020). Amido de mandioca modificado por oxidação: propriedades físicas e químicas e perfil de textura de géis. Research, Society and Development, 9(10), e9089108238. http://dx.doi.org/10.33448/rsd-v9i10.8238
Sopade, P. A., Halley, P. J., Cichero, J. A. Y., Ward, L. C., Liu, J., & Varliveli, S. (2008). Rheological characterization of food thickeners marketed in Australia in various media for the management of dysphagia. III. Fruit juice as a dispersing medium. Journal of Food Engineering, 86(4), 604–615. https://doi.org/10.1016/j.jfoodeng.2007.11.013
Sukkar, S. G., Maggi, N., Cupillo, B. T. & Ruggiero, C. (2018). Optimizing Texture Modified Foods for Oro-pharyngeal Dysphagia: A Difficult but Possible Target? Frontiers in Nutrition, 5, 68. https://doi.org/10.3389/fnut.2018.00068
Toneli, J. T. C. L., Murr, F. E. X. & Park, K. J. (2005). Review: estudo da reologia de polissacarídeos utilizados na indústria de alimentos. Revista Brasileira de Produtos Agroindustriais, 7(2), 181-204.
Wei, Y., Guo, Y., Li, R., Ma, A., & Zhang, H. (2021). Rheological characterization of polysaccharide thickeners oriented for dysphagia management: Carboxymethylated curdlan, konjac glucomannan and their mixtures compared to xanthan gum. Food Hydrocolloids, 110, 106198. https://doi.org/10.1016/j.foodhyd.2020.106198
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