Abstract
Modifying the consistency of a given edible fluid matrix by incorporating food thickeners is a common nursing remedy for individuals with dysphagia when adequate water consumption is a concern. As apple pectin (AP) offers nutraceutical benefits, properly formulated apple pectin (AP)-based thickeners featuring xanthan gum (XG) can be superior candidates for preparation of dysphagia-friendly matrices (DFMs). Our recruited DFMs exhibit fluid-like behavior (loss modulus > storage modulus, G” > G’) at lower AP concentrations (2 and 5%, w/w); they turn into weak/critical gels (G’ ≈ G”) as the concentration becomes higher (9%). In contrast, XG-DFMs display gel-like attributes with G’ > G”, even at rather low concentrations (<1%) and become more resistant to sugar, Na+, and Ca2+ modifications. The composite matrix of AP1.8XG0.2 (constraint at 2%) exhibits a confined viscosity of 278 ± 11.7 mPa∙s, which is considered a DFM, in comparison to only AP- or XG-thickened ones. The hardness measurements of XG0.6 and AP1.2XG0.8 are 288.33 ± 7.506 and 302.00 ± 9.849 N/m2, respectively, which potentially represent a promising formulation base for future applications with DFMs; these textural values are not significantly different from a commercially available product (p > 0.05) for dysphagia nursing administrations.
Highlights
As per the above justified concerns, this study aims to conduct a systematic study on the rheological and textural properties of an apple pectin (AP)-based composite formula with dysphagia-friendly potential by incorporating xanthan gum (XG) as a modifier as well as commonly available food ingredients, including sugar or sucrose, table salt or monovalent sodium ion, and divalent calcium ion, when formulated for dysphagia-friendly matrices (DFMs)
Citrus pectin samples were reported to have Degree of Esterification (DE) ranging from 27.9% to 77.8% [22], whereas pectin extracted from sugar beets was reported to range from 61.29 to 70.13% depending on the pH value [18]
RascónChu et al [36] recently conducted a pectin collecting process by extracting pectin from thinning apple (Malus demestica Borkh) with a DE of 41%, which is comparable to our measured value
Summary
The normal swallowing process in adults is divided into four phases: oral preparatory, oral transit, pharyngeal, and esophageal [1]. Oropharyngeal dysphagia, defined as difficulty swallowing, is a neurological disorder often diagnosed among the elderly, especially in patients with stroke, motor neuron disease, and Parkinson’s disease [2]. Conservative estimates suggest that 8% of the world population experiences difficulty consuming regular thin liquids because of dysphagia; regular thin liquid intake for elderly patients with dysphagia is problematic, as its turbulent and fast propagation is difficult to control during passage through the pharynx [3]. Dysphagic patients tend to develop a reluctance toward consuming the recommended amount of water/moisture from thin liquids to avoid aspiration (leading to frequent bulking or even pneumonia), exposing themselves to severe dehydration and malnutrition [4]
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