Dysphagia Diet Research Articles

Rheological characterization of chia seed gum as a thickening agent used for dysphagia management

Dysphagia has emerged as a serious health issue facing contemporary society. Consuming thickened liquids is an effective approach for improving the swallowing safety for dysphagia patients. The thickening effect of chia seed gum (CSG), a novel thickener, in different dispersing media (water, orange juice, and skim milk) was investigated. Moreover, the potential application of CSG for dysphagia management was evaluated by comparison with xanthan gum (XG) and guar gum (GG). The thickened liquids prepared with 0.4 %–1.2 % (w/v) CSG, XG, and GG could be classified into levels 1–4, 2–4, and 1–3, respectively, according to the International Dysphagia Diet Standardization Initiative (IDDSI) framework. All the thickened liquids displayed shear-thinning characteristics that facilitated safe swallowing. The viscosities (η50) of CSG dissolved in water (0.202–1.027 Pa·s) were significantly greater than those of CSG dissolved in orange juice (0.070–0.690 Pa·s) and skim milk (0.081–0.739 Pa·s), indicating that CSG had a greater thickening effect in water than in orange juice and skim milk. Compared with those prepared with GG, the thickened liquids prepared with CSG and XG exhibited greater viscoelasticity, better water-holding capacity, and more compact networks. The findings suggested that CSG can be used as a potential thickener for thickening liquid foods to manage dysphagia.

Engineering plant-based protein-rich soft and bite-sized 3D printed dysphagia food

This study investigates the 3D printability of horse gram (Macrotyloma uniflorum) flour (HGF) substituted with chia (Salvia hispanica L.) seed flour (CSF) for engineering dysphagia food (Level 6) according to the International Dysphagia Diet Standardization Initiative (IDDSI). Four composite formulations of pretreated (germinated and roasted) HGF substituted by 5, 10, 15, and 20% (weight basis) CSF and one formulation without substitution of CSF were prepared, and their rheological characterization and printing performance were analyzed. The IDDSI tests for Level 6 dysphagia food were further conducted on the printed constructs and validated with their texture profile analysis results. The study revealed that germination followed by roasting of horse gram significantly (p < 0.05) increased the water holding capacity (WHC) of the formulations, which further impacted their rheological and textural properties. Substitution of 10% and 15% CSF demonstrated the best printing accuracy (>95%) in 2D and 3D printings. Further, the substitution of CSF in the formulations showed reduced hardness (6.77 ± 0.24 to 3.86 ± 0.10 N) and increased cohesiveness (0.153 ± 0.02 to 0.234 ± 0.01) in the 3D printed constructs, which are desirable for safe bolus formulation. The printed constructs were tested for the fork, spoon, and break-apart tests, and were observed to satisfy the criteria of Level 6 dysphagia food as per IDDSI guidelines.

Emulsion gel-based inks for 3D printing of foods for dysphagia patients: High internal type emulsion gel-biopolymer systems

High internal type emulsion gels (HIPE gels) are usually a soft semi-solid material consisting of tightly packed oil droplets stabilized by a layer of emulsifier. The semi-solid nature of HIPE gels means they can be used as edible inks in 3D food printing applications. However, the rheological properties of HIPE gels are typically unable to satisfy the demands of 3D printing applications, resulting in unsatisfactory printing performance. In this study, HIPE gel-based inks (85% by volume of oil) with improved 3D printing performance were prepared by using pea protein-inulin complexes as emulsifiers. In addition, the effects of oil type (corn, sunflower, flaxseed, or olive oil) on the 3D printing property, rheological properties, and microstructure of the HIPE gels was analyzed since different oils have different nutritional and physicochemical properties. Moreover, International Dysphagia Diet Standardization Initiative (IDDSI) foods created by 3D printing with these edible inks were evaluated in a population of the elderly suffering from dysphagia. It was found that HIPE-based edible inks containing an optimized inulin level (0.75% w/v) had the best 3D printing properties. In terms of oil type, the edible inks formulated from corn oil and from flaxseed oil had the best 3D printing property. As analyzed in the Lissajous plot, the addition of inulin remarkably improved the viscoelasticity of the inks, which improved their 3D printing property. These inks also exhibited high thixotropic recovery and good thermal stability. Moreover, cryo-SEM analysis showed that the PPI-inulin complex formed a barrier on the oil droplets' surface and a dense cross-linked structure between the particles. The IDDSI evaluation found that the HIPE gel inks were able to satisfy the requirements of Class IV and V foods in the IDDSI framework and could be classified as transitional foods, which would satisfy the food needs of patients with dysphagia.

The Research Effect Of Chewing Function Nursing Techniques In Improving Swallowing Dysfunction Among Children With Cerebral Palsy

The objective of this study was to analyze the efficacy of chewing function nursing techniques in improving swallowing dysfunction among children with cerebral palsy. A total of 60 children with cerebral palsy and swallowing disorders, admitted to our hospital from January 2020 to December 2022, were included in the study. The children were randomly divided into an observation group and a control group using a random number table. The control group received routine rehabilitation nursing, while the observation group received additional nursing measures focusing on chewing function techniques in addition to the routine rehabilitation nursing. Both groups underwent interventions for a period of 3 months. Swallowing dysfunction, eating ability, and oral motor function were evaluated and compared between the two groups before and after treatment. Specifically, the Dysphagia Diet Scale (DDS) was used to assess swallowing dysfunction, the Eating and Drinking Ability Classification System (EDACS) was used to evaluate eating ability, and the Structured Oral Motor Assessment (SOMA) was used to assess oral motor function. The results showed that before rehabilitation nursing, there was no significant difference in DDS scores between the two groups. However, after rehabilitation nursing, both groups exhibited lower DDS scores compared to before, and the observation group had lower scores than the control group, indicating a significant difference (P &lt; 0.05). Similarly, before rehabilitation nursing, there was no significant difference in EDACS ratings between the two groups. After rehabilitation nursing, both groups of children showed improvement in EDACS ratings, with the observation group demonstrating better outcomes than the control group. The difference between the two groups was significant (P &lt; 0.05). Prior to rehabilitation nursing, there was no significant difference in SOMA scores between the two groups (P &gt; 0.05). However, after rehabilitation nursing, both groups exhibited improved SOMA scores, with the observation group scoring higher than the control group. The difference between the two groups was also significant (P &lt; 0.05). In conclusion, compared to routine nursing care, chewing function nursing techniques can alleviate swallowing dysfunction among children with cerebral palsy, enhance their swallowing function, and improve their quality of life. Therefore, this approach is worthy of clinical application and promotion.

Predictors for Failed Removal of Nasogastric Tube in Patients With Brain Insult.

To construct a prognostic model for unsuccessful removal of nasogastric tube (NGT) was the aim of our study. This study examined patients with swallowing disorders receiving NGT feeding due to stroke or traumatic brain injury in a regional hospital. Clinical data was collected, such as age, sex, body mass index (BMI), level of activities of daily living (ADLs) dependence. Additionally, gather information regarding the enhancement in Functional Oral Intake Scale (FOIS) levels and the increase in food types according to the International Dysphagia Diet Standardization Initiative (IDDSI) after one month of swallowing training. A stepwise logistic regression analysis model was employed to predict NGT removal failure using these parameters. Out of 203 patients, 53 patients (26.1%) had experienced a failed removal of NGT after six months of follow-up. The strongest predictors for failed removal were age over 60 years, underweight BMI, total dependence in ADLs, and ischemic stroke. The admission prediction model categorized patients into high, moderate, and low-risk groups for removal failure. The failure rate of NGT removal was high not only in the high-risk group but also in the moderate-risk groups when there was no improvement in FOIS levels and IDDSI food types. Our predictive model categorizes patients with brain insults into risk groups for swallowing disorders, enabling advanced interventions such as percutaneous endoscopic gastrostomy for high-risk patients struggling with NGT removal, while follow-up assessments using FOIS and IDDSI aid in guiding rehabilitation decisions for those at moderate risk.

Association Between Malnutrition and Food Texture Levels in Integrated Facilities for Medical and Long-Term Care.

This study aims to investigate the association between malnutrition using the global consensus criteria and food texture levels in residents of Integrated Facilities for Medical and Long-Term Care (IFMLCs), which are new long-term care insurance facilities in Japan. This single-center study had a retrospective cross-sectional design. The study was conducted from November 1 to 30, 2021, and the study participants were residents admitted to an IFMLC during the study period. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Food texture levels consumed by patients at admission were categorized based on the International Dysphagia Diet Standardization Initiative (IDDSI) framework. Multivariate logistic regression models were used to determine the association between the food texture levels consumed and malnutrition. A total of 98 older residents were analyzed in this study. The median age of the participants was 88 years, and 68 (69%) female participants were included. The IDDSI framework levels were 24% in levels 7 and 6 and 26% in levels 5 and 4. A significant difference in the prevalence of low BMI, reduced muscle mass, and reduced food intake or assimilation was noted between IDDSI framework levels 4 and 7. Multivariate logistic regression analysis was performed for malnutrition, adjusting simultaneously for potential confounders. IDDSI level 4 (odds ratio, 5.074; 95% confidence interval, 1.059-28.092; p=0.042) consumption was independently associated with malnutrition. The consumption of lower food texture levels categorized using the IDDSI framework was associated with a higher malnutrition prevalence in IFMLC residents.

Co (ne) víme o úpravě konzistence stravy u pacientů s dysfagií a s čím by mohla pomoci iniciativa IDDSI (International Dysphagia Diet Standardization Initiative)

Summary Texture-modified diet and thickening liquids are a therapeutic option for dysphagia. Many of the terms referring to liquid viscosity modifications and solid diet modifications are terminologically ambiguous and vague, e. g. “honey consistency liquid” or “soft-textured diet.” The inconsistent terminology adversely affects patient safety and the efficiency of the application of this therapeutic method. Possible misunderstanding of the vague terms between staff members can result in using a different consistency of the fluid or food from the consistency that was found to be safe during the objective swallowing examination. The International Dysphagia Diet Standardization Initiative (IDDSI) is seeking application of international standardized terminology for texture-modified foods and liquids for use in people with dysphagia of all ages, in all care settings, and in different cultural settings. The goal of IDDSI is to improve patient safety of oral intake and evolve the field of dysphagia research. Key words dysphagia – texture-modified food – thickened liquids – IDDSI

Flow Rates of Bottle Nipples/Teats With Different Thicknesses of Barium and Infant Formula

Purpose: The aim of this study was to evaluate the bottle nipple flow rate of liquid barium sulfate of three different International Dysphagia Diet Standardisation Initiative (IDDSI) thicknesses (i.e., thin, slightly thick, and mildly thick) and compare flow rates of infant formula thickened with Gelmix or oatmeal cereal to comparable thicknesses. Method: Liquid preparations were IDDSI flow tested to determine thickness. Nipple flow rate testing was conducted using 50 ml of liquid in a 4-oz Dr. Brown's bottle with the venting system in place. Liquid was extracted using a breast pump. The weight of liquid extracted was converted to flow in milliliters per minute using the density of the liquid in grams per milliliter. Results: Across nipple types and liquid thicknesses, the flow rate through the bottle nipple with formula was faster than with barium of the same thickness. Thickening with oatmeal cereal resulted in clogging of the nipple. Pulverizing the oatmeal did not improve clogging but did impact caloric density of the formula. Conclusions: Bottle nipple flow rates of liquid barium sulfate are not consistent with flow rates of thin infant formula or formula thickened with Gelmix to the same IDDSI thickness. These findings may impact the safety of oral feeding for some infants. Parents and clinicians need to be aware of clogging with oatmeal cereal as a factor that could contribute to variability in flow as well as difficulty extracting fluid for nutrition.

Development of easy-to-swallow and lipid-enhanced 3D printed surimi based on high internal phase emulsions

The elderly often suffered from chewing/swallowing difficulty, it is crucial to develop attractive dysphagia food. High internal phase emulsions (HIPEs) can be used as texture modifiers to create dysphagia food. Firstly, the multiple light scattering and micro-rheology results indicated that HIPEs stabilized by microbial transglutaminase (at 3.0 U/g) crosslinking of fish scale gelatin (FSG-TG-3) exhibited the highest stability. Subsequently, the effect of FSG-TG-3-stable fish oil HIPEs on the rheological properties, water distribution, 3D printability, textural properties, and swallowing behavior of surimi compared to the addition of fish oil were investigated. Results demonstrated that compared with oil-added group, HIPEs-added counterparts had relatively lower apparent viscosity, yield stress, and storage modulus, which was more suitable for 3D printing. Furthermore, the HIPEs addition effectively decreased the hardness and adhesiveness of the surimi gel, which could be classified into the level-6 (soft and bite-sized) diet in the International Dysphagia Diet Standardization Initiative (IDDSI) framework. However, the direct oil-added group not met the dysphagia diet because it returned its original shape when the fork was removed. Finally, we found that the internal structure of surimi-HIPEs was modified by controlling filling types and densities, which might be suitable for the elderly with different degrees of dysphagia. In summary, the surimi-HIPEs might could create attractive and lipid-enhanced 3D printed food for elderly with dysphagia.

Natural product nobiletin-loaded Pickering emulsion stabilized by bovine serum albumin/carboxymethyl inulin complexes: preparation and digestive characteristics.

To expand the application of nobiletin (NOB) in semi-solid functional foods, bovine serum albumin (BSA)/carboxymethyl inulin (CMI) complexes-stabilized Pickering emulsion (BCPE) (φoil = 60%, v/v) was fabricated, and the swallowing index and bioavailability of the NOB-loaded Pickering emulsion was evaluated. Confocal laser scanning microscope (CLSM) and cryo-scanning electron microscopy (cryo-SEM) images revealed that BSA/CMI complexes attached to the oil-water interface. NOB-loaded BCPE exhibited a viscoelastic and shear-thinning behavior. Fork drip test results suggested that the textural value of unloaded and NOB-loaded emulsions was International Dysphagia Diet Standardisation Initiative Level 4, which could be swallowed directly without chewing. The in vitro lipolysis model suggested that NOB had a faster digestive profile and a higher bioaccessibility in the BCPE than in the oil suspension. The in vivo rat model revealed that the oral bioavailability of NOB was increased by 2.07 folds in BCPE compared to its bioavailability in unformulated oil. Moreover, BCPE led to a higher plasma concentration of the major demethylated metabolite of NOB (4'-demethylnobiletin) than the unformulated oil. Accordingly, BCPE enhanced the oral bioavailability of NOB by improving bioaccessibility, absorption, and biotransformation.

Dysphagia food: Impact of soy protein isolate (SPI) addition on textural, physicochemical and microstructural properties of peach complex gels

In this study, dysphagia-friendly diets were prepared based on the interaction between polysaccharides from peach, namely Meirui (MR), Yangshan (YS) and Cons758 (Cons), and soy protein isolate (SPI). MR-alcohol insoluble residues (AIR) and YS-AIR were low methoxylated polymers, while Cons-AIR was high methoxylated polymer. According to the international dysphagia diet standardization initiative, YS-SPI and MR-SPI could be qualified as level 5-minced/moist dysphagia diets. Following SPI addition, the apparent viscosity, G′ and G″ of peach pulp-SPI complexes were significantly increased. At the shear rate of 10 s−1, corresponding to oral processing, MR-SPI performed the highest apparent viscosity (35.2 Pa s), followed by YS-SPI (33.5 Pa s). Additionally, the SPI-treated strategy pronounced improved the hardness, springiness, adhesiveness and chewiness of complexes. Both YS-SPI and Cons-SPI showed the reduced particle size, alongside the uniform distribution, owing to the strong hydrogen bonding and electrostatic interaction between peach pulp substances and SPI, which was confirmed by FT-IR result. The biggest ζ-potential value (−23.55 mV) was found in YS-SPI. Meanwhile, compared with peach pulps, the highest increase ratio (87.94%) of water holding capacity was depicted in MR-SPI. LF-NMR analysis revealed immobilized water was dominant in peach pulp-SPI. The results suggested that MR was promising for the optimal choice to form gel food for people with swallowing problems.

Changing the culture around hospital-based nutrition.

Following a serious incident and inquest after the death of a patient due to choking at Sheffield Teaching Hospitals NHS Foundation Trust, the Trust put in place an action plan and implemented strategies to reduce the risk of recurrence. Four key actions were identified as essential to try to reduce the risk of a similar event: introduction of a standard operating procedure for mealtimes that included a pre-meal safety 'pause'; use of an electronic communication icon to indicate modified diet/fluid requirements, from emergency department and onward as a patient is transferred; job-specific mealtime safety training; and use of bedside posters with specific dietary requirements (in line with the International Dysphagia Diet Standards Initiative Framework). A new role of Lead Educator for Nutrition was introduced to support the changes and provide training. Changes were also made to the incident reporting system to ensure easy identification of events relating to dysphagia, so that these could be monitored, themes identified and lessons shared. A series of audits following the changes have shown that more staff across disciplines and teams have accessed training on nutrition and hydration practices, wards have increased the use of the icon and posters, and successfully implemented pre-meal safety pauses. The Lead Educator for Nutrition has helped embed learning, and increased awareness and knowledge about nutrition and hydration.

Characterization of Chinese shrimp (Fenneropenaeus chinensis) powder and corn starch composite gels as dysphagia diet

In the present study, the effects of corn starch (CS) on the properties of Chinese shrimp (Fenneropenaeus chinensis) powder (SP) were characterized to explore the feasibility of developing dysphagia diet. The SP/CS gels were prepared by adding CS at different concentrations. The SP/CS mixture presented low gel properties at CS concentrations ranging from 12 to 48 mg/mL, but did demonstrate gelation behavior with the highest G′ value of 1134.2 Pa and a water holding capacity of 90% at 60 mg/mL. As the CS concentration increased, the stability of the SP/CS mixture also improved, as evidenced by the significantly reduced relaxation times T22 and T23, enhanced gel network formation, and the presence of hydrogen bonding and electrostatic interactions between SP and CS. Furthermore, the international dysphagia diet standardisation initiative (IDDSI) swallowing level of the SP/CS mixtures were 2, 3, 4, and 5 at CS concentrations of 12, 24, 36, 48 and 60 mg/ml, respectively. The SP/CS-60 mixture gel was considered suitable for dysphagia patients. These findings suggest that the gel properties of SP can be modified by CS, and that the SP/CS mixture gels have the potential to be used as a texture-modified diet with high-quality protein for dysphagia patients.

Structural changes of flaxseed protein modified by fermentation and the gel properties and swallowing characteristics of its composite system with mung bean starch

The fermentation modification of plant-based proteins has attracted extensive attention recently. This study was to investigate the effect of fermentation on molecular structures of flaxseed protein (FP), and evaluate the gel properties and swallowing characteristics of the composite gel composed of mung bean starch (MBS) and fermented FP (FFP). After 10 h of fermentation, the content of free amino acids in FFP increased ∼14.3 times over that of the unfermented FP, while the proportion of small peptides increased by ∼37.2%. Fermentation reduced the α-helical conformation in FFP. After heating, FFP was easier to cross-link with MBS to form strengthened composite gel network with denser and larger pores as well as thicker pore wall, in which the maximum gel hardness increased by 2.6 times. MBS-FFP composite gels also exhibited increase in viscoelastic moduli, cohesiveness, thermal stability, and water-holding capacity (WHC) than the control gel. The WHC was increased from 63.4% to 92.3% when composite gel contained 10 h fermented FP. Furthermore, international dysphagia diet standardization initiative (IDDSI) tests indicated that all MBS-FFP composite gels could be categorized as level 7 dysphagia food. These findings provide new insights into the structural nature and potential application of plant protein-based fermentation-induced gel systems.

Assessing Adhesiveness Levels in a Dysphagia Diet for Older Adults.

Viscosity is a common focus in the diet of patients with dysphagia. However, adhesiveness is an equally significant property that can affect swallowing function, even in semi-solid foods with similar levels of viscosity. The purpose of this study was to classify the adhesiveness of food into stages and determine whether these classifications are relevant to swallowing function. This study included 30 healthy elderly adults aged 65 years. After categorizing adhesiveness into three levels based on the results of the sensory test, 30 participants were asked to swallow representative foods at each level. A videofluoroscopic swallowing study (VFSS) was performed to determine the presence or absence of pharyngeal residues based on the level of adhesiveness. The chi-square test was used to verify whether there was a difference in remnants according to the level of adhesiveness, and significance was judged with a p-value of less than 0.05. Adhesiveness was categorized into three distinct levels: level 1 (0-4 mJ), level 2 (4-18 mJ), and level 3 (>18 mJ). Upon examining the subjects presenting with residual material, we observed three cases of level 1 adhesiveness, 16 cases of level 2, and 25 cases of level 3. The chi-square test was used to assess the statistical significance between the levels, revealing a significant difference with a p-value < 0.0001. We presented the level of adhesiveness by dividing it into three stages and proved that it is meaningful in relation to the swallowing function. Selecting and recommending foods with an appropriate level of adhesiveness will help enhance swallowing safety in older adults.

Tailoring the high-protein texture-modified foods for the dysphagia elderly by heating whey protein isolate-pectin complexes

Adequate dietary protein intake is an effective way to combat muscle wasting disorders in the elderly, who are highly susceptible to dysphagia due to declining physiological functions. Herein, whey protein isolate (WPI) and pectin electrostatic complexes were chosen to prepare texture-modified foods with high protein (15%, w/v) for dysphagia elderly. Firstly, the region of soluble complex formation was initially identified as pH 4.2–5.5 by determination of the zeta potential of both biopolymers. Following this, it was found that the stability of WPI-pectin complexes was significantly dependent on the increase in the amount of pectin (from 1.0 to 2.0 %, w/v). However, the viscoelasticity and the degree of WPI aggregation of these complexes after heat treatment (90 °C, 20 min) both showed the lowest level at pH 4.6 (it was fluid state) regardless of the pectin content, and the degree of protein aggregation weakened with the increase of pectin content. Additionally, the shear viscosity, yield stress, and tribological properties of the thermal complexes were also positively correlated with the degree of protein thermal aggregation. Moreover, based on the dietary texture classes developed by the International Dysphagia Diet Standardisation Initiative (IDDSI), unlike pure WPI thermally-induced gels that are attributed to level 6, the WPI-pectin thermal complexes can achieve texture class coverage from level 3 to level 6. These findings suggest that by modulating the electrostatic binding strength and positive-negative charge balance between WPI and pectin, tailored design of high-protein diets for elderly people with varying degrees of dysphagia may be achieved.

Validation of the IDDSI funnel for liquid flow testing.

In 2017, the International Dysphagia Diet Standardisation Initiative (IDDSI) introduced the IDDSI flow test which enables patients, clinicians, caregivers, food service professionals and researchers to classify liquid thickness into five levels based on the volume of liquid remaining in a standard 10 mL slip tip syringe after 10 s of flow under gravity. Within a few months of publishing the IDDSI flow test instructions, several barriers emerged: (1) the preferred model of syringe (BD 303134) was not equally accessible around the world, causing some users to perform flow tests with alternate models of syringe; (2) differences in syringe geometry across models led to variations in IDDSI flow test results; and (3) the need to use a second syringe for sample loading added complexity and cost to end users. To address these barriers, IDDSI designed the IDDSI funnel, a novel device, which combines the geometry of the BD 303134 syringe with a kitchen funnel to facilitate easy loading of liquid samples without need for a second syringe. In this report, we compare the IDDSI flow test results across two devices: syringe BD 303134 and IDDSI funnel. IDDSI level classifications were in complete agreement with the syringe reference test results in 67/73 (92%) of the test fluids and temperature conditions with mean difference of residual liquid across devices of 0.2 (2% full scale). These results demonstrate excellent correspondence between the two devices.

IDDSI-compliant recipes containing oral contrast agents for radiological dysphagia diagnostics.

Videofluoroscopic swallowing study (VFSS), alongside flexible endoscopic evaluation of swallowing, represents the gold standard for diagnosing swallowing disorders and to determine severity, pathophysiology, and effective interventions, including texture modification. The clinical swallowing examination and assessment supplements these instrumental methods and serves as the basis for the modules of swallowing diagnostics. The adaptation of food and drink consistencies in dysphagia management has become widespread. For valid results of a VFSS with respect to confirming swallowing safety and efficiency of different liquid and food consistencies and textures, the use of uniform recipes containing radio-opaque contrast media is important. Our goal was to identify recipes that would produce consistencies that conform to the liquid and food levels of 0-7, as defined by the International Dysphagia Diet Standardization Initiative (IDDSI), with barium- and iodine-based contrast media, xanthan gum-based thickeners, and other edible components, which also show sufficient contrast on VFSS. In this study, we determined the different recipes using IDDSI testing methods and explored their radiological characteristics using a Philips MultiDiagnost Eleva fluoroscopy system and two different fluid contrast agents: barium- (Micropaque®) and iodine-based (Telebrix®). All recipes showed sufficient contrast on fluoroscopy and could be visualized in the amounts used for swallowing examinations. They were practical and easy to implement in terms of production and availability of the components. The homogeneity of the recipes diminished with higher IDDSI levels, which represent transitional food, but appeared still sufficient for fluoroscopic examination. The opacity did not significantly differ between the barium- and iodine-based contrast media.

Spray‐Drying Assisted 3D Printing to Manufacture Beef Products

AbstractPotato starch (PS), a naturally occurring carbohydrate biopolymer, is commonly used in the meat industry to enhance the processing and nutritional properties of meat products. This study utilizes spray drying to produce PS‐based powders for the production of 3D printed beef products. The effects of incorporating PS‐based materials at 1% concentrations into beef pastes are investigated, focusing on the impact on product texture, cooking properties, printing accuracy, freeze‐thaw stability, and color. Additionally, the suitability of the 3D printed beef products for individuals with dysphagia is assessed using the International Dysphagia Diet Standardization Initiative (IDDSI). The 3D printed beef products containing PS‐based powders are successfully manufactured and maintained their structure during printing and cooking. The addition of these powders improve moisture content, cooking yield, lightness, and reduced diameter reduction, redness, hardness, cohesiveness, and chewiness. Moreover, the results suggest that P‐N, can be classified as potential level 6 diets (soft and bite‐sized) according to the IDDSI framework.

One-bite-sized 3D printed finger foods, oriented to malnutrition, sarcopenia and frailty prevention in the older people.

In this study, innovative chocolate, citrus and mixture flavoured tofu-based nutritionally customised, dysphagia-oriented, comfortably consumed, appetising, one-bite-sized finger foods, oriented to malnutrition, sarcopenia and frailty prevention in older people were created by using 3D printing technology. Developed products were characterised by evaluating chemical composition and physical properties and performing sensory evaluation among geriatric clinic residents (≥60 years). The dietary composition of the developed foods was: 19-21 g (100 g)-1 protein, 6-8 g (100 g)-1 fibre, 8-9 g (100 g)-1 fat, 11 mg (100 g)-1 iron, 14 mg (100 g)-1 zinc, 70 μg (100 g)-1 selenium. Foods were also enriched with branched-chain amino acids, such as leucine, isoleucine and valine. All formulated foods were classified as level 6 by International Dysphagia Diet Standardisation Initiative classification. Chocolate-flavoured food was much harder (4914 g) with lower adhesiveness value (-33.6 g s), compared to the citrus- or mixture-flavoured foods. Older people evaluated all finger foods as very easy handled by hand, soft, easy to swallow, having a moderate flavour intensity and a weak afterfeel. Despite the fact that the chocolate food was evaluated as having the highest hardness and gumminess values by the instrumental method, this difference was not noticeable to the evaluators. However 7% of the participants said that 3D printed foods were sticky to dentures. The results suggest that it is possible to create nutrient-dense comfortably consumed 3D printed foods, oriented to malnutrition, sarcopenia and frailty prevention in older people. © 2024 Society of Chemical Industry.