Texture-modified Foods Research Articles

First assessment at home of amyotrophic lateral sclerosis (ALS) patients by a nutrition network in the French region of Limousin

Malnutrition is associated with poor survival among patients with amyotrophic lateral sclerosis (ALS). This study aimed to evaluate nutritional assessment by a network during first consultations in patients' homes. Patients identified by the regional ALS centre gave their informed consent. Assessment included functional, nutritional issues, evaluation of the need for help, whether personal or the use of aids, and noted any dietary supplementation and modification of the texture of food. Forty patients were seen a mean of 7.4 months after diagnosis; 52.5% had bulbar disease, 7.5% were malnourished; 29.4 ± 10.1 kcal/kg/day were consumed and protein intake was 1.3 ± 0.5 g/kg/day. Thirty-five percent of patients were anorexic, 43.8% reported taste disorders, and 70% had dysphagia, significantly associated with salivary stasis. Only 30% of dysphagic patients ate texture-modified food, and 90% of patients with problems drinking liquids did not use a thickener. In conclusion, assessment at home by a nutritional network can be conducted promptly. Malnutrition is rare in early disease, despite the fact that patients' diets are often low in energy and dysphagia is common. Unexpected taste disorders are detected. Dysphagia is very common but inadequately addressed. Consequently, home assessment by the network led several beneficial interventions.

Analysis of the food consumption of 87 elderly nursing home residents, depending on food texture.

Texture-modified food (chopped, mashed, or mixed) is often used for patients, and particularly for dependent elderly people facing swallowing disorders or dental problems. Food must be energy and protein enriched, because dilution is needed for preparation, and several meals like bread can be removed. The aim of the study was to assess the food consumption of residents in four French nursing homes depending on diet texture. DESIGN/PARTICIPANTS/MEASUREMENTS: The food consumption of 87 elderly people followed by a nutrition network, randomly taken and living in nursing homes in which texture-modified food enrichment was practiced was evaluated according to the type of texture used. 13.8% of residents had chopped texture and 29.9% mixed texture. There was no relationship between used food textures and nutritional status residents. Calorie consumption was below the recommended intakes for elderly nursing home residents in France, whatever the type of texture. The mixed texture had more protein than the normal one and was better balanced regarding fat intake. Protein consumption was at the lower limit of the recommended intakes. Residents in overweight were those whose food consumption relative to their weight was the lowest. It seems important to check the mode of preparation of texture-modified food in nursing homes and to assess the real energy and protein consumptions of residents receiving this food.

Objective and quantitative definitions of modified food textures based on sensory and rheological methodology

Introduction: Patients who suffer from chewing and swallowing disorders, i.e. dysphagia, may have difficulties ingesting normal food and liquids. In these patients a texture modified diet may enable that the patient maintain adequate nutrition. However, there is no generally accepted definition of ‘texture’ that includes measurements describing different food textures.Objective: Objectively define and quantify categories of texture-modified food by conducting rheological measurements and sensory analyses. A further objective was to facilitate the communication and recommendations of appropriate food textures for patients with dysphagia.Design: About 15 food samples varying in texture qualities were characterized by descriptive sensory and rheological measurements.Results: Soups were perceived as homogenous; thickened soups were perceived as being easier to swallow, more melting and creamy compared with soups without thickener. Viscosity differed between the two types of soups. Texture descriptors for pâtés were characterized by high chewing resistance, firmness, and having larger particles compared with timbales and jellied products. Jellied products were perceived as wobbly, creamy, and easier to swallow. Concerning the rheological measurements, all solid products were more elastic than viscous (G′>G″), belonging to different G′ intervals: jellied products (low G′) and timbales together with pâtés (higher G′).Conclusion: By combining sensory and rheological measurements, a system of objective, quantitative, and well-defined food textures was developed that characterizes the different texture categories.

Food Preferences and Meal Satisfactionof Meals on Wheels Recipients

To investigate Edmonton Meals on Wheels (MOW) recipients' food preferences and meal satisfaction. A preliminary study of 13 lunch club participants divided into two focus groups was conducted to determine overall themes in clients' menu preferences and suggestions. A questionnaire was developed, based on previous MOW client comments, and delivered to all clients (n=271) receiving hot meal service from the Edmonton MOW program; 140 surveys (52% response rate) were returned. The majority (72% to 88%) of hot meal clients were satisfied with the taste, texture, value, variety, and portion size of their meals. Popular menu items were barbecued chicken, perogies, and desserts. Up to 25% of participants indicated that meats were too tough and vegetables were too firm. Vegetables such as broccoli and Brussels sprouts were the most commonly disliked items. Overall, clients find the Edmonton MOW menu foods appealing and enjoyable. MOW programs should advertise the availability of texture-modified foods and offer a variety of vegetables. Meal services for the elderly must continue to monitor meal acceptance as client needs change with our aging population.

A Comparative Study of Ready-to-use Frozen Texture Modified Foods to Institution Prepared Texture Modified Foods in a Long Term Care Setting

LEARNING OUTCOME: To determine if a menu of ready-to-use (RTU) frozen texture modified foods (TMF) resulted in better acceptance, tolerance, and ingestion compared to the current menu of pureed foods.The purpose of this study was to determine if the RTU food prototypes tested would result in positive measurable response patterns in the following areas: 1) improved mastication, transfer, and swallowing; 2) increased rate of ingestion; 3) unproved ingestion amount; and 4) improved compliance. In this prospective study, subjects (n = 37) served as their own control. Information collected consisted of plate waste at lunch and dinner for five days during two identical menu cycle rotations and completion of a brief questionnaire at each meal to determine quantitative and qualitative consumption data. Analysis included: all meals, lunch, meat at lunch, vegetable at lunch, dinner, meat at dinner, and vegetable at dinner. Consumption of all meals for the control group was 75.7% (± 32.7%) compared to 92.1% (± 21.2%) for the test group (p = 0.0001). Consumption increased for all meals (lunch and dinner) and for the test products (meats and vegetables) at each meal. Low compliance and ingestion of institutionally prepared TMF is often due to poor visual presentation, unpalatable taste, and inappropriate texture which compromises nutrient intake and nutritional status. This study demonstrated that ingestion of the RTU TMF increased amount ingested and compliance to diet order. Additional data from patient caretakers and speech pathologists showed improved ability to ingest the RTU TMF products over the control products. Long term care facilities do not always posses the financial or labor resources to prepare consistent quality TMF. The frozen RTU TMF in this study provided residents with consistent quality, exceptional taste, appropriate texture, and appealing appearance while remaining nutrient-dense. The use of these RTU products may lead to an overall increase in the consumption of TMF by long term care residents, thereby preventing deterioration in nutritional status caused by inadequate consumption of institutionally prepared texture modified foods.