Nutr Res Pract.  2022 Jun;16(3):354-365. 10.4162/nrp.2022.16.3.354.

Improvement of chewing and swallowing risks in community-dwelling older adults using texture-modified food

• Park S
• Kim Dk
• Park H
• Yoon D
• Byambaa S

• KMID: 2530396
• DOI: http://doi.org/10.4162/nrp.2022.16.3.354

Abstract

BACKGROUND/OBJECTIVES
Understanding the mechanism of chewing and swallowing food is important when creating a proper diet for older adults. This study investigated whether texture-modified model foods can reduce the difference in chewing and swallowing parameters between healthy community-living young and older adults.
SUBJECTS/METHODS
In total, 35 older and 20 young adults (mean age: 75 and 25 years, respectively), matched for sex and number of teeth, were recruited and their unstimulated salivation and tongue pressure were measured. Simultaneous assessment of chewing and swallowing characteristics was conducted using surface electromyography and a videofluoroscopic swallowing study while the participants ingested 8 g of model food with one to four levels of hardness.
RESULTS
The average tongue pressure and salivation among older adults were 61% and 49.7%, respectively, of the corresponding values observed in young adults. The older adult group used significantly (P < 0.05) increased muscle force with more chewing cycles (P < 0.05) than the young adult group, which was maintained even when consuming foods with the lowest hardness, although without chewing. However, the age effect on oral processing time existed only for the hardest foods. Swallowing difficulties among older adults were demonstrated by the significant increase in vallecula aggregation time. The total food intake duration was significantly (P < 0.05) longer in older adults than in young adults, regardless of food hardness.
CONCLUSIONS
There were measurable differences in the process of chewing and swallowing food between young and older adults, which can be improved with food hardness control. Adjusting food hardness may help food intake in healthy older adults.

Keyword

Elderly; food hardness; texture-modified food; chewing; dysphagia

Figure

• 

  Fig. 1 Classification of food bolus transit time parameters: (A) OPT, (B) PFAT, (C) VAT, and (D) HTT.OPT, oral processing time; PFAT, post-faucial aggregation time; VAT, vallecula aggregation time; HTT, hypopharyngeal transit time.

• 

  Fig. 2 Differences in chewing parameters between young and older adults according to food hardness. (A) MPA; (B) NC; (C) OPT. Different letters a-c or A-C above a bar indicate statistically differences among the level of food hardness on the post hoc Duncan test within a group of participants.MPA, normalized maximum peak amplitude; NC, number of chewing cycle; OPT, oral processing time.*P < 0.05.

• 

  Fig. 3 Differences in swallowing behaviors between young and older adults according to food hardness. (A) VAT; (B) FSD; (C) S–S2; (D) TD. Different letters a-b or A-B above a bar indicate statistically differences among the level of food hardness on the post hoc Duncan test within a group of participants.VAT, vallecula aggregation time; FSD, first subsequence duration; S–S2, second subsequence duration; TD, total duration of intake.*P < 0.05.

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