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      Texture-modified meat and carrot products for elderly people with dysphagia: preference in relation to health and oral status

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          Abstract

          Background

          Reduced taste and smell, chewing problems and swallowing dysfunction are common among elderly people and affect perception, food choice and the ability to eat.

          Objective

          To study the preference for texture-modified carrot and meat products in elderly people aiming to meet the needs of people with impaired chewing and/or swallowing.

          Design

          Data were collected using questionnaires focusing on health, oral status and preference for the products. Altogether, 108 elderly people in ordinary housing (OH) and 50 living in special housing (SH) in Malmö (SH-M) and Göteborg (SH-G) participated.

          Results

          19% had a body mass index ≤22, predominantly in SH (24%). Stroke was reported by 20% of the subjects in SH. Among those with subjectively experienced difficulties in swallowing (12%), 58% reported coughing, 21% a gurgly voice in association with food intake and 50% obstruction during swallowing. Only 20% with subjective swallowing difficulties had been specifically examined regarding this problem. All the tested products were easy to masticate and swallow. Compared with OH, people in SH-M found the meat products easier to masticate and swallow. Compared with OH, subjects in SH found the carrot products easier to masticate

          Conclusions

          There is a need to develop tasty texture-modified nutritious food products for people with mastication and/or swallowing problems. Possible factors for differences in preference between groups, in this study OH and SH, may be related to health status in general and specifically mastication and swallowing functions.

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          Most cited references34

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          Functional units, chewing, swallowing, and food avoidance among the elderly.

          The number of teeth in the dentition was compared with the number and types of dental functional units (opposing tooth pairs) to correlate the number of functional units with complaints about chewing and swallowing in the elderly. Complaints of oral pharyngeal function and food avoidance practices were compared with the number and types of functional units. A convenience sample of 602 elderly subjects (468 men, 134 women, mean age 70 years) were interviewed and examined dentally. Functional unit measures, which included functional arrangement of the teeth and the number and type of teeth present, were found to be more discriminatory and descriptive of masticatory potential than the more number of teeth. Elderly persons (> or = 60 years of age) with reduced numbers of functional units tended to report difficulty chewing, avoidance of stringy foods (including meat), crunchy foods (including vegetables), and dry solid foods (including breads), and difficulty in swallowing. Removable prostheses did not appear to prevent these consequences and, at least in this elderly population, did not appear to be equivalent to natural teeth in terms of masticatory potential. It is possible that compromised dental function results in the swallowing of poorly chewed food, food avoidance patterns, dietary inadequacies, and systemic changes favoring illness, reduced vigor, debilitation, and shortened life expectancy. Emphasis should be placed on maintaining natural teeth whenever possible.
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            A novel dysphagia diet improves the nutrient intake of institutionalized elders.

            Dysphagia affects 35% to 60% of the institutionalized elderly population. This study aimed at evaluating the nutrient intake of frail institutionalized elderly persons with dysphagia and to assess the impact of Sainte-Anne's Hospital Advanced Nutritional Care program on dietary intake and weight. A 12-week intervention study. Ninety-three individuals residing in a Montreal, Canada, long-term care facility who were aged at least 65 years were evaluated. Seventeen subjects with a body mass index (BMI; calculated as kg/m(2)) 7.5% within 3 months and with dysphagia were included. The treated group (n=8; aged 82.5+/-4.41 years, weight 55.9+/-12.1 kg, BMI 22.4+/-3.93) received Sainte-Anne's Hospital reshaped minced- or pureed-texture foods with thickened beverages where required. The control group (n=9; aged 84.6+/-3.81 years, weight 54.3+/-7.49 kg, BMI 21.2+/-2.31) maintained traditional nourishment. Macronutrient and micronutrient intake, weight, and BMI were measured at baseline, 6 weeks, and 12 weeks. Student t tests were performed to evaluate change within and between groups. The treatment and control groups were similar at baseline, having a mean age of 82.5+/-4.41 years vs 84.6+/-3.81 years and BMI of 22.4+/-3.93 vs 21.2+/-2.31, respectively. The average weight in the treated group increased compared to the control group (3.90+/-2.30 vs -0.79+/-4.18 kg; P=0.02). Similarly, the treated group presented an increased intake of energy, proteins, fats, total saturated fats, monounsaturated fats, potassium, magnesium, calcium, phosphorus, zinc, vitamin B-2, and vitamin D compared to control subjects (P<0.05). Institutionalized elderly patients with dysphagia can eat better and increase body weight via a diversified, modified in texture, and appealing oral diet that meets their nutrition needs.
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              Prevalence of dysphagia among community-dwelling elderly individuals as estimated using a questionnaire for dysphagia screening.

              The objective of this cross-sectional study was to determine the prevalence of dysphagia among elderly persons living at home in a community using a questionnaire for dysphagia screening. As the reliability of the questionnaire had not yet been confirmed in an epidemiological study, it was also verified. The relationship between dysphagia and the level of daily living competence was also clarified. The subjects consisted of 1313 elderly persons 65 years and older (575 males and 738 females) living at home in a community. The questionnaire included questions concerning the individual's past history of stroke, and questions for dysphagia screening, competence scoring, and perceived ill health. The reliability of the questionnaire was confirmed after calculating the Cronbach's alpha coefficient to be 0.83. The results of a factor analysis showed that the cumulative contribution rate was 61.8%. The prevalence rate of dysphagia was 13.8%. After matching for age and sex, there were significant differences in the competence scores, history of stroke, and perceived ill health status observed between the group with dysphagia and the group without dysphagia.
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                Author and article information

                Journal
                Scand J Food Nutr
                FNR
                Scandinavian Journal of Food &#x0026; Nutrition
                CoAction Publishing
                1748-2976
                1748-2984
                December 2007
                : 51
                : 4
                : 141-147
                Affiliations
                [1 ]Department of Clinical Nutrition, Sahlgrenska University Hospital, Göteborg, Sweden
                [2 ]SIK, The Swedish Institute for Food and Biotechnology, Göteborg, Sweden
                [3 ]Diagnostic Centre of Imaging and Functional Medicine, Malmö University Hospital, Lund University, Malmö, Sweden
                [4 ]Findus Sverige AB, Bjuv, Sweden
                Author notes
                Elisabet Rothenberg, Department of Clinical Nutrition, Sahlgrenska University Hospital, Bruna stråket 11B Plan 4, SE-413 45, Göteborg, Sweden, Tel: +43 31 34 28 62, elisabet.rothenberg@ 123456vgregion.se
                Article
                FNR-51-141
                10.1080/17482970701760675
                2606992
                5c084259-c482-41b1-88df-40667e5f286d
                © 2007 Taylor & Francis

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 October 2007
                : 22 October 2007
                Categories
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                Nutrition & Dietetics
                modified texture,meat product,health status,carrot product,dysphagia,elderly
                Nutrition & Dietetics
                modified texture, meat product, health status, carrot product, dysphagia, elderly

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