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

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 Malmouml (SH-M) and Goumlteborg (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

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

Knowledge and practice among dietitians in four Western European countries regarding malnutrition, starvation, cachexia and sarcopenia

Adequate distinction between malnutrition, starvation, cachexia and sarcopenia is important in clinical care. Despite the overlap in physical characteristics, differences in etiology have therapeutical and prognostic implications. We aimed to determine whether dietitians in selected European countries have ‘proper knowledge’ of malnutrition, starvation, cachexia and sarcopenia, and use terminology accordingly

Does the Mediterranean diet predict longevity in the elderly? A Swedish perspective

Dietary pattern analysis represents a useful improvement in the investigation of diet and health relationships. Particularly, the Mediterranean diet pattern has been associated with reduced mortality risk in several studies involving both younger and elderly population groups. In this research, relationships between dietary macronutrient composition, as well as the Mediterranean diet, and total mortality were assessed in 1,037 seventy-year-old subjects (540 females) information. Diet macronutrient composition was not associated with mortality, while a refined version of the modified Mediterranean diet index showed a significant inverse association (HR = 0.93, 95% CI: 0.89; 0.98). As expected, inactive subjects, smokers and those with a higher waist circumference had a higher mortality, while a reduced risk characterized married and more educated people. Sensitivity analyses (which confirmed our results) consisted of: exclusion of one food group at a time in the Mediterranean diet index, exclusion of early deaths, censoring at fixed follow-up time, adjusting for activities of daily living and main cardiovascular risk factors including weight/waist circumference changes at follow up. In conclusion, we can reasonably state that a higher adherence to a Mediterranean diet pattern, especially by consuming wholegrain cereals, foods rich in polyunsaturated fatty acids, and a limited amount of alcohol, predicts increased longevity in the elderly

Vad är god mat för äldre sjuka? Maten, måltiden och ätandet.

Mat är ett av de glädjeämnen i livet som vi först förvärvar och som sist lämnar oss. Maten skall engagera alla sinnen och utgöra en höjdpunkt på dagen värd att se fram emot. Behovet av föda innebär dock inte bara lust och fägring utan också livsnödvändig näring och energi för att kroppen skall må bra och tillfriskna vid sjukdom. Åldrandet i sig innebär inte förändrat behov av mat och näring, men risken för sjuklighet och funktionshinder, som försvårar näringsintaget ökar däremot med stigande ålder. Vanliga problem bland riktigt gamla människor är förutom dålig aptit, tugg- och sväljsvårigheter samt muntorrhet. I kombination med nedsatt syn, hörsel och muskelstyrka utgör dessa handikapp hinder för att njuta av maten på samma sätt som tidigare och måltiden kan lätt upplevas som stressande. Med stigande ålder minskar muskelmassan och man rör sig allt mindre. Äldre människor behöver därför mindre mängd energi och därmed mindre mängd mat än yngre. Problemet är dock att deras behov av näringsämnen inte sjunker. Det betyder att för att de riktigt gamla skall få i sig lika mycket av olika näringsämnen på mindre portioner, som de yngre får, måste maten för äldre måste hålla en hög kvalitet. Det skall vara mycket näring per kalori, det vill säga en hög näringstäthet

Sjukdomsrelaterad undernäring - äldreomsorgens utmaning

Sjukdomsrelaterad undernäring drabbar många sjuka äldre. Tillståndet kan obehandlat vara livshotande, leder till minskad funktion och livskvalitet samt ökad morbiditet och mortalitet. Evidensbasen för diagnostik och behandling har ökat kraftigt under senare år. Kunskapen om vad som bör göras är tillgänglig. Problemet är att denna inte är tillräckligt spridd. Det gäller slutenvården och i än högre utsträckning kommunal äldreomsorg. Att få tillstånd ett adekvat nutritionsomhändertagande i äldreomsorgen är en stor utmaning. Här vid behöver framförallt hemtjänsten uppmärksammas då allt fler sjuka äldre bor i ordinärt boende med hemtjänst. Samverkan mellan är av stor betydelse för att vårdkedjan skall fungera och nödvändig information överföras mellan vårdgivarna. Det finns också ett behov av tydliga riktlinjer för matens kvalitet då kosten utgör basen i nutritionsbehandlingen.Denna artikel har tidigare varit införd i tidskriften Nordisk Geriatrik 2008:1

To Feed and Move the Muscles are Crucial for Healthy Ageing

Ageing is associated with reduced margins and impairments in several physiological systems including increase in body fat and a decline in lean mass called sarcopenia and limiting physical abilities. Disease Related Malnutrition (DRM) becomes prevalent due to increased risk to develop chronic disease by age. To prevent and reduce the loss of muscle mass and function physical activity and nutrition are of importance. The evidence for a combination effect is convincing. Except adequate energy intake protein and vitamin D are of specific importance to maintain muscle mass. Some amino acids seem of key importance. A major cause of sarcopenia is inactivity and anabolic resistance. Physical exercise, mainly resistance training has been shown to be of significant importance for muscle protein synthesis. Adequate muscular function is a prerequisite for independence and quality of life. It is urgent to learn more about how to prevent and treat loss of muscle mass and function in ageing