市販ゲル化剤を用いた嚥下造影検査食に関する基礎的な検討

Objective: Videofluoroscopic examination of swallowing requires barium sulfate. It has been reported that barium sulfate changes the viscosity of thickened liquids. However, there have been few studies of the effect of barium sulfate on the texture of jelly provided for severe dysphagic patients. Moreover, the texture of jelly is affected by temperature. We investigated the effect of barium sulfate on jelly texture, and the effect of temperature on barium jelly. Method: We made test food using liquid barium diluted 50wv% with ion exchanged water. We used five different commercial gelling agents to make jelly; agar, gelatin, xanthan gum, carrageenan, and pectin. Water jelly was the control. CREEP METER was used to measure hardness, adhesiveness, and cohesiveness. Result: We found that barium has various effects on the texture of jelly. Furthermore, the texture of barium jelly is affected by temperature. Agar and pectin were less affected by temperature than other gelling agents. Conclusion: These results indicate the necessity of standardized test foods for dysphagic patients.原著Original国立情報学研究所で電子

新しい特別用途食品制度の基準区分に準じた嚥下造影検査食の検討

Foods for People with Difficulty Swallowing in accordance with the new Foods for Special Dietary Use System enacted in April 2009 are based on three levels of criteria classifications corresponding to severity according to physical property criteria consisting of hardness, adhesion and aggregation. On the other hand, since in-depth testing of individual cases using Videofluoroscopic examination of swallowing (VF) and the like becomes increasingly indispensible as the severity of the patient's condition increases, in the case the patient uses commercially available foods certified as "Foods for People with Difficulty Swallowing", it is necessary that the type of foods selected coincide with test results. With this in mind, a study was conducted of conditions for preparing VF test foods suitable for each level of the aforementioned criteria classifications for the purpose of achieving a correlation between clinical findings and commercially available foods consumed on a daily basis. [Methods] Test foods were prepared by using a commercially available gelling agent and thickener in liquid barium diluted to 50 w/v%. At that time, physical properties of the test foods were measured while changing the concentrations of gelling agent and thickener. Measurements were made using a creep meter, while hardness, adhesion and aggregation were calculated based on methods defined in the regulations for approval of indication of foods for special dietary use. [Results] The hardness of the prepared test foods demonstrated higher values at 10°C than at 20°C in all cases. The test foods were determined to be able to be prepared at gelling agent concentrations of 1.00 % and 1.75 % for approval level I, at gelling agent concentrations of 0.50 % and 2.25 % for approval level II, and at a thickener concentration of 1.00% and gelling agent concentration of 2.75% for approval level III at 10°C , and at gelling agent concentrations of 1.00% and 2.00% for approval level I, at gelling agent concentrations of 0.75% and 2.50% for approval level II, and at a thickener concentration of 1.50% and gelling agent concentration of 3.00% for approval level III at 20°C. [Conclusion] The use of the results of this study will enable the preparation of test foods that satisfy each approval level of "Foods for People with Difficulty Swallowing" according to the new Food for Special Dietary Use System in the clinical setting. This suggested that it will be possible to achieve agreement between VF test results and commercially available foods