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Kumar A, Almotairy N, Merzo JJ, Wendin K, Rothenberg E, Grigoriadis A, Sandborgh-Englund G, Trulsson M. Chewing and its influence on swallowing, gastrointestinal and nutrition-related factors: a systematic review. Crit Rev Food Sci Nutr 2023; 63:11987-12017. [PMID: 35837677 DOI: 10.1080/10408398.2022.2098245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The study aimed to evaluate the hypothesis that chewing is a mechanical and physiological contributor to swallowing, physiologic/pathologic processes of the gastrointestinal tract (GIT), and nutrition-related factors. A search strategy was applied to three different databases to investigate if chewing function in adults affects the swallowing, physiologic/pathologic processes of the GIT, and nutrition-related factors compared to controls with no exposure. The included studies were evaluated for methodological quality and risk of bias and certainty of evidence. The results showed 71 eligible studies. Overall, the results showed that 46 studies supported the hypothesis while 25 refuted it. However, the GRADE analysis showed low to very low certainty of the evidence to support the hypothesis that chewing is an important contributor in the swallowing process, and physiologic/pathologic processes in the GIT. The GRADE analysis also showed a moderate to very low certainty of the evidence to suggest that chewing function contributes to nutrition-related parameters. The overall results of the current study showed that a majority (64.7%) of the studies (46 out of 71) supported the hypothesis. However, robust studies with proper design, adequate sample size, and well-defined outcome parameters are needed to establish conclusive evidence.
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Affiliation(s)
- Abhishek Kumar
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Nabeel Almotairy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | | | - Karin Wendin
- Food and Meal Science, Kristianstad University, Kristianstad, Sweden
- Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | - Elisabet Rothenberg
- Food and Meal Science, Kristianstad University, Kristianstad, Sweden
- Facutly of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Anastasios Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Gunilla Sandborgh-Englund
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Academic Center for Geriatric Dentistry, Karolinska Institutet, Stockholm, Sweden
| | - Mats Trulsson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Academic Center for Geriatric Dentistry, Karolinska Institutet, Stockholm, Sweden
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