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Tsubokawa M, Fujitani J, Ashida K, Hayase M, Kobayashi N, Horita C, Sakashita M, Tokunaga T, Hamano T, Kikuta KI, Fujieda S. Potential of Rice-Flour Jelly Made from High-Amylose Rice as a Dysphagia Diet: Evaluation of Pharyngeal Residue by FEES. Dysphagia 2022:10.1007/s00455-022-10529-y. [PMID: 36242646 DOI: 10.1007/s00455-022-10529-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/30/2022] [Indexed: 11/26/2022]
Abstract
Dysphagia diets are recommended to prevent choking and aspiration in people with dysphagia; however, rice-porridge and mashed rice-porridge, which are used as staple foods for people with dysphagia in Japan, are time-consuming to prepare. The National Agriculture and Food Research Organization has found jelly-like food products made from high-amylose rice-flour (rice-flour jelly) to be easy to prepare with a texture suitable for dysphagia diets. To investigate the potential of rice-flour jelly for the dysphagia diet, we evaluated the amount of pharyngeal residue after swallowing rice-flour jelly using fiberoptic endoscopic evaluation of swallowing and compared it with those of rice-porridge, mashed rice-porridge, and fruit jelly. We enrolled 70 participants (43 males and 27 females, aged 32-96 years, median 74.5 years) and evaluated their pharyngeal residue using the Yale Pharyngeal Residue Severity Rating Scale which includes five levels from I (none) to V (severe). Statistical analysis showed that level I was more common in fruit jelly for vallecula residue and pyriform sinus residue, and level III (mild) was more common in rice-porridge for vallecula residue (p < 0.05). No differences of pharyngeal residue were found in rice-flour jelly or mashed rice-porridge. No significant difference was observed in the number of participants with laryngeal penetration or aspiration. Therefore, rice-flour jelly is a suitable alternative to rice-porridge as a staple food for people with dysphagia in terms of food texture.
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Affiliation(s)
- Misao Tsubokawa
- Department of Rehabilitation Medicine, Fukui University Hospital, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| | - Junko Fujitani
- Department of Rehabilitation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kanae Ashida
- Institute of Food Research, National Agriculture and Food Research Organization, 2-1-12, Kannondai, Tsukuba City, Ibaraki, 305-8642, Japan
| | - Mika Hayase
- Nutrition Department, Fukui University Hospital, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Namiko Kobayashi
- Department of Rehabilitation Medicine, Fukui University Hospital, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Chika Horita
- Department of Rehabilitation Medicine, Fukui University Hospital, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Masafumi Sakashita
- Department of Otorhinolaryngology and Head & Neck Surgery, University of Fukui, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
- Medical Research Support Center, Fukui University Hospital, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Takahiro Tokunaga
- Research Promotion Office, Shinseikai Toyama Hospital, 89-10, Shimowaka, Imizu City, Toyama, 939-0243, Japan
- Medical Research Support Center, Fukui University Hospital, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Tadanori Hamano
- Department of Neurology, University of Fukui, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Ken-Ichiro Kikuta
- Department of Neurosurgery, University of Fukui, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Shigeharu Fujieda
- Department of Otorhinolaryngology and Head & Neck Surgery, University of Fukui, 23-3, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
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Cichero JAY, Lam P, Steele CM, Hanson B, Chen J, Dantas RO, Duivestein J, Kayashita J, Lecko C, Murray J, Pillay M, Riquelme L, Stanschus S. Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework. Dysphagia 2017; 32:293-314. [PMID: 27913916 PMCID: PMC5380696 DOI: 10.1007/s00455-016-9758-y] [Citation(s) in RCA: 443] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/08/2016] [Indexed: 12/20/2022]
Abstract
Dysphagia is estimated to affect ~8% of the world's population (~590 million people). Texture-modified foods and thickened drinks are commonly used to reduce the risks of choking and aspiration. The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded with the goal of developing globally standardized terminology and definitions for texture-modified foods and liquids applicable to individuals with dysphagia of all ages, in all care settings, and all cultures. A multi-professional volunteer committee developed a dysphagia diet framework through systematic review and stakeholder consultation. First, a survey of existing national terminologies and current practice was conducted, receiving 2050 responses from 33 countries. Respondents included individuals with dysphagia; their caregivers; organizations supporting individuals with dysphagia; healthcare professionals; food service providers; researchers; and industry. The results revealed common use of 3-4 levels of food texture (54 different names) and ≥3 levels of liquid thickness (27 different names). Substantial support was expressed for international standardization. Next, a systematic review regarding the impact of food texture and liquid consistency on swallowing was completed. A meeting was then convened to review data from previous phases, and develop a draft framework. A further international stakeholder survey sought feedback to guide framework refinement; 3190 responses were received from 57 countries. The IDDSI Framework (released in November, 2015) involves a continuum of 8 levels (0-7) identified by numbers, text labels, color codes, definitions, and measurement methods. The IDDSI Framework is recommended for implementation throughout the world.
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Affiliation(s)
- Julie A Y Cichero
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia.
- School of Pharmacy, Pharmacy Australia Centre of Excellence (PACE), The University of Queensland, 20 Cornwall St, Brisbane, QLD, 4102, Australia.
| | - Peter Lam
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
- Peter Lam Consulting, Vancouver, BC, Canada
| | - Catriona M Steele
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ben Hanson
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Department of Mechanical Engineering, University College London, London, UK
| | - Jianshe Chen
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Zhejiang Gongshang University, Hangzhou, China
| | - Roberto O Dantas
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Janice Duivestein
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Access Community Therapists, Vancouver, BC, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jun Kayashita
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Caroline Lecko
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- National Health Service Improvement, London, UK
| | - Joseph Murray
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Ann Arbor Veterans Affairs, Ann Arbor, MI, USA
| | - Mershen Pillay
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Speech Pathology, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
- Manchester Metropolitan University, Manchester, UK
| | - Luis Riquelme
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Department of Speech-Language Pathology, New York Medical College, Valhalla, NY, USA
- Barrique Speech-Language Pathology at Center for Swallowing & Speech-Language Pathology, New York Methodist Hospital, Brooklyn, NY, USA
| | - Soenke Stanschus
- International Dysphagia Diet Standardisation Initiative (IDDSI) Working Committee, Brisbane, QLD, Australia
- Swallowing and Speech Pathology, Hospital zum Heiligen Geist, Kempen, Germany
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