多糖在吞咽障碍食品中应用的研究进展

doi:10.6040/j.issn.1671-7554.0.2024.0651

摘要/Abstract

摘要： 随着咀嚼和吞咽能力下降,吞咽障碍成为影响老年人身心健康的重要因素之一。吞咽障碍食品是指通过加工,包括粉碎或添加增稠剂等食品添加剂后制成的能够满足吞咽障碍人群经口进食需求的特殊食品,是吞咽障碍患者康复治疗中常用的手段。多糖基增稠剂因其具有调整食物流变特性和质构特性的能力,能够有效降低吞咽障碍患者吸入性肺炎的风险,在吞咽障碍患者的治疗和护理过程中应用广泛。基于人口老龄化的发展趋势,对吞咽障碍食品的研究现状、评价标准,以及多糖在吞咽障碍食品中的应用现状进行讨论,旨在为我国吞咽障碍患者专用食品的创制提供参考依据。

关键词: 老年人, 吞咽障碍食品, 多糖, 增稠剂, 评价标准

Abstract: As the ability of chewing and swallowing decreased, dysphagia has become one of the important factors affecting the physical and mental health of the elderly. Dysphagia food is a mainstay of compensatory intervention for individual with swallowing disorder, which could be obtained through processing including chopping or food thickeners addition. Modification of the rheological and textural properties of food by polysaccharide-based thickener is one of the key dysphagia management strategies to reduce the risk of aspiration during swallowing, hence widely used in the treatment and care of patients with dysphagia. Trends based on population ageing, this article discusses the research status, evaluation standards, and application status of polysaccharides in dysphagia food at home and abroad. The aim is to provide reference for the creation of specialized food for patients with dysphagia in China.

Key words: Elderly, Dysphagia food, Polysaccharide, Thickener, Evaluation standard

中图分类号:

TS218

王利红,窦少坤,栾惠,李宝瑞,宗爱珍,徐同成. 多糖在吞咽障碍食品中应用的研究进展[J]. 山东大学学报 (医学版), 2024, 62(8): 1-8.

WANG Lihong, DOU Shaokun, LUAN Hui, LI Baorui, ZONG Aizhen, XU Tongcheng. Research progress on the application of polysaccharides in dysphagia food[J]. Journal of Shandong University (Health Sciences), 2024, 62(8): 1-8.

参考文献

[1] 董梦晗, 王旭莲, 刘倩, 等. 老年特殊食品的研究现状与设计策略[J]. 中国食品学报, 2023, 23(12): 349-361. doi:10.16429/j.1009-7848.2023.12.035. DONG Menghan, WANG Xulian, LIU Qian, et al. Research status and design strategy of special food for the elderly[J]. Journal of Chinese Institute of Food Science and Technology, 2023, 23(12): 349-361. doi:10.16429/j.1009-7848.2023.12.035.
[2] 刘雅鑫, 蒋运兰, 黄孝星, 等. 中国老年人吞咽障碍患病率的Meta分析[J]. 中国全科医学, 2023, 26(12): 1496-1502, 1512. doi:10.12114/j.issn.1007-9572.2022.0639. LIU Yaxin, JIANG Yunlan, HUANG Xiaoxing, et al. The prevalence of dysphagia among Chinese older adults: a meta-analysis[J]. Chinese General Practice, 2023, 26(12): 1496-1502, 1512. doi:10.12114/j.issn.1007-9572.2022.0639.
[3] 中国康复医学会吞咽障碍康复专业委员会. 中国吞咽障碍康复管理指南(2023版)[J]. 中华物理医学与康复杂志, 2023, 45(12): 1057-1072.
[4] Abu-Ghanem S, Chen S, Amin MR. Oropharyngeal dysphagia in the elderly: evaluation and prevalence[J]. Curr Otorhinolaryngol Rep, 2020, 8(1): 34-42.
[5] 中国吞咽障碍膳食营养管理专家共识组. 吞咽障碍膳食营养管理中国专家共识(2019版)[J]. 中华物理医学与康复杂志, 2019, 41(12): 881-888.
[6] Liu SH, Qiao DL, Cheng ZH, et al. Towards designing dysphagia foods: recent advances in influencing factors and computer modeling for the swallowing of thickened fluids[J]. Trends Food Sci Technol, 2023, 137: 17-30. doi:10.1016/j.tifs.2023.05.008.
[7] Vieira JM, Oliveira FD Jr, Salvaro DB, et al. Rheology and soft tribology of thickened dispersions aiming the development of oropharyngeal dysphagia-oriented products[J]. Curr Res Food Sci, 2020, 3: 19-29. doi:10.1016/j.crfs.2020.02.001.
[8] Funami T, Ishihara S, Nakauma M, et al. Texture design for products using food hydrocolloids[J]. Food Hydrocoll, 2012, 26(2): 412-420..
[9] Martínez O, Vicente MS, De Vega MC, et al. Sensory perception and flow properties of dysphagia thickening formulas with different composition[J]. Food Hydrocoll, 2019, 90: 508-514. doi:10.1016/j.foodhyd.2018.12.045.
[10] Hou YJ, Zhao JY, Yin JY, et al. The synergistic gelation of Dendrobium officinale polysaccharide(Dendronans)with xanthan gum and its rheological and texture properties[J]. Food Hydrocoll, 2023, 141: 108674. doi:10.1016/j.foodhyd.2023.108674.
[11] Vieira JM, Mantovani RA, Raposo MFJ, et al. Effect of extraction temperature on rheological behavior and antioxidant capacity of flaxseed gum[J]. Carbohydr Polym, 2019, 213:217-227. doi: 10.1016/j.carbpol.2019.02.078.
[12] Torres O, Yamada A, Rigby NM, et al. Gellan gum: a new member in the dysphagia thickener family[J]. Biotribology, 2019, 17:8-18. doi: 10.1016/j.biotri.2019.02.002.
[13] Sopade PA, Halley PJ, Cichero JAY, et al. Rheological characterization of food thickeners marketed in Australia in various media for the management of dysphagia. III. Fruit juice as a dispersing medium[J]. J Food Eng, 2008, 84(4): 553-562.
[14] Moret-Tatay A, Rodríguez-García J, Martí-Bonmatí E, et al. Commercial thickeners used by patients with dysphagia: Rheological and structural behaviour in different food matrices[J]. Food Hydrocoll, 2015, 51: 318-326. doi:10.1016/j.foodhyd.2015.05.019.
[15] McCallum SL. The National Dysphagia Diet: implementation at a regional rehabilitation center and hospital system[J]. J Am Diet Assoc, 2003, 103(3): 381-384. doi:10.1053/jada.2003.50074.
[16] Schmidt H, Komeroski MR, Steemburgo T, et al. Influence of thickening agents on rheological properties and sensory attributes of dysphagic diet[J]. J Texture Stud, 2021, 52(5/6): 587-602. doi:10.1111/jtxs.12596.
[17] Yang Y, Xu J, Sang TT, et al. A review and evidence based recommendations on starch- and gum-based thickeners for dysphagic patients[J]. J Food Meas Charact, 2022, 16(4): 3140-3152. doi:10.1007/s11694-022-01418-x.
[18] Dysphagia Diet Committee of the Japanese Society of Dysphagia Rehabilitation, Kayashita J, Fujishima I, et al. The Japanese dysphagia diet of 2021 by the Japanese society of dysphagia rehabilitation[J]. Jpn J Compr Rehabil Sci, 2022, 13: 64-77. doi:10.11336/jjcrs.13.64.
[19] Cichero JA, Lam P, Steele CM, et al. Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: the IDDSI framework[J]. Dysphagia, 2017, 32(2): 293-314.
[20] 黄远标. 多糖在食品工业中的应用现状[J]. 现代食品, 2017, 7(14): 23-25. HUANG Yuanbiao. Application status of polysaccharide in food industry[J]. Mod Food, 2017, 7(14): 23-25.
[21] 王子朝, 郑欣欣, 余晓雪, 等. 多糖对食品物性及功能影响的研究进展[J]. 河南工业大学学报(自然科学版), 2023, 44(1): 126-134. WANG Zichao, ZHENG Xinxin, YU Xiaoxue, et al. Research progress on the effect of polysaccharide on physical property and function of food[J]. Journal of Henan University of Technology(Natural Science Edition), 2023, 44(1): 126-134.
[22] 钟磊, 吴柳拿, 周烈, 等. 吞咽障碍者增稠流体食品流变学研究进展[J]. 食品科学, 2018, 39(1): 313-319. ZHONG Lei, WU Liuna, ZHOU Lie, et al. Progress in rheology of thickened liquid foods for dysphagic patients[J]. Food Science, 2018, 39(1): 313-319.
[23] Cho HM, Yoo B. Rheological characteristics of cold thickened beverages containing xanthan gum-based food thickeners used for dysphagia diets[J]. J Acad Nutr Diet, 2015, 115(1): 106-111.
[24] 张丽静, 王远亮, 王传花. 黄原胶在食品工业中的应用[J]. 农产品加工(下半月), 2020(11): 77-79.
[25] Sezgin B, Durusoy D, Demirci MS, et al. The effect of “xanthan gum-based fluid thickener” on hydration, swallowing functions and nutritional status in total maxillectomy patients[J]. Eur Arch Otorhinolaryngol, 2018, 275(12): 2997-3005.
[26] 孙彦君, 张静, 乔冉冉, 等. 黄原胶类增稠剂对老年脑卒中后吞咽功能障碍的临床研究[J]. 中华保健医学杂志, 2021, 23(4): 362-365. SUN Yanjun, ZHANG Jing, QIAO Ranran, et al. Clinical study of xanthan gum thickener on dysphagia after stroke in elderly patients[J]. Chinese Journal of Health Care and Medicine, 2021, 23(4): 362-365.
[27] 颜准, 谭荣华, 艾连中, 等. 溶液环境对吞咽障碍食品胶基增稠剂流变学性质的影响[J]. 食品与发酵工业, 2022, 48(19): 99-107. YAN Zhun, TAN Ronghua, AI Lianzhong, et al. The effect of solution environment on the rheological properties of gum-based thickener for dysphagia[J]. Food and Fermentation Industries, 2022, 48(19): 99-107.
[28] Baszak BB, Gozdecka G, Shyichuk A. Carrageenan as a functional additive in the production of cheese and cheese-like products[J]. Acta Sci Pol Technol Aliment, 2018, 17(2): 107-116.
[29] Bitencourt BS, Guedes JS, Saliba ASMC, et al. Mineral bioaccessibility in 3D printed gels based on milk/starch/κ-carrageenan for dysphagic people[J]. Food Res Int, 2023, 170: 113010. doi:10.1016/j.foodres.2023.113010.
[30] Suebsaen K, Suksatit B, Kanha N, et al. Instrumental characterization of banana dessert gels for the elderly with dysphagia[J]. Food Biosci, 2019, 32: 100477. doi:10.1016/j.fbio.2019.100477.
[31] Jiang XY, Li L, Yan JN, et al. Binary hydrogels constructed from lotus rhizome starch and different types of carrageenan for dysphagia management: Nonlinear rheological behaviors and structural characteristics[J]. Food Chem X, 2024, 22: 101466. doi:10.1016/j.fochx.2024.101466.
[32] Sharma M, Kristo E, Corredig M, et al. Effect of hydrocolloid type on texture of pureed carrots: Rheological and sensory measures[J].Food Hydrocoll, 2017, 63: 478-487. doi:10.1016/j.foodhyd.2016.09.040.
[33] 李秀秀,尚静,杨曦,等. 多糖的增稠、胶凝及乳化特性研究进展[J].食品科学, 2021(15): 300-308. LI Xiuxiu, SHANG Jing, YANG Xi, et al. A Review on Thickening, Gelling and Emulsifying Properties of Polysaccharides. [J]. Food Sci, 2021(15): 300-308.
[34] Laguna L, Sarkar A. Influence of mixed gel structuring with different degrees of matrix inhomogeneity on oral residence time[J]. Food Hydrocoll, 2016, 61: 286-299. doi:10.1016/j.foodhyd.2016.05.014.
[35] Rivero-Ramos P, Valdez MI, Sanz T, et al. Rice starch-alginate systems gelatinised by high hydrostatic pressure(HHP)as dysphagia-oriented matrices[J]. Food Hydrocoll, 2024, 151: 109793. doi:10.1016/j.foodhyd.2024.109793.
[36] Chakraborty I, Pooja N, Mal SS, et al. An Insight into the Gelatinization Properties Influencing the Modified Starches Used in Food Industry: a review[J]. Food and Bioprocess Technology, 2022, 15(6): 1195-1223. doi:10.1007/s11947-022-02761-z.
[37] Yang HW, Lin Y. Effect of thermal processing on flow properties and stability of thickened fluid matrices formulated by tapioca starch, hydroxyl distarch phosphate(E-1442), and xanthan gum associating dysphagia-friendly potential[J]. Polymers, 2021, 13(1): 162. doi:10.3390/polym13010162.
[38] Methacanon P, Gamonpilas C, Kongjaroen A, et al. Food polysaccharides and roles of rheology and tribology in rational design of thickened liquids for oropharyngeal dysphagia: a review[J]. Compr Rev Food Sci Food Saf, 2021, 20(4). doi:10.1111/1541-4337.12791.
[39] 李晓敏, 董阳, 陈云, 等. 黄原胶及预糊化淀粉在老年吞咽助剂中的应用研究[J]. 中国食品添加剂, 2023, 34(11): 139-144. LI Xiaomin, DONG Yang, CHEN Yun, et al. Application of xanthan gum and pre-gelatinized starch in swallowing aids for Elders[J]. China Food Additives, 2023, 34(11): 139-144.
[40] Liu T, Zheng JH, Du J, et al. Food processing and nutrition strategies for improving the health of elderly people with dysphagia: a review of recent developments[J]. Foods, 2024, 13(2): 215. doi:10.3390/foods13020215.
[41] Ortega O, Bolívar-Prados M, Arreola V, et al. Therapeutic effect, rheological properties and α-amylase resistance of a new mixed starch and xanthan gum thickener on four different phenotypes of patients with oropharyngeal dysphagia[J]. Nutrients, 2020, 12(6): 1873. doi:10.3390/nu12061873.

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