Eating and drinking have miscellaneous

Eating and drinking have miscellaneous functions in humans and should not be regarded only as a way of providing calories to body. Cessation of eating resulted from fear of choking or discomfort, embarrassment, anxiety or panic reactions during mealtime, depression and isolation are common events symptoms among dysphagic people [4,5]. Logemann classified three basic types of dysphagia treatment strategies as behavioral, medical and surgical. He also claimed that the behavioral treatment was the first and easiest one [6]. One of the important behavioral treatments is diet modification where thickened foodstuffs were used control the flow rates. This increase in eating and drinking ability should go along with minimizing risks of aspiration and related complications. Thus, diet modification and altering rheological properties of common food and drinks are important operative methods [7,8]. The present article attempted to collate some recently published data on the rheological efforts to produce and analyze dysphagia-oriented products.
Role of rheology in management of dysphagia Rheological properties of food and composed faah inhibitor are very important for the swallowing process [9]. The key to safe swallowing is the coordination between rheological attributes of the bolus, propulsive forces applied by the oropharyngeal musculature and biomechanical measures utilized for protecting the airway [10]. Defects in oral cavity control, impairment in bolus preparation or delayed pharyngeal responses are reasons for using thickened food and drinks in dysphagic patients, because thickened food products changes the rate at which food is transported through the pharynx, which is related to this third factor by reducing the risk of aspiration [11]. Thickening agents are commercially available and are intended specifically for use in dysphagia diets. Because these products alter sensory properties of the foods or beverages, acceptability of these foods or beverages might be also altered [12,13]. Hence there are some challenges for producing thicker foodstuffs. In addition to the inconsistent terminology in addressing thickened foods among specialists, recent literature has summarized some of the problems associated with thickening agents and their use, including sensory characteristics [12,14], influence of dispersing media [15–18], effect of standing time [19], effect of temperature [20,21] and lack of training/education of end users [3].
Standardizing dysphagia-oriented products An important branch of dysphagia related literature is devoted to setting a united approach on dysphagia diets and foodstuffs. One of the earliest efforts on the standardization of dysphagia-oriented products was made at a rehabilitation center in USA. A dietician and two speech-language pathologists designed a program and assessed the efficacy of a standard diet in preventing aspiration and improving quality of life. The results demonstrated high tolerance for menu items, low incidence of aspiration and decreased reliance on tube feeding. [22] Bakheit [23] proposed “syrup-like” or “yogurt-like” concepts for ideal viscosity for neurogenic dysphagics. Such viscous liquids present little opportunity for patients to aspirate. However, optimum thickness of liquids is very crucial in their overall acceptability. In the case of thin liquids, there is a risk of aspiration. On the other hand, too much thickened liquids are frequently refused by spleen patients [23]. A well-known guideline about thickened dietary supplements is National Dysphagia Diet (NDD). This guideline has been used as a reference in many papers related to dysphagia [24–33]. The NDD guideline has categorized viscosity into groups of thin (1–50cP), nectar-thick (51–350cP), honey-thick (351–1750cP) and spoon thick (>1750cP) foodstuffs. The viscosity is measured by shear rate for swallowing of , which may be useful only for comparative purpose. Most authors have considered shear rate as a reference [34,35].