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Clinical nutrition

Design and implementation of modified-texture diet in older adults with oropharyngeal dysphagia: a randomized controlled trial

European Journal of Clinical Nutrition volume 73, pages 989–996 (2019)Cite this article

Subjects

Abstract

Background/Objectives

Oropharyngeal dysphagia (OD) is a common problem in elderly population that negatively affects the oral intake and body composition resulting in clinical complications as malnutrition and dehydration. The aim of this study was to design, implement, and evaluate the effect of texture-modified foods and thickened drinks diet, with nectar or pudding viscosity and controlled bolus volume in older adults with OD on body composition and oral intake.

Subjects/Methods

Randomized clinical trial, simple blind. Patients ≥ 65 years, admitted at a national institute, who had a confirmed diagnosis of OD were included. A texture-modified foods and thickened drinks diet, with nectar or pudding viscosity and controlled bolus volume, was compared to isocaloric standard treatment for 12 weeks. Body composition was evaluated by bioelectrical impedance, muscular functionality was evaluated by handgrip strength, and daily energy and protein intake by 24-h recall and evaluated by Food Processor Nutrition Analysis® software.

Results

Twenty participants were included per group, with mean age 76 years. After 12 weeks, the consumption of energy (29 ± 10 to 40 ± 15 kcal/kg, p = 0.009) and protein (1.3 ± 0.6 to 1.8 ± 0.7 g/kg, p = 0.03), as well as phase angle (4.4 ± 1.8 to 5.5 ± 2.5°, p = 0.05), body weight (56 ± 10 to 60 ± 10 kg, p < 0.001), and handgrip strength (18 ± 11 to 21 ± 13 kg, p = 0.004) increased in the intervention group. In control group there were no changes.

Conclusions

The dietary intervention improved oral intake, weight, handgrip strength, and phase angle, which can prevent or limit the nutritional complications associated with the OD.

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Acknowledgements

The authors thank clinical nutrition service members as well as the nursing and medical staff for providing valuable assistance.

Funding

The National Council of Science and Technology (CONACYT) provided a graduate scholarship for the principal investigator. Victus® laboratory donated the Enterex Food Thickener for the intervention in the study. The CONACYT and Victus® laboratory took no part in design, conduct of the study, collection, management, analysis, interpretation of the data, preparation, review, and approval of the manuscript.

Author contributions

AES-Z, LC-M, C-N, RR-T: study concept and design. AGR-V, RR-G, MZ-S: clinical diagnoses and data collection. LC-M and CAR-T: analysis and interpretation of data. CAR-T and AGR-V: drafting of the manuscript. AES-Z, LC-M: critical revision of the manuscript. All authors have reviewed the manuscript and approved its submission.

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Authors and Affiliations

  1. Clinical Nutrition Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Carlos A Reyes-Torres, Lilia Castillo-Martínez, Aniela G Ramos-Vázquez & Aurora E Serralde-Zúñiga

  2. Stomatology Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Roberto Reyes-Guerrero

  3. Department of Gastroenterology, Motility Unit, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico

    Mónica Zavala-Solares

  4. Department of Food Technology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Lorena Cassis-Nosthas

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  1. Carlos A Reyes-Torres
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Correspondence to Aurora E Serralde-Zúñiga.

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Reyes-Torres, C.A., Castillo-Martínez, L., Reyes-Guerrero, R. et al. Design and implementation of modified-texture diet in older adults with oropharyngeal dysphagia: a randomized controlled trial. Eur J Clin Nutr 73, 989–996 (2019). https://doi.org/10.1038/s41430-019-0389-x

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