Academic journal article Iranian Journal of Public Health

Rheological Characterization and Cluster Classification of Iranian Commercial Foods, Drinks and Desserts to Recommend for Esophageal Dysphagia Diets

Academic journal article Iranian Journal of Public Health

Rheological Characterization and Cluster Classification of Iranian Commercial Foods, Drinks and Desserts to Recommend for Esophageal Dysphagia Diets

Article excerpt


Background: In the absence of dysphagia-oriented food products, rheological characterization of available food items is of importance for safe swallowing and adequate nutrient intake of dysphagic patients. In this way, introducing alternative items (with similar ease of swallow) is helpful to improve quality of life and nutritional intake of esophageal cancer dysphagia patients. The present study aimed at rheological characterization and cluster classification of potentially suitable foodstuffs marketed in Iran for their possible use in dysphagia diets.

Methods: In this descriptive study, rheological data were obtained during January and February 2012 in Rheology Lab of National Nutrition and Food Technology Research Institute Tehran, Iran. Steady state and oscillatory shear parameters of 39 commercial samples were obtained using a Physica MCR 301 rheometer (Anton-Paar, GmbH, Graz, Austria). Matlab Fuzzy Logic Toolbox (R2012 a) was utilized for cluster classification of the samples.

Results: Using an extended list of rheological parameters and fuzzy logic methods, 39 commercial samples (drinks, main courses and desserts) were divided to 5 clusters and degree of membership to each cluster was stated by a number between 0 and 0.99.

Conclusion: Considering apparent viscosity of foodstuffs as a single criterion for classification of dysphagia-oriented food products is shortcoming of current guidelines in dysphagia diets. Authors proposed to some revisions in classification of dysphagia-oriented food products and including more rheological parameters (especially, viscoelastic parameters) in the classification.

Keywords: Esophagus cancer, Esophageal dysphagia, Rheology, Diet, Food Industry

(ProQuest: ... denotes formulae omitted.)


Dysphagia is a prevalent symptom which is com-mon in a wide range of diseases. Effects of dysphagia ranges from less-threatening conditions such as discomfort (e.g., chest pain) and psych-ological effects (such as embarrassment from cou-ghing) to more severe conditions and illnesses such as choking, aspiration (the food entering the airway and passing the vocal folds), aspiration pneumonia, dehydration, malnutrition and even death (1).

In a general view, dysphagia is divided to oropharyngeal and esophageal dysphagia. In re-cent years, there has been an increasing interest in the treatment of oropharyngeal dysphagia and most researches have not dealt with the esopha-geal dysphagia (2-4).

One of main causes of esophageal dysphagia is the esophagus cancer. Esophageal cancer is the 6th most common cause of cancer death in the world (5). Golestan Province in northeastern Iran is one of the famous high-risk areas with the age standardized rates (ASR) of more than 100/-100000 (6, 7).

Several attempts have been made to the introduce strategies to the management of dysphagia. Logemann classified three basic types of dysphagia treatment strategies as behavioral, medical and surgical. He also claimed that behavioral treatments could be the first and easiest treatments (8). One of the important behavioral treatments is diet modification and using thickened foodstuffs to control the flow rate of foodstuffs. In developed countries, health-concerning food companies pro-vide some choices (with certain rheological proper-ties) for dysphagic patients and healthcare teams and families are supplied with these products.

If there are not proper choices and alternative items in the diet of dysphagic patients, they may get susceptible to undergo malnutrition and lack of micro and macronutrients may have negative effects on their health (9, 10).

Losing eating pleasure and social interaction is another negative consequence of impaired swallowing. Therefore, several studies have re-vealed that, in addition to physical health effects, dysphagia may lead to serious psychosocial and wellbeing problems, especially among the elderly (11). …

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