2010 Volume 14 Issue 1 Pages 17-26
[Objective] We aimed to evaluate the rationality of the proposed standard regulations of “Foods for people with difficulty in swallowing” compiled as a part of the “Food for Special Dietary Uses,” formulated by the Ministry of Health, Labour and Welfare in Japan in 2008, by comparing the subjective opinions of clinicians with the findings of objective measurements.
[Methods] We investigated the correlation between rheological measurements and clinicians’ subjective evaluation about the jelly, which was prescribed to people with severe dysphagia. Fifty-two clinicians who had treated cases of dysphagia for at least 1 year participated in the study. Eight jellies with different textures were used. The clinicians were required to assign the jellies to the level of dysphagia either to Standard Regulation levels I, II, or III or to “no suitable level” on the basis of their subjective evaluation. The physical properties of the jellies were measured using texture profile analysis, and the ratios of syneresis were measured.
[Results] The findings of the comparison were as follows: the values of the lower limit of hardness mentioned in Standard Regulation I and adhesiveness mentioned in Standard Regulations I and II were too high and that the value of the upper limit of hardness mentioned in Standard Regulation II was too low. Compared to other jellies, the jellies that were assigned to “no suitable level” were more frequently evaluated as “seems to undergo syneresis” or “liquefy in the mouth.”
[Conclusion] The findings of our study suggested that (1) the lower limit of hardness mentioned in Standard Regulation I should be revised to 2,500 N/m2, (2) the upper limit of hardness mentioned in Standard Regulation II should be revised to 15,000 N/m2, and (3) no lower limit should be assigned to adhesiveness in all the levels of the Standard Regulation. Further research is required to determine a method for measuring the ratios of syneresis of jellies and to apply the findings of this method to determine the diets for individuals with difficulty in swallowing.
