2021 Volume 25 Issue 3 Pages 215-221
Objective: As there are few hospitals and nursing homes providing dysphagia diets that have texture measuring devices, texture-modified diets in the Japanese Dysphagia Diet 2013 (JDD2013) are not described based on physical properties but by text explanations. Therefore, the interpretation of these descriptions differs among facilities, especially for Code 4 of JDD2013. In this study, two types of simplified evaluation methods for determination of hardness of food were investigated: one method using a rod and an electronic scale (scale method) and the other using a cap with a protrusion and a PET bottle (PB method).
Methods: Thirty-four types of processed foods and fresh foods were used as samples. They were cut into 20 mm long, 20 mm wide and 10 mm tall pieces. Samples were placed on the stage using a creepmeter (RE2-3305C, Yamaden Co., Ltd.) and a cylindrical plunger of 5 mm diameter was plunged into the sample. Samples were kept at 20±2℃, and the plunging rate was 1 mm/s. Hardness was calculated from the highest point as the distortion factor of 0–90%. In the scale method, the sample placed on the electronic scale was compressed using a rod of 5 mm diameter, and the maximum weight displayed until the rod penetrated the sample was measured. In the PB method, a cap with a cylindrical protrusion of 5 mm diameter was attached to a PET bottle, and the bottle was filled with water so that the pressure at the tip of the protrusion when the bottle was inverted was 100 kPa or 200 kPa. When the tip of the protrusion placed in the center of the sample could penetrate the sample, the hardness of the food was estimated to be ＜100 kPa or 200 kPa.
Results: Measurements obtained using a creepmeter showed that the hardness of the samples was 7 to 564 kPa. Spearman's correlation coefficient between the values obtained using the scale method and hardness by a creepmeter was 0.956 to 0.969, showing a strong positive correlation. In the PB method, hardness was estimated in the following three levels: ＜100 kPa, 100―200 kPa, and ≥ 200 kPa. However, the results of the PB method and hardness by a creepmeter did not agree for seven samples.
Conclusions: Both the scale method and the PB method can be used as simplified evaluation methods to determine food hardness for the dysphagia diet Code 4.
