maltodextrin and Deglutition-Disorders

Clinical management options for dysphagia include the use of thickeners to increase the consistency of liquids. Health professionals may not be aware of the nutrition value of these products, since there are no such recommendation in clinical guidelines. Our aim was to estimate the added nutrition value of the 2 types of commercial thickeners (starch and xanthan gum) to daily nutrition intake and compare their nutrition value for nectar, honey, and pudding consistencies. Additionally, we compared the nutrition value of both thickeners with a high-energy powder, since they share the same main ingredients.. We collected recommended dosages for obtaining the 3 different consistencies and nutrition content from the technical food labels. Daily intake of fluids was estimated from the Portuguese National Food, Nutrition and Physical Activity Survey. Total daily amount of thickener needed was estimated, as well as their correspondent nutrition contributions.. Estimated daily fluid intake was 2439 mL. Starch thickeners provide significantly more energy at all consistencies than xanthan gum provides (423-846 kcal, P < 0.05, and 103-308 kcal, P < 0.05, respectively). Significantly more fiber is provided by xanthan gum thickeners (9 g in nectar and 27 g in pudding consistencies, P < 0.05). Median energy and carbohydrate values per 100 g of high-energy powder modules and starch thickeners are similar.. The nutrition value of thickeners should be routinely considered in the nutrition assessment and planning of patients with dysphagia for liquids, since they contribute significantly with energy, carbohydrate, and fiber.

Topics: Beverages; Deglutition Disorders; Dietary Carbohydrates; Dietary Fiber; Honey; Humans; Nutrition Assessment; Nutritional Support; Nutritive Value; Plant Nectar; Polysaccharides; Polysaccharides, Bacterial; Portugal; Powders; Starch; Viscosity

Introduction: thickeners are widely used in swallowing disorders, both for diagnosis and to achieve a safe and effective diet. Recently, products composed of gums have been commercialized in the Spanish market in order to improve the organoleptic and physical qualities of thickened foods. Objective: to compare thickening agents of clinical scope marketed in Spain, and to verify their organoleptic and physical characteristics, to be used in the diagnostic procedures and the feeding of patients with dysphagia. Method: the organoleptic (appearance, colour, smell, taste, aftertaste) and physical (solubility, stability) properties of eight thickeners (4 classic starch-based and 4 new gum-based) were assessed in a sample of 44 healthy subjects. In addition, their usefulness in diagnostic tests was studied by mixing them with dyes and water-soluble contrasts. Results and conclusions: new-generation thickeners, based on gums, generally obtain better scores for their physical and organoleptic qualities than conventional thickeners. Starch thickeners are more suitable for diagnostic tests, as gum thickeners present some peculiarities in their mixtures with dyes and contrasts that must be taken into account in diagnostic tests.. Introducción: los espesantes son muy utilizados en los trastornos de la deglución, tanto para su diagnóstico como para conseguir una alimentación segura y eficaz. Recientemente se han comercializado en el mercado español productos compuestos por gomas con el fin de mejorar las cualidades organolépticas y físicas de los alimentos espesados. Objetivo: comparar agentes espesantes de ámbito clínico comercializados en España y verificar sus características organolépticas y físicas para ser utilizados en los procedimientos diagnósticos y en la alimentación del paciente con disfagia. Método: se valoraron las propiedades organolépticas (apariencia, color, olor, sabor y regusto) y físicas (solubilidad y estabilidad) de ocho espesantes (4 clásicos con almidón y 4 nuevos a base de gomas) en una muestra de 44 sujetos sanos. Además, se estudió su utilidad en las pruebas diagnósticas al mezclarlos con colorantes y contrastes hidrosolubles. Resultados y conclusiones: los espesantes de nueva generación, a base de gomas, obtienen en general mejores puntuaciones en sus cualidades físicas y organolépticas con respecto a los espesantes convencionales. Los espesantes con almidón son más adecuados en las pruebas diagnósticas, ya que los espesantes con gomas presentan algunas peculiaridades en las mezclas con colorantes y contrastes que deben ser tenidas en cuenta en dichas pruebas.

Topics: Adult; Color; Contrast Media; Deglutition Disorders; Female; Food Additives; Food Coloring Agents; Galactans; Healthy Volunteers; Humans; Mannans; Odorants; Plant Gums; Polysaccharides; Polysaccharides, Bacterial; Solubility; Spain; Starch; Taste; Young Adult

Oral feeding safety is necessary to provide nutrition, hydration, and eating pleasure for patients with dysphagia. Commercial thickeners are prescribed for these patients to change food viscosity and may alter the proper preparation of modified food.. Analyze composition, employed terminology, preparation instructions, recommended amount and weight of provided measuring spoons, nutritional information, and viscosity of 7 commercial thickeners.. The sample comprised all thickeners from different brands available in Brazil, named A to G. Products were submitted to viscosity analysis using viscometer and the International Dysphagia Diet Standardization Initiative (IDDSI) test. Samples were prepared with mineral water (25°C) and with the amount of thickener recommended to obtain intermediate viscosity (level 2) according to the manufacturer's instructions.. Products B, C, and E presented similar composition. Manufacturer's information about the amount and preparation procedure, time, temperature, and base liquid was incomplete. Viscosity tests revealed that thickener C was basically solid while D displayed results out of the desired viscosity level.. The study showed differences in components and viscosity, beyond the lack of label details. There was no established correlation between viscosity classifications provided by National Dysphagia Diet and IDDSI.

Topics: Beverages; Deglutition Disorders; Food Additives; Humans; Polysaccharides; Reproducibility of Results; Starch; Viscosity

Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification. The effect of a commercial polysaccharide thickener, designed to be added to fluids to promote safe swallowing by dysphagic patients, on rheology and acetaminophen dissolution was tested using crushed immediate-release tablets in water, effervescent tablets in water, elixir and suspension. The inclusion of the thickener, comprised of xanthan gum and maltodextrin, had a considerable impact on dissolution; acetaminophen release from modified medications reached 12-50% in 30 min, which did not reflect the pharmacopeia specification for immediate release preparations. Flow curves reflect the high zero-shear viscosity and the apparent yield stress of the thickened products. The weak gel nature, in combination with high G' values compared to G'' (viscoelasticity) and high apparent yield stress, impact drug release. The restriction on drug release from these formulations is not influenced by the theoretical state of the drug (dissolved or dispersed), and the approach typically used in clinical practice (mixing crushed tablets into pre-prepared thickened fluid) cannot be improved by altering the order of incorporation or mixing method.

Topics: Acetaminophen; Administration, Oral; Chemistry, Pharmaceutical; Deglutition; Deglutition Disorders; Drug Delivery Systems; Drug Liberation; Humans; Polysaccharides; Polysaccharides, Bacterial; Rheology; Solubility; Suspensions; Tablets; Viscosity; Water