Relationship among oral health status, bolus formation and food comfortability during consumption of model cheeses in elderly.

The aim of this study was to investigate the impact of oral impairment on chewing behaviour, food bolus properties and food comfortability during elderly consumption of model cheeses. Seventy-two elderly persons (aged 66 to 88) was recruited and classified into two groups according to dental status (poor vs. satisfactory). They showed a wide range of salivary flow rates whatever their dental status (stimulated: 0.2-3.8 mL min-1, resting: 0.1-0.8 mL min-1). Standardized bites of four model cheeses with an identical composition but different textures (soft, hard, processed and whipped) were tested. The time and number of chewing cycles required to form a bolus were measured. The rheological properties of the bolus were studied, as was saliva moistening. Food comfortability was assessed by means of a questionnaire composed of 5 sections (1-oral comfort, 2-bolus formation, 3-pain, 4-texture and 5-flavour perception). The chewing parameters measured were not modified by the oral health. However, elderly with poor dentition formed harder boluses than elderly with satisfactory dentition. Moreover, for elderly with poor dentition, the quantity of saliva incorporated into the bolus was correlated with the stimulated salivary flow rate, which was not the case for elderly with satisfactory dentition. General oral comfort and its different attributes were poorly associated with the oral health of the elderly. A multifactorial analysis performed on an average cheese showed that food comfortability is independent of changes in the hardness and moistening of the bolus, regardless of dental status. In particular, poor dental status increases the hardness of the bolus without modifying its comfortability.

Bolus quality and food comfortability of model cheeses for the elderly as influenced by their texture.

The aim of this study was to examine the influence of the texture of dairy products on bolus properties and food comfortability as perceived by elderly persons. Four cheese models identical in terms of their nutritional composition but different by the type of texture (Soft, Hard, Processed and Whipped) were developed to resemble market cheese. Study was performed with a panel of 38 elderly persons without dental impairment but with variable rate of saliva flow. The time of chewing required to form the bolus was measured. The rheological properties of the bolus obtained were studied as well as the quantity of saliva incorporated. Food comfortability was assessed by means of a questionnaire asking about in-mouth comfort, bolus formation, pain, and perceived texture and flavor. Results showed that food comfortability was positively correlated to the ease of forming the bolus which depended on the food texture. Thus, the bolus formed with the Whipped product which required more saliva, was harder than the other three products and so judged the least comfortable. This product was characterized by a dry and sticky texture. On the other hand, the Soft and Processed products led to a softer food bolus that was more easily formed, and thus were judged as more comfortable. Their textures were perceived as soft, fatty and melting. This work highlights the importance of considering food bolus formation and related properties when looking for the link between food product characteristics and the enjoyment of eating in the case of the elderly population.

Association between Salivary Hypofunction and Food Consumption in the Elderlies. A Systematic Literature Review.

OBJECTIVES: This systematic literature review aims to summarize the existing scientific evidence about the association between a reduced salivary function and food consumption in elderly people. METHODS: A validated search strategy in two databases (PubMed and ISI Web of Knowledge) was carried out and retrieved papers together with their reference lists were screened by two independent reviewers. The quality of the included studies was critically appraised via the Quality Assessment Criteria for Evaluating Primary Research Papers. RESULTS: From the originally identified studies (n=391), only 15 articles (all cross-sectional studies) met the pre-fixed inclusion/exclusion criteria. The methodological quality of the included studies was in general good, although only 3 from 15 obtained the maximum score. The control of confounding factors was the quality variable more poorly rated in the selected studies. Salivary hypofunction was associated with a decrease of the objective chewing and swallowing abilities and taste perception. Moreover, most of the selected studies showed a relationship between salivary hypofunction and food consumption (in terms of appetite loss, unbalanced dietary intake and malnutrition), although no causality could be established. CONCLUSIONS: This study highlights the fact that salivary hypofunction definition and measurements are different across the studies. Therefore, future research efforts should focus on establishing a gold standard to define and identify salivary hypofunction throughout life and on performing longitudinal studies controlling for confounding factors to establish causality.

Model cheese aroma perception is explained not only by in vivo aroma release but also by salivary composition and oral processing parameters.

The aim of the present paper was to determine, from four model cheeses differing in fat content and firmness and consumed by fourteen well characterised subjects, the respective impacts of in vivo aroma release, bolus rheology, chewing activity, mouth coating and salivary composition on dynamic aroma perception. The originality of the approach is that it considers all the parameters together and is able to evaluate their relative contribution using multi-block partial least square (MB-PLS) regression. The fruity aroma perception of the more hydrophilic compound (ethyl propanoate) was related to its dynamic release parameters before swallowing whereas the blue cheese aroma perception of the more hydrophobic compound (nonan-2-one) was related to its dynamic release parameters after swallowing and was highly impacted by mouth coating. Moreover the MB-PLS approach made it possible to evidence the combined effects of saliva composition and cross-modal interactions to understand why in some cases dynamic aroma perception could not be explained by dynamic in vivo aroma release data. Subjects with a low sodium content in saliva perceived fruity aroma which is not congruent with saltiness as less intense and salt- congruent (blue cheese) aroma as more intense, which was explained by their higher sensitivity to salt. Subjects with high lipolysis activity perceived fruity aroma which is not congruent to fat as less intense and fat-congruent (blue cheese) aroma as more intense, which should be explained by the link between lipolysis activity and fat sensitivity. These results could be considered for the reformulation of foods towards specific populations taking into account nutritional recommendations.

Inter-individual retronasal aroma release variability during cheese consumption: Role of food oral processing.

The aim of our study was to explain inter-individual differences on in vivo aroma release during cheese consumption by oral physiological parameters. To reach this objective, 34 subjects were recruited. Their salivary flow, oral volume and velum opening were determined. Six cheddar-based melted cheeses with different fat levels and firmness were flavoured with nonan-2-one (NO) and ethyl propanoate (EP). During their consumption (free protocol), in vivo retro nasal aroma release was followed by Atmospheric Pressure Chemical Ionisation-Mass Spectrometry (APCI-MS). Chewing activity was evaluated by electromyography recordings. Bolus saliva content, mouth-coating, and bolus rheology were also determined. Based on the quantity of aroma released before and after swallowing, subjects can be clustered into three groups: the first one (HRG) is characterized by a large quantity of aroma release whatever the aroma compound; the second one (MRG) showed a large release for EP and a lower one for NO; the third group (LRG) was characterized by a low quantity of aroma release whatever the compound. Whatever the group of subjects, fat and firmness effects differed according to the aroma compound. EP release increased with firmness and fat content, whereas NO release was not affected by firmness and decreased when fat content increased. Physiological parameters which better differentiated the three groups of subjects according to their release behaviour were chewing activity, mouth coating and frequency of velum opening. Subjects from HRG were differentiated from LRG subjects by a higher chewing activity, and more frequent velum opening. Subjects from MRG presented a lower mouth coating explaining their lower release of NO, the more hydrophobic compound. This study shows that the total amount of aroma released in the nasal cavity during food consumption depends not only on the characteristics of the product but also on the oral physiology of the subjects and on their food oral processing.

Solid cheese consumption: quantification of oral coating.

Mouth coating, defined as the residual food that sticks to the oral surface after food ingestion, plays an important role in both the delivery of food components and mouth feel and after-feel perceptions. The aim of this work was to adapt a rapid and simple instrumental method to the quantification of food remaining after the in vivo ingestion of a solid food. This method was investigated in 12 non-trained subjects who consumed four melted cheeses differing in terms of their fat and water contents. Mouth coating was determined by fluorescence measurements using curcumin, an oil-soluble dye that had been added to the cheeses during their preparation. The results obtained showed that this method was reproducible, reliable and discriminating and could be used for solid cheeses covering a broad range of textures.

Effects of food texture change on metabolic parameters: short- and long-term feeding patterns and body weight.

A complete diet was prepared with cooked pieces of meat, beans, cream starch, and water and presented to the rats in two different textures: a blended purée and a rough mixture that required a lot of chewing. We hypothesized that this texture modification might change both anticipatory reflexes and feeding behavior. Feeding rate, meal size, intermeal intervals, and their correlation were monitored in response to each texture. The long-term (6 wk) effect on body weight was assessed. Periprandial plasma glucose, insulin, glucagon, and lipid concentrations were assayed. Whole and background metabolism, respiratory quotient, and locomotion were measured using a computerized calorimeter of original design. In the short term, rats preferred the mixture. However, after 3 wk, they ingested more purée than mixture and gained more body weight per gram of food ingested as purée. Insulin response declined earlier with the mixture. During meals, glycerol and free fatty acid increased earlier with purée, whereas in the postprandial period, glycerol increased earlier with mixture. The metabolic rate, however, was not significantly affected. We concluded that texture, an everyday manipulation performed on food for human consumption, affects not only palatability of ingestants but also their metabolic management in the short and long term.