Age related impairments in ingestion from a large population based-sample.

OBJECTIVES: Epidemiological data regarding the evolution of problems related to mastication and swallowing with age are lacking. This study aims to (i) describe changes in oral function with age, using data from a large French population, (ii) validate online, self-report uses of an ICF questionnaire in older persons, and (iii) assess whether impairment is related to avoidance of certain foods, xerostomia, body mass index (BMI) and oral health related quality of life (OHRQoL). METHODS: Volunteers aged ≥18 years with internet access completed a series of questionnaires on sociodemographic, anthropometric and oral health characteristics (oral function, Xerostomia Index (XI), OHRQoL, reasons for avoidance of certain food). Oral function was assessed using items derived from the International Classification of Functioning (ICF). Five ICF items related to ingestion function and six items related to activities and participation were used. A validation study was undertaken to identify those with poor chewing ability and low salivary flow amongst older participants reporting impairment. FINDINGS: 39 597 individuals were included. The prevalence of individuals with impairment for ICF items related to ingestion function and oral activity (eating, drinking and speaking), and the percentage of participants with poor OHRQoL increased significantly with age (p < 0.001). Each ICF item was significantly associated with OHRQoL (p < 0.001), XI (p < 0.001), BMI (p < 0.001) and avoidance of certain food due to chewing or swallowing difficulties. CONCLUSION: Overall, 21.5% and 13.5% of the study population had chewing and/or biting impairments respectively, which might affect food selection and consumption. These findings raise individual and population-based issues. Further studies are needed to assess whether impairment in oral function might increase frailty in older individuals, and also to compare data with those from other countries.

Food matrix structure (from Biscuit to Custard) has an impact on folate bioavailability in healthy volunteers.

PURPOSE: We examined the impact of matrix food structure on post-prandial folate bioavailability (and other macronutrients) in human volunteers using a randomized, controlled, crossover experimental design. METHODS: Twelve healthy male volunteers (22.6 ± 0.4 years old) were offered four food models (differing in matrix structure: Custard, Pudding, Sponge cake and Biscuit) to which 1 mg of folic acid was added, according to a randomized, controlled, crossover experimental design. Plasma folates, glucose, insulin, alpha amino nitrogen and triglycerides were measured over the post-prandial period (from T0 to T480 min). RESULTS: Food matrix structure was capable of altering folate plasma availability. The highest folate availability was observed for pudding and to a lesser extent Sponge cake whereas the lowest was for the two matrices presenting extreme rheological properties: Custard (liquid) (P < 0.05 total AUC) and to a lesser extent Biscuit (hard solid) (P < 0.05, AUC 180 min). The analysis of plasma kinetics of appearance of other nutrients/metabolites helps to understand/explain the lower bioavailability of folates in Custard and Biscuit. CONCLUSION: A least overall efficient bio-accessibility of all macronutrients and folic acid is observed in the gut lumen for Biscuit (delayed/incomplete destructuration of biscuit along the digestive tract). On the contrary, the lower folic acid absorption observed with custard does not fit with the rapid plasma appearance of other nutrients and should require further investigation.

Consensus on the terminologies and methodologies for masticatory assessment.

A large number of methodological procedures and experimental conditions are reported to describe the masticatory process. However, similar terms are sometimes employed to describe different methodologies. Standardisation of terms is essential to allow comparisons among different studies. This article was aimed to provide a consensus concerning the terms, definitions and technical methods generally reported when evaluating masticatory function objectively and subjectively. The consensus is based on the results from discussions and consultations among world-leading researchers in the related research areas. Advantages, limitations and relevance of each method are also discussed. The present consensus provides a revised framework of standardised terms to improve the consistent use of masticatory terminology and facilitate further investigations on masticatory function analysis. In addition, this article also outlines various methods used to evaluate the masticatory process and their advantages and disadvantages in order to help researchers to design their experiments.

Effect of salivary fluid characteristics on the physical features of in vitro bread bolus: From the absence of saliva to artificially simulated hypersalivation.

Saliva facilitates food oral processing, bolus formation, swallowing, and sensory perception, in addition to contributing to oral health and phonation. Ageing, health affections, and polymedication are among many causes altering salivary production, modifying the mastication process, the food impregnation ratio, and in turn altering the characteristics of the bolus, swallowing, and digestion. In this in vitro work, using the AM2 masticator apparatus, which replicates the mechanical actions taking place while chewing solid foods and produces realistic food bolus in various oral conditions, we investigated the effect of salivary fluid characteristics, i.e., composition, quantity (from absence to hypersalivation), temperature, and enzymatic action, on the physical characteristics (i.e., particle size distribution (PSD), bolus mass, salivary fluid content) of in vitro boluses of Traditional French baguette. A ready-to-swallow bolus of baguette displayed on average a d50 value (median particle size by mass) of 4.1 ± 0.4 mm, with saliva fluid constituting âˆ¼ 35 % of the final bolus mass. The absence of saliva in mouth led to a deficient oral processing, forming bread boluses constituted by extremely big particles (ca. 80 % of particles had a size > 7.1 mm) that likely cannot be swallowed safely. On the contrary, an excess of saliva favoured an excessive breaking down of bread, leading to bread boluses constituted by smaller particles than those formed under healthy salivary conditions (d50 decreased from 4.1 mm to 3.1 mm), having a higher salivary fluid content (+10 %). On the other hand, the salivary fluid temperature did not affect PSD, d50, bolus mass, or salivary fluid content of in vitro bread boluses, however, the addition of human salivary α-amylase did, favouring particle size reduction (d50 decreased to 2.6 mm). Therefore, beyond the correlation between bolus hydration by saliva and food properties such as hardness and moisture content, our findings indicate that the quantity of salivary fluid present in the oral cavity and the enzymatic activity of salivary α-amylase during bread mastication significantly influence both the particle size distribution and the fluid content of bread boluses, ultimately determining the physical properties of the bolus and, therefore, potentially impacting the subsequent swallowing process.

Fava bean (Vicia faba L.) protein concentrate added to beef burgers improves the bioaccessibility of some free essential amino acids after in vitro oral and gastrointestinal digestion.

The influence of partial replacement of animal protein by plant-based ingredients on the protein digestibility of beef burgers was investigated. Beef burgers were supplemented with fava bean protein concentrate (FB) or a mixture of FB and flaxseed flour (FBFS), both processed by extrusion, at different levels: 0 (control), 10, 15, and 20 % (w/w). A pilot sensory analysis was conducted to select the percentage of flour inclusion for further assays: control, 10 % FB, and 10 % FBFS. Protein digestibility, amino acid profile, and protein secondary structure of these burgers after in vitro oral and gastrointestinal digestion were studied. In vitro boluses were prepared with the AM2 masticator, simulating normal mastication, and static in vitro digestion of boluses was performed according to the INFOGEST method. Inclusion of 10 % FB in beef burgers did not alter their flavour or tenderness compared to the control, whereas tenderness and juiciness scored slightly higher for the 10 % FBFS burgers compared to 15 % and 20 % FBFS ones. Poor lipid oxidative stability during storage was observed with 10 % FBFS burgers. Total protein content was significantly higher (p < 0.05) in 10 % FB burgers than in control burgers after in vitro oral digestion. Additionally, 10 % FB burgers presented higher amounts of free essential amino acids like isoleucine, leucine, phenylalanine, and valine at the end of digestion, as well as methionine, tyrosine, and histidine. Partial substitution of meat protein by 10 % FB improves the nutritional profile of beef burgers, without altering their sensory qualities.

Contributory role of the tongue and mandible in modulating the in-mouth air cavity at rest.

OBJECTIVES: The tongue-to-palate distance influences the volume of the in-mouth air cavity (IMAC), thus conditioning the entry of aromatic compounds to the olfactory mucosa site. This study was set out to record the IMAC volume by measuring tongue-to-palate distance at rest. MATERIALS AND METHODS: Twelve young adults in good general health were tested--lips contacting, with at-rest posture of the tongue and jaw during a silent reading task. Observations in this study were limited to pre- and post-swallowing sequences. The tongue-to-palate distance was measured using three electromagnetic sensors placed on the tongue upper surface. IMAC volume was evaluated from a geometrical model, taking into account the tongue-to-palate distance, the IMAC transversal distance measured from dental casts and historic data giving the anterior-posterior distance of the oral cavity. RESULTS: (1) In the at-rest posture, the tongue-to-palate distance was significantly greater at the posterior sensor level. (2) A vertical shift in tongue posture at rest frequently appeared following deglutition. The upward shifts were of larger amplitude and more frequent than the downward shifts. (3) Evaluation of the IMAC volume gave an approximate value of 12 ml at rest. (4) The chin sensor at rest was 2.8 ± 0.8 mm below its position when in occlusion. CONCLUSION: The tongue and mandible contribute to shaping the IMAC volume. CLINICAL RELEVANCE: These and other results suggest that deglutition changes tongue-to-palate distance and influences aroma release during mastication/deglutition acts through modulation of the IMAC volume.

Oral and gastrointestinal nutrient bioaccessibility of gluten-free bread is slightly affected by deficient mastication in the elderly.

The main goal of this work was to investigate the impact of impaired mastication on nutrient bioaccessibility of gluten-free bread in the elderly. In vitro boluses were produced with the AM2 masticator by using two types of programming: normal mastication (NM) and deficient mastication (DM). Static in vitro gastrointestinal digestion was performed with the digestive physiology conditions of the elderly. Subsequently, the granulometric properties of the in vitro boluses produced, their starch and protein digestibility, and lipid peroxidation after in vitro oral and gastrointestinal digestion were evaluated. DM boluses presented higher proportions of large particles, resulting in insufficiently fragmented boluses. A delay in oral starch digestion was observed in DM boluses, probably due to the presence of larger particles that limited the bolus-saliva exchanges. Furthermore, DM boluses exhibited a lower degree of protein hydrolysis at the end of gastric digestion, whereas no differences were observed for protein hydrolysis, sugar release, and lipid peroxidation at the end of digestion (intestinal phase). The results of this study show that impaired mastication somewhat delays the nutrient bioaccessibility of the gluten-free bread tested. Such understanding of the effect of oral decline on the nutrient bioaccessibility of foods is crucial when designing food commodities with enhanced functionalities for the elderly.

Contrarily to whey and high protein diets, dietary free leucine supplementation cannot reverse the lack of recovery of muscle mass after prolonged immobilization during ageing.

During ageing, immobilization periods increase and are partially responsible of sarcopaenia by inducing a muscle atrophy which is hardly recovered from. Immobilization-induced atrophy is due to an increase of muscle apoptotic and proteolytic processes and decreased protein synthesis. Moreover, previous data suggested that the lack of muscle mass recovery might be due to a defect in protein synthesis response during rehabilitation. This study was conducted to explore protein synthesis during reloading and leucine supplementation effect as a nutritional strategy for muscle recovery. Old rats (22­24 months old) were subjected to unilateral hindlimb casting for 8 days (I8) and allowed to recover for 10­40 days (R10­R40). They were fed a casein (±leucine) diet during the recovery. Immobilized gastrocnemius muscles atrophied by 20%, and did not recover even at R40. Amount of polyubiquitinated conjugates and chymotrypsin- and trypsin-like activities of the 26S proteasome increased. These changes paralleled an 'anabolic resistance' of the protein synthesis at the postprandial state (decrease of protein synthesis, P-S6 and P-4E-BP1). During the recovery, proteasome activities remained elevated until R10 before complete normalization and protein synthesis was slightly increased. With free leucine supplementation during recovery, if proteasome activities were normalized earlier and protein synthesis was higher during the whole recovery, it nevertheless failed in muscle mass gain. This discrepancy could be due to a 'desynchronization' between the leucine signal and the availability of amino acids coming from casein digestion. Thus, when supplemented with leucine-rich proteins (i.e. whey) and high protein diets, animals partially recovered the muscle mass loss.

Muscle wasting and resistance of muscle anabolism: the "anabolic threshold concept" for adapted nutritional strategies during sarcopenia.

Skeletal muscle loss is observed in several physiopathological situations. Strategies to prevent, slow down, or increase recovery of muscle have already been tested. Besides exercise, nutrition, and more particularly protein nutrition based on increased amino acid, leucine or the quality of protein intake has generated positive acute postprandial effect on muscle protein anabolism. However, on the long term, these nutritional strategies have often failed in improving muscle mass even if given for long periods of time in both humans and rodent models. Muscle mass loss situations have been often correlated to a resistance of muscle protein anabolism to food intake which may be explained by an increase of the anabolic threshold toward the stimulatory effect of amino acids. In this paper, we will emphasize how this anabolic resistance may affect the intensity and the duration of the muscle anabolic response at the postprandial state and how it may explain the negative results obtained on the long term in the prevention of muscle mass. Sarcopenia, the muscle mass loss observed during aging, has been chosen to illustrate this concept but it may be kept in mind that it could be extended to any other catabolic states or recovery situations.

Comprehensive Dental Treatment under General Anesthesia Improves Mastication Capability in Children with Early Childhood Caries-A One-Year Follow-Up Study.

BACKGROUND: Using the granulometry of ready-to-swallow food boluses, this study investigated the evolution of masticatory capability of children with Early Childhood Caries (ECC) after comprehensive dental treatment under general anesthesia (GA). METHODS: Sixteen children with ECC were assessed before and over one year after dental treatment under GA, in comparison with 12 children with a Healthy Oral State (HOS). Oral health criteria, quality of life, body mass index, and frequency of orofacial dysfunctions were recorded. Masticatory kinematic parameters and median food bolus particle size (D50) at swallowing were assessed while masticating raw carrot (CAR), cheese (CHS), and breakfast cereals (CER). The impact of posterior teeth extractions was analyzed. RESULTS: Quality of life and orofacial functions improved after dental treatment. Chewing frequency for all three foods increased without reaching the values of children with HOS, while D50 values for CAR and CHS decreased. After one year, children with posterior teeth extractions exhibited higher D50 values for CAR and CHS than children with only conservative treatment. One third of children with ECC were overweight or obese. CONCLUSIONS: Comprehensive dental treatment improved children's mastication, and their BMI subsequently increased. Links between mastication and nutrition should be investigated further in children.

In vitro models of gut digestion across childhood: current developments, challenges and future trends.

The human digestion is a multi-step and multi-compartment process essential for human health, at the heart of many issues raised by academics, the medical world and industrials from the food, nutrition and pharma fields. In the first years of life, major dietary changes occur and are concomitant with an evolution of the whole child digestive tract anatomy and physiology, including colonization of gut microbiota. All these phenomena are influenced by child exposure to environmental compounds, such as drugs (especially antibiotics) and food pollutants, but also childhood infections. Due to obvious ethical, regulatory and technical limitations, in vivo approaches in animal and human are more and more restricted to favor complementary in vitro approaches. This review summarizes current knowledge on the evolution of child gut physiology from birth to 3 years old regarding physicochemical, mechanical and microbial parameters. Then, all the available in vitro models of the child digestive tract are described, ranging from the simplest static mono-compartmental systems to the most sophisticated dynamic and multi-compartmental models, and mimicking from the oral phase to the colon compartment. Lastly, we detail the main applications of child gut models in nutritional, pharmaceutical and microbiological studies and discuss the limitations and challenges facing this field of research.

Important determinants to take into account to optimize protein nutrition in the elderly: solutions to a complex equation.

During ageing, skeletal muscle develops anabolic resistance towards the stimulation of protein synthesis induced by dietary amino acids. The stimulation of muscle protein synthesis after food intake remains insufficient, even with a protein intake recommended for healthy adults. This alteration is one of the mechanisms known to be responsible for the decrease of muscle mass and function during ageing, namely sarcopenia. Increasing dietary protein intake above the current RDA(0⋅83 g/kg/d) has been strongly suggested to overcome the anabolic resistance observed. It is also specified that the dietary protein ingested should be of good quality. A protein of good quality is a protein whose amino acid (AA) composition covers the requirement of each AA when ingested at the RDA. However, the biological value of proteins may vary among dietary sources in which AA composition could be unbalanced. In the present review, we suggest that the quality of a dietary protein is also related to several other determinants. These determinants include the speed of digestion of dietary proteins, the presence of specific AA, the food matrix in which the dietary proteins are included, the processes involved in the production of food products (milk gelation and cooking temperature), the energy supply and its nature, and the interaction between nutrients before ingestion. Particular attention is given to plant proteins for nutrition of the elderly. Finally, the timing of protein intake and its association with the desynchronized intake of energetic nutrients are discussed.

Do implant-supported prostheses affect bioavailability of nutrients of complete and partially edentulous patients? A systematic review with meta-analysis.

BACKGROUND & AIMS: Debate still exists about the impact of dental implant-supported prostheses on nutritional status of partially and complete edentulous patients. This review aims to answer the focused question: "Do complete and partial edentulous patients, using implant-supported prostheses, present better nutritional and masticatory functions when compared to those using conventional rehabilitations?". A possible cause-effect relationship between masticatory improvements and nutritional gain was also evaluated. METHODS: Literature search included 6 databases (PubMed/Medline, Embase, LILACS, Scopus, Web of Science, and The Cochrane Library - CENTRAL), grey literature (Google Scholar, Proquest Dissertations and Thesis and Open Grey databases) and manual search (last update June 2020), without language, publication time and follow-up restrictions. We included only studies evaluating both masticatory and nutritional outcomes. The PICO question comprised complete and partial edentulous patients (Population), submitted to implant-supported prostheses (Intervention), in comparison to conventional dental prosthetic rehabilitation, evaluating masticatory function and nutrition parameters (outcomes). Risk of bias was assessed by using Cochrane Collaboration's tool (randomized clinical trials), Joanna Briggs Institute critical appraisal checklist (paired clinical trials), and Meta-Analysis of Statistics Assessment and Review Instrument" (JBI - MAStARI) critical appraisal tools (cohort studies). All meta-analyses were conducted at 5% level of significance. This report followed the PRISMA guidelines. (Review registration PROSPERO - CRD42019135744). RESULTS: We identified 1199 articles while searching databases. Fourteen articles met eligibility criteria, including 817 prostheses installed in 660 patients (mean age = 66.8 years-old). Patients wearing implant overdentures (IOD) presented better masticatory function in comparison to conventional complete denture (CD) wearers (p < 0.05). However, bioavailability of several nutrients remained within the same range, except for serum folate that was lower in IOD patients after 6 (mean difference 3.51 nmol/L; p = 0.01) and 12 months of rehabilitation (mean difference 3.69 nmol/L; p = 0.003). When comparing the effects of CD and IOD rehabilitations along time (for the same patient), serum albumin and vitamin B12 levels also decreased for both groups after 12 months-follow-up, but still within the reference range. The additional retention of the implants did not interfere in body weight, but reduced the risk of malnutrition (using the Mini Nutritional Assessment). Implant-supported partial prostheses also improved mastication in comparison to the conventional ones, increasing short-term daily intake of carbohydrates, protein, calcium, fiber, and iron, whereas decreasing the consumption of cholesterol. However, no long-term changes on bioavailability of most nutrients were observed, expect for a slight increase in ferritin and cholinesterase, and a small reduction in folate and Vitamin A. CONCLUSION: Current evidence indicates significant masticatory improvements for dental fixed implant-supported prostheses in comparison to conventional removable prostheses. However, bioavailability remained stable for most of the nutrients, especially for complete edentulous patients. These results indicate the importance of a multidisciplinary approach during oral rehabilitation (nutrient specialist), in order to enhance food choices and promote health benefits to the patients.

Masticatory Adaptation to Occlusal Changes.

This review deals with the frequent wide variability of masticatory capacity/incapacity. Neither researchers nor clinicians have taken sufficient account of this variability despite its implications for nutrition. Mastication in normal healthy oral conditions is first described, followed by a short presentation of the mechanisms of masticatory adaptation in the nervous system. Capacity, incapacity, and successful compensatory adaptation of mastication are then defined, along with the different methods used for their evaluation. Examples of adaptation needs are given, such as those concomitant with dental wear or occlusal changes. Finally, given its vital importance for deeply impaired mastication/deglutition function, the impact of masticatory adaptation processes on nutrition is examined.

Natural food mastication capability in preschool children according to their oral condition: A preliminary study.

This study investigated, for the first time, the masticatory capability of preschool children using natural foods, and the impact of an early oral health alteration (early childhood caries: ECC) on the granulometry of ready-to-swallow food boluses. Thirteen children with ECC were compared to 13 preschool children with a healthy oral condition. Oral health criteria and NOT-S scores (Nordic Orofacial dysfunction Test-Screening) were recorded. For each child, number of masticatory cycles (Nc), chewing time (Ti), and frequency (Fq = Nc/Ti) were recorded during mastication of raw carrot (CAR), cheese (CHS) and breakfast cereals (CER) samples. Food boluses were collected by stopping children at their food-dependent individual swallowing threshold (Nc), and the median food bolus particle size value (D50) was calculated. Correlations were sought between oral health and masticatory criteria. In the ECC group, mean Fq values were significantly decreased for all three foods (p ≤ .001) and mean D50 values were significantly increased (p ≤ .001) compared to the control group (i.e., D50 CAR = 4,384 µm ± 929 vs. 2,960 µm ± 627). These alterations were related to the extent of ECC. The NOT-S mean global score was significantly increased in children with ECC (2.62 ± 1.37 vs. 1 ± 0.91 in the control group, p ≤ .01), due to "Mastication and swallowing" domain impairment. This study gives granulometric normative values for three foods in preschool children and shows the impact of ECC on D50 values. The progression of children's masticatory capability after dental treatment, and the impact of such modifications of sensory input on future eating habits should be explored.

Food Structure Modulates the Bioavailability of Triglycerides and Vitamin D, and Partly That of Lutein: A Randomized Trial with a Crossover Design in Adults.

SCOPE: The specific effect of the food matrix structure on fat-soluble micronutrient bioavailability is only partly understood. Evaluating fat-soluble micronutrient bioavailability after consumption of foods displaying similar composition but different structure is aimed at. METHODS AND RESULTS: Twelve healthy subjects are enrolled in a randomized, open label, crossover postprandial trial. Four different model foods are tested: custard, pudding, sponge cake, and biscuit. Vitamin D3 , lutein, and triglyceride chylomicron responses, evaluated as postprandial areas under the curve, are then assayed. Custard triglyceride response is higher than pudding and biscuit responses (up to +122.7%, p < 0.0001). Sponge cake vitamin D3 response is higher than biscuit response (+26.6%, p = 0.047). No difference between the model foods are observed regarding lutein responses. Triglyceride responses peak at 3 h for all conditions, while vitamin D3 and lutein peaks are delayed by 1 h with the biscuit matrix compared to other model foods. CONCLUSION: Food structure can significantly impact on triglyceride and vitamin D3 bioavailability in terms of absorbed amounts and/or maximum absorption time. The data highlight positive correlations between triglyceride, vitamin D, and lutein nutrient responses. These results are of particular interest to develop functional foods for population subgroups such as the elderly.

Which variables should be controlled when measuring the granulometry of a chewed bolus? A systematic review.

The distribution of food particles in a chewed bolus characterizes the food destruction after food oral processing (FOP). Previous reviews report that it could be affected by a lot of parameters as the number of chewing strokes, the dental status, but the conditions for producing reproducible data allowing inter-studies comparison have not been clearly described yet. This systematic review aims to identify the variables that can affect bolus granulometry determination, and to calculate their relative weights in the median particle size (D50 ) variations. The systematic review focuses on granulometry expressed as D50 of the most used foods (peanuts, carrots, and almonds) and materials (Optosil and Optocal). Based on 58 studies, 5 variables among 60 being extracted could explain the D50 variations. Conceptual differences between the conditions for FOP should be considered. After Chewing-test, the bolus is collected after a predefined number of strokes and its granulometry characterizes the effects of the dental and muscular apparatus on food destruction, while after Mastication-test the bolus is collected at the swallowing threshold, and its granulometry reflects the outcome of the abilities of the subject to adapt his/her mastication behavior to food texture. Experimental conditions related either to physical sieving or image analysis used to analyze the collected boluses impact the D50 values. Finally, when type of test, sieving conditions, type of food or material, number of chewing strokes, and the oral status of the subjects are controlled, mean D50 values are reproducible and could be used for inter-studies comparisons. PRACTICAL APPLICATIONS: This review provides tables that could be useful to control mean D50 variations in further research.

Masticatory behavior for different solid foods in preschool children according to their oral state.

Gradual introduction of solid foods in early childhood takes part in the maturation of mastication. The impact of any oral state alteration on food oral processing development is poorly documented for this age group. This study investigated the masticatory behavior in 3 to 6 year-old children with or without early childhood caries (ECC) for three solid foods of different textures. Twenty-one children with healthy oral state and 23 children with severe ECC were observed during complete mastication of calibrated samples of raw carrot, cheese and breakfast cereals. Food refusals and kinematic parameters (Ti: chewing time, Nc: number of cycles and Fq: chewing frequency) were used to assess children masticatory behavior. Oral Health-related Quality of Life and orofacial dysfunctions were evaluated using, respectively the early childhood oral health impact scale (ECOHIS) and the Nordic orofacial dysfunction test screening (NOT-S). Children suffering from ECC exhibited significantly higher ECOHIS and NOT-S scores, in particular for the mastication domain. Accordingly, lower chewing frequencies values were recorded in children with ECC (i.e., carrot Fq: 1.21 ± 0.20 vs 1.35 ± 0.22, p ≤ 0.01), as well as more frequent refusals for carrots. Kinematic parameters were shown to be repeatable in all children for successive samples of the same food, and tended to vary depending on the proposed food. Some masticatory behavior regulation according to food properties could already be present in preschool children. Children with ECC developed alternative behavioral strategies to overcome feeding difficulties. Further studies should investigate food bolus properties according to oral health, as well as nutritional issues. PRACTICAL APPLICATIONS: During childhood, the way solid foods are processed in the oral cavity to be safely swallowed and then digested in available nutrients, is poorly documented. In this study, preschool children have been shown to repeatedly adapt their masticatory behavior to a given food. The collection of various food boli as recorded at the moment of swallowing could then be considered in further food bolus properties research investigations. Moreover, this study suggested that children with altered dentition modified their masticatory kinematic parameters and developed alternative strategies, including food or texture selection, to overcome their feeding difficulties. The development of a mastication evaluation protocol could help medical professionals to detect children masticatory deficiencies and then propose diet adaptations. Considering the importance of food diversity in mastication development and maturation, food industries may consider to develop a range of texture adapted foods for young children, especially designed to gradually rehabilitate the masticatory function.

Effect of occlusal appliance wear on chewing in persons with Down syndrome.

The effects of Down syndrome (DS) include orofacial dysmorphology with neuro-motor difficulties and inter-maxillary discrepancy. It is unclear whether improving the inter-arch relationship would suffice to overcome feeding difficulties in persons with DS. This randomized, double-blind, placebo-controlled crossover study is a first step in evaluating the impact of wearing an orthetic intra-oral appliance on chewing variables in 8 subjects with DS (4 males and 4 females; mean age: 27.6+/-6.1 years). The primary chewing variables were measured through video and electromyographic (EMG) recordings. Secondary variables were (i) modifications in oral health status using the oral assessment for Down syndrome (OADS) questionnaire, (ii) number of inter-arch contacting units (ICUs), (iii) subjects' compliance in wearing the appliance and (iv) subjects' preference between placebo and occlusal appliances. The simultaneous use of EMG and video recordings revealed the presence of lower jaw movements not corresponding to EMG activities in the masticatory muscles. Compared with the pre-treatment situation, wearing an occlusal appliance decreased chewing frequency and increased masticatory time. It is not known whether these changes were indicative of an improvement or a worsening of masticatory function. Persons with DS did not fully adapt to changes in food hardness. A large inter-subject variability was noted, but pre-treatment individual values were not predictive of appliance effect. The maintenance of the number of ICUs obtained at the first installation of appliance and the responses to OADS and satisfaction questionnaires suggested that patients felt more comfortable and that jaw and tongue protrusion were reduced with the appliance.

At same leucine intake, a whey/plant protein blend is not as effective as whey to initiate a transient post prandial muscle anabolic response during a catabolic state in mini pigs.

BACKGROUND: Muscle atrophy has been explained by an anabolic resistance following food intake and an increase of dietary protein intake is recommended. To be optimal, a dietary protein has to be effective not only to initiate but also to prolong a muscle anabolic response in a catabolic state. To our knowledge, whether or not a dairy or a dairy/plant protein blend fulfills these criterions is unknown in a muscle wasting situation. OBJECTIVE: Our aim was, in a control and a catabolic state, to measure continuously muscle anabolism in term of intensity and duration in response to a meal containing casein (CAS), whey (WHEY) or a whey/ plant protein blend (BLEND) and to evaluate the best protein source to elicit the best post prandial anabolism according to the physio-pathological state. METHODS: Adult male Yucatan mini pigs were infused with U-13C-Phenylalanine and fed either CAS, WHEY or BLEND. A catabolic state was induced by a glucocorticoid treatment for 8 days (DEX). Muscle protein synthesis, proteolysis and balance were measured with the hind limb arterio-venous differences technique. Repeated time variance analysis were used to assess significant differences. RESULTS: In a catabolic situation, whey proteins were able to initiate muscle anabolism which remained transient in contrast to the stimulated muscle protein accretion with WHEY, CAS or BLEND in healthy conditions. Despite the same leucine intake compared to WHEY, BLEND did not restore a positive protein balance in DEX animals. CONCLUSIONS: Even with WHEY, the duration of the anabolic response was not optimal and has to be improved in a catabolic state. The use of BLEND remained of lower efficiency even at same leucine intake than whey.