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.

Impact of blade tenderization, marinade and cooking temperature on oral comfort when eating meat in an elderly population.

Several studies demonstrated that oral health impairment, such as tooth loss or a decrease in salivary flow might lead elderly people to reduce their meat intake. The present study assessed the impact of culinary processes liable to improve meat texture and smooth down meat oral processing, in order to fulfil the oral capacities of elderly people. Four culinary processes were selected: cooking bag, blade tenderizer, marinade and low-temperature cooking. A panel of 40 elderly participants with good and poor dental status were asked to assess 5 chicken breast samples, 5 roast beef samples and 4 beefsteak samples prepared according to different process conditions by using an "oral comfort" questionnaire. Results highlighted the fact that oral impairment may alter food bolus formation as well as texture perception while eating meat in elderly people. Furthermore, they revealed that easy-to-do culinary processes may improve meat tenderness and juiciness as well as smooth down food bolus formation, in particular for the roast beef.

Using food comfortability to compare food's sensory characteristics expectations of elderly people with or without oral health problems.

Food consumption is by far the most important point where food's organoleptic properties can be perceived and can elicit sensory pleasure. Ageing is often accompanied by oral impairments. Those impairments may impact food perception by changing texture perception and the release of flavor components, which have a significant impact on food acceptability. The present study aimed at evaluating the impact of oral health on the perception of food comfortability in an elderly population. This was achieved by asking elderly people with a good oral health and elderly people with poor oral health to rate six cereal products and six meat products using a food comfortability questionnaire. Thirty-seven and 35 elderly people (65-87 years old) underwent either a cereal or meat session, respectively. The present study showed very few effects of dental and saliva status on food perception. For the cereal products, a significant effect of dental status was observed for one texture descriptor and one flavor descriptor, and a significant effect of salivary status was observed for two texture descriptors and one flavor descriptor. For the meat products, a significant effect of dental status and a significant effect of salivary status were observed on one flavor descriptor. For both products, no significant impact of dental or salivary status was observed on the general perception of food oral comfort nor on food bolus formation. Future studies exploring the impact of a broader set of oral parameters and potential adapting factors are needed to further explore the results of the present study. PRACTICAL APPLICATIONS: During oral food consumption, mastication, salivation, and swallowing play a key role in the acceptance of food and beverages by modulating the perception of texture, taste, and aroma, as well as providing eating comfort by assisting the food breakdown process into a bolus that can be safely swallowed. The age-related oral impairments such as loss of teeth, decrease in salivary flow or dysphagia are known to have an impact on food consumption. However, very few products are developed to skirt those impairments. Therefore, in the context of an ageing population, there is a need to develop functional foods that meet the specific nutritional needs of the elderly population, as well as a well-balanced flavor and texture framework. Considering the large interindividual variability observed on the elderly people, developing adapted functional foods is a major challenge for the food industry and society.