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<p>Dysphagia, a swallowing difficulty common in the aging population, is often accompanied by symptoms such as coughing, choking during meals and a sensation of food getting stuck in the throat. Worldwide, more than 590&#xa0;million people are suffering from dysphagia. The foods usually given to the dysphagia patients are diluted to match their affected swallowing abilities. However, the dilution reduces the nutritional value of the foods and thus results in malnutrition. The demand for ethnic nutritional products, especially Indian cuisine, is growing due to the diverse aging populations in nursing homes and hospitals around the world. This trend is also driven by the rise in convenience foods, supported by factors like increased health awareness and advancements in food technology. International Dysphagia Diet Standardisation Initiative (IDDSI) is being followed in many countries for the formulation of texture-modified foods for dysphagia patients. However, limited research work has been conducted on the development of Indian convenience foods for inclusion in the diets of dysphagia patients. This study is the first to apply electromyography (EMG) to correlate oral processing parameters with sensory texture in IDDSI-compliant Indian convenient foods. For this purpose IDDSI level 7 regular foods <i>viz. chapatis</i> and <i>pranthas</i> (whole wheat flour <i>chapati</i> (WWC), cauliflower <i>prantha</i> (CP), carom seeds and salt <i>prantha</i> (CSP), maize <i>chapati</i> (MC) and pearl millet flour <i>chapati</i> (PMC)) enriched with vegetables, herbs, spices and various cereal grains were prepared and then dried and converted into powders. These powders can be conveniently reconstituted into purees and shaped into <i>chapatis</i> or <i>pranthas</i> complying with IDDSI level 4 foods. These formulated foods were analyzed for IDDSI levels using fork drip test, spoon tilt test and fork pressure test, physico-chemical properties, antioxidant activity and sensory properties. The overall acceptability scores of these products ranged from 7.80 to 8.90 on a 9-point hedonic scale, suggesting their potential for commercialization. However, IDDSI ignores multidimensionality of food oral processing as the method focuses only on rheological properties of the foods. Realizing the limits of rheological approach in food texture evaluation, the current study also analyzed the oral processing behaviors of these prepared foods using electromyography. EMG is an innovative and non-invasive technique which is used for in vivo investigation of the chewing and swallowing muscles’ response to different textured foods. It was found that the decrease in the IDDSI level of the formulated foods from level 7 to 4 facilitated their chewing and swallowing behaviors. The EMG investigations of these formulated foods revealed that the EMG parameters, namely, time for oral processing; number of chews and masseter activity per chew before the start of swallowing; and masseter activity and the amplitude of suprahyoid actions after the start of swallowing, correlated significantly (<i>p</i> &lt; 0.01) with the sensory textural perceptions of the formulated foods. Thus, EMG can serve as a valuable tool for design and development of texture-modified foods for dysphagia patients. Thus it is recommended that evaluation of oral processing behaviors of foods with EMG be integrated into IDDSI protocols, to confirm their compliance with a particular IDDSI level, during dysphagia diet development. In future investigations, these formulated foods can be administered to dysphagia patients in consultation with a nutritionist under the supervision of a medical practitioner.</p>

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Formulation and electromyographic evaluation of Indian convenience foods (chapatis, pranthas and their instant purees) for dysphagia patients under IDDSI levels 4 and 7

  • 期刊论文

  • 发表日期：

    2026年1月8日

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  • Shivangi Sharma,
  • Navdeep Singh Sodhi,
  • Bhavnita Dhillon,
  • Sukhraj Kaur

摘要

Dysphagia, a swallowing difficulty common in the aging population, is often accompanied by symptoms such as coughing, choking during meals and a sensation of food getting stuck in the throat. Worldwide, more than 590 million people are suffering from dysphagia. The foods usually given to the dysphagia patients are diluted to match their affected swallowing abilities. However, the dilution reduces the nutritional value of the foods and thus results in malnutrition. The demand for ethnic nutritional products, especially Indian cuisine, is growing due to the diverse aging populations in nursing homes and hospitals around the world. This trend is also driven by the rise in convenience foods, supported by factors like increased health awareness and advancements in food technology. International Dysphagia Diet Standardisation Initiative (IDDSI) is being followed in many countries for the formulation of texture-modified foods for dysphagia patients. However, limited research work has been conducted on the development of Indian convenience foods for inclusion in the diets of dysphagia patients. This study is the first to apply electromyography (EMG) to correlate oral processing parameters with sensory texture in IDDSI-compliant Indian convenient foods. For this purpose IDDSI level 7 regular foods viz. chapatis and pranthas (whole wheat flour chapati (WWC), cauliflower prantha (CP), carom seeds and salt prantha (CSP), maize chapati (MC) and pearl millet flour chapati (PMC)) enriched with vegetables, herbs, spices and various cereal grains were prepared and then dried and converted into powders. These powders can be conveniently reconstituted into purees and shaped into chapatis or pranthas complying with IDDSI level 4 foods. These formulated foods were analyzed for IDDSI levels using fork drip test, spoon tilt test and fork pressure test, physico-chemical properties, antioxidant activity and sensory properties. The overall acceptability scores of these products ranged from 7.80 to 8.90 on a 9-point hedonic scale, suggesting their potential for commercialization. However, IDDSI ignores multidimensionality of food oral processing as the method focuses only on rheological properties of the foods. Realizing the limits of rheological approach in food texture evaluation, the current study also analyzed the oral processing behaviors of these prepared foods using electromyography. EMG is an innovative and non-invasive technique which is used for in vivo investigation of the chewing and swallowing muscles’ response to different textured foods. It was found that the decrease in the IDDSI level of the formulated foods from level 7 to 4 facilitated their chewing and swallowing behaviors. The EMG investigations of these formulated foods revealed that the EMG parameters, namely, time for oral processing; number of chews and masseter activity per chew before the start of swallowing; and masseter activity and the amplitude of suprahyoid actions after the start of swallowing, correlated significantly (p < 0.01) with the sensory textural perceptions of the formulated foods. Thus, EMG can serve as a valuable tool for design and development of texture-modified foods for dysphagia patients. Thus it is recommended that evaluation of oral processing behaviors of foods with EMG be integrated into IDDSI protocols, to confirm their compliance with a particular IDDSI level, during dysphagia diet development. In future investigations, these formulated foods can be administered to dysphagia patients in consultation with a nutritionist under the supervision of a medical practitioner.