Date of Award

8-2024

Document Type

Project

Degree Name

Master of Science in Nutrition Science

Department

Health Science and Human Ecology

First Reader/Committee Chair

Chen-Maynard, Dorothy

Abstract

Managing dysphagia can help prevent adverse outcomes for patients with swallowing issues. This project aims to identify the best thickener that holds food texture and to identify which thickener is most palatable and acceptable by evaluators. A Spoon Tilt test was used to as one of the objective tests to determine the best thickener that holds food texture. The three thickening agents used were: apple pectin powder, tapioca starch, and a commercial thickener. The three pureed food items used to test the thickening agents were baked chicken, broccoli, and rice. An audit tool by the International Dysphagia Diet Standardization Initiative (IDDSI), was used as an objective test due to its combination of testing methods and to determine if a modified diet or fluid meets the required properties of a food or beverage to be swallowed safely. This tool was used to determine the results of a Spoon Tilt Test to objectively measure the consistency of the products. To perform this spoon test, the process involved holding the spoon in a level plane with the desired pureed food e.g. (chicken , broccoli, rice) with added thickener and then tilting it to a 90 degree angle to observe how the sample behaves when the spoon is tilted (IDDSI.org). According to the IDDSI assessment criteria Level 4 (for pureed food) the samples should stay on the spoon, holding its shape, with minimal or no flow. The participants involved in the subjective taste test were ten hospital employees from the Food and Nutrition Department. They are cooks, diet aides, and dietitians at the hospital and all of the individuals have some knowledge of dysphagia diets. Participants included were both males and females, with an age range from 25 to over 64 years. Of the 10 participants only one person reported difficulty swallowing and chewing.

An online Google survey form was used to evaluate the three thickened products to assess which is the most palatable and acceptable; and the evaluation included four categories of assessment (Appearance, Taste, Texture, and Overall quality). A Likerts rating scale of one to five (1=Terrible; 5= Tasty) was used to evaluate each product. All ten participants completed all of the surveys for each food product. Based on their evaluation of appearance, taste, texture, and overall quality, the majority of the participants preferred the products thickened with apple pectin. Additionally, the objective Spoon Tilt Test part of the study showed that the commercial thickener demonstrated superior performance in maintaining spoon shape and preventing food from becoming sticky or spreading throughout the plate.

Individuals with dysphagia are at a higher risk of malnutrition due to difficulties in swallowing, which can impact their ability to consume adequate nutrition. The study’s findings suggest that alternative thickening agents can maintain texture stability in home-made pureed foods while enhancing their nutritional content and cost saving.

Word Count: 439

Keywords: Dysphagia, Swallowing Difficulty, Thickener, Acceptability, Palatability

Abbreviations: IDDS, International Dysphagia Diet Standardization Initiative; SLP, Speech-Language Pathologists

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