Formulation of Functional Liquid Diets Under IDDSI Levels 0 to 2 for Dysphagia Patients: Physico-Chemical, Sensory, Antioxidant and Electromyographic Oral Processing Analyses

Navdeep Singh Sodhi; Bhavnita Dhillon; Pashaura Singh Sandhu; Deepak Bhagat; Priya Gupta; Amritpal Kaur; Shivangi Sharma; Zakir Showkat Khan

doi:10.1007/s00455-024-10671-9

Formulation of Functional Liquid Diets Under IDDSI Levels 0 to 2 for Dysphagia Patients: Physico-Chemical, Sensory, Antioxidant and Electromyographic Oral Processing Analyses

Dysphagia. 2024 Feb 21. doi: 10.1007/s00455-024-10671-9. Online ahead of print.

Authors

Navdeep Singh Sodhi¹, Bhavnita Dhillon², Pashaura Singh Sandhu³, Deepak Bhagat¹, Priya Gupta¹, Amritpal Kaur¹, Shivangi Sharma¹, Zakir Showkat Khan¹

Affiliations

¹ Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India.
² Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India. bhavnita.food@gndu.ac.in.
³ Department of Medicine, Government Medical College, Amritsar, 143001, Punjab, India.

PMID: 38381156
DOI: 10.1007/s00455-024-10671-9

Abstract

Dysphagia is a significant health concern especially amongst the old age population. It is an ailment brought on by the weakening of the swallowing muscles. To reduce the risk of choking in dysphagia patients, the food is usually diluted to suit their swallowing ability. But dilution results in reducing the nutritional density of the foods thus causing undernutrition and malnutrition in patients. In this study, functional liquid diets were formulated under International Dysphagia Diet Standardization Initiative (IDDSI) levels 0-2. The developed diets were analysed for their proximate composition, colour, antioxidant and sensory properties. Antioxidant activities were determined using 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS⁺), 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing antioxidant power (FRAP) and total phenolic content (TPC) methods. The highest ABTS⁺ value was observed in pumpkin puree (level-2) i.e. 98.59%. Black carrot juice (level-1) showed the highest DPPH free radical scavenging activity and FRAP value viz. 88.43% and 689.33 µM TE/g, respectively. Electromyography (EMG) is an upcoming technique of food texture evaluation which provides real-time information about food oral processing. In this study, an EMG was conducted to measure the myoelectrical activity of human suprahyoid and masseter muscles by placing electrodes on the skin's surface during the oral processing of liquid. The EMG parameters correlated significantly with viscosity, ease of swallowing and IDDSI levels of the formulated diets. Hence EMG can be used as a tool for design and development of textured-modified diets for dysphagia patients. The sensory scores of formulated diets in this study were high indicating that these liquid diets may be incorporated into the diet plans of dysphagia patients.

Keywords: Antioxidants; Dysphagia; Electromyography; Functional liquid diets; International Dysphagia Diet Standardization Initiative (IDDSI); Sensory.