Karin Wendin, an associate professor at the SP Technical Research Institute of Sweden, has undertaken a variety of research projects examining how to develop foods that overcome swallowing problems in the elderly, known under the broad medical term dysphagia. She says that as many as 40% of 70 year olds suffer from some form of dysphagia, although definitions of its different types and recognition of its phases vary from country to country.
It is an underlying problem in designing foods for the elderly – foods that also need to take other age-related issues into account, such as the need for different nutrition, with more protein and energy at each meal; the loss of taste and smell; and even embarrassment about eating in company due to difficulties in swallowing or chewing food.
“It is one of our big challenges in society right now,” Wendin said. “…You need to adjust the texture of food and if you adjust the texture you also adjust the taste. It is not easy at all.”
For many elderly individuals, the first sign of dysphagia may be eliminating whole muscle meat from the diet, perhaps choosing something easier to chew like meatballs instead, she said.
“You can cut one thing at a time until you are only left with yoghurt – and then you’re in trouble.”
At the other end of the textural spectrum, thin broths can also pose problems for some people, so one challenge with texture is to produce something that can be swallowed in a single piece to reduce the risk of inhalation.
“You can use different kinds of thickeners or you can grind the food. But it is not about just grinding it because that can make it dry and bland,” she said.
There are already some products on the market, including Hormel’s Thick & Easy food thickener, which is designed to improve the mouthfeel and consistency of foods, as well as their visual appeal, while making them easier to swallow. And Sweden-based Findus has a department dedicated to developing foods in this area, from soups to snacks, with textures described as resembling coarse paté, timbale, liquid or jelly.
Developing a texture lexicon
Winden says that describing textures is another of the big challenges in the area, and she has done some work on establishing a lexicon for the physical properties of foods, using common words like ‘whipped cream’ and ‘thick soup’. However, it is not always straightforward.
“If I say ‘honey-like’ for example, it is completely different in Sweden from what an American would understand by a ‘honey-like’ texture,” she said.
And the culture-specific aspects of creating palatable food clearly extend to flavour too.
“We should not forget that this needs to be something that people want to eat,” said Wendin. “…We need to ask the elderly themselves [what they like], but we need to be careful because we need to ask people who are really conscious of what they like and why they like it.”
Unlike the loss of our other senses, there is no such thing as glasses or hearing aids for the loss of taste and smell, so product developers need to find other ways to ensure eating is still a pleasurable experience. While many elderly people may add extra salt or sugar to foods to help enhance flavour, Wendin says there are other options for flavour modification at the food manufacturer level.
“If you have something with carrot for example, or strawberries, you could add extra carrot or strawberry flavour,” she said.
In general, the R&D challenge is fourfold, encompassing nutrition, texture, an individual’s loss of taste, and the flavour of the food itself.
“Communciation is also a problem,” said Wendin. “You can come up with something in the hospital and end up with something else in the home.”
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