{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:49:27Z","timestamp":1791870567785,"version":"4.3.4"},"reference-count":32,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T00:00:00Z","timestamp":1693180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Hep\u00e1ticas y Digestivas","award":["CB06\/04\/1087"],"award-info":[{"award-number":["CB06\/04\/1087"]}]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Hep\u00e1ticas y Digestivas","award":["PID2020-117016RB-100"],"award-info":[{"award-number":["PID2020-117016RB-100"]}]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Hep\u00e1ticas y Digestivas","award":["PRE2021-09699"],"award-info":[{"award-number":["PRE2021-09699"]}]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Hep\u00e1ticas y Digestivas","award":["PRE\/161\/2019"],"award-info":[{"award-number":["PRE\/161\/2019"]}]},{"name":"MCIN\/AEI\/10.13039\/501100011033","award":["CB06\/04\/1087"],"award-info":[{"award-number":["CB06\/04\/1087"]}]},{"name":"MCIN\/AEI\/10.13039\/501100011033","award":["PID2020-117016RB-100"],"award-info":[{"award-number":["PID2020-117016RB-100"]}]},{"name":"MCIN\/AEI\/10.13039\/501100011033","award":["PRE2021-09699"],"award-info":[{"award-number":["PRE2021-09699"]}]},{"name":"MCIN\/AEI\/10.13039\/501100011033","award":["PRE\/161\/2019"],"award-info":[{"award-number":["PRE\/161\/2019"]}]},{"name":"Government of Catalunya-Generalitat de Catalunya within the framework of the European Regional Developments Funds of Catalonia Operational Programme 2014\u20132020","award":["CB06\/04\/1087"],"award-info":[{"award-number":["CB06\/04\/1087"]}]},{"name":"Government of Catalunya-Generalitat de Catalunya within the framework of the European Regional Developments Funds of Catalonia Operational Programme 2014\u20132020","award":["PID2020-117016RB-100"],"award-info":[{"award-number":["PID2020-117016RB-100"]}]},{"name":"Government of Catalunya-Generalitat de Catalunya within the framework of the European Regional Developments Funds of Catalonia Operational Programme 2014\u20132020","award":["PRE2021-09699"],"award-info":[{"award-number":["PRE2021-09699"]}]},{"name":"Government of Catalunya-Generalitat de Catalunya within the framework of the European Regional Developments Funds of Catalonia Operational Programme 2014\u20132020","award":["PRE\/161\/2019"],"award-info":[{"award-number":["PRE\/161\/2019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Texture-modified diets are the first-line compensatory strategy for older patients with swallowing and mastication disorders. However, the absence of a common protocol to assess textural properties inhibits their standardization and quality control and, thus, patient safety. This study aimed to (a) assess the rheological and textural properties of ten thick purees (Texture C, British Dietetic Association), (b) understand the effect of oral processing, and (c) measure the properties of the ready-to-swallow bolus after oral processing in healthy adults. Shear viscosity at 50 s\u22121 and 300 s\u22121 and textural properties (maximum force, cohesiveness, and adhesiveness) of boluses of ten thick purees were analyzed with a rheometer and a texture analyzer before and after oral processing (ready-to-swallow) in five healthy volunteers. Viscosity varied by 81.78% at 50 s\u22121 (900\u20134800 mPa\u00b7s) among purees before oral processing. Maximum force varied by 60% (0.47\u20131.2 N); cohesiveness, 18% (0.66\u20130.82), and adhesiveness, 32% (0.74\u20131.1 N\u00b7s). The high variability of viscosity was also present in ready-to-swallow boluses, 70.32% among purees. Oral processing significantly reduced viscosity in most purees (French omelet, zucchini omelet, turkey stew, red lentils, noodles, and hake fish) and also significantly reduced maximum force (7\u201336%) and adhesiveness (17\u201351%) but hardly affected cohesiveness (&lt;5%). All thick purees met the qualitative textural descriptors for Level C texture. However, all ten purees showed significant differences in all parameters measured instrumentally and were affected differently by oral processing. This study demonstrates the need to use instrumental quality control using standardized protocols and SI units to narrow the variability and provide the optimal values for patients with dysphagia who require texture-modified diets.<\/jats:p>","DOI":"10.3390\/nu15173767","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T08:51:14Z","timestamp":1693299074000},"page":"3767","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Measuring the Rheological and Textural Properties of Thick Purees Used to Manage Patients with Swallowing Disorders"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5786-0237","authenticated-orcid":false,"given":"Kovan","family":"Ismael-Mohammed","sequence":"first","affiliation":[{"name":"Gastrointestinal Physiology Laboratory, Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona, 08304 Mataro, Spain"},{"name":"Institute of Agrochemistry and Food Technology (IATA-CISC), 46980 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8896-1150","authenticated-orcid":false,"given":"Mireia","family":"Bolivar-Prados","sequence":"additional","affiliation":[{"name":"Gastrointestinal Physiology Laboratory, Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona, 08304 Mataro, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (Ciberehd), 08304 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8551-1886","authenticated-orcid":false,"given":"Laura","family":"Laguna","sequence":"additional","affiliation":[{"name":"Institute of Agrochemistry and Food Technology (IATA-CISC), 46980 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0696-8560","authenticated-orcid":false,"given":"Pere","family":"Clav\u00e9","sequence":"additional","affiliation":[{"name":"Gastrointestinal Physiology Laboratory, Hospital de Matar\u00f3, Universitat Aut\u00f2noma de Barcelona, 08304 Mataro, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (Ciberehd), 08304 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,28]]},"reference":[{"key":"ref_1","unstructured":"Amarya, S., Singh, K., and Sabharwal, M. (2023, August 21). Ageing Process and Physiological Changes. Gerontology. Available online: https:\/\/www.researchgate.net\/publication\/326215802_Ageing_Process_and_Physiological_Changes."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.euroecorev.2012.03.004","article-title":"Ageing, cognitive abilities and retirement","volume":"56","author":"Mazzonna","year":"2012","journal-title":"Eur. Econ. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1046\/j.1532-5415.2002.50270.x","article-title":"Prevalence of Impaired Swallowing in Institutionalized Older People in Taiwan","volume":"50","author":"Lin","year":"2002","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Liu, H.Y., Chen, J.H., Hsu, K.J., Yao, C.T., Chen, P.H., and Hsiao, S.Y. (2021). Decreased Tongue Pressure Associated with Aging, Chewing and Swallowing Difficulties of Community-Dwelling Older Adults in Taiwan. J. Pers. Med., 11.","DOI":"10.3390\/jpm11070653"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1177\/0022034510370801","article-title":"Age-related Changes in Tongue Pressure during Swallowing","volume":"89","author":"Tamine","year":"2010","journal-title":"J. Dent. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.otc.2014.06.004","article-title":"Oropharyngeal Dysphagia in Children: Mechanism, Source, and Management","volume":"47","author":"Durvasula","year":"2014","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1079\/NRR200375","article-title":"Influence of age on mastication: Effects on eating behaviour","volume":"17","author":"Mioche","year":"2004","journal-title":"Nutr. Res. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.12968\/indn.2018.9.17","article-title":"Maintaining or improving nutrition and hydration in dysphagia","volume":"2018","author":"Nazarko","year":"2018","journal-title":"Indep. Nurse"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.12968\/bjcn.2013.18.Sup5.S14","article-title":"Dysphagia and quality of life","volume":"18","author":"Vesey","year":"2013","journal-title":"Br. J. Community Nurs."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.mayocp.2020.08.001","article-title":"Dysphagia in Older Adults","volume":"96","author":"Thiyagalingam","year":"2021","journal-title":"Mayo Clin. Proc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1038\/nrgastro.2015.49","article-title":"Dysphagia: Current reality and scope of the problem","volume":"12","author":"Shaker","year":"2015","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e507","DOI":"10.1016\/S2666-7568(21)00143-4","article-title":"Oral frailty and its determinants in older age: A systematic review","volume":"2","author":"Dibello","year":"2021","journal-title":"Lancet Healthy Longev."},{"key":"ref_13","first-page":"79","article-title":"Prevalence of poor self-rated mastication and associated factors in Brazilian elderly","volume":"26","author":"Galli","year":"2010","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"13","DOI":"10.17126\/joralres.2016.004","article-title":"Prevalencia de trastornos temporomandibulares en un grupo de adultos mayores Mexicanos","volume":"5","author":"Murrieta","year":"2016","journal-title":"J. Oral Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e13695","DOI":"10.1111\/nmo.13695","article-title":"Effect of a gum-based thickener on the safety of swallowing in patients with poststroke oropharyngeal dysphagia","volume":"31","author":"Rofes","year":"2019","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1007\/s00455-016-9729-3","article-title":"Erratum to: Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD)","volume":"31","author":"Newman","year":"2016","journal-title":"Dysphagia"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ortega, O., Bol\u00edvar-Prados, M., Arreola, V., Nascimento, W.V., Tomsen, N., Gallegos, C., Brito-de La Fuente, E., and Clav\u00e9, P. (2020). Therapeutic Effect, Rheological Properties and \u03b1-Amylase Resistance of a New Mixed Starch and Xanthan Gum Thickener on Four Different Phenotypes of Patients with Oropharyngeal Dysphagia. Nutrients, 12.","DOI":"10.3390\/nu12061873"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Brito-de la Fuente, E., Ekberg, O., and Gallegos, C. (2012). Rheological Aspects of Swallowing and Dysphagia. Dysphagia Diagn. Treat., 493\u2013506.","DOI":"10.1007\/174_2011_362"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Bolivar-Prados, M., Tomsen, N., Hayakawa, Y., Kawakami, S., Miyaji, K., Kayashita, J., and Clav\u00e9, P. (2022). Proposal for a Standard Protocol to Assess the Rheological Behavior of Thickening Products for Oropharyngeal Dysphagia. Nutrients, 14.","DOI":"10.3390\/nu14235028"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"106960","DOI":"10.1016\/j.foodhyd.2021.106960","article-title":"A bit thick: Hidden risks in thickening products\u2019 labelling for dysphagia treatment","volume":"123","author":"Tomsen","year":"2022","journal-title":"Food Hydrocoll."},{"key":"ref_21","unstructured":"(2023, August 21). National Dysphagia Diet: Standardization for Optimal Care\u2014National Dysphagia Diet Task Force, American Dietetic Association. Available online: https:\/\/books.google.com.pr\/books?id=MZ5mSbGPOE4C&printsec=frontcover#v=onepage&q&f=false."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"64","DOI":"10.11336\/jjcrs.13.64","article-title":"The Japanese Dysphagia Diet of 2021 by the Japanese Society of Dysphagia Rehabilitation","volume":"13","author":"Kayashita","year":"2022","journal-title":"Jpn. J. Compr. Rehabil. Sci."},{"key":"ref_23","unstructured":"Clinical Governance Board, Development Committees Panel (2023, August 21). National Descriptors for Texture Modification in Adults. Available online: https:\/\/www.acquiredbraininjury-education.scot.nhs.uk\/wp-content\/uploads\/National-Descriptors-Texture-Modification-Adults-2009.pdf."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.12968\/bjnn.2017.13.Sup2.S18","article-title":"The International Dysphagia Diet Standardisation Initiative (IDDSI) framework: The Kempen pilot","volume":"13","author":"Lam","year":"2017","journal-title":"Br. J. Neurosci. Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"022106","DOI":"10.1088\/1755-1315\/548\/2\/022106","article-title":"Texture-modified foods for the elderly and people with dysphagia: Insights from Japan on the current status of regulations and opportunities of the high pressure technology","volume":"548","author":"Maksimenko","year":"2020","journal-title":"IOP Conf. Ser. Earth Environ. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Costa, A., Carri\u00f3n, S., Puig-Pey, M., Ju\u00e1rez, F., and Clav\u00e9, P. (2019). Triple Adaptation of the Mediterranean Diet: Design of A Meal Plan for Older People with Oropharyngeal Dysphagia Based on Home Cooking. Nutrients, 11.","DOI":"10.3390\/nu11020425"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.foodhyd.2007.11.013","article-title":"Food oral processing\u2014A review","volume":"23","author":"Chen","year":"2009","journal-title":"Food Hydrocoll."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/jtxs.12411","article-title":"The role of saliva in oral processing: Reconsidering the breakdown path paradigm","volume":"51","author":"Boehm","year":"2020","journal-title":"J. Texture Stud."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1017\/S0007114520005176","article-title":"Chew on it: Influence of oral processing behaviour on in vitro protein digestion of chicken and soya-based vegetarian chicken","volume":"126","author":"Chen","year":"2020","journal-title":"Br. J. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1111\/j.1365-2621.1963.tb00216.x","article-title":"The Texturometer\u2014A new instrument for objective texture measurement","volume":"28","author":"Friedman","year":"1963","journal-title":"J. Food Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1111\/j.1365-2036.2006.03118.x","article-title":"The effect of bolus viscosity on swallowing function in neurogenic dysphagia","volume":"24","author":"Arreola","year":"2006","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.meatsci.2012.11.050","article-title":"Texture, sensory and swallowing characteristics of high-pressure-heat-treated pork meat gel as a dysphagia diet","volume":"93","author":"Tokifuji","year":"2013","journal-title":"Meat Sci."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/17\/3767\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:41:18Z","timestamp":1760128878000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/17\/3767"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,28]]},"references-count":32,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["nu15173767"],"URL":"https:\/\/doi.org\/10.3390\/nu15173767","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,28]]}}}