A SYSTEMATIC EVALUATION OF FOOD TEXTURES TO DECREASE PACKING AND INCREASE ORAL INTAKE IN CHILDREN WITH PEDIATRIC FEEDING DISORDERS

Results of our study suggest that contemporary changes in beverage patterns, particularly the increase in soda pop consumption, have the potential to increase dental caries rates in children. Consumption of regular soda pop, regular powdered beverages, and, to a lesser extent, 100% juice was associated with increased caries risk. Milk had a neutral association with caries. Associations between different types of sugared beverages and caries experience were not equivalent, which could be attributable to the different sugar compositions of the beverages or different roles in the diet. Our data support contemporary dietary guidelines for children: consume 2 or more servings of dairy foods daily, limit intake of 100% juice to 4 to 6 oz daily, and restrict other sugared beverages to occasional use. Pediatricians, pediatric nurse practitioners, and dietitians are in a position to support pediatric dentists in providing preventive guidance to parents of young children.

Accuracy of Minimum Data Set in Identifying Residents at Risk for Undernutrition: Oral Intake and Food Complaints

Introduction: Sensory defensiveness could block the development of the gastro-intestinal tract and the immune system. Sensory defensiveness refers to a more general problem of the tactile and other sensory systems. Occupational therapists are aware that tactile defensive children (TDC) could have problems with constipation, allergies and are fussy/problem eaters. The details of their likes and dislikes regarding food textures have not been described before. Objective: To explore the food textures that tactile defensive children avoid or prefer. Methods: The study sample were 62 subjects between ages three and ten years and of both genders, divided into experimental (n=29) and control (n=33) groups based on a checklist for tactile defensiveness and the Winnie Dunn Caregiver profile questionnaire. A questionnaire on eating habits was compiled. Detail: Biographical detail; Detail of parent or guardian and family eating habits; Feeding habits of the child; Smell and temperature of food and texture of food eaten by child; Detail of child’s likes/dislikes of food; Food table of food served, feeding of child, likes and dislikes; Allergy detail and medical history of child. The questionnaires were completed during a personal interview with the parents. The following statistical analyses were performed: descriptive statistics to determine measures of central tendency, dispersion and distribution and inferential statistics (Chi-square goodness of fit test, Chi-square test of independence, t-test). Results: Based on the question relating to the consistency of food the child eats, TDC were significantly less inclined than non-tactile defensive children (NTDC) to accept the following types of food: mashed table foods (p<0.05), chewy (e.g. meat) (p<0.01), crunchy foods(e.g. carrots)(p<0.01), and the typical cooked family meal (p<0.01). Significantly more (51.7%) tactile defensive children refused to eat porridge with lumps than (21.7%) non-tactile children (p<0.05). Statistically significant differences were also found for low textured food such as mashed potatoes, baby cereal, pureed soups(p<0.05) and high textured food such as raw vegetables, coconut, nuts/seeds, raisins(p<0.01). Conclusion: Results of this study show that it could be a problem to feed a tactile defensive child. They have a pronounced aversion to certain food textures. A multi-disciplinary approach important to help solve the problem.

IntroductionChewing a greater number of chews per bite has been shown to increase fullness, lower hunger levels and lead to a lower energy intake, when compared to chewing each bite fewer times. Increased levels of fullness and decreased levels of hunger have also been observed after consuming harder textured foods which require more chewing activity and have a longer oro-sensory exposure time. The aim of this study was to investigate whether consumption of foods differing in texture, classified as ‘fast’ or ‘slow’ foods, combined with differences in oral processing behaviours (chewing normally or more slowly), has an impact on self-reported hunger, fullness and satiety outcomes.Materials and MethodsThis is an interim analysis of a randomised crossover experiment designed to test the impact of both oral processing behaviours and food texture on self-reported hunger, fullness and satiety. Participants consumed two breakfasts of different texture (a ‘fast’ yoghurt and fruit compote option, and a ‘slow’ granola option) twice; once at their normal rate of eating and once after being instructed to eat slowly. Measures of self-reported appetite (hunger, fullness, satiety, desire to eat and prospective food consumption) were assessed using a visual analogue scale at three time points; baseline (minimum 20 minutes before consumption), immediately pre-consumption and post-consumption. Statistical analysis was conducted in SPSS; paired sample t tests and one-way analysis of variance was conducted to measure whether change in appetite ratings between the time points differed between the four breakfast options.ResultsData were collected from 16 healthy volunteers (study aiming to recruit n = 21; mean age 32.1 y, female n = 13, 81.3%). For all four breakfast options, levels of hunger, desire to eat and prospective food consumption significantly decreased, and levels of fullness and satiety significantly increased between both baseline and post-consumption, (p &lt; 0.05) and between pre-consumption and post-consumption (p &lt; 0.05). However, amongst the four breakfast options, no significant differences were observed in change in these appetite measures between baseline and post-consumption and pre- and post-consumption (p &gt; 0.05).DiscussionThis interim analysis demonstrates no differences in mean change in appetite measures for breakfast options of different texture chewed normally or more slowly. Analysis of the full study will determine the effect of oral processing behaviours and food texture on self-reported hunger, fullness and satiety outcomes.

Expression of mRNA for proglucagon and glucagon-like peptide-2 (GLP-2) receptor in the ruminant gastrointestinal tract and the influence of energy intake

(1) Background: Pediatric dysphagia presents significant nutritional challenges, often impacting growth and development due to reduced oral intake, increased nutritional needs, and gastrointestinal complications; (2) Methods: This prospective quasi-experimental study assessed 117 children under 14 years old (20 patients were under 1 year old, 80 were aged 1-7 years, and 17 were older than 7 years), diagnosed with swallowing disorders, to analyze their caloric, macro-, and micronutrient intake and identify potential deficiencies. The severity of dysphagia was established using functional oral intake scales, and dietary records were reviewed over a 3-day period; (3) Results: The study revealed that 39.8% of participants did not meet their total energy expenditure (TEE), highlighting a high prevalence of malnutrition among these children. Furthermore, patients using feeding devices exhibited a significantly lower caloric intake, and over half required significantly modified food textures. After individualized speech therapy and nutritional rehabilitation, participants showed significant improvements in caloric intake, with their energy coverage increasing from 958% to 1198% of the daily requirement. Rehabilitation also improved tolerance to a broader range of food textures; (4) Conclusions: This research underscores the importance of multidisciplinary, individualized nutritional strategies to address the specific challenges of pediatric dysphagia, emphasizing the role of enteral nutrition and therapeutic interventions in improving the quality of life and nutritional outcomes of these children. Further studies are recommended to assess the long-term impact of such strategies.

Food texture encompasses physical characteristics perceived by the senses. Research in this area must be multidisciplinary in nature, accounting for fracture of food, sounds it makes during biting and chewing, its microstructure, muscle movements during mastication, swallowing, and acceptability. Food texture thus encompasses chemistry, physics, physiology, and psychology. This brief review of the field covers the areas of recent research in food texture and specifies where further understanding is needed.

Influence of low and decreasing food levels on Daphnia-algal interactions: Numerical experiments with a new dynamic energy budget model

Adaptation to undernutrition: how much food does man need?

SUMMARYGrowth and development of young mammals have been investigated in relation to environmental temperature and energy intake. The experimental design and statistical analysis have allowed an evaluation of the separate and combined effects of two environmental variables and the time it takes for these effects to develop. Piglets aged 14 days lived at either 35 or 10 °C, on a high or low energy intake (the energy content of the former was twice that of the latter). The influence of each of the four treatment combinations was assessed up to 64 days of age.At 64 days of age the piglets at 35 °C on the high intake (35H) were twice as heavy as those at 10 °C on the low intake (10L). The other two groups (35L and 10H) had similar body weights, and these were between the 35H and 10L. Ambient temperature had a rapid influence on appearance and morphology: animals in the cold were shorter and squatter than those in the warm. In general, energy intake influenced the absolute size of the internal organs whereas temperature affected their size relative to body weight. Skeletal growth was faster in the warm than the cold, and on the high than the low intake. No statistically significant interactions were generally found between temperature and intake, indicating that their effects were exerted independently. Most of the effects were established after only 17 days.The present investigation has helped in interpreting earlier studies on growth which concentrated on the effects of only one of the two environmental variables of temperature and nutrition. It emphasizes the key roles of nutrition in adaptation to environmental temperature, and of ambient temperature to nutritional studies.

Background: Several studies have found a U-shaped association between sodium intake and mortality. The increased mortality risk of low sodium intake has raised debates and hampers widespread acceptance of public health campaigns and dietary guidelines on reducing sodium intake. Whether the excess risk can be attributed to low sodium intake alone or concomitant inadequate intake of other relevant nutrients is unknown. Objective: We investigated whether concomitant low protein intake could explain the lower part of the U-shaped association of sodium intake with all-cause mortality. Methods: We included 1603 individuals aged between 60 and 75 years old from the gender- and socioeconomic status-balanced prospective Lifelines-MINUTHE cohort study. Using multivariable Cox regression analyses, we investigated the association of sodium intake (24 h urinary sodium excretion) with all-cause mortality, including the interaction with protein intake calculated from the Maroni formula. Results: Mean intakes of sodium and protein were 3.9 ± 1.6 g/day and 1.1 ± 0.3 g/kg/day, respectively. After a median follow-up of 8.9 years, 125 individuals (7.8%) had died. The proportion of participants with insufficient protein intake (<0.8 g/kg/day) was inversely related to sodium intake (i.e., 23.3% in Q1 versus 2.8% in Q4, p < 0.001). We found an increased risk for mortality in both the highest quartile (Q4, >4.7 g/day; hazard ratio (HR) 1.74 (95% confidence interval (CI) 1.03–2.95)) and the lowest two quartiles of sodium intake (Q1, 0.7–2.8 g/day; 2.05 (1.16–3.62); p = 0.01 and Q2, 2.8–3.6 g/day; 1.85 (1.08–3.20); p = 0.03), compared with the third quartile of sodium intake (Q3, 3.6–4.7 g/day). This U-shaped association was significantly modified by protein intake (Pinteraction = 0.006), with the increased mortality risk of low sodium intake being reversed to the lowest mortality risk with concomitant high protein intake. In contrast, the increased mortality risk of low sodium intake was magnified by concomitant low protein intake. Conclusions: We found that a higher protein intake counteracts the increased mortality risk observed in subjects with a low sodium intake. In contrast, a joint low intake of sodium and protein is associated with an increased mortality risk, allegedly due to poor nutritional status. These findings support the guidelines that advocate a lower sodium intake, while highlighting the importance of recognizing overall nutritional status among older adults.

Poor appetite is a key contributor to malnutrition in older adults, partly due to reduced dietary intake. While nutritional deficits are well recognized, the biological mechanisms driving poor appetite remain incompletely understood. Growth Differentiation Factor-15 (GDF-15) and the Simplified Nutritional Appetite Questionnaire (SNAQ) may help identify patients at risk of insufficient intake. This study examines the association between GDF-15 and insufficient energy and protein intake and evaluates the predictive performance of GDF-15 and SNAQ - individually and in combination - to identify insufficient energy and protein intake (<75 % and <100 % of estimated requirements, respectively) in acutely admitted older adults. This exploratory study included 130 older adults (≥65 years) with or at risk of malnutrition, admitted for acute medical illness and assessed at baseline, and 8 and 16 weeks post-discharge (FW8 and FW16). GDF-15 plasma concentrations were measured from blood samples, SNAQ scores from validated questionnaire, and energy and protein intake were evaluated through 3-day dietary records. Associations were analyzed using regression models and predictive performance was evaluated using Receiver Operating Characteristic analysis. A doubling of GDF-15 showed a 6.73 % (-13.98-0.51) and 5.07 % (-12.18-2.05) lower baseline energy and protein intake, and results decreased after discharge. Using predefined cut-offs of ≥1500 pg/mL for GDF-15 and ≤14 for SNAQ, the highest positive predictive values (PPVs) were 86 (95 % CI: 0.83-0.89) and 90 (0.79-1.00) at baseline and FW8 for insufficient protein intake, respectively, with corresponding sensitivities of 84 (0.75-0.92) and 60 (0.44-0.74). For estimated cut-offs of 2095 pg/mL for GDF-15 at baseline and 18.5 for SNAQ at FW8, the highest PPVs were 89 (0.84-0.94) and 87 (0.86-0.87), with sensitivities of 73 (0.62-0.84) and 99 (0.96-1.00), both for insufficient protein intake, respectively. Combining GDF-15 and SNAQ yielded improved PPVs at the expense of reduced sensitivity in most models. All results were non-significant. Higher GDF-15 levels showed a non-significant trend toward lower baseline energy and protein intake. GDF-15 and SNAQ offer limited ability to identify insufficient energy and protein intake, based on predictive performance. These exploratory findings should therefore be interpreted cautiously. Larger studies are needed to validate and further refine the use of GDF-15 and SNAQ in clinical settings.

Alterations of fatty acid metabolism have been associated with diabetes. Triacylglycerol (TAG) can be obtained from dietary sources and synthesized de novo. The composition and location of the fatty acyl groups in a TAG can affect its physicochemical features such as melting temperature, and physiological characteristics such as digestion, absorption, and lipid metabolism. We hypothesize that the TAG fatty acyl position affects the body weight gain and lipid metabolism of mice in a high-fat diet (HFD) setting. Twenty-seven 6-week-old male C57/BL6J mice were randomly assigned to 3 dietary treatment groups, 1,2-dipalmitoyl-3-oleoylglycerol (PPO, 36 % w/w diet) , 1,3-dipalmitoyl-2-oleoylglycerol (POP, 36% w/w diet) , and the chow diet control groups. Mice in each group were fed their respective diet for 6 weeks, and food intake and body weight were measured daily. Mice fed the PPO diet had significantly higher food intake, calories intake and body wight gain rate, and lower liver to body weight ratio than those fed the POP diet. Mice fed the chow diet had significantly higher total grams of food intake, but lower calories intake, liver and epididymal fat weight, and body weight gain rate than those fed the PPO, but not the POP, diet. Mice in the PPO group had significantly higher serum glucose than that in other two groups, whereas mice fed the chow diet had significantly lower plasma cholesterol level than those HFD groups. The plasma TAG levels were not different among them. The hepatic levels of insulin receptor substrate 1, and fatty acid synthase, and phosphorylated acetyl CoA carboxylase in mice fed the chow diet are significantly higher than those fed the PPO or POP diet, whereas the hepatic expression level of stearoyl CoA desaturase 1 in mice fed the POP diet was lower than those fed the PPO or chow diet. We conclude that feeding a HFD affects the expression levels of hepatic proteins for lipid metabolism in mice. In addition, the position of fatty acyl group in a TAG affects the food intake, the body weight gain rate and lipid homeostasis in mice. Disclosure X. Hu: None. T. Wang: None. G. Chen: None.

The prevalence of hypercholesterolemia in Indonesia is recorded in the elderly group at 15.5%. Pre-elderly and elderly are at-risk groups who are prone to hypercholesterolemia, especially in several conditions, such as over-nutrition status, high fat and low fiber food intake, and having a family history of hypercholesterolemia. This study aims to analyze the factors that influence total cholesterol levels in pre-elderly and elderly people in Kedaung Village. The study was conducted analytically observational with a cross-sectional design. Respondents in this study were 50 pre-elderly and elderly obtained from sample calculations using stratified sampling techniques. Data collection was taken using an SQ-FFQ questionnaire and analyzed by univariate analysis showed the frequency distribution of respondents' characteristics, and bivariate analysis was conducted using a chi-square test to identify the relationship between variables. The results of the study reported that 56% of respondents with total cholesterol levels ≥200 mg/dL. A total of 70% of respondents consumed high fat intake, 58% of respondents consumed low fiber intake, 60% of respondents had overweight status, and 64% had a family history of hypercholesterolemia. Analysis showed that the determinant factors associated with respondents' total cholesterol levels were fat intake (p=0.035), fiber intake (p=0.013), and family history (p=0.015). Pre-elderly and elderly with total cholesterol levels ≥200 mg/dL were found in respondents with high fat intake, low fiber intake, and a family history of hypercholesterolemia.

Assessing the food texture via mastication is important for advancing knowledge of food properties so as to develop favorable and healthy food products. Oral processing of food by robots can enable an in vitro assessment of food texture by simulating human mastication objectively. In this study, a chewing robot is developed to mimic the rhythmic motion of the molars to enable controllable chewing kinematics and a biomimetic oral environment. The robotic chewing is realized using a 3 degree-of-freedom (DOF) linkage mechanism, which recreates the molar grinding movement based on molar trajectories and chewing cycle durations previously reported in the literature. Moreover, a soft pneumatically actuated cavity is developed to provide a space to contain and reposition the food between occlusions. To regulate the robotic chewing having variable molar trajectories and chewing durations, the mathematical relationship of the linkage’s actuators and molar movements is investigated for the purpose of motion analysis and control. Accordingly, the design of the robot in terms of linkage, oral cavity, and mechatronics system is performed. The built robot is validated by tracing a planned variable molar trajectory while chewing peanuts. The performance of robot chewing is validated by demonstrating the ability of the robot to chew the peanuts similar to that by human through comparison of peanut particle size distributions (PSDs) and particle median size diameters.