Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

February 2022 Independent Eating and Drinking Newsletter

	February Topic: Food Texture
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Food Texture

Over many years this newsletter has often discussed food textures. Typically the discussions have revolved around changing the textures of different foods to make them easier to chew and swallow for people who have dysphagia. However, there are many foods that have some type of “peculiarity” and we decided to discuss a few of them in this article.

It would seem that one of the easiest foods to eat would be pudding. You simply scoop a spoonful, put it in your mouth and swallow it. No real chewing is needed and there are no particles in it to be a problem. Yet pudding can be a real problem for some people causing them to choke or even aspirate the pudding. Several things can happen to trigger this. When a spoonful of pudding is put into some people’s mouths they can loose track of where it is in their mouth due to limited oral sensation. Thus their control of the pudding in their mouth is limited or non-existent.  Additionally, rather than staying together in a well formed bolus, the pudding, when it mixes with saliva, thins and can move around the mouth more like a liquid. This change of texture is fine for most people because they are able to process a bolus formed from either solid or liquid. But for some people the change of texture can be challenging to handle. When pudding is placed in the mouth the sugar (i.e., sweetness) stimulates the production of saliva. For the first bite the pudding maintains some of its original structure even though it is thinned when it mixes with the saliva. The second bite exacerbates this function and by the third and fourth bites, the pudding is a liquid. This is the same reaction that we all experience when we smell or see a food item that is appealing; we salivate and continue to do so when we eat the food item.

Another thing to be considered is the position of the head when eating. If the chin is raised higher than 90 degrees from the neck, the pudding, as it liquefies, will trickle to the back of the mouth and can cause gagging. If it enters the throat it can cause choking.

It should be noted that a description that is used to describe a modified diet appropriate for someone with dysphagia is "pudding-like". A pudding-like modified food is simply soft and smooth, but does not have the ingredients that is in pudding and, therefore, will not behave in the same way as real pudding does.

Food that is breaded or battered can cause problems. This includes: fish, chicken, chicken fried steak and pork chops as well as many other items. It is not the food that has been breaded that causes trouble but the batter itself. Depending upon the cook, the breading can be crispy all over, or soft in places and crunchy in others. The crunchy parts can have little bits of batter that are like crispy crumbs. In fact, Long John Silver’s restaurants call these batter bits Crumblies and add them to many of their entrees. These little bits of batter are small enough that they aren’t easy to chew and soften with saliva. Instead they remain solid in the mouth and, if they get separated from the mouthful of food that they were eaten with, they can move to the throat and can cause choking or coughing. Unless the batter crumb is actually broken apart with the teeth, it will not break down simply by being exposed to saliva in the brief time it stays in the mouth.

The same principle that applies to battered foods can be applied to sweet items like cakes, brownies, or cookies that have chopped nuts in them. The nut pieces remain hard even when the food is baked and the small nut particles can separate from the rest of the bite of food in the mouth and cause choking or aspiration. It is wise to avoid baked goods that have nuts in them if you have any difficulties with swallowing.

Peanut butter is sticky and doesn’t dissolve freely in the mouth without help from tongue movement. If you put a blob of peanut butter on your tongue and just let it set there keeping your tongue still, the peanut butter will stay in a lump on your tongue for more than a minute. If you move your tongue rubbing the peanut butter on the roof of your mouth it will gradually melt, but sometimes if the lump is big enough, it can stick on the roof of your mouth or behind your front teeth and will take a while and lots on tongue movement to get it too dissolve. The residue that is created as the peanut butter melts is thick and can cause gagging or choking if a significant amount moves to the back of the throat. A way to avoid having this situation is to mix peanut butter and jelly thoroughly together before it is put into the mouth. The jelly changes the texture of the peanut butter enough to reduce it cohesive nature making it easier to clear from the mouth in a reasonable amount of time without too much effort.

Hopefully, this brief discussion has drawn attention to the less obvious impacts of different foods and readers will consider the “side effects” of foods and their associated textures and changes in texture when preparing food for those they care for. 

 

The Mealtime Partner Dining System

Serving a Variety of Textures and Volumes of Food and the Pace of Eating is User Controlled

For those individuals who have chewing and swallowing difficulties, the Mealtime Partner Dining System can serve foods of a wide-range of textures. The device can serve regular table food that has been cut up, or it can serve chopped, minced, or pureed foods. The amount of food served for each bite can be controlled from a level spoonful to a rounded or heaped spoonful. Thus small bites can be provided for those who should eat a small amount at a time. Food volume is controlled by the unique Bowl Covers that are attached to the bowls.

Additionally, because the user controls when they take a bite of food from the spoon, they can pace how quickly or slowly they eat each bite of food.

The Mealtime Partner Dining Device Presenting a Bite of Food

Because the Mealtime Partner is such a flexible device, it can meet the dining needs of a diverse group of individuals. For complete information about the Mealtime Partner Dining System, click here. For additional information, or for assistance selecting the best eating or drinking system(s) to serve your needs, email us at info@mealtimepartners.com, or give us a call at 800-996-8607.

 

Did You Know? Did you know that the long flowing skirts that women wore in the 1800’s were known as the Septic Skirt? Not only were the skirts heavy and bulky but they also dragged on the ground inside and outside the house. When women walked outside, their skirts were notorious for picking up dirt and disease. In turn, whatever the hemline had picked up was brought home and distributed to the family. The skirts were blamed for the spread of influenza, tuberculosis (TB), and typhoid fever. Hemlines began to rise when women began participating in sporting activities and found shorter skirts easier to walk in. Even after skirts could no longer be blamed for the spread of TB, according to the Centers for Disease Control (CDC), it has remained the leading infectious disease killer in the world. In 2018, 1.7 billion people were infected by TB bacteria.