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Effects of Food and Liquid Properties on Swallowing Physiology and Function in Adults

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Abstract

Foods and liquids have properties that are often modified as part of clinical dysphagia management to promote safe and efficient swallowing. However, recent studies have questioned whether this practice is supported by the evidence. To address this, a scoping review was conducted to answer the question: “Can properties of food and liquids modify swallowing physiology and function in adults?” Online search in six databases yielded a set of 4235 non-duplicate articles. Using COVIDENCE software, two independent reviewers screened the articles by title and abstract, and 229 full-text articles were selected for full-text review. One-hundred eleven studies met the inclusion criteria for qualitative synthesis and assessment of risk of bias. Three randomized controlled trials and 108 non-randomized studies were analyzed. Large amounts of variability in instrumental assessment, properties of food and liquids, and swallowing measures were found across studies. Sour, sweet, and salty taste, odor, carbonation, capsaicin, viscosity, hardness, adhesiveness, and cohesiveness were reported to modify the oral and pharyngeal phase of swallowing in both healthy participants and patients with dysphagia. Main swallow measures modified by properties of food and liquids were penetration/aspiration, oral transit time, lingual pressures, submental muscle contraction, oral and pharyngeal residue, hyoid and laryngeal movement, pharyngeal and upper esophageal sphincter pressures, and total swallow duration. The evidence pooled in this review supports the clinical practice of food texture and liquid consistency modification in the management of dysphagia with the caveat that all clinical endeavors must be undertaken with a clear rationale and patient-specific evidence that modifying food or liquid benefits swallow safety and efficiency while maintaining quality of life.

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Funding

Funding was provided by Beca Igualdad de Oportunidades Fulbright-ANID (BECAS/DOCTORADO EXTRANJERO/56150014) and National Institutes of Health (1K76AG068590).

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Authors and Affiliations

  1. Swallowing and Salivary Bioscience Laboratory, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA

    Rodolfo E. Peña-Chávez & Atsuko Kurosu

  2. Department of Communication Sciences & Disorders, University of Wisconsin-Madison, Madison, WI, USA

    Rodolfo E. Peña-Chávez, Nicole E. Schaen-Heacock & Michelle R. Ciucci

  3. Departamento de Ciencias de La Rehabilitación en Salud, Universidad del Bío-Bío, Chillán, Chile

    Rodolfo E. Peña-Chávez

  4. Department of Surgery-Otolaryngology, University of Wisconsin-Madison, Madison, WI, USA

    Nicole E. Schaen-Heacock, Atsuko Kurosu, Ryo Suzuki & Michelle R. Ciucci

  5. Ebling Library, University of Wisconsin-Madison, Madison, WI, USA

    Mary E. Hitchcock

  6. Department of Food Science, University of Wisconsin-Madison, Madison, WI, USA

    Richard W. Hartel

  7. Division of Geriatrics, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA

    Nicole M. Rogus-Pulia

  8. Swallowing and Salivary Bioscience Laboratory, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison GRECC (11G), Room 4240, Madison, WI, 53705, USA

    Nicole M. Rogus-Pulia

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Peña-Chávez, R.E., Schaen-Heacock, N.E., Hitchcock, M.E. et al. Effects of Food and Liquid Properties on Swallowing Physiology and Function in Adults. Dysphagia 38, 785–817 (2023). https://doi.org/10.1007/s00455-022-10525-2

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