IT201900002823A1 - Food preparation with modified consistency and method for its production - Google Patents

Description

DESCRIPTION

Field of application

The present invention relates to the food sector, in particular to the sector of modified consistency food preparations.

More specifically, the present invention refers to a method for the production of a food preparation with a modified consistency, as well as to the food preparation with a modified consistency obtained therefrom to facilitate the intake of food for dysphagic subjects.

Known art

It is known that the term dysphagia generally refers to all the difficulties or inability to correctly implement an autonomous oral diet. Dysphagia is therefore considered to be a swallowing disorder, that is to say, the ability to properly take food, both in solid and liquid form.

This disorder can be present in people suffering from neurological diseases, such as multiple and neuro-degenerative sclerosis, Parkinson's and Alzheimer's disease, or it can occur following surgery on both the nervous system and other structures directly involved in swallowing (lips, tongue, teeth, pharynx, larynx, esophagus) or even in elderly people, simply due to aging, as a consequence of weakening of the jaw muscles and loss of teeth, or as a side effect of taking certain drugs .

It is also known that, in dysphagic people, the oral preparation phase of the food introduced into the mouth and transformed into a "bolus", which is managed by the lips, teeth and saliva, can only be partially controlled voluntarily, and it is absolutely necessary to transit the food bolus correctly towards the esophagus without it entering the respiratory tract, causing coughing, suffocation or lung inflammation (aspiration pneumonia).

Depending on the level at which the swallowing malfunction occurs, three types of dysphagia have been identified: oral dysphagia (bolus formation through chewing of food mixed with saliva and its transport to the back of the mouth); pharyngeal dysphagia (passage of the bolus from the mouth to the pharynx, where the esophagus and trachea meet and the mechanisms that prevent the aspiration of food into the broncho-pulmonary system are activated); and, finally, esophageal dysphagia (passage of the bolus into the esophagus and then into the stomach).

It is also known a classification concerning the severity of the symptoms of dysphagia, or the so-called "DOSS severity scale" (Dysphagia Outcome and Severity Scale). This classification correlates the severity of the symptoms of a dysphagic subject, assigning him a variable score between 1 and 7, with indications on the type of diet to be followed. The DOSS classes are as follows:

- Severe dysphagia (score 1): oral feeding is not possible, but artificial nutrition (enteral or parenteral) is necessarily required;

- Severe-moderate dysphagia (score 2): oral feeding is possible only partially and in some cases, through the use of thickened liquids; however, artificial nutrition prevails.

- Moderate dysphagia (score 3): facilitating strategies are used through the oral administration of food with a modified consistency.

- Mild / moderate dysphagia (score 4): facilitating strategies are used through the oral administration of food with a modified consistency.

- Mild dysphagia (score 5): facilitating strategies are used through the oral administration of food with a modified consistency.

- Swallowing with functional limits (score 6): it may take a longer time to feed but there is no risk of aspiration of food into the respiratory system.

- Normal swallowing in all situations (score 7): normal diet. It is known that an alteration in swallowing, typical of dysphagia subjects, can cause various problems, including the slowing of the swallowing reflex, the loss of strength of the muscles involved in swallowing, the lack of coordination of breathing with swallowing, up to conditions more serious, such as food aspiration pneumonia, malnutrition and dehydration.

It is known that one of the possible strategies to promote swallowing in dysphagia subjects is dietary re-education, aimed both at preventing and treating the state of protein-energy malnutrition and dehydration and at preventing episodes of aspiration and suffocation. In this way, the dysphagia patient can eat safely, with the least possible effort and introducing all the varieties and quantities of the necessary nutrients.

It is also known that such food re-education can take place operationally by taking food preparations with a modified consistency.

Among the main characteristics of a food preparation with a modified consistency suitable for intake by a dysphagic subject, there are: homogeneity to ensure uniformity of consistency, compactness to reduce the risk of crushing of the food preparation in the cavity oro-pharyngeal, and the viscosity to allow it to slide correctly into the cavity itself.

Among the conventional techniques, notoriously used in hospital kitchens or health care facilities, to change the consistency of food preparations we can mention the shredding and fiulling of the dishes of the daily menu, through the use of small equipment available to the kitchens themselves ( such as, in general, small hand blenders).

However, the product obtained by these techniques may involve risks for the patient's health, as the homogenization activity may not be complete and sufficient, and double consistencies (solid and liquid) not suitable for a patient may coexist in the product. with swallowing disorders. Furthermore, often, to obtain the desired consistency, the blended dishes are nutritionally and organoleptically depleted by the addition of water or broth and, appearing as a substantially liquid puree, are perceived as unappetizing by the dysphagic subject.

The same problem has been encountered with the use of products on the market in the form of freeze-dried products (powder) which, once dissolved in hot water, have a consistency, color and smell very different from those of the starting food and which they present themselves as unappetizing.

In an attempt to make the final product denser, the possibility of adding thickening agents is known, the purpose of which is to maintain the consistency of the blended food in a semi-solid or semi-liquid state.

Among these agents, for example, thickening powders and pre-thickening liquids are known, mainly based on modified starch. However, it has been found that these ingredients, in addition to being perceived by the dysphagic consumer as unnatural, have a viscosity that varies over time, which can further modify the consistency of the food with which they have been mixed, causing an undesirable increase in the risk of suffocation and / or aspiration of liquids or food particles into the lungs.

The problem underlying the present invention is that of providing a food preparation with a modified consistency, capable of effectively relieving the difficulty of swallowing in dysphagic subjects and that can satisfy all nutritional needs, while at the same time being palatable and pleasing.

Summary of the invention

The aforesaid problem has been solved by the present invention by providing a method for the production of a food preparation with a modified consistency having a viscosity of at least 1,500 mPa / s at 40 ° C, suitable for consumption by dysphagic subjects and which can be stored at a temperature of refrigerator for at least 15 days, including the steps of:

a) subjecting at least one food ingredient selected from the group comprising cereals, legumes, vegetables, fruit, eggs, milk and its derivatives, meat and its derivatives, fish and their derivatives, to a pre-cooking;

b) homogenizing the at least one precooked food ingredient of step a), obtaining a food preparation with a modified consistency;

c) vacuum packaging the food preparation with a modified consistency inside plastic packaging for food, applying a vacuum between 700-900 mbar, obtaining a food preparation with a modified consistency packaged;

d) cooking the food preparation with modified consistency packaged by immersion in water having a temperature between 75 ° and 90 ° C for a time ranging from 2.5 hours to 12 hours.

e) subjecting the cooked packaged modified consistency food preparation obtained from step d) to a cooling step by immersion in water having a temperature of 0 ° -5 ° C for a time ranging from 1 hour to 3 hours.

Preferably, the present method further comprises, before step e), a step d ') of subjecting the cooked packaged modified consistency food preparation obtained from step d) to a pre-cooling step by immersion in water having a temperature of 12 ° - 15 ° C for at least 10 minutes, preferably 10 - 20 minutes.

In one embodiment, the food ingredient is selected from the group comprising cereals, legumes, vegetables, fruit, eggs, milk and its derivatives, fish and their derivatives and the pre-cooking step a) takes place for a time ranging from 15 minutes to 45 minutes, being performed by at least one cooking technique chosen by the group comprising browning, boiling, steaming, grilling, baking and microwave cooking.

In this pre-cooking step a) it is possible to add to the aforementioned at least one food ingredient at least one complementary organoleptically characterizing ingredient, which is preferably selected from the group comprising salt, vegetable oils, animal fats, garlic, onion, celery, shallot, mushrooms, spices and herbs.

In a further embodiment, the at least one food ingredient consists of meat or its derivatives and step a) of pre-cooking includes:

i) vacuum-pack the food ingredient inside a food-grade plastic wrapper, applying a vacuum between 700-900 mbar, obtaining the packaged food ingredient;

ii) pre-cook the packaged food ingredient by immersion in water at a temperature between 75 ° and 90 ° C for a time ranging from 2.5 hours to 12 hours;

iii) subjecting the pre-cooked packaged food ingredient obtained from phase ii) to a pre-cooling phase by immersion in water having a temperature of 12 ° -15 ° C for a time of 10-30 minutes, preferably about 15 minutes; iv) subjecting the precooked pre-cooled packaged food ingredient obtained from step iii) to a cooling step by immersion in water having a temperature of 0 ° -5 ° C for a time between 1 hour and 3 hours, obtaining a packaged food ingredient pre-cooked cooled;

v) extract the cooled pre-cooked packaged food ingredient obtained in step iv) from the package and optionally mix it with at least one complementary organoleptically characterizing ingredient.

Preferably, this organoleptically characterizing complementary ingredient is selected from the group comprising salt, vegetable oils, animal fats, garlic, onion, celery, shallot, mushrooms, spices and aromatic herbs.

Subsequently, steps b) -e) described above are carried out.

Preferably, the food preparation with modified consistency suitable for consumption by dysphagic subjects can be stored at refrigerator temperature for a period of between 20 and 50 days, conveniently for a period of 40-50 days.

Preferably, the homogenization step b) is carried out by means of a cutter with a vertical blade.

Preferably, the vacuum packaging step c) takes place at a temperature comprised between 2 ° -10 ° C.

Preferably, the aforementioned food-grade plastic material casings are made of polyethylene / polyamide or polypropylene.

Advantageously, step c) of vacuum packing food preparations allows to obtain an enhancement of the volatile aromatic components that are produced during the subsequent cooking step but which, being the products cooked directly in the closed and sealed package, are not dispersed in the environment. In addition to improving the quality of food, this aspect allows to reduce the use of salt and seasonings compared to traditional cooking.

A further advantage determined by this packaging and cooking phase is the reduction of health and hygiene risks from contamination and / or oxidation in contact with the environment; in fact, the products undergo the cooking and subsequent cooling phases directly in the same vacuum package. In particular, the absence of oxidation processes involving lipids contained in food greatly reduces the production of unpleasant odors.

Further advantages are determined by the cooking phase d).

First of all, this phase of cooking at low temperatures (75-90 ° C) avoids thermal shock as well as the evaporation and dispersion of nutrient-rich liquids, to which food preparations are typically subjected during traditional cooking methods, for example for conduction, convection or radiation (110-130 ° C).

The preservation of the nutrients within the modified consistency preparation of the present invention advantageously allows to obtain tastier products, and therefore more palatable for dysphagic subjects.

In addition, this cooking phase allows to obtain a final product that maintains its chemical, physical and organoleptic characteristics constant, also thanks to the guaranteed microbiological stability due to the elimination of any heat-sensitive pathogenic microorganisms in the original foods.

The cooking at low temperatures of the present invention also advantageously allows to obtain food preparations characterized by a significantly lower glycemic index than that of the same food preparations cooked according to traditional cooking methods.

The transmission of heat to the preparations of the present invention takes place by means of water (that is, in a water bath); this advantageously involves uniform and, consequently, effective cooking of food preparations with respect to other types of heat transmission.

The low temperature vacuum cooking with continuous cooling to which the preparations of the present invention are subjected guarantees greater hygienic-sanitary safety, inhibits the oxidation of lipids and proteins, also ensuring a better preservation and enhancement of the organoleptic characteristics of the same and the maintenance of the nutritional characteristics, compared to vacuum cooking followed by temperature reduction not continuously, but inside cold rooms, separately from cooking.

In particular, in the embodiment in which the food preparation is based on vegetables, the cooking phase is advantageously followed immediately by the cooling phase (therefore the pre-cooling phase is not performed), to preserve the intensity of the characteristic color of the material. before departure.

The present invention also relates to a food preparation with a modified consistency having a viscosity of at least 1,500 mPa / s at 40 ° C suitable for consumption by dysphagic subjects and which can be stored at refrigerator temperature, obtainable from the aforementioned method of the present invention.

Preferably, the modified consistency food preparation may further comprise a thickener selected from the group comprising: corn starch, potato starch and xanthan gum.

In one aspect, the modified consistency food preparation according to the present invention has a viscosity between 1,500 and 4,900 mPa / s at 40 ° C and is suitable for use in the treatment of subjects suffering from oral dysphagia.

In another embodiment, the aforementioned modified consistency food preparation has a viscosity greater than 5,000 mPa / s, preferably between 5,000 and 10,000 mPa / s at 40 ° C, for use in the treatment of subjects suffering from pharyngeal dysphagia .

The product obtained from the process described above is a homogenized food preparation cooked and vacuum-packed, which advantageously has a very palatable taste and appearance for subjects suffering from dysphagia.

This preparation preferably has a shelf life of about 40-50 days at refrigerator temperature (2 ° -4 ° C), maintains its physical, chemical and organoleptic characteristics unaltered over time and is free of additives and preservatives.

Furthermore, the food preparations packaged according to the present invention can be quickly prepared for consumption; in fact, it is sufficient to regenerate them by heating them in a bain-marie while they are still contained inside their sealed package. Consequently, no further processing steps of the packaged product are necessary, such as for example cooking and / or blast chilling, thus reducing the product handling steps and the overall meal preparation time for the dysphagic person.

This advantage is not ensured, however, by the conventional procedures for preparing meals for dysphagia patients carried out by homogenizing the foods included in the menu of the day, with the use of immersion blenders or similar equipment, as is frequently the case in most kitchens that deal with it. of the diet of dysphagic subjects.

Furthermore, simple blending can cause serious risks to the patient's health due to the inadequate and / or incomplete homogenization of the dishes, which is obtained with the use of inappropriate tools (generally small immersion blenders), thus resulting in a high risk of coexistence in food of double consistencies (liquid and solid), which favors the aspiration of food / liquids in the respiratory tract and increases the risk of suffocation of the dysphagic subject.

Advantageously, the food preparations according to the present invention have characteristics of homogeneity, compactness and viscosity which make them particularly suitable for consumption by a dysphagic person.

In particular, food preparations have a homogeneous and uniform consistency, and are free from unwanted double consistencies (solid and liquid), which would make swallowing complex for a dysphagic subject, thus exposing him to a high risk of aspiration of liquids and / or food in the airways.

The compactness of the food preparations according to the present invention minimizes the risk of them breaking into the oral cavity.

In order to achieve the desired density and compactness, according to requirements, the food preparations can optionally comprise thickeners, such as starches, in particular corn starch and potato starch and water-soluble fibers, in particular xanthan gum.

The adequate viscosity of food preparations ensures a reduction in friction against the walls of the oropharyngeal cavity and therefore a correct degree of sliding in the cavity itself. To obtain the desired viscosity, depending on the needs, the food preparations of the invention may include water, cow's milk, meat or vegetable broth, or condiments such as cream and olive oil or extra virgin olive oil.

Another advantage of the present invention consists in the fact that the nutritional characteristics (bromatological composition) of the food preparations with modified consistency described here are studied and designed at the time of definition and standardization of the recipes and remain practically unchanged following cooking, thanks to the technology of vacuum cooking with continuous cooling inside the packages.

Therefore, by administering defined portions of carbohydrate-based food preparations, protein-based food preparations and vegetable-based food preparations obtained according to the method of the present invention, the intake of all macronutrients and micronutrients of which the dysphagic subject is guaranteed needs, significantly reducing the risks of malnutrition and sarcopenia, generally very high in fragile subjects suffering from dysphagia.

The present invention also relates to a kit for use in the treatment of dysphagia, comprising a modified consistency food preparation as described above and a separately packaged viscosity regulator, which consists of an aqueous solution comprising maize maltodextrin and whey protein. milk.

Advantageously, this viscosity regulator ensures a contribution of calories, carbohydrates, proteins and fats comparable to the average values of the same nutrients contained in the food preparations obtained according to the invention.

The use of this regulator therefore allows to regulate the consistency of the food preparations themselves, depending on the viscosity of the original ingredients, where necessary, ensuring the maintenance of the bromatological composition almost unchanged and avoiding the nutritional impoverishment that would occur with the simple addition of water or common vegetable broth.

The expression "food preparation with modified consistency" means a food preparation suitable for promoting the feeding of patients with mechanical or functional swallowing problems, by virtue of adequate characteristics of homogeneity, viscosity and compactness.

With the expressions "food preparation based on carbohydrates" or "food preparation with modified consistency based on carbohydrates", used here interchangeably, we mean a food preparation with modified consistency as defined above which mainly includes carbohydrates, deriving in particular from durum wheat semolina, rice, potatoes, etc.

The expression "protein-based food preparation" or "protein-based food preparation with modified consistency", used here interchangeably, means a food preparation with a modified consistency as defined above which mainly includes proteins, deriving in particular from meat, fish, but also from eggs and cheeses.

The expression "vegetable-based food preparation" or "vegetable-based food preparation with modified consistency", used here interchangeably, means a food preparation with a modified consistency as defined above which mainly includes vegetables.

With the expression "traditional cooking methods", as used here, we mean cooking by convection (frying, boiling, immersion in a hot liquid), conduction (cooking on the plate, on the grill or in a pan) and irradiation (cooking in oven) which take place at temperatures between 110-130 ° C.

The expression "continuous cooling", as used here, means that the cooling phase of the food preparation takes place immediately after the cooking phase, thus resulting substantially in continuous with the previous cooking phase.

Brief description of the figures

Figure 1 shows a graph of the mean glycemic response curve in relation to the consumption of the sample of glucose (Glucose), of the sample of vacuum cooked lentil soup according to the present invention (SV), of the sample of cooked lentil soup according to the method traditional (TR).

Detailed description

The procedure

The present invention relates to a method for the production of a food preparation with a modified consistency suitable for favoring swallowing by dysphagic subjects.

The main steps of this method are described below.

- Reception and storage of ingredients (raw materials)

The reception and storage phases include the proper verification of the raw materials received and the storage of the same, depending on the type of product, perishable or non-perishable, inside the warehouse (at room temperature) or inside cold rooms at a controlled temperature.

- The precooking of the ingredients

The processing areas, the location of the equipment and the paths inside the kitchen allow you to operate with a "forward" production flow to guarantee the safety of the final product, in order to avoid possible cross-contamination between the food preparations being processed (in in particular food preparations cooked with food preparations still raw).

Every day, for each recipe in production on the following day, the individual ingredients that compose it are weighed and prepared in special processing trolleys.

The trolleys thus prepared are placed inside the factory's positive cold room of the day, ready for subsequent processing.

At the time of processing, the ingredients are taken from the cold room to make a specific food preparation, which are then subjected to a pre-cooking phase.

This pre-cooking phase can take place in different ways depending on the ingredient to be treated, using, among others, professional bratt pans (mainly dedicated to cooking vegetables), high pressure salsamat (used for the preparation of sauces, creams and velvets), steam boilers (for uniform cooking mainly of sauces, creams and condiments), electric ovens (capable of performing the three different cooking functions: convection, mixed and steam and equipped with an automatic washing system, dedicated to various food preparations) , electric pasta cookers (ideal for cooking mainly cereals and legumes).

- Homogenization and abatement

The ingredients that make up the selected food preparation are subsequently assembled and homogenized using professional vertical blade cutters.

These tools allow you to mix hot or cold ingredients until you get a pre-cooked food preparation based on carbohydrates, or based on vegetables or proteins, which appears as a homogeneous, compact and viscous compound. Once homogenization is complete, the temperature of the food preparations thus obtained is rapidly lowered to 2 ° C by means of special blast chillers.

- Vacuum packing

After blast chilling, the food preparations thus prepared and cooled are vacuum-packed cold (+ 2 / + 10 ° C) in plastic packaging for food made from a multilayer film of polyethylene / polyamide or polypropylene by means of special thermoforming machines ( Reference legislation: Regulation 1935/04 / EC, Regulation 2023/06 / EC, Commission Regulation EU 10/2011 of 14/01/2011 and subsequent amendments, updates and modifications).

In particular, after setting the degree of breakthrough of the plastic material and the vacuum, a pre-metered quantity of homogenized food preparation is inserted into a plastic material for foodstuffs obtained from a multilayer film of polyethylene / polyamide or polypropylene and, through a vacuum pump, the packaging machine sucks air from the package by applying a vacuum that varies between 700mbar and 800mbar.

The subsequent heat sealing seals the food preparation inside the package.

- Vacuum cooking at low temperature with continuous cooling The cooking of food preparations sealed inside the aforementioned wrappers takes place in a system that includes, separately:

- 4 main cooking tanks;

- a first storage tank containing a predetermined volume of water maintained at a temperature of about 97 ° C,

- a second storage tank containing a volume of freezing water maintained at a temperature of about 2 ° C;

- a system for supplying hot water and icy water from the storage tanks to the pools;

- an aqueduct water supply system for pre-cooling of the products;

- a system for implementing and controlling the cooking and cooling processes based on pre-established recipes.

In particular, the packages are placed on perforated and stackable baskets, which are subsequently positioned and completely immersed inside the main tanks filled with hot water (temperature between 75 ° C and 90 ° C), where the cooking of the food preparation takes place. sealed inside the packages.

The cooking time varies between 2.5 hours and 12 hours, depending on the food preparation to be cooked.

In particular, the aforementioned hot water derives from the mixing of water taken from the first storage tank with water from the aqueduct until the desired temperature is reached.

A water recirculation system and integration of the same with water coming from the first tank is foreseen in order to compensate the losses due to the dispersions of the system and to the heating of the products, in order to keep the water temperature constant throughout the cooking time of food preparation.

For the same purpose, the temperature of the water inside the tank is made uniform by varying the level of water present in the cooking tank, keeping the products completely immersed.

Once the cooking time is over, the pre-cooling phase takes place (optional, depending on the type of food preparation).

This phase takes place by emptying the tanks of hot water and filling them with water from the aqueduct, having a temperature generally between 12 / + 15 ° C.

The quantity of mains water is such as to completely submerge the trolleys on which the packages containing the cooked food preparation are placed.

The permanence of the aqueduct water inside the tank is 15 minutes. Subsequently, the tank is emptied of the aqueduct water.

Filling the tank with water at a temperature between 0 ° and 5 ° C, typically between 1 ° C and 3 ° C, released from the special second tank, starts the cooling phase.

The packages remain completely submerged in the freezing water for a time between 1 and 3 hours, during which the water temperature is uniformed by varying the level of the water in the tank, making sure to keep the packages constantly immersed in the water and making appropriate additions of further icy water.

The combination of continuous cooking and cooling involves, in fact, a pasteurization of the food preparation carried out in such a way as to obtain a compliant and stable product from a microbiological point of view, which can be stored at refrigerator temperature (2-4 ° C) for a period of at least 15 days, preferably 40-50 days from the date of production and provided with excellent organoleptic and structural characteristics.

The aforementioned stages of cooking, pre-cooling and continuous cooling are controlled by a computer. Based on the type of product to be cooked, different pasteurization programs have been validated which provide for cooking and cooling phases that differ in time and temperature.

The validation of a program takes place in a test phase, by inserting a probe inside the food preparation supported by the aforementioned procedure and by monitoring the progress of the process; in particular, the actual attainment of the temperature is monitored, which guarantees the health and hygiene safety of food preparations. Once validated, the created and chosen program is reported on the recipe production sheet and made selectable by the reference computer, so that each product follows its specific process, such as not only to make it hygienically safe, but also not to alter it. chemical, physical (in this case, in particular, consistency) and organoleptic qualities.

At the end of the cooking phase and the immediate subsequent continuous cooling phase, the food preparation sealed inside the packages is completely cooked and has a temperature between 2 ° C and 5 ° C.

- Refrigerated storage

Subsequently, at the end of the continuous cooling phase, the packages are removed from the tanks, subjected to further weighing to confirm the one carried out before pasteurization, and then labeled.

Subsequently, the packaged food preparations are stored in positive cells at 2 / + 4 ° C awaiting distribution to customers.

The product obtained from the above procedure

The food preparations with modified consistency obtained by the above procedure can be divided into the following two classes defined on the basis of viscosity:

- Semi-liquid food preparations (viscosity between 1,500mPa / s and 4,900mPa / s at 40 ° C) homogenized food preparations with a higher liquid component, indicated when the swallowing disorder is localized at the oral level (difficulty in chewing, bolus formation and its progression towards the back of the mouth), but there is a good swallowing reflex at the pharyngeal level. Food preparations of this consistency do not in fact require chewing but only a slight preparation by the mouth but, being a predominantly liquid component, proceed rather quickly towards the pharynx, which is why a rather immediate activation of the swallowing reflex is required.

- Semi-solid food preparations (viscosity higher than 5,000 mPa / s at 40 ° C, preferably between 5,000 mPa / s and 10,000mPa / s at 40 ° C homogenized food preparations with a higher solid component, indicated when the swallowing disorder is localized in the pharynx ( slow and difficult activation of the swallowing reflex), but there are good abilities to prepare the bolus at the oral level. Food preparations of this consistency, in fact, require greater activity at the level of the mouth (stirring and pushing towards the back) but, being more dense, they proceed more slowly towards the pharynx, stimulating the glottis and giving sufficient time for the swallowing reflex (in this case slowed down) to activate correctly.

Semi-liquid and semi-solid food preparations are the basis of diets for people suffering from moderate and mild dysphagia, whose therapy is in fact based on the intake of food preparations that alleviate, at least partially, the difficulties in swallowing such subjects.

Furthermore, thanks to the process of the present invention, in particular the vacuum cooking and the immediate subsequent continuous cooling, the food preparations of the present invention are rich in nutrients and are highly palatable.

Specifically, as demonstrated by the Applicant in the Examples, the intake of the food preparations with a modified consistency of the present invention determines a significant improvement in the nutritional status of dysphagic subjects.

In fact, for example, the food preparations of the present invention contribute to increasing body weight, thanks to their balanced supply of nutrients, counteracting malnutrition. The balanced supply of proteins guaranteed by the preparations of the present invention determines a significant increase in the levels of pre-albumin and albumin, leading patients from being malnourished to being normal-fed. In addition, they contribute to significantly increase the values of vitamin D, ionized calcium and folic acid, important metabolites for bone health and at the same time significantly reduce the concentration of inflammatory markers in the body (eg. C reactive protein).

A further factor that favors the increase in body weight of dysphagia subjects lies in the fact that the food preparations of the present invention are particularly popular, because they have a color and taste very similar to those of the original ingredients (thus keeping the memory of traditional and well-known dishes), as well as an adequate consistency for correct swallowing. The food preparations of the present invention also have a lower glycemic index than the same food preparations cooked according to traditional cooking methods.

The glycemic index is a measure of the speed with which the blood sugar changes in relation to the intake of a certain food. It is defined as the incremental area under the glycemic response curve (AUC) determined by a portion of food containing 50 g of available carbohydrates, expressed as a percentage of the AUC determined by 50 g of glucose (reference food) in the same subject. . A food with a low glycemic index allows you to avoid spikes in blood sugar and insulin, and to reduce the risk of onset of certain metabolic diseases, such as diabetes.

This characteristic of the food preparations with modified consistency of the present invention significantly contributes to the maintenance in good health of dysphagic subjects, who typically undergo food problems linked to malnutrition and dehydration.

The vacuum-packaged food preparations with modified consistency of the present invention have a shelf-life of about 40/50 days.

The term "shelf-life", as used herein, refers to the maximum period within which the food preparation of the present invention can be kept at a refrigerator temperature (+ 2 / + 4 ° C) without altering its quality; the shelf life is validated by organoleptic and microbiological analysis, comparing the freshly prepared vacuum-packed food preparation with the same food preparation after a storage period of 50 days from the date of production.

The food preparations with modified consistency of the present invention are devoid of any additive and / or preservative and are stable from a microbiological and nutritional point of view during the whole period of their shelf-life.

In order to be consumed, the food preparations of the present invention can be heated in a water bath to a maximum temperature of 80 ° C for about 30 minutes directly in the vacuum package; at the end of the heating phase, the package is first shaken, then opened and the food preparation is served.

In a further aspect of the present invention, a kit is also described comprising a packaged modified consistency food preparation obtained according to the method of the present invention and, separately, a packaged viscosity regulator.

The viscosity regulator, that is an aqueous solution comprising maltodextrin and whey proteins, can be added to the ready-to-serve food preparation (after heating, which takes place in the same way as the preparations of the present invention), before it is served to the consumer. .

In this way, it is possible to further modify the consistency of the food preparation to meet the specific requests and tastes of dysphagia subjects, thus alleviating the difficulties of subjects suffering from different types of dysphagia.

Furthermore, since the viscosity regulator comprises a source of carbohydrates and proteins, its addition to the food preparation of the present invention represents a nutrient enrichment of the food preparation itself.

On the contrary, the addition of simple broth or water to soften / dilute the consistency of food preparations with a modified consistency, an operation frequently used in kitchens, leads to a nutritional depletion of the preparations themselves.

The present invention will be further described with reference to some embodiment examples provided below for illustrative and non-limiting purposes.

EXAMPLES

Example 1 - The detailed process of the present invention for the production of modified consistency "carrot mousse"

79% of carrots, 10% of extra virgin olive oil, 8% of water, 2% of grated cheese, salt and garlic were weighed and stored in a cold room at a temperature of 2 / + 4 ° C .

The percentages reported above, as well as all percentages indicated in the present description, must be understood as percentages by weight on the total weight of the food preparation.

Subsequently the ingredients were removed and subjected to the precooking phase in the bratt pan for about 30 minutes at a temperature of 80 ° C.

Subsequently, the ingredients were homogenized by means of a vertical blade cutter for 15 minutes obtaining a food preparation based on pre-cooked homogenized carrots.

The food preparation thus obtained was cooled in about 30 minutes to a temperature of 2 ° C in a blast chiller.

A pre-measured quantity of about 1 kg of food preparation was subsequently vacuum-packed at a temperature of about 2 + 4 ° C in a polyethylene / polyamide or polypropylene plastic wrapper for food, using a thermoforming machine, applying a vacuum equal to 800 mbar.

The sealed packages of about 1 kg of food preparation thus obtained were weighed and placed on perforated and stackable trolleys, which were immersed in a tank of the cooking system filled with 500 liters of hot water (85 ° C), for 30 minutes.

Every 15 seconds, the water level was changed, to uniform the temperature of the water in the tank, keeping the packages completely submerged.

Subsequently, the cooking tank was emptied of hot water, which was directed to its special system tank, and was filled with cold water (temperature of 2 ° C), released from the special system tank.

The carrot-based food preparation of the present invention does not require the pre-cooling step; consequently, the cooking phase is immediately followed by the cooling phase.

The packages remain completely submerged in cold water for 1 hour and 30 minutes, a time during which the water temperature is uniformed by varying the water level in the tank every 15 seconds, making sure to keep the packages constantly immersed in water and making suitable additions of further cold water.

At the end of the cooling phase, the food preparation sealed inside the packages was completely cooked and had a temperature of 2 - 4 ° C.

The trolleys are removed from the cooking tank and the packages are subjected to further weighing, to verify and confirm the weighing carried out after cooking.

The weighed packages were labeled and then stored in positive cold rooms at 2 / + 4 ° C awaiting distribution to customers.

Example 2 - the detailed process of the present invention for the production of modified consistency "pork with rosemary"

94% of pork, 4.5% of extra virgin olive oil, 1.5% of a mixture of olive oil, salt, pepper and rosemary were weighed and stored in a cold room at a temperature of 2 / + 4 ° C.

The percentages reported above, as well as all percentages indicated in the present description, must be understood as percentages by weight on the total weight of the food preparation.

Subsequently, a pre-measured amount of pork is flavored with the addition of salt and pepper and vacuum-packed in a polyethylene / polyamide or polypropylene plastic wrapper for food, using a thermoforming machine, applying a vacuum of 800 mbar.

The sealed packages of about 1 kg of food preparation thus obtained were weighed and placed on perforated and stackable trolleys, which were immersed in a cooking system tank, filled with 500 liters of hot water (75 ° C), for 5 hours. .

Every 5 seconds, the water level was changed, to uniform the temperature of the water in the tank, keeping the packages completely submerged.

Subsequently, the cooking tank was emptied of hot water, which was directed to its special tank of the system, and was filled with water from the aqueduct (temperature of 12/15 ° C), keeping the packages completely immersed. for 15 minutes (pre-cooling phase).

Subsequently, the tank was emptied of the water from the aqueduct and filled with cold water (+ 2 ° C) from the special system tank.

The packages were completely submerged in cold water for 1 hour and 30 minutes, a time during which the water temperature is uniformed by varying the water level in the tank every 5 seconds, making sure to keep the packages constantly immersed in the water and making appropriate additions of further cold water (cooling phase).

At the end of the cooling phase, the semi-finished pork product thus obtained, sealed inside the packages, was completely cooked and had a temperature of 2 - 4 ° C.

The trolleys are removed from the cooking tank and the packages are subjected to further weighing, to verify and confirm the weighing carried out after cooking.

The weighed packages were labeled and then stored in positive cold rooms at 2 / + 4 ° C.

Subsequently, the packages of cooked semi-finished pork meat were removed from the positive cold rooms at 2 / + 4 ° C and opened.

The remaining ingredients, extra virgin olive oil, olive oil and rosemary were added to the aforementioned semi-finished product and everything was homogenized by means of a vertical blade cutter for 15 minutes obtaining a pre-cooked food preparation based on rosemary pork.

Subsequently, a pre-dosed quantity of about 1 kg of food preparation was subsequently vacuum-packed in a food-grade plastic wrapper obtained from a polyethylene / polyamide or polypropylene film, by means of a thermoforming machine, applying a vacuum equal to 800 mbar.

The sealed packages of about 1 kg of food preparation thus obtained were weighed and placed on perforated and stackable trolleys, which were immersed in a tank of the cooking system, filled with 500 liters of hot water (90 ° C), for 1 hour. and 30 minutes.

Every 5 seconds, the water level was changed, to uniform the temperature of the water in the tank, keeping the packages completely submerged.

Subsequently, the cooking tank was emptied of hot water, which was directed to its special system tank, and was filled with water from the aqueduct (temperature of 12/15 ° C), keeping the packages completely immersed. for 15 minutes (pre-cooling).

At the end of the pre-cooling phase, the tank was emptied of the water from the aqueduct and filled with cold water (+ 2 ° C) from the special system tank.

The packages were completely submerged in cold water for 1 hour and 30 minutes, a time during which the water temperature was uniform by varying the level of water in the tank every 5 seconds, making sure to keep the packages constantly immersed in the water and making appropriate additions of further cold water (cooling phase).

At the end of the cooling phase, the food preparation sealed inside the packages was completely cooked and had a temperature of 2 ° C.

The trolleys are removed from the cooking tank and the packages are subjected to further weighing, verification and confirmation of the weighing after cooking.

The weighed packages were labeled and then stored in positive cold rooms at 2 / + 4 ° C awaiting distribution to customers.

Example 2A - Cooking and cooling parameters

Depending on the modified preparation food, the temperature and time parameters of the continuous cooking, pre-cooling and cooling phases of the present invention may vary to ensure uniform and complete cooking of the ingredients that make up the food preparations.

Table a) below shows the water temperature and time parameters of the cooking, pre-cooling (optional) and cooling phases applied for the production of carbohydrate-based food preparations, protein-based food preparations, food preparations vegetable-based and semi-processed meat products (which constitute protein-based food preparations after further processing steps).

Example 3 - Vacuum cooking of the present invention compared with traditional cooking: effects on the glycemic index of a food preparation.

A study was carried out to determine and compare the glycemic index value referred to two samples of the same product, which were cooked by the sous-vide cooking technique according to the present invention and according to the traditional cooking, respectively.

The comparison made it possible to establish, in the case of the desired product, which of the two cooking techniques favors the achievement of a lower glycemic index.

The classification of the glycemic index that best respects the digestive physiological reality is as follows:

- low glycemic index: value between 0 and 35

- average glycemic index: value between 36 and 50

- high glycemic index: value between 50 and 100

Materials and methods

The method for measuring the glycemic index was based on the indications of the following references: “Food and Agriculture Organization of the United Nations. FAO Food and Nutrition Paper 66. Carbohydrates in human nutrition. Report of an FAO / WHO expert consultation on carbohydrates, Aprii 14-18,1997, Rome, Italy. Rome Italy: FAO, 1998 "and" Brouns F, Bjorck I, Frayn KN, et al., Glycaemic index methodology Nutr Res Rev. 2005 Jun; 18 (1): 145-71 ".

This method was integrated with the observations of “Wolever et al., Measuring the glycemic index of foods: interlaboratory study. A J Clin Nutr 2008; 87 (suppl) 247S-57S ".

The analyzes of the glycemic content were carried out in the laboratory of Neurobiology and Integrated Physiology of the Department of Biology and Biotechnology “L. Spallanzani "of the University of Pavia.

The tested food preparation

As part of this study, two samples of the same "lentil and pumpkin soup" were delivered to the analysis laboratory, at a refrigerated temperature, with information on the size of the portions, the nutrient content and the cooking method.

In order to be consumed, the two samples, which are completely identical from a nutritional point of view, required their cooking to be completed respectively in a thermostatic bath at 65 ° C for 10 minutes (vacuum packed soup), and in an oven. microwave at 850 W for 2 minutes (soup not packaged).

The laboratory provided the glycemic index value of the glucose sample used as a reference (Glucose Sciavo Diagnostics 75g / 150ml, Sciavo Diagnostics International S.r.l.).

The test and reference soup samples were given in portions providing 50g of available carbohydrates, defined as total carbohydrates net of fiber.

The order in which the samples were tested, including the reference order, was randomized.

Subjects

Ten healthy and diabetes-free volunteers were recruited: 7 females (not pregnant and not breastfeeding) and 3 males, aged between 25 and 60 years (40 ± 12). To increase the accuracy of the glycemic index calculation, subjects were asked to eat a normal meal the evening before the study and to avoid unusual physical activity.

Experimental procedure

Subjects were studied on separate occasions for each sample. The samples (soup and reference) were administered on separate occasions for each sample, one morning after a single day of overnight fasting of 10-12 hours.

For each test, a fasting blood draw was performed and within 15 minutes the subject took the sample at a leisurely pace; subsequent blood samples were taken at 15, 30, 45, 60, 90 and 120 minutes after the start of the sample.

While taking the sample, it was possible to consume water in quantities between 250ml and 500ml.

The laboratory sampled whole blood by capillary sampling from the finger with LifeSca's “One Touch Ultra Easy”, which provides the blood glucose value in mg / 100ml.

The results

Glucose values were converted to mM / L.

Figure 1 shows the average glycemic response curve compared to fasting glycemia, calculated on the 10 subjects tested.

In relation to each sample (glucose, lentil soup and vacuum cooked pumpkin according to the present invention (SV), and lentil soup and pumpkin cooked according to the traditional method (TR)), the incremental area of the glycemic response was calculated ( AUC) using the "trapezoid rule", for each subject. Glucose values below the fasting value were ignored, as required by the standardization of the procedure (Wolever et al., 2008). The ORIGIN® program was used to calculate the incremental area

The mean value of the AUC values resulting from the individual subjects was calculated for each sample.

The glycemic index of each sample was expressed in percentage values as the ratio of the average of the AUC values of the tested sample to the average of the AUC values of the reference sample (glucose).

The glycemic index values are shown in Table 1 below:

Glycemic index sample

Glucose 100

Lentil soup and TR 58 soup

Lentil soup SV 46

Table 1: Samples and related glycemic indexes

Referring to the previous classification of high, medium and low glycemic index values, it emerges that the lentil and pumpkin soup obtained by vacuum cooking has a glycemic index classified as "medium", while the same product prepared by traditional cooking is characterized by a glycemic index classified as "high".

In light of the above, the sous-vide cooking technique made it possible to obtain a lentil and pumpkin soup with a glycemic index of 12 percentage points lower than the equivalent product obtained with the traditional cooking technique.

Vacuum cooking therefore has the advantage of guaranteeing a lower glycemic index of food preparations than that obtained with traditional cooking techniques.

Example 4 - List of some examples of food preparations with modified consistency of the present invention

The food preparations with modified consistency according to the present invention are many and, by way of non-limitation, some examples are reported in Table 2 below, subdividing them into: food preparations based on carbohydrates, food preparations based on vegetables and food preparations based on proteins.

Food preparations based on Speck and saffron pasta

carbohydrates Pasta al'amatriciana

Pasta with tomato sauce

Pasta alla norma

Risoto alla Milanese

Risoto with gorgonzola

Risoto with mushrooms

Ricotta and pesto pasta

Cream of potatoes

Cream of zucchini, leeks and potatoes Rice soup with vegetables

Pureed beans

Pea cream

Chickpea cream with rosemary

Food preparations based on Carrot Mousse

vegetables Pea mousse

Stewed peppers

Green bean and potato mousse

Vegetable caponata

Vegetable salad

Herb and potato mousse

Mashed potatoes

Grated cauliflower

Food preparations based on Chicken with vegetables (potatoes and courgettes) proteins Cod with vegetables

Livorno codfish

Beef with pizzaiola

Ham Mousse

Chicken with vegetables

Citrus turkey

Beef with vegetables

Pork with rosemary

Pork with vegetables

Pian di zucchini

Flan Spinach

Table 2: Examples of modified consistency food preparations of the present invention.

Example 5 - Examples of recipes of food preparations with modified consistency according to the present invention.

Bean puree

Ingredients:

• Water: 71%

• Dried borlotti beans: 19%

Potato flakes: 4%

■ Whey protein (contains soy lecithin) 3%

• Onion <2%

• Extra virgin olive oil <2%

• Vegetable cube without glutamate (salt, dehydrated vegetables 31% (onion, carrot, potato) in variable proportions, yeast extract, maize maltodextrin) <2% • Salt iodized <2%

• Basil <2%

Risoto alla Milanese

Ingredients:

• Cream of rice (Water; rice flour; iodized salt) 48%

• Water 38%

• Tresco grated mix cheese (Aged cheeses: Grana Padano DOP (Milk, salt, rennet, preservative: E1105 (Lysozyme: protein extracted from egg)) 4%

• Whey protein (contains soy lecithin) 4%

Cream powder (Cream, skim milk, stabilizer: E450)

• Extra virgin olive oil <2%

• Butter <2%

• Fine iodized salt <2%

• Saffron <2%

Cod with vegetables

Ingredients:

• Vegetables in variable proportions (Carrots; courgettes) 41%

■ Cod (Alaska origin) 32%

• Potatoes 20%

Mixed vegetables for sautéing (Vegetables in variable proportions: carrot, celery, onion) 3%

• Olive oil 2%

• Thickener: XANTHANE GUM <2%

• Fine iodized salt <2%

Pork with rosemary

Ingredients:

• Cooked pork (Pork, salt, pepper) 94%

• Extra virgin olive oil 4.5%

• Olive oil <2%

• Rosemary <2%

Carrots

Ingredients:

• Carrots 79%

• Extra virgin olive oil 10%

• Water 8%

• Fresh grated mix cheese (aged cheeses: Grana Padano DOP (milk, salt, rennet, preservative: E1105 (Lysozyme: protein extracted from egg)), Parmigiano Reggiano DOP (milk, salt, rennet)) 2%

• Fine iodized salt <2%

Garlic <2%

For all the food preparations listed above, the respective microbiological characteristics were determined at time zero (i.e. at the beginning of the life of the finished product), obtaining the values shown in the following table:

Example 6 - Determination of the viscosity of the food preparations with modified consistency of the present invention

Reference classification

Scientific literature has validated different classification scales of solids and liquids based on their viscosity.

In particular, a study by the "American Congress of Rehabilitation Medicine" and "American Academy of Physical Medicine and Rehabilitation" classified diets for dysphagia based on their viscosity, measured by a special viscometer, in cP (Centipoise) or mPa.s (Millipascal / second) and "Line Spread Test", which measures the sliding of a liquid or food, in centimeters, along a flat surface and which has proved to be a valid practical method of measuring viscosity, related to the measurements of the viscometer .

Specifically, it has been shown that the viscosity measured by a viscometer increases exponentially as the concentration of the solution increases, while the flow of the Line Spread Test is inversely proportional to it.

The viscosity determined with the viscometer and the "Line Spread Test" (LST) made it possible to divide the foods according to viscosity into four different categories, as follows:

First category (LST> 4 cm, viscosity 1-9 mPa.s): water, orange juice, There is no food / liquid suitable for a diet for dysphagia in this category.

Second category (LST 3.0-3.9 cm, viscosity 10-99 mPa.s): drinking yoghurt, tomato juice, thickened liquids (water gel).

Third category (LST 1.1 -2.9 cm, viscosity 100-9.999 mPa.s): Greek yogurt, whipped vegetables, velvety, vegetable creams, semolina.

Fourth category (LST 0-1 cm, viscosity> 10,000 mPa.s): pudding, mashed potatoes, pureed cota meat.

The food preparations of the present invention have been subjected to the aforementioned classification, based on viscosity, by using a special professional viscometer (PCE-RVI2, R2-R7 impellers for medium-high viscosity) for non-Newtonian fluids (i.e. whose viscosity varies with the variation of the rotational speed of the impeller and the applied shear force).

The rotational viscometer PCE-RVI 2 V1R

The viscosity of a liquid can be precisely determined with the rotational viscometer PCE-RVI 2 V1R. The rotational viscometer measures the mechanical resistance of a liquid which acts against the rotating movement of a cylinder.

The result is a viscosity value referred to the cylinder geometry, which can be indicated in the range between 20 - 13,000,000 mPa s, with an accuracy of ± 1%. The rotational viscometer also measures the temperature of the test liquid and displays it in the 4-line display, as well as other parameters such as the number of rotations, the selected rotor or the set range. The PCE-RVI 2 V1R rotational viscometer menu is used with the keys on the front panel and allows, in combination with different rotor geometries, the optimal adaptation of the parameters to the properties of the liquid.

Via the RS-232 interface, the PCE-RVI 2 V1R rotational viscometer can be connected to a computer for subsequent in-depth analysis of the results.

Features:

- DIN ISO 2555

- 19 levels of rotation

- RS-232 interface

- Software

- Cylinders

- Temperature measurement

- Wide scope of application

- LCD display with multiple indication

Technical specifications:

Measuring principle: Rotational viscometer ASTM / - DIN ISO 2555 Rotational speed (rpm) 0.3 / 0.5 / 0.6 / 1 / 1.5 / 2 / 2.5 / 3/4/5/6 / 10/12/20/30/40/50/60/100/200

Viscosity: 20 - 13,000,000 mPa s

Accuracy: ± 1%

Temperature / Resolution / Accuracy: -15 - 180 ° C / 0.1 ° C / ± 1 ° C Display indications: Temperature, Rotations, Measuring system, Viscosity Power supply: 100 - 240 V AC 50/60 Hz

Operating conditions: 10 - 40 ° C / <80% R.H.

Dimensions: 330 x 300 x 430 mm

Weight: 10 kg

Calibration: BS EN ISO 17025 certified for non-Newtonian fluids, accredited according to UKAS at test temperature of 20-25 ° C.

The parameters of the viscometer for measuring the viscosity of the food preparations of the present invention

The parameters for the determination of the food preparations of the present invention are the following:

- Sample vessel size: 500ml borosilicate beaker

- Filling level: Ref. Cleat on impeller, about 200-300g

- Thermostatic bath set temperature: 50 ° C

- Sample temperature: 40 ° C

- Rotation speed: variable according to the tested sample

- Impeller used: variable according to the tested sample

- Impeller protection: no

The goal was to catalog products with viscosity between 1,500 mPa / s and 4,900 mPa / s at 40 ° C (semi-liquid consistency) and products with viscosity higher than 5,000 mPa / s at 40 ° C, generally between 5,000 and 10,000 mPa / s a 40 ° C (semi-solid consistency)

The viscosities detected at the maximum possible speed and at a shear stress <90% were recorded, ie considering the higher values of the two variables, in correspondence with which the viscosity of the products is still detectable.

For values> 5,000 mPa / s at 40 ° C the possibility of diluting the product is indicated to allow its use to those who need a semi-liquid diet. The dilution takes place with a viscosity regulator developed so as not to dilute the nutritional characteristics of the product.

Table 3 below shows the viscosity values and the parameters at which this viscosity was determined of some examples of food preparations with modified consistency and of the viscosity regulator.

Table 3: Viscosity of food preparations with modified consistency of the present invention and of the viscosity regulator.

From the analysis it emerged that the food preparations of the present invention have a viscosity from 1,500 mPa / s to over 10,000 mPa / s. at 40 ° C

The above viscosities include two main types of food consistencies, namely semi-liquid consistency foods (1,500 mPa / s and 4,900 mPa / s at 40 ° C) and semi-solid consistency foods (5,000 and 10,000 mPa / s at 40 ° C), which are ideal to facilitate the swallowing of a person suffering from moderate, mild-moderate and mild dysphagia.

Example 7 - Evaluation of the nutritional and metabolic effects derived from the intake of food preparations with a modified consistency of the present invention on dysphagia subjects

A study was carried out in collaboration with the University of Pavia, to evaluate the effectiveness of the intake of food preparations with a modified consistency, in the context of a balanced menu in macronutrients and micronutrients developed by the Applicant, on the state of nutrition and on the metabolic parameters. of a group of elderly subjects with oropharyngeal dysphagia.

The population studied

The population enrolled in the study test involved a population of subjects with an average age of 89.8 ± 5.2 years and all suffering from oropharyngeal dysphagia of level 3 to 5 on the DOSS scale (Dysphagia Outcome and Severity Scale).

Diet

The enrolled population was administered a biweekly rotating menu, consisting of food preparations with a modified consistency of the present invention, with standardized weight.

The single meal (lunch / dinner) consisted of the following preparations: - 1 portion (100 g) of carbohydrate-based preparation (to be chosen from those listed as an example in table 2)

- 1 portion (100 g) of protein-based preparation (to be chosen from those listed as an example in table 2)

-1 portion (100 g) of vegetable-based preparation (to be chosen from those listed as an example in table 2)

The aforementioned menu has been developed in such a way as to guarantee the following average daily nutritional intake, according to the following Table 4:

kcal 1400

Fat 46 g (29.6%)

of which saturated 13 g (8.3%)

Carbohydrates 202 g (57.7%)

of which sugars 24 g (6.8%)

Protein 53 g (15.1%)

Table 4: Average daily nutritional intake

Materials and methods

The parameters taken into consideration at time T0 and at time T1 (after 12 weeks of intake of food preparations with modified consistency of the present invention) were the following:

- Anthropometric evaluation: weight, height, body mass index, arm circumference, calf circumference, waist circumference.

- Evaluation of the nutritional status: through Mini Nutritional Assessment (MNA).

- Hematochemical parameters: glycemia, insulin, HOMA (Homeostasis Metabolic Assessment), total cholesterol, HDL cholesterol and LDL cholesterol, triglycerides, blood count.

- Inflammatory markers: C reactive protein, Tumor Necrosis Factor Alfa. - Hepatic (ALT, AST, gamma GT) and renal function (cretininemia) - Nutritional haematochemical parameters: Vitamin D, folic acid, sideremia. The satisfaction of the meal was also assessed by measuring with a visuanalogic scale (visual analogue) with a measurement from 0 (unwelcome) to 10 (very welcome).

For the statistical evaluation of comparison of the parameters recorded at time T0 and at time T1, the Student's t-test for unpaired data was used. A p-value greater than 0.05 is considered significant.

The results

Table 5 below reports the values expressed as the mean of the results collected from each patient ± the standard deviation.

Table 5: Parameters, time values 0 (T0), time values T1 (12 weeks from T0) and statistical value p.

where is it:

- the "Mini Nutritional Assessment" (MNA) allows to evaluate the risk of malnutrition in subjects with functional and cognitive alternations, aged over 75 years

- the "Handgrip" parameter measures the isometric muscle strength of the hand using a dynamometer, which can be corrected with the muscle strength of the lower limb, with the flexion and extension exercise on the knees and with the values of the calf muscle area (Canon & Crimmins, 2011; Paddon-Jones 2006; Laurentani et al., 2003).

The study showed that the assumption for 12 weeks (3 months) of a balanced menu in macronutrients and micronutrients, based on food preparations with a modified consistency of the present invention, well appreciated by the subjects (according to what is detected by the visuanalogic scale: 7, 3 ± 0.8 at T0 and 7.8 ± 0.6 at T1) for the organoleptic qualities and the variety proposed, allowed a significant improvement in the nutritional status of the subjects involved in the study, initially in a mild state of malnutrition.

In particular:

- The significant increase in the intake of food preparations, due to the high level of satisfaction with the meal, increased by 7% with the administration of the food preparations of the present invention, resulted in an increase in caloric intake, with consequent weight gain body (+ 3%) and muscle circumferences of the arm (+ 4%) and calf (+ 4%);

- With regard to the nutritional status, a significant improvement in the score resulting from the Mini Nutritional Assessment (+ 11%) was found at time T1;

- The increase in protein intake guaranteed by the menu of modified consistency food preparations of the present invention resulted in a significant increase in the levels of albumin (+ 6%) and pre-albumin (+ 10%); in particular, by analyzing the albumin values, patients passed from malnutrition to normal nutrition.

- With regard to vitamins and mineral salts, there was a significant increase in the circulating levels of vitamin D (+ 30%), ionized calcium (+ 23%) and folic acid (+ 67%).

- Interesting was the significant reduction of C reactive protein (-57%), an important inflammatory marker. It can be hypothesized that the increase in the intake of fish (included in the menu 3 times a week), therefore of foods with a high content of polyunsaturated fatty acids of the omega 3 series, molecules with well-known anti-inflammatory activity and the increase in intake of vegetables (not only as a side dish but as a component of first and second courses), rich in vitamins, minerals and molecules with anti-inflammatory and antioxidant activity, have determined this improvement in the chronic inflammatory state, typical of old age.

In light of the above, the study has shown that the modified consistency food preparations of the present invention constitute a meal with an adequate rheological consistency, at the same time pleasant and varied, so as to allow an adequate intake of macronutrients and micronutrients, counteracting the problem of malnutrition and ensuring an improvement in the quality of life of dysphagia patients.

Claims (15)

CLAIMS 1. Method for the production of a food preparation with a modified consistency having a viscosity of at least 1,500 mPa / s at 40 ° C, suitable for consumption by dysphagic subjects and which can be stored at refrigerator temperature for at least 15 days, comprising the steps of: a) subjecting at least one food ingredient selected from the group comprising cereals, legumes, vegetables, fruit, eggs, milk and its derivatives, meat and its derivatives, fish and their derivatives, to a pre-cooking; b) homogenizing said at least one precooked food ingredient of step a), obtaining a food preparation with a modified consistency; c) vacuum packaging said food preparation with a modified consistency inside plastic packaging for food, applying a vacuum between 700-900 mbar, obtaining a food preparation with a modified consistency packaged; d) cooking said food preparation with modified consistency packaged by immersion in water having a temperature between 75 ° and 90 ° C for a time ranging from 2.5 hours to 12 hours. e) subjecting the cooked packaged modified consistency food preparation obtained from step d) to a cooling step by immersion in water having a temperature of 0 ° -5 ° C for a time ranging from 1 hour to 3 hours. 2. Method according to claim 1, comprising, before said step e), a step d ') of subjecting said food preparation with a modified cooked packaged consistency obtained from step d) to a pre-cooling step by immersion in water having a temperature of 12 ° -15 ° C for a time of at least 10 minutes, preferably 10 -20 minutes. Method according to claim 1 or 2, wherein said food ingredient is selected from the group comprising cereals, legumes, vegetables, fruit, eggs, milk and its derivatives, fish and their derivatives and said pre-cooking step a) takes place for a time comprised between 15 minutes and 45 minutes, being carried out by at least one cooking technique chosen by the group comprising browning, boiling, steaming, grilling, baking and microwave cooking. 4. Method according to claim 3, in which in said pre-cooking step a) at least one complementary organoleptically characterizing ingredient is added to said at least one food ingredient. 5. Method according to claim 1 or 2, wherein said at least one food ingredient consists of meat or its derivatives and in which said pre-cooking step a) comprises: i) vacuum-packing said food ingredient of a wrapper of plastic material for food, applying a vacuum of between 700-900 mbar, obtaining said packaged food ingredient; ii) pre-cooking said packaged food ingredient by immersion in water having a temperature between 75 ° and 90 ° C for a time ranging from 2.5 hours to 12 hours; iii) subjecting the pre-cooked packaged food ingredient obtained from phase ii) to a pre-cooling phase by immersion in water having a temperature of 12 ° -15 ° C for a time of 10-30 minutes, preferably about 15 minutes; iv) subjecting the precooked pre-cooled packaged food ingredient obtained from step iii) to a cooling step by immersion in water having a temperature of 0 ° -5 ° C for a time between 1 hour and 3 hours, obtaining a packaged food ingredient pre-cooked cooled; v) extract the cooled pre-cooked packaged food ingredient obtained in step iv) from the package and optionally mix it with at least one complementary organoleptically characterizing ingredient. Method according to claim 4 or 5, wherein said at least one organoleptically characterizing ingredient is selected from the group comprising salt, vegetable oils, animal fats, garlic, onion, celery, shallot, mushrooms, spices and aromatic herbs. Method according to any one of claims 1-6, wherein said food preparation with a modified consistency suitable for consumption by dysphagic subjects can be stored at refrigerator temperature for a period of between 20 and 50 days, preferably 40-50 days. Method according to any one of claims 1-7, in which said homogenization step b) is carried out by means of a cutter with a vertical blade. Method according to any one of claims 1-8, in which said vacuum packaging step c) takes place at a temperature between 2 ° C and 10 ° C. Method according to any one of claims 1-9, wherein said wrappers of plastic material for food are made of polyethylene / polyamide or polypropylene. 11. Modified consistency food preparation having a viscosity of at least 1,500 mPa / s at 40 ° C, suitable for consumption by dysphagic subjects and storable at refrigerator temperature, obtainable by the method according to any one of claims 1-9. A modified consistency food preparation according to claim 11, further comprising a thickener selected from the group comprising: corn starch, potato starch and xanthan gum. 13. Modified consistency food preparation according to claim 11 or 12, having a viscosity between 1,500 mPa / s and 4,900 mPa / s at 40 ° C, for use in the treatment of a subject suffering from oral dysphagia. 14. Modified consistency food preparation according to claim 11 or 12, having a viscosity greater than or equal to 5,000 mPa / s at 40 ° C, preferably between 5,000 mPa / s and 10,000 mPa / s, at 40 ° C, for use in the treatment of a person suffering from pharyngeal dysphagia. Kit for use in the treatment of dysphagia, comprising a modified consistency food preparation according to any one of claims 11-14 and a separately packaged viscosity regulator, consisting of an aqueous solution comprising maize maltodextrin and whey protein .