JP2006109723A - Easily swallowing liquid composition - Google Patents
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本発明は、嚥下（食物を飲み込むこと）に何らかの障害を持つ患者（以下、嚥下困難者という。）が誤嚥（誤って気管に食物が入ること）することなく、安心かつ容易に摂食することができる液状組成物及びその物性値の特定方法に関する。より詳しくは、温度20℃の物性値が粘度0.6〜2.3Pa・sかつ、降伏応力0.07〜0.75Paであることを特徴とする液状組成物及びその物性値の特定方法に関する。 The present invention allows a patient (hereinafter referred to as a person having difficulty in swallowing) who has any disorder in swallowing (swallowing food) to eat safely and easily without aspiration (food accidentally enters the trachea). The present invention relates to a liquid composition that can be used and a method for specifying physical properties thereof. More specifically, the present invention relates to a liquid composition characterized in that a physical property value at a temperature of 20 ° C. is a viscosity of 0.6 to 2.3 Pa · s and a yield stress of 0.07 to 0.75 Pa, and a method for specifying the physical property value.
嚥下適性と食品物性との関係について、トロミ調整食品により粘性を付与した液状食品を用い、健常者を対象とした飲み込み評価と、力学的な物性値を比較した研究例がある（非特許文献１）。また、ゼラチンゼリーやお粥などの固体状食品により同様の検討を行った研究例がある（非特許文献２〜４）。これらは何れも流動性の低い固体状（ゲル状、ペースト状など）食品を用いた研究例である。一方、流動性の高い液状（ゾル状）食品を用い、嚥下困難者を対象とした飲み込み評価と、力学的な物性値を比較・検討した研究例はない。
Regarding the relationship between swallowing aptitude and food physical properties, there is a research example comparing the swallowing evaluation for healthy subjects and the mechanical physical properties using a liquid food that has been given viscosity by a trolley-adjusted food (Non-patent Document 1) ). In addition, there are research examples in which the same study was performed using solid foods such as gelatin jelly and porridge (
嚥下困難者は水やお茶など、流動性の良いサラサラの液体を口に含んだ時に、極めて短時間で咽頭に達してしまう。咽頭反射が出現する前に咽頭に達するため、誤嚥してしまうことがある。こうした誤嚥を防ぐことを目的として、トロミ調整食品などを用いて液状食品に粘性を付与するような工夫がなされる。しかし、その適切な物性については明確な基準はなく、栄養士や看護士の判断に任されているのが現状である。このとき、飲み込み易いとされる物性は、ベタつかず、変形しやすく、まとまりが良いなどの非常に曖昧な表現で特徴付けられている。 People who have difficulty swallowing can reach the pharynx in a very short time when they have a smooth liquid such as water or tea in their mouth. A pharyngeal reflex may be reached before the pharyngeal reflex occurs, resulting in aspiration. For the purpose of preventing such aspiration, a device is devised to impart viscosity to the liquid food using a trolley-adjusted food or the like. However, there is no clear standard for the appropriate physical properties, and it is left to the judgment of nutritionists and nurses. At this time, the physical properties that are easy to swallow are characterized by very vague expressions such as being non-sticky, easily deformed, and well organized.
摂食・嚥下機能に障害のある高齢者向けの食品では、誤嚥や窒息を起こさないことが重要である。具体的には、口腔から咽頭部を滑らかに通り、むせずに、粘つかないで嚥下できる「のどごしの良い食事」とされている（非特許文献５）。しかし、その物性については明確な規定はなく、病院・介護施設などの栄養士にとって、嚥下困難者が飲み込み易い物性に液状食品を調製する際の判断基準がない状況となっている。 It is important not to cause aspiration or suffocation in foods for the elderly with impaired eating and swallowing functions. Specifically, it is said to be a “smooth meal” that can be swallowed smoothly without passing through the pharynx from the oral cavity (Non-Patent Document 5). However, there is no clear provision for the physical properties, and there are no criteria for preparing liquid foods for nutritionists such as hospitals and care facilities that are difficult for swallowers to swallow.
飲み込み易い物性を評価する方法として、健常者による粘つき感や飲み込み易さなどの官能評価を検討した研究例がある（特許文献１）。また、咀嚼・嚥下機能が低下した者が、摂食し易い食品（嚥下食）に求められる要件として、(1) 組織が均一なこと、(2) 適当な粘度があって口腔内でまとまりやすいこと、(3) 口腔や咽頭でべたつかないこと、(4) 硬すぎないことを挙げ、これらの要件と動的粘弾性との関連を調べた研究例がある（特許文献２）。しかし、いずれの研究例も嚥下困難者を対象とした評価ではなく、健常者を対象としている。つまり、物性を評価した試料について嚥下困難者が飲み込んだ実際の嚥下動態を評価していないものである。 As a method for evaluating physical properties that are easy to swallow, there is a research example in which sensory evaluation such as stickiness by a healthy person and ease of swallowing was examined (Patent Document 1). In addition, those who have reduced mastication / swallowing function are required to have a food that is easy to eat (swallowing food): (1) The tissue is uniform, (2) It has an appropriate viscosity and is easy to be integrated in the oral cavity (3) There is a research example in which the relationship between these requirements and dynamic viscoelasticity was examined by mentioning that it is not sticky in the oral cavity and pharynx and (4) that it is not too hard (Patent Document 2). However, all the research examples are not evaluated for persons with difficulty in swallowing, but are for healthy persons. In other words, the actual swallowing dynamics swallowed by a person with difficulty in swallowing the sample whose physical properties were evaluated were not evaluated.
本発明は、上記従来技術の課題点を鑑みてなされたものであり、本発明は、嚥下困難者が誤嚥することなく、安心かつ容易に摂食することができる液状組成物及びその調製方法並びにその物性値の特定方法を提供することを目的とする。 The present invention has been made in view of the above-described problems of the prior art, and the present invention provides a liquid composition that can be safely and easily consumed by a person with difficulty in swallowing without aspiration, and a method for preparing the liquid composition. An object of the present invention is to provide a method for specifying the physical property values.
本発明は、嚥下造影用の造影模擬食品として用いる、易嚥下液状組成物及びその調製方法を提供することを別の目的とする。 Another object of the present invention is to provide an easy-to-swallow liquid composition and a method for preparing the same, which are used as contrast-enhancing foods for swallowing imaging.
本発明は、嚥下困難者を対象とした飲み込み評価（嚥下動態評価）と、力学的な物性値を比較・検討した結果に基づく、易嚥下液状組成物及びその調製方法を提供することを別の目的とする。 It is another object of the present invention to provide a swallowable liquid composition and a preparation method thereof based on the results of comparing and examining swallowing evaluation (swallowing kinetic evaluation) for persons with difficulty in swallowing and mechanical physical property values. Objective.
本発明は、医療・介護現場などで、嚥下困難者の飲み込み易い物性値に、液状食品を調製する際の判断基準とできる、易嚥下液状組成物及びその調製方法を提供することを別の目的とする。 Another object of the present invention is to provide an easy-to-swallow liquid composition and a method for preparing the same that can be used as criteria for preparing liquid foods in physical properties that are easily swallowed by people with difficulty in swallowing at medical and nursing care sites. And
本発明者らは、上記課題に鑑み、鋭意研究を重ねた結果、温度20℃の物性値が粘度0.6〜2.3Pa・sかつ、降伏応力0.07〜0.75Paである液状組成物が嚥下困難者の飲食に適していることを見出し、本発明を完成するに至った。 In light of the above problems, the present inventors have conducted intensive research, and as a result, a liquid composition having a physical property value at a temperature of 20 ° C. of a viscosity of 0.6 to 2.3 Pa · s and a yield stress of 0.07 to 0.75 Pa has been It has been found that it is suitable for eating and drinking, and the present invention has been completed.
さらに、その液状組成物は、ずり流動化を示し、ずり速度0.1s-1の定常ずり粘度が5.6〜28Pa・sかつ、ずり速度500s-1の定常ずり粘度が0.02〜0.038Pa・sであることを見出した。 Further, the liquid composition exhibits shear fluidization, a steady shear viscosity at a shear rate of 0.1 s −1 is 5.6 to 28 Pa · s, and a steady shear viscosity at a shear rate of 500 s −1 is 0.02 to 0.038 Pa · s. I found out.
嚥下動態評価の一般的な手法として、嚥下造影（VF）試験があり、これには造影模擬食品が用いられる。この造影模擬食品として、ゾル状バリウム製剤にトロミ調整食品を加え、物性を４段階に調整した液状組成物を用いた。通常の飲料を嚥下する際に、ムセが認められた嚥下障害患者（嚥下困難者）を対象とし、嚥下動態評価を実施した。その際に、嚥下動態を確認すると同時に、その液状組成物の物性値を各種レオロジー測定装置で評価した。このような手段により、嚥下困難者を対象とした実体調査と、力学的な物性値との相関関係を、液状食品について世界に先駆けて見出した。ここで、良好に嚥下される物性は従来に考えられていた粘度よりも低く、かつ降伏応力の高いことが特徴であった。つまり、試料が流れ出すまでの力（ずり応力）は幾らか必要だが、流れ出すと極めて流動性が良いものである。こうした物性を有する食品の実例はなく、ある食品に対して何らかの構造を付与することで可能となる。 As a general method for evaluating swallowing dynamics, there is a swallowing contrast (VF) test, which uses a contrast-enhanced simulated food. As this contrast-enhancing food, a liquid composition was used in which trolley-adjusted food was added to the sol-form barium preparation and the physical properties were adjusted to 4 levels. A swallowing kinetic evaluation was performed for patients with dysphagia (poor dysphagia) in which musiness was observed when swallowing a normal beverage. At that time, while confirming the swallowing dynamics, the physical properties of the liquid composition were evaluated with various rheology measuring devices. By such means, we found the world's first correlation between a physical survey for persons with difficulty in swallowing and mechanical property values for liquid foods. Here, the physical property of being swallowed well was characterized by a lower viscosity than previously considered and a high yield stress. In other words, some force (shear stress) is required until the sample flows out, but when it flows out, the fluidity is very good. There is no actual example of food having such physical properties, and it is possible by giving some structure to a certain food.
前述した先行技術のように、嚥下困難者用の固体状食品についての知見はあるが、液状食品についての知見はない。つまり、嚥下動態評価に基づく嚥下困難者の摂食に適した液状組成物を世界に先駆けて見出した。この物性値は、医療・介護現場などで、嚥下困難者用の液状組成物を調製する際の判断基準とできる。 As in the prior art described above, there is knowledge about solid foods for those who have difficulty swallowing, but there is no knowledge about liquid foods. In other words, we have pioneered the world's first liquid composition suitable for feeding people with difficulty in swallowing based on swallowing dynamics evaluation. This physical property value can be used as a criterion for preparing a liquid composition for persons with difficulty in swallowing at medical / care sites.
ここで得られた知見は、水やお茶などへ、トロミ調整食品を用いて粘性を付与する際に、明確な判断基準を提供できると同時に、嚥下困難者が嚥下し易い液状組成物を提供できる点で極めて有用である。前述した物性値は、これらの知見に基づくものである。 The knowledge obtained here can provide a clear criterion when applying viscosity to water, tea, etc. using a trolley-adjusted food, and at the same time, can provide a liquid composition that can be easily swallowed by those who have difficulty swallowing. Very useful in terms. The physical property values described above are based on these findings.
すなわち、本発明は、
[1] 温度20℃の物性値が、粘度0.6〜2.3Pa・sかつ、降伏応力0.07〜0.75Paである液状組成物、
[2] ずり流動化を示し、温度20℃の物性値が、ずり速度0.1s-1の定常ずり粘度が5.6〜28Pa・sかつ、ずり速度500s-1の定常ずり粘度が0.02〜0.038Pa・sであることを特徴とする上記[1]に記載の液状組成物、
[3] 嚥下造影用の造影模擬食品であることを特徴とする上記[1]及び[2]のいずれかに記載の液状組成物、
[4] 上記[1]〜[3]のいずれかに記載の液状組成物を含有することを特徴とする嚥下困難者用の飲食品、
[5] 上記[1]〜[3]のいずれかに記載の液状組成物の調製方法、
[6] 物性値として、粘度及び、降伏応力を、嚥下困難者用の液状組成物を調製する際の判断基準とすることを特徴とする、易嚥下液状組成物の特定方法、
[7] 物性値として、ずり速度に対する定常ずり粘度の関係を、嚥下困難者用の液状組成物を調製する際の判断基準とすることを特徴とする、易嚥下液状組成物の特定方法、
[8] 温度20℃の物性値が、粘度0.6〜2.3Pa・sかつ、降伏応力0.07〜0.75Paを、嚥下困難者用の液状組成物を調製する際の判断基準とすることを特徴とする、易嚥下液状組成物の特定方法、
[9] ずり流動化を示し、温度20℃の物性値が、ずり速度0.1s-1の定常ずり粘度が5.6〜28Pa・sかつ、ずり速度500s-1の定常ずり粘度が0.02〜0.038Pa・sであることを、嚥下困難者用の液状組成物を調製する際の判断基準とすることを特徴とする、易嚥下液状組成物の特定方法
からなる。
That is, the present invention
[1] A liquid composition having a physical property value at a temperature of 20 ° C. and a viscosity of 0.6 to 2.3 Pa · s and a yield stress of 0.07 to 0.75 Pa,
[2] shows the shear thinning, physical properties of the temperature 20 ° C. is steady shear viscosity shear rate 0.1s -1 is and 5.6~28Pa · s, the steady shear viscosity of shear rate 500 s -1 is 0.02～0.038Pa · s is a liquid composition according to the above [1],
[3] The liquid composition according to any one of the above [1] and [2], which is a contrast-imitation food for swallowing imaging,
[4] A food / beverage product for persons with difficulty in swallowing, comprising the liquid composition according to any one of [1] to [3] above,
[5] A method for preparing the liquid composition according to any one of [1] to [3] above,
[6] A method for identifying an easily swallowable liquid composition, characterized by using viscosity and yield stress as physical property values as criteria for preparing a liquid composition for those having difficulty swallowing,
[7] A method for identifying an easily swallowable liquid composition, characterized in that, as a physical property value, the relationship between the steady shear viscosity and the shear rate is used as a criterion for preparing a liquid composition for those having difficulty swallowing,
[8] The physical property value at a temperature of 20 ° C. is characterized by using a viscosity of 0.6 to 2.3 Pa · s and a yield stress of 0.07 to 0.75 Pa as criteria for preparing a liquid composition for those having difficulty swallowing. , A method for identifying a swallowable liquid composition,
[9] shows the shear thinning, physical properties of the temperature 20 ° C. is steady shear viscosity shear rate 0.1s -1 is and 5.6~28Pa · s, the steady shear viscosity of the shear rate 500s -1 0.02~0.038Pa · It is a method for identifying an easily swallowable liquid composition, characterized in that s is a criterion for preparing a liquid composition for persons with difficulty in swallowing.
本発明において「粘度」は、B型粘度計を用い、厚生労働省「特別用途食品 高齢者用食品」の粘度測定方法に準じた測定値である。このとき、B型粘度計の回転数は12rpmに設定した。実際の測定温度は幾らか変化し、20±2℃であった。また、「降伏応力」、「ずり速度」に対する「定常ずり粘度」は、通常のレオロジー測定方法に準じた測定値である。 In the present invention, “viscosity” is a measured value according to the viscosity measurement method of “Special Use Foods for the Elderly” by the Ministry of Health, Labor and Welfare using a B-type viscometer. At this time, the rotation speed of the B-type viscometer was set to 12 rpm. The actual measurement temperature varied somewhat and was 20 ± 2 ° C. The “steady shear viscosity” with respect to “yield stress” and “shear rate” is a measured value according to a normal rheological measurement method.
本発明によれば、嚥下困難者が誤嚥することなく、安心かつ容易に摂食することができる液状組成物及びその調製方法並びにその物性値の特定方法を提供することができる。 ADVANTAGE OF THE INVENTION According to this invention, the liquid composition which can be eaten safely and easily, and its preparation method, and the identification method of the physical-property value can be provided, without a person having difficulty swallowing aspiration.
本発明によれば、嚥下困難者を対象とした飲み込み評価（嚥下動態評価）と、力学的な物性値を比較・検討した結果に基づく、易嚥下液状組成物及びその調製方法を提供することができる。 According to the present invention, it is possible to provide an easy-to-swallow liquid composition and a method for preparing the same based on the results of comparing and examining swallowing evaluation (swallowing dynamics evaluation) for persons with difficulty in swallowing and mechanical properties. it can.
本発明によれば、医療・介護現場などで、嚥下困難者の飲み込み易い物性値に、液状食品を調製する際の判断基準とできる、易嚥下液状組成物及びその調製方法を提供することができる。 According to the present invention, it is possible to provide an easily swallowable liquid composition and a method for preparing the same, which can be used as a criterion for preparing a liquid food with a physical property value that can be easily swallowed by a person with difficulty in swallowing at a medical / care site. .
本発明の液状食品は、嚥下困難者が液状食品を摂食する際の適切な物性値を有しており、トロミ調整食品などを用いて容易に調製することが可能である。このとき、温度20℃の物性値として、好ましくは粘度0.6〜2.3Pa・sかつ、降伏応力0.07〜0.75Paである。 The liquid food of the present invention has appropriate physical property values when a person with difficulty in swallowing eats the liquid food, and can be easily prepared using a trolley-adjusted food or the like. At this time, the physical property value at a temperature of 20 ° C. is preferably a viscosity of 0.6 to 2.3 Pa · s and a yield stress of 0.07 to 0.75 Pa.
温度20℃の物性値として、粘度0.2Pa・s以下あるいは、降伏応力0.02Pa以下では、嚥下困難者に嚥下前及び嚥下中の誤嚥、及び多くの喉頭侵入が認められた。咽頭反射の出現前に造影模擬食品が咽頭に達しており、嚥下困難者は誤嚥しやすい。一方、温度20℃の物性値として、粘度6.8Pa・s以上あるいは、降伏応力3.5Pa以上では、咽頭や喉頭蓋谷への付着・残留が多く、嚥下困難者に嚥下後の誤嚥が認められた。 As a physical property value at a temperature of 20 ° C., when the viscosity was 0.2 Pa · s or less or the yield stress was 0.02 Pa or less, aspiration difficulty before swallowing and during swallowing, and many laryngeal intrusions were observed. The contrast-imitation food reaches the pharynx before the appearance of the pharyngeal reflex, and those who have difficulty swallowing are likely to swallow. On the other hand, when the viscosity was 6.8 Pa · s or higher, or the yield stress was 3.5 Pa or higher, the physical property value at a temperature of 20 ° C was that most of the pharynx and epiglottis adhered and remained, and aspiration after swallowing was observed in those with difficulty .
誤嚥のなかった、粘度0.6Pa・sかつ、降伏応力0.07Paの場合は僅かに喉頭侵入が認められた例があり、この粘度及び降伏応力を適切に嚥下できる下限値と判断した。誤嚥のなかった、粘度2.3Pa・sかつ、降伏応力0.75Paの場合は僅かに咽頭への付着が認められた例があり、この粘度及び降伏応力を適切に嚥下できる上限値と判断した。 In the case of a viscosity of 0.6 Pa · s and a yield stress of 0.07 Pa with no aspiration, there was an example where a laryngeal invasion was observed slightly, and this viscosity and the yield stress were judged to be lower limit values that allow proper swallowing. In the case of a viscosity of 2.3 Pa · s and a yield stress of 0.75 Pa with no aspiration, there was an example in which slight adhesion to the pharynx was observed, and this viscosity and yield stress were determined to be upper limit values that can be appropriately swallowed.
本発明の液状食品は、物性の特徴として、粘度や降伏応力に加えて、ずり流動化を示す。また、温度20℃の物性値として、好ましくは、ずり速度0.1s-1の定常ずり粘度が5.6〜28Pa・sかつ、ずり速度500s-1の定常ずり粘度が0.02〜0.038Pa・sである。ずり流動化とは、物性の特徴として、ずり速度の増加に伴い、定常ずり粘度が減少することである。当該液状食品は、食道等の狭い流路を通過する際に、ずり速度が増加しても定常ずり粘度が減少することから、嚥下が容易となる。 The liquid food of the present invention exhibits shear fluidization in addition to viscosity and yield stress as a characteristic of physical properties. Further, as a physical property value at a temperature of 20 ° C., the steady shear viscosity at a shear rate of 0.1 s −1 is preferably 5.6 to 28 Pa · s, and the steady shear viscosity at a shear rate of 500 s −1 is 0.02 to 0.038 Pa · s. The shear fluidization is a characteristic of physical properties that the steady shear viscosity decreases as the shear rate increases. When the liquid food passes through a narrow channel such as the esophagus, the steady shear viscosity decreases even if the shear rate increases, so that it is easy to swallow.
ずり速度0.1s-1の定常ずり粘度が1.4Pa・s以下あるいは、ずり速度500s-1の定常ずり粘度が0.01Pa・s以下では、嚥下困難者に嚥下前及び嚥下中の誤嚥、及び多くの喉頭侵入が認められた。咽頭反射の出現前に造影模擬食品が咽頭に達しており、嚥下困難者は誤嚥しやすい。一方、ずり速度0.1s-1の定常ずり粘度が254Pa・s以上あるいは、ずり速度500s-1の定常ずり粘度が0.09Pa・s以上では、咽頭や喉頭蓋谷への付着・残留が多く、嚥下困難者に嚥下後の誤嚥が認められた。 If the steady shear viscosity at a shear rate of 0.1 s -1 is 1.4 Pa · s or less, or the steady shear viscosity at a shear rate of 500 s -1 is 0.01 Pa · s or less, aspiration before swallowing and during swallowing, and many Invasion of the larynx was observed. The contrast-imitation food reaches the pharynx before the appearance of the pharyngeal reflex, and those who have difficulty swallowing are likely to swallow. On the other hand, if the steady shear viscosity at a shear rate of 0.1 s -1 is 254 Pa · s or higher, or the steady shear viscosity at a shear rate of 500 s -1 is 0.09 Pa · s or more, there are many adhesions and residues on the pharynx and epiglottis, making swallowing difficult The person was found to have aspiration after swallowing.
誤嚥のなかった、ずり速度0.1s-1の定常ずり粘度が5.6Pa・sかつ、ずり速度500s-1の定常ずり粘度が0.02Pa・sでは僅かに喉頭侵入が認められた例があり、この定常ずり粘度を適切に嚥下できる下限値と判断した。誤嚥のなかった、ずり速度0.1s-1の定常ずり粘度が28Pa・sかつ、ずり速度500s-1の定常ずり粘度が0.038Pa・sでは僅かに咽頭への付着が認められた例があり、この定常ずり粘度を適切に嚥下できる上限値と判断した。 There was an example in which the laryngeal invasion was slightly observed when the steady shear viscosity at a shear rate of 0.1 s -1 was 5.6 Pas and the steady shear viscosity at a shear rate of 500 s -1 was 0.02 Pas without any aspiration. This steady shear viscosity was judged to be the lower limit value that allows proper swallowing. There was an example in which the steady shear viscosity at a shear rate of 0.1 s -1 was 28 Pa · s and the steady shear viscosity at a shear rate of 500 s -1 was 0.038 Pa · s, which was slightly attached to the pharynx without aspiration. The steady shear viscosity was determined to be the upper limit value that allows proper swallowing.
本発明の液状食品は、嚥下困難者に配慮した適切な物性値の嚥下造影用の造影模擬食品として使用することが可能である。具体的には、ゾル状バリウム製剤にトロミ調整食品を加えたものであり、嚥下造影（VF）試験に使用することができる。 The liquid food of the present invention can be used as a contrast-enhanced simulated food for swallowing contrast imaging having appropriate physical property values in consideration of those who have difficulty swallowing. Specifically, it is a sol-like barium preparation with a trolley-adjusted food, and can be used for a swallowing imaging (VF) test.
本発明の液状組成物の物性値は、造影剤を含み粘性を付与した造影模擬食品を用いて特定した。嚥下動態評価の一般的な手法として、嚥下造影（VF）試験がある。この造影模擬食品として、ゾル状バリウム製剤にトロミ調整食品を加え、物性を4段階に調整した液状組成物を用いた。通常の飲料を嚥下する際に、ムセが認められた嚥下障害患者（嚥下困難者）を対象とし、嚥下動態評価を実施した。その際に、嚥下動態を確認すると同時に、その液状組成物の物性値を各種レオロジー測定装置で評価した。嚥下困難者が誤嚥せず飲み込むことができた物性値を特定した。その物性値を、粘度、降伏応力、定常ずり粘度という3つの特性値で特定した。これら3つの特性値は流体の特性を表現するために欠かすことができないものである。粘度、降伏応力、定常ずり粘度が分かれば、同一物性の液状組成物を再現することができ、本発明の液状組成物を特定できる。 The physical property values of the liquid composition of the present invention were specified using a contrast simulation food containing a contrast agent and imparted with viscosity. As a general method for evaluating swallowing dynamics, there is a swallowing imaging (VF) test. As this contrast-enhancing food, a liquid composition in which trolley-adjusted food was added to sol-like barium preparation and physical properties were adjusted in 4 stages was used. A swallowing kinetic evaluation was performed for patients with dysphagia (poor dysphagia) in which musiness was observed when swallowing a normal beverage. At that time, while confirming the swallowing dynamics, the physical properties of the liquid composition were evaluated with various rheology measuring devices. The physical property values that could be swallowed by a person with difficulty in swallowing without aspiration were identified. The physical property values were specified by three characteristic values: viscosity, yield stress, and steady shear viscosity. These three characteristic values are indispensable for expressing the characteristics of the fluid. If the viscosity, yield stress, and steady shear viscosity are known, a liquid composition having the same physical properties can be reproduced, and the liquid composition of the present invention can be specified.
本発明の液状食品は、嚥下困難者に配慮した適切な物性値の飲食品として使用することが可能である。具体的には、家庭（在宅）あるいは医療・介護現場などで容易に調製して使用することができる。ここでいう飲食品とは、幾らかの固形状食品を含有した液状食品も対象としている。飲食品の全体として前述した物性値を保持していれば、嚥下の妨げにはならない。 The liquid food of the present invention can be used as a food / beverage product having appropriate physical properties in consideration of those who have difficulty swallowing. Specifically, it can be easily prepared and used at home (at home) or medical / nursing care sites. The food and drink here refers to a liquid food containing some solid food. If the above-mentioned physical property values of the food and drink are maintained, the swallowing is not hindered.
嚥下動態（嚥下機能）は加齢によって低下することが知られている。年齢が30歳未満、30〜59歳、60歳以上、それぞれの検査食量と咽頭通過時間との関係を調べた報告によれば、咽頭通過時間には、加齢による顕著な差があった（Logemann 摂食・嚥下障害, P.29〜32, Jeri A Logeman 著, 道健一・道脇幸博 監訳, 医歯薬出版株式会社）。この結果からも明らかなように、嚥下困難者に配慮した液状組成物は、従来の液状組成物や固体状組成物に比べて飲み込み易い。そのため、本発明の液状組成物は、嚥下困難者の飲食品に有用なだけでなく、健常高齢者にも有用である。 It is known that swallowing dynamics (swallowing function) decreases with aging. According to a report examining the relationship between the amount of test food and pharyngeal transit time for ages under 30 years, 30-59 years, 60 years and older, pharyngeal transit time was significantly different due to aging ( Logemann eating and dysphagia, P.29-32, written by Jeri A Logeman, directed by Kenichi Michi and Yukihiro Michiwaki. As is apparent from this result, the liquid composition considering the person with difficulty in swallowing is easier to swallow than the conventional liquid composition or solid composition. Therefore, the liquid composition of the present invention is useful not only for foods and drinks for those with difficulty in swallowing but also for healthy elderly people.
本発明の液状組成物の調製方法としては、バリウム製剤の様な比重の大きい液状組成物に、トロミ調整食品の水溶液を混合することが例示できる。 Examples of the method for preparing the liquid composition of the present invention include mixing an aqueous solution of a trolley-adjusted food with a liquid composition having a large specific gravity such as a barium preparation.
本発明の易嚥下液状組成物の特定方法は、物性値として、粘度及び、降伏応力を、嚥下困難者用の液状組成物を調製する際の判断基準とすることが可能であり、さらに、ずり速度に対する定常ずり粘度の関係を、嚥下困難者用の液状組成物を調製する際の判断基準とすることが可能である。具体的に、本発明の易嚥下液状組成物の特定方法として、温度20℃の物性値が、粘度0.6〜2.3Pa・sかつ、降伏応力0.07〜0.75Paを、嚥下困難者用の液状組成物を調製する際の判断基準とすることが好ましく、さらに、ずり流動化を示し、温度20℃の物性値が、ずり速度0.1s-1の定常ずり粘度が5.6〜28Pa・sかつ、ずり速度500s-1の定常ずり粘度が0.02〜0.038Pa・sであることを、嚥下困難者用の液状組成物を調製する際の判断基準とすることが好ましい。つまり、液状組成物の物性値の特定方法は、嚥下困難者を対象とした嚥下動態との相関関係に基づいており、嚥下適正の実体を表現していることとなる。 The method for specifying an easily swallowable liquid composition of the present invention can use viscosity and yield stress as physical property values as criteria for preparing a liquid composition for persons with difficulty in swallowing, and further, shearing. The relationship between the steady shear viscosity and the speed can be used as a criterion for preparing a liquid composition for persons with difficulty in swallowing. Specifically, as a method for specifying the easy-to-swallow liquid composition of the present invention, the physical property value at a temperature of 20 ° C. has a viscosity of 0.6 to 2.3 Pa · s and a yield stress of 0.07 to 0.75 Pa. It is preferable to use as a criterion for the preparation, and further, it exhibits shear fluidization, a physical property value at a temperature of 20 ° C., a steady shear viscosity at a shear rate of 0.1 s −1 is 5.6 to 28 Pa · s, and a shear rate is 500 s. It is preferable that a steady shear viscosity of −1 is 0.02 to 0.038 Pa · s as a criterion for preparing a liquid composition for those having difficulty in swallowing. That is, the method of specifying the physical property value of the liquid composition is based on the correlation with the swallowing dynamics for the person with difficulty in swallowing, and expresses the proper swallowing entity.
以下、本発明に関して実施例を挙げて説明するが、本発明は、これにより限定されるものではない。 Hereinafter, although an example is given and explained about the present invention, the present invention is not limited by this.
嚥下造影試験に用いた造影模擬食品の調製方法は以下の通りである。すなわち、バリウム製剤「バリトゲンゾル145（伏見製薬(株)製）」に、トロミ調整食品「トロメイク（明治乳業(株)製）」の水溶液を混合した。バリウム製剤は、硫酸バリウム濃度36w/v%の水溶液である。トロメイクの水溶液は、それぞれの濃度を2.50、1.25、0.63、0.32w/v%の4水準とした。 The method for preparing a contrast-enhanced simulated food used in the swallowing contrast test is as follows. That is, an aqueous solution of “Toromake” (manufactured by Meiji Dairies Co., Ltd.), a trolley-adjusted food, was mixed with barium preparation “Valitogen sol 145 (Fushimi Pharmaceutical Co., Ltd.)”. The barium preparation is an aqueous solution having a barium sulfate concentration of 36 w / v%. The tromake aqueous solution was adjusted to four levels of 2.50, 1.25, 0.63, and 0.32 w / v%, respectively.
上記試料の物性測定方法は以下の通りである。すなわち、粘度の測定には、B型粘度計（TVB-10型粘度計、東機産業(株)製）を用い、回転数12rpm、回転時間2分後の条件で測定した。降伏応力及び、ずり速度に対する定常ずり粘度の測定には、RHEOSTRESS 600（HAAKE製）を用い、直径60mmのコーンプレートに対してギャップ0.103mmの条件で測定した。測定温度は全て20±2℃とした。 The method for measuring physical properties of the sample is as follows. That is, the viscosity was measured using a B-type viscometer (TVB-10 type viscometer, manufactured by Toki Sangyo Co., Ltd.) under the conditions of a rotation speed of 12 rpm and a rotation time of 2 minutes. For measurement of yield stress and steady shear viscosity with respect to shear rate, RHEOSTRESS 600 (manufactured by HAAKE) was used, and measurement was performed under the condition of a gap of 0.103 mm with respect to a cone plate having a diameter of 60 mm. All measurement temperatures were 20 ± 2 ° C.
上記試料を用いた嚥下造影試験方法は以下の通りである。すなわち、臨床的に液状物を嚥下した際に、ムセなどの咽頭相障害が認められた15例の嚥下困難者を被験者の対象とした。対象内容として年齢が60〜93才（平均年齢77才）、性別として男性が7例、女性が8例、原因疾患として慢性期脳血管障害が9例、パーキンソン病が4例、その他が2例である。
The swallowing contrast test method using the sample is as follows. That is, 15 subjects with difficulty in swallowing who had pharyngeal phase disorders such as mussels when clinically swallowing a liquid substance were subjects. Age range 60-93 years (average age 77 years), male 7 cases, female 8 cases, chronic cerebrovascular disorder 9 cases, Parkinson's disease 4 cases,
嚥下動態の評価は以下の通りである。すなわち、咽頭相障害を有する15例と健常者の5例の嚥下造影画像を次の項目について比較・検討して判断した。評価項目は、(1) 咽頭反射の惹起し易さ、(2) 咽頭の通過速度、(3) 咽頭残留や付着の程度、(4) 誤嚥や喉頭侵入の有無の4つである。 The evaluation of swallowing dynamics is as follows. That is, the swallowing contrast images of 15 cases with pharyngeal phase disorder and 5 cases of healthy subjects were compared and examined for the following items. There are four evaluation items: (1) ease of causing pharyngeal reflexes, (2) pharyngeal passage speed, (3) degree of pharyngeal residue and adhesion, and (4) presence or absence of aspiration or laryngeal invasion.
［実施例１］ 硫酸バリウム濃度36w/v%溶液中のトロメイク濃度が0.63w/v%の場合について造影模擬食品の物性値を測定し、嚥下動態を評価した。結果を表１に示した。 [Example 1] When the tromake concentration in the solution of barium sulfate concentration 36 w / v% was 0.63 w / v%, the physical property value of the contrast-enhanced simulated food was measured, and the swallowing dynamics was evaluated. The results are shown in Table 1.
［実施例２］ 硫酸バリウム濃度36w/v%溶液中のトロメイク濃度が1.25w/v%の場合について造影模擬食品の物性値を測定し、嚥下動態を評価した。結果を表１に示した。 [Example 2] When the tromake concentration in the barium sulfate concentration 36 w / v% solution was 1.25 w / v%, the physical property values of the contrast-enhanced food were measured, and the swallowing dynamics were evaluated. The results are shown in Table 1.
［比較例１］ 硫酸バリウム濃度36w/v%溶液中のトロメイク濃度が0.32w/v%の場合について造影模擬食品の物性値を測定し、嚥下動態を評価した。結果を表２に示した。 [Comparative Example 1] When the tromake concentration in the barium sulfate concentration 36 w / v% solution was 0.32 w / v%, the physical property values of the contrast-enhanced simulated food were measured, and the swallowing dynamics were evaluated. The results are shown in Table 2.
［比較例２］ 硫酸バリウム濃度36w/v%溶液中のトロメイク濃度が2.50w/v%の場合について造影模擬食品の物性値を測定し、嚥下動態を評価した。結果を表２に示した。 [Comparative Example 2] The physical property value of the contrast-enhanced simulated food was measured when the tromake concentration in the barium sulfate concentration 36 w / v% solution was 2.50 w / v%, and the swallowing dynamics was evaluated. The results are shown in Table 2.
上記試料を用いた嚥下造影試験による嚥下動態の評価結果は以下の通りである。すなわち、バリウム濃度36w/v%溶液中のトロメイク濃度が0w/v%（トロメイクの水溶液を無添加）の場合、嚥下困難者に嚥下前及び嚥下中の誤嚥が認められた（表には無し）。トロメイク濃度が0.32w/v%（比較例１）の場合、嚥下困難者に多くの喉頭侵入が認められた。トロメイク濃度が0.32w/v%以下では、咽頭反射の出現前に造影模擬食品が咽頭に達しており、嚥下困難者は誤嚥しやすかった。一方、トロメイク濃度が2.50w/v%（比較例２）の場合、咽頭や喉頭蓋谷への付着・残留が多く、嚥下困難者に嚥下後の誤嚥が認められた。トロメイク濃度が0.63及び1.25w/v%の場合、嚥下困難者は誤嚥せずに飲み込むことができた。 The evaluation results of swallowing dynamics by the swallowing contrast test using the above sample are as follows. In other words, when the tromake concentration in the barium concentration 36w / v% solution was 0w / v% (no tromake solution added), aspiration problems were observed in swallowing patients before and during swallowing (none in the table) ). When the tromake concentration was 0.32 w / v% (Comparative Example 1), many laryngeal intrusions were observed in those with difficulty swallowing. When the tromake concentration was 0.32 w / v% or less, the contrast-imitation food reached the pharynx before the appearance of the pharyngeal reflex, and those with difficulty in swallowing were easy to swallow. On the other hand, when the tromake concentration was 2.50 w / v% (Comparative Example 2), there were many adhesions / residues on the pharynx and epiglottis and aspiration after swallowing was observed in those with difficulty in swallowing. When the tromake concentration was 0.63 and 1.25 w / v%, those with difficulty in swallowing could swallow without aspiration.
嚥下困難者に液状食品を提供する際に、その適切な物性（粘性）範囲を提示しており、病院・介護施設でトロミ調整食品等を用いて液状食品の物性を調整する際の判断材料となり得る。また、その範囲の物性を有する液状組成物を提供することで、嚥下困難者に対して嚥下に配慮した適切な物性の液状食品を提供することができる。さらに、嚥下機能は加齢によって低下することが知られており、こうした嚥下に配慮した液状組成物は飲み込み易く、健常な高齢者にとっても有用である。 When providing liquid food to people with difficulty in swallowing, the appropriate physical property (viscosity) range is presented, and it can be used as a judgment material when adjusting the physical properties of liquid food using trolley-adjusted food etc. in hospitals and nursing homes obtain. In addition, by providing a liquid composition having physical properties in that range, it is possible to provide a liquid food having appropriate physical properties in consideration of swallowing for those who have difficulty swallowing. Furthermore, it is known that the swallowing function decreases with aging, and such a swallowable liquid composition is easy to swallow and is useful for healthy elderly people.
Claims (9)
It indicates shear thinning, physical properties of the temperature 20 ° C. is steady shear viscosity shear rate 0.1s -1 is 5.6~28Pa · s and steady shear viscosity of shear rate 500 s -1 is in 0.02~0.038Pa · s This is used as a criterion for preparing a liquid composition for persons with difficulty in swallowing.
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| JP2011234758A (en) * | 2010-04-30 | 2011-11-24 | Sanei Gen Ffi Inc | Method for evaluating or sorting easily swallowable composition |
| US8652563B2 (en) | 2005-08-29 | 2014-02-18 | Ajinomoto Co., Inc. | Nutrient composition |
| JP2015514790A (en) * | 2012-04-27 | 2015-05-21 | ネステク ソシエテ アノニム | How to improve swallowing efficiency |
| JP2019219185A (en) * | 2018-06-15 | 2019-12-26 | 三栄源エフ・エフ・アイ株式会社 | Evaluation method of swallowing property of food and drink |
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| JP2011234758A (en) * | 2010-04-30 | 2011-11-24 | Sanei Gen Ffi Inc | Method for evaluating or sorting easily swallowable composition |
| JP2015514790A (en) * | 2012-04-27 | 2015-05-21 | ネステク ソシエテ アノニム | How to improve swallowing efficiency |
| JP2019219185A (en) * | 2018-06-15 | 2019-12-26 | 三栄源エフ・エフ・アイ株式会社 | Evaluation method of swallowing property of food and drink |
| JP7101056B2 (en) | 2018-06-15 | 2022-07-14 | 三栄源エフ・エフ・アイ株式会社 | Evaluation method of swallowing characteristics of food and drink |
| JP2020003433A (en) * | 2018-06-29 | 2020-01-09 | 株式会社明治 | Oral ingestion product development support method and oral ingestion product development support system |
| JP7082000B2 (en) | 2018-06-29 | 2022-06-07 | 株式会社明治 | Oral ingestion product development support method and oral ingestion product development support system |
| IT201900002823A1 (en) * | 2019-02-27 | 2020-08-27 | So Vite S P A | Food preparation with modified consistency and method for its production |
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