2026· International journal of research and scientific innovation· Vol 13, pp. 6560-6587· 0 citations
TL;DR
This article critically reviews the challenges of hydrophilic hydrocolloids investigated for food fortification purposes, in particular with regards to sensory acceptance, variability in viscosity and risk of nutritional dilution.
Abstract
Dysphagia refers to difficulty swallowing which is estimated to affect more than 800 million people worldwide and occurs by conditions (e.g. neurological diseases, aging, stroke, head and neck cancers). Swallowing is one of the most complex and coordinated physiological activities that human beings engage in but patients with dysphagia may have impaired safe intake of food and liquids, necessitating innovative solutions to avoid complications including aspiration pneumonia, malnutrition, dehydration. Dietary modification, most notably in terms of texture-modified foods (TMFs) and thickened liquids, has emerged as one of the mainstay non-pharmacological approaches in dysphagia management. Due to their unique capacity of modifying viscosity and bolus cohesion at swallowing, stability; hydrocolloids are a major formulation component in these type of foods. These biopolymers consisting of polysaccharides and proteins are common food ingredients to be used as thickening, gelling and stabilizing agents in various food systems; hence utilised in dysphagia diets. This review aims to give an comprehensive overview of the unique characteristics that hydrocolloids play to modify food consistency for patients with dysphagia. The paper first considers the pathophysiology of dysphagia and its nutrition implications, then provides a background on the International Dysphagia Diet Standardisation Initiative (IDDSI) framework for food textures and liquid thickness classification. It explores functional and physicochemical properties of hydrocolloids, focusing on their rheological behaviour and the production of swallowing-safe products. This has led to efforts aimed at leaving the corresponding backgrounds of dysphagia and its diet in reformation, selecting appropriate hydrocolloids for use as thickening vehicles in persons with dysphagia and analysing their properties such as molecule thickening and stability as well as teaching how thickness can help take care of swallowing situation between mechanisms. The review also emphasizes the role of rheological characterization in safe swallowing and optimal bolus flow.
In addition, the uses of hydrocolloids in thickened beverages, pureed meals and ready-to-eat dysphagia products are also described. This article critically reviews the challenges of hydrophilic hydrocolloids investigated for food fortification purposes, in particular with regards to sensory acceptance, variability in viscosity and risk of nutritional dilution. The article is also reviewed to assess the potential of novel approaches (eg, hydrocolloid blends, microstructural design and 3D food printing) in developing high-quality or personalized diets for dysphagia management.
In conclusion, hydrocolloids serve as functional components to enhance the safety, stability and palatability of texture-modified foods frequently consumed by dysphagia patients. Ongoing endeavours to elucidate the mechanism of hydrocolloid action, as well as investigations into optimally rheological properties and consumer acceptability, will ultimately work to inform improvements in dysphagia management
Amyotrophic lateral sclerosis (ALS) is frequently accompanied by progressive dysphagia, weight loss, and hypermetabolism, which complicate the maintenance of adequate nutritional status. For these patients, food systems must not only provide sufficient energy and protein within a limited volume but also exhibit textural and rheological properties that support safe swallowing. This review analyzes technological and rheological approaches to the design of texture‐modified food systems for nutritional support in ALS. Particular attention is given to apparent viscosity, shear‐thinning behavior, yield stress, structural homogeneity, and storage stability as parameters affecting bolus formation, swallowing safety, and product performance. The relevance of the International Dysphagia Diet Standardization Initiative framework for classifying food textures and liquid consistencies is also considered. The review further examines the functional and technological roles of animal‐ and plant‐based raw materials, including regional raw materials, in the formulation of energy‐dense and structurally stable foods. Proteins, lipids, hydrocolloids, starch gels, and polysaccharide networks are discussed as key components for controlling texture, viscosity, gelation, emulsion stability, and nutritional density. Technological strategies such as homogenization, emulsification, protein‐based structuring, hydrocolloid thickening, high‐pressure homogenization, and 3D food printing are considered in relation to their potential for developing safe, acceptable, and locally adaptable products for patients with ALS‐related dysphagia. The findings highlight the need to integrate food texture science, rheological control, nutritional adequacy, sensory acceptability, and regional availability in the development of clinically relevant texture‐modified foods.
Z. Konarbayeva· Journal of texture studies· 0 citations
Dysphagia, or difficulty in swallowing, affects a significant proportion of the aging population and individuals with neurological or physiological impairments, necessitating the development of safe, nutritious, and appealing texture‐modified foods. The International Dysphagia Diet Standardisation Initiative (IDDSI) provides a globally recognized framework to ensure consistent food texture and fluid thickness; however, delivering meals that are both compliant and sensory‐acceptable remains a challenge. This narrative review explores current research on 3D food printing for dysphagia, encompassing nutrition, food science, engineering, and clinical practice. Particular attention is given to the practicality of printing a complete, safe, and nutritionally adequate meal using 3D printing. Key challenges include formulation variability, printability of IDDSI‐compliant foods, equipment limitations, and practical issues in meal preparation and service. This review highlights the technological challenge of 3D food printing in dysphagia care, emphasizing that coordinated, multidisciplinary research is essential to translate this technology into routine clinical use.
Deepa Agarwal, Annie‐Claude M. Lassemillante, Sahiti Peddisetti et al.· Food Frontiers· 0 citations
The feasibility of creating high-protein gel systems suitable for dysphagia patients by adjusting the levels of egg white protein and collagen hydrolysate is examined, offering a viable approach for designing tailored high-protein food formulations for dysphagia.
Deimantė Dagytė, Ieva Bartkuvienė, Evren Gölge et al.· International Journal of Foo...· 0 citations
Bakery products including bread, cookies, biscuits and cake are commonly consumed staples across the life course. They can therefore be targeted for enrichment with protein-rich ingredients which may enhance their textural properties and address age-related nutritional challenges such as dysphagia, sarcopenia, and protein malnutrition in older adults. This systematic review aimed to highlight current advances in the use of bakery products formulated with protein and texture-modulating ingredients as potential vehicles to deliver protein and address age-related nutritional challenges in older adults. A systematic search for relevant articles was conducted on the databases PubMed, Scopus, ScienceDirect and Cochrane Library up to October 01, 2025. Fourteen papers (n = 14) investigated the ease of chew and swallow in older adults. The most frequently reported vehicle was bread (n = 9). Commonly used ingredients for enrichment of the bakery products included soy protein isolate, whey protein isolate, soybean soluble polysaccharide, drum-dried pumpkin flour, inulin, sacha inchi seed cake and chicken protein powder. Most enriching ingredients were good sources of protein. Incorporation into the bakery products resulted in reduction of hardness and improved the subjective ease of chew and swallow. Enriching bread with protein-rich ingredients resulted in a significant increase in the protein intake of older adults. Recipe reformulation, through controlled inclusion of protein isolates, hydrocolloids, vegetable flours, or dietary fibers, can enhance the nutritional value, improve the textural properties and ingestion of bakery products and could address protein malnutrition in older adults. Future studies should explore the use of other underutilized protein-rich ingredients for bakery product reformulation.
Isaac Amoah, Vanessa Adu Sarpong, Comfort Adjei-Boamah et al.· Food, Nutrition and Health· 0 citations
Diet texture modification is a common intervention for oropharyngeal dysphagia. In 2015, the International Dysphagia Diet Standardisation Initiative (IDDSI) published a systematic review summarizing evidence on how liquid consistency and food texture influence swallowing behavior. This updated review synthesizes new evidence published between 2012 and 2024 addressing how differences in liquid consistency or food texture affect swallowing in humans. A PROSPERO-registered, PRISMA-guided review was conducted using the Covidence platform. A multi-engine search identified English, peer-reviewed studies reporting comparable quantitative measures across two or more consistencies defined using IDDSI terminology. Screening and full-text review were performed in duplicate. Articles were appraised using the FRONTIERS framework, and data synthesis focused on swallowing safety, efficiency, and other physiologic metrics. From 63,247 initial records, 24,196 abstracts were screened and 2,310 full texts reviewed, yielding 465 eligible studies. Of these, 70 studies (from 2017 onward) provided non-overlapping data mapped to the IDDSI Framework. Sixty-eight articles reported findings for drink levels 0–4 and 25 for food levels 5–7. Videofluoroscopy was the most common instrumental method used, followed by endoscopy and high-resolution manometry; other physiologic measures were used less frequently. Across all 25 studies reporting safety outcomes, thicker liquids improved swallowing safety compared with thinner liquids. Among studies reporting efficiency, smaller bolus volumes helped limit residue with thickened liquids. Food textures seldom elicited penetration-aspiration but were associated with increased residue in patient populations. Overall, findings reinforce the need for individualized clinical decision-making regarding texture modification, informed by careful assessment.
C. Steele, Isuru Dharmarathna, J. Benfield et al.· Dysphagia (New York. Print)· 1 citation
Modified texture diets (MTDs), thickened liquids and texture-altered foods, are the dominant interventions offered by speech and language therapists for oropharyngeal dysphagia, and their use rests on the long-held assumption that reducing aspiration reduces aspiration pneumonia. Three bodies of evidence have matured largely in parallel but are rarely brought together: the efficacy literature for MTDs in pneumonia prevention, the literature on their iatrogenic harms, and the emerging empirical literature on informed consent for their prescription. This integrative narrative review synthesises these three strands. Randomised trial and observational evidence do not support a reliable pneumonia prevention benefit, and a 2024 matched cohort study of nearly 9,000 hospitalised patients with dementia found no mortality advantage and a higher rate of respiratory complications in the thick liquids group. Concurrently, MTDs are consistently associated with reduced fluid and nutrient intake, altered medication bioavailability, poorer quality of life, and reduced mealtime satisfaction. Against this backdrop, recent survey evidence indicates that most clinicians cannot fully list the known harms of MTDs, and fewer than half report routinely disclosing those harms to patients before prescription. Read together, the three strands describe an evidence, ethics mismatch: a high volume intervention of uncertain benefit and documented harm is being delivered without meaningful informed consent. Closing this gap will require patient facing empirical work on understanding and recall, trials of structured consent tools, qualitative research on the institutional drivers of under-disclosure, and cross-cultural work on consent in settings where autonomy, family, and food culture interact differently.
D. Das· Advances in Communication an...· 0 citations