Sensory appeal and acceptance of a novel food intervention programme for older adults living with dysphagia
Authors
J.Holmes1, K. Light1 and J, Andrews2
1. The Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
2. Dorset County Hospital NHS Foundation Trust, Dorchester, UK
holmesj@bournemouth.ac.uk
klight@bournemouth.ac.uk
janineelizabeth@hotmail.com
Submitted to Nutrition Society Congress, Belfast, 2024
Approximately 60% of older adults living in residential care live with dysphagia (difficulty swallowing and chewing) (Baijens et al 2016) and require texture modified foods (TMF). Despite the International Dysphagia Diet Standardisation Initiative (IDDSI), foods are often prepared with variation in texture, flavour, and consistency leading to further swallowing difficulties and safety concerns (Garcia et al 2018). Nutritional quality of food is detrimentally impacted by modifying texture of food due to over cooking and addition of liquid to adhere to guidelines leading to malnutrition risk.
Specially prepared, sensory rich, nutrient enhanced TMF could positively impact nutritional status and wellbeing of those living with dysphagia (Balesteros-Pomar et al. 2020). A novel food intervention programme (NFIP) (Dysphameal™) has been developed using food technology solutions to thicken food using proteins. Zanini et al (2021) evaluated this novel food intervention and identified positive clinical outcomes in Italy, but to date no work has evaluated this product from a sensory and food experience perspective.
Aim of study
This qualitative pilot study aimed to understand the sensory appeal, and acceptance of the novel food intervention programme (NFIP) for older adults living with dysphagia.
Method
Carers (n = 9 aged 30-60 years) were recruited independently of the workplace; with the condition they had or were currently supporting older adults living with dysphagia. Additionally, healthy, independent, older adults (n = 9 aged 65 years and over) were recruited to represent comparable sensory aptitude to a similar age group living with dysphagia. Samples (n= 6 flavours) of selected NFIP were available for participants to taste during semi structured interviews.  Interviews were recorded and transcribed. Data collection and analysis used Braun and Clark’s (2014) six stage thematic analysis until data saturation had been reached.
Results
Three themes arose to understand sensory appeal, and acceptance of the NFIP:
· Negative sensory experience comprised of taste (bland, lack of seasoning, after-taste), texture (starchy, comparable to wallpaper paste, dependent on serving temperature), smell and visual appearance, primarily colour.
· Performance of the products included acceptability, meeting expectations, ingredient suggestions to improve sensory characteristic especially flavour.
· Acceptability of individual products varied.
Conclusion
The NFIP provides an opportunity to boost nutritional intake and be incorporated as part of a hybrid food delivery service to replace hard to puree, nutritionally dilute foods, especially bland products such as rice and pasta to serve alongside fresh counterparts and, reduce risk of malnutrition for those living with dysphagia. Opportunities exist to further develop this type of texture modified food product to improve palatability, enhance flavour, and appearance characteristics for those living with dysphagia, through advances in molecular gastronomy, controlling antioxidant activity and loss of volatiles.
References
Baijens L, Clave P & Cras, P (2016). Cl Int in Aging 11, 1403-1428
Balesteros-Pomar M D, Cherubini A, et al (2020) Health and Ageing 24 (6), 576-581
Garcia et al (2018) Am J of Speech-Language Pathology 27 1458–1473
Zanini et al (2021) J Nursing Management 29, 2620-2629
No conflict of interests declared
We would like to thank Harg, Italy for providing the Dysphameal products free of charge. (Note to editors – other than providing product, this project was not funded by Harg)

**Sensory appeal and acceptance of a novel food intervention programme for older adults living with dysphagia**
**Authors**
J.Holmes1, K. Light1 and J, Andrews2
_1. The Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK_
_2. Dorset County Hospital NHS Foundation Trust, Dorchester, UK_
[holmesj@bournemouth.ac.uk](mailto:holmesj@bournemouth.ac.uk)
[klight@bournemouth.ac.uk](mailto:klight@bournemouth.ac.uk)
[janineelizabeth@hotmail.com](mailto:janineelizabeth@hotmail.com)
**Submitted to Nutrition Society Congress, Belfast, 2024**
Approximately 60% of older adults living in residential care live with dysphagia (difficulty swallowing and chewing) (Baijens et al 2016) and require texture modified foods (TMF). Despite the International Dysphagia Diet Standardisation Initiative (IDDSI), foods are often prepared with variation in texture, flavour, and consistency leading to further swallowing difficulties and safety concerns (Garcia et al 2018). Nutritional quality of food is detrimentally impacted by modifying texture of food due to over cooking and addition of liquid to adhere to guidelines leading to malnutrition risk.
Specially prepared, sensory rich, nutrient enhanced TMF could positively impact nutritional status and wellbeing of those living with dysphagia (Balesteros-Pomar et al. 2020). A novel food intervention programme (NFIP) (Dysphameal™) has been developed using food technology solutions to thicken food using proteins. Zanini et al (2021) evaluated this novel food intervention and identified positive clinical outcomes in Italy, but to date no work has evaluated this product from a sensory and food experience perspective.
**Aim of study**
This qualitative pilot study aimed to understand the sensory appeal, and acceptance of the novel food intervention programme (NFIP) for older adults living with dysphagia.
**Method**
Carers (n = 9 aged 30-60 years) were recruited independently of the workplace; with the condition they had or were currently supporting older adults living with dysphagia. Additionally, healthy, independent, older adults (n = 9 aged 65 years and over) were recruited to represent comparable sensory aptitude to a similar age group living with dysphagia. Samples (n= 6 flavours) of selected NFIP were available for participants to taste during semi structured interviews.  Interviews were recorded and transcribed. Data collection and analysis used Braun and Clark’s (2014) six stage thematic analysis until data saturation had been reached.
**Results**
Three themes arose to understand sensory appeal, and acceptance of the NFIP:
· Negative sensory experience comprised of taste (bland, lack of seasoning, after-taste), texture (starchy, comparable to wallpaper paste, dependent on serving temperature), smell and visual appearance, primarily colour.
· Performance of the products included acceptability, meeting expectations, ingredient suggestions to improve sensory characteristic especially flavour.
· Acceptability of individual products varied.
**Conclusion**
The NFIP provides an opportunity to boost nutritional intake and be incorporated as part of a hybrid food delivery service to replace hard to puree, nutritionally dilute foods, especially bland products such as rice and pasta to serve alongside fresh counterparts and, reduce risk of malnutrition for those living with dysphagia. Opportunities exist to further develop this type of texture modified food product to improve palatability, enhance flavour, and appearance characteristics for those living with dysphagia, through advances in molecular gastronomy, controlling antioxidant activity and loss of volatiles.
**References**
Baijens L, Clave P & Cras, P (2016). _Cl Int in Aging_ 11, 1403-1428
Balesteros-Pomar M D, Cherubini A, et al (2020) _Health and Ageing_ 24 (6), 576-581
Garcia et al (2018) _Am J of Speech-Language Pathology_ 27 1458–1473
Zanini et al (2021) _J Nursing Management_ 29, 2620-2629
No conflict of interests declared
We would like to thank Harg, Italy for providing the Dysphameal products free of charge. (Note to editors – other than providing product, this project was not funded by Harg)

OC245 - Sensory appeal and acceptance of a novel food intervention programme for older adults living with dysphagia

Unique to the new Congress (previously the Summer Conference) is that you will have greater opportunity to engage with more nutrition science than ever before. In 2024 the core programme will be delivered by the Irish Section of The Nutrition Society, supported by the Science Committee. The theme of these symposia will be ‘new data – focused approaches and challenges’. Outside of the core programme you will have the chance to hear the latest research from the Society’s partner organisations, universities, the private sector and more, on a diverse range of research.