Applications of Nanoemulsions in Food Manufacturing

Nanoemulsions are increasingly used in the food industry for the encapsulation of lipophilic compounds such as nutraceuticals, flavors, vitamins, antioxidants, and colors. The advantages of nanoemulsion-based encapsulation include increased bioavailability, higher solubility, control release, protection from chemical degradation, and incorporation of different ingredients into food products. Food industries are interested in the preparation of natural polymer-based nanoemulsions to prepare clean label products. A variety of polymers such as soya lecithin, WPI, GA, and modified starches have been used to fabricate nanoemulsion-based delivery systems for nutraceuticals and micronutrients. Hence, nanoemulsion-fortified food products have received great attention due to consumer demand for safer and healthier food products. Additionally, nanoemulsions can be used for the texture modification of food products and encapsulation as well as delivery of antimicrobial agents. The main challenge for the preparation of nanoemulsions is the selection of appropriate ingredients.

Facilitators and Barriers to Implementing the International Dysphagia Diet Standardisation Initiative in Care Facilities in Upstate New York

Introduction: Dysphagia is a swallowing disorder that can result in aspiration, asphyxiation, or other complications. One method of facilitating safer swallowing is modification of the diet and fluids of individuals living with dysphagia. The International Dysphagia Diet Standardisation Initiative (IDDSI) is a globally standardized framework for texture modification. Its implementation has been recommended in the United States, but adoption is not yet universal. This study investigated implementation issues by surveying health care professionals in health care facilities in rural, Upstate New York. Method: A questionnaire created through the SurveyMonkey platform was distributed to health care facilities within a predetermined geographical area in Upstate New York. The survey consisted of 22 questions and utilized a mixed-methods design. Results: Forty-six participants from 10 individual professions and nine types of facilities completed the study. Twenty texture modification labels and 10 fluid modification labels were described. Analysis of qualitative data yielded three main barriers to implementation: funding, education, and communication. Within each barrier, awareness and resources were recurrent themes. Discussion: The variety of modification labels in comparison with the sample size demonstrates a lack of standardization of texture modification processes across facilities. While nearly half the respondents had not heard of IDDSI prior to the survey, 89% agreed that a standardized dysphagia diet would improve patient health and safety. This demonstrated a willingness to adopt IDDSI and indicated that staff attitudes may not be a barrier to its implementation. Participants felt that training was needed for successful implementation and expressed concern about the lack of availability of financial resources. Supplemental Material: https://doi.org/10.23641/asha.17270861

Sarcopenic Dysphagia: A Narrative Review from Diagnosis to Intervention

Sarcopenia, defined as a decline in muscle mass and function related to aging, affects both limb and swallowing-related muscles. Sarcopenic dysphagia is characterized by decreased swallowing function; therefore, early detection of subclinical dysphagia and subsequent intervention appear to be crucial in the elderly. Numerous tools have been employed to measure the function, strength, and mass of swallowing-related muscles in sarcopenic elderly. The swallowing function can be evaluated by questionnaires like Eating Assessment Tool, Functional Oral Intake Scale, and Food Intake Level Scale, and tests such as the modified water swallowing test and videofluoroscopic swallowing study. Surface electromyography and high-resolution manometry can be applied for quantifying swallowing-related muscle strength. Modalities such as ultrasonography and magnetic resonance imaging are capable of estimating the swallowing muscle mass. In patients with sarcopenic dysphagia, a thorough assessment should be given followed by an integrated intervention combining swallowing muscle strengthening, nutrition support, food texture modification, physical, and occupational therapies. This article aimed to comprehensively summarize the diagnostic criteria/tools as well as their associations/performance in sarcopenic dysphagia. The intervention strategy will also be narrated in this review.

Content identification for the development of a nutrition resource kit for malnourished and at-risk elderly: A review

Introduction: Elderly population is more likely to suffer from malnutrition, thereby requiring appropriate nutrition education as part of nutrition intervention to overcome this issue. This review aims to identify content suitable for developing a nutrition resource kit that provides nutritional guidance to combat malnutrition among malnourished and at-risk elderly in health clinics setting, particularly in Malaysia. Methods: A literature search was conducted up to 15th December 2019 in four databases: PubMed, Scopus, COCHRANE, and ProQuest Health & Medical Collection. Potential literature on nutrition education, suitable dietary guidelines and existing educational materials for elderly in the community, in English and Malay languages, were searched to identify suitable content for the nutrition resource kit. All relevant documents were included based on inclusion and exclusion criteria. Data were extracted and analysed according to the PRISMA-ScR guidelines. Results: A total of 27 documents consisting of articles, printed materials and guidelines were included for analysis. Suitable content included information related to malnutrition such as definition, signs and symptoms, cause-consequences, and nutrition management, which included food plate, serving size, menu suggestion, examples of recipes, tips to increase energy and protein intakes through food or drink, texture modification, a guide to using oral nutritional supplements, tips for maintaining nutrient content in food and drink, tips to encourage to eat, and oral health. Conclusion: A nutrition resource kit tailored for malnourished and at-risk elderly would be a beneficial nutrition intervention. There is a need to incorporate these information in the development of a nutrition resource kit to improve their dietary intake.

Quantitative use-wear analysis of stone tools: Measuring how the intensity of use affects the identification of the worked material

The identification of the use of stone tools through use-wear analysis was one the major methodological advances in Prehistoric Archaeology during the second half of the 20th century. Studies of use-wear analysis have decisively contributed to a better understanding of the cognitive capacities and the socio-economic organization of Prehistoric societies. Among use-wear traces, microwear polish is the most relevant evidence, as it allows the identification of the worked materials (i.e. wood, antler, hide, bone, stone…). This identification is currently carried out through the qualitative and visual comparison of experimental and archaeological tools. During the last decade, confocal microscopy is allowing the quantitative identification of the worked material through the texture analysis of microwear polish. Previous tests have accounted for the variability of use-wear traces as caused by different types of worked material. However, how the intensity of use, which is widely recognized as an important factor conditioning microwear polish characteristics, affects our capacity to identify the worked materials is poorly understood. This research addresses the dynamic nature of microwear polish through confocal microscopy and texture analysis. This research shows that use-wear polishing is a dynamic process and surface texture evolves continuously during the working time. The evolution fits a logarithmic function, so most texture modification takes place during the first phases of work. The way in which polish texture evolves through time differs from one contact material to the other. We demonstrate that, despite the dynamic nature of use-wear polish, different worked materials can be discriminated. However, some overlapping between used and unused surfaces and between worked materials occurs in the first stages of use. Moreover, polishes of similar characteristics (i.e. bone and antler) can show similar texture at advanced stages of use. These problems in identification can be in good measure overcome by creating dynamic models of polish texture in which not only the worked material but also the time of use is considered.