STUDIES OF THE ORAL CAPABILITIES IN RELATION TO BOLUS
MANIPULATIONS AND THE EASE OF INITIATING BOLUS FLOW
WOROUD ABDULRAHMAN ALSANEI and JIANSHE CHEN
1
School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, U.K.
This article originated from a presentation given during the conference, “Food Oral Processing – Physics, Physiology, and Psychology of Eating”,
held in Beaune (France) on July 1–5, 2012.
KEYWORDS
Bolus size, bolus swallowing, deglutition
disorders, deglutition, dysphagia, maximum
isometric tongue pressure, oral pressure, oral
volume
1
Corresponding author.
TEL: +(00)-44-113-3432748;
FAX: +(00)-44-113-3432982;
EMAIL: j.chen@food.leeds.ac.uk
Received for Publication December 4, 2012
Accepted for Publication July 23, 2013
doi:10.1111/jtxs.12041
ABSTRACT
Bolus swallowing can be a difficult task and/or highly hazardous to people with
dysphagia (swallowing impairment), involving a risk of choking and airway
obstruction. Food and pharmaceutical industries are under growing pressure to
design and provide quality food for safe consumption by these disadvantaged
populations and urgently need knowledge and a proper understanding of the con-
trolling mechanisms of bolus manipulation and swallowing. In this study, physi-
ological capabilities related to oral food handling, including maximum isometric
tongue pressure, the volume of oral cavity, optimum bolus size, and tongue pres-
sures applied during bolus swallowing were investigated. A total of 106 healthy
subjects of different ages, genders and ethnic groups were involved in the investi-
gation. A wide range of maximum isometric tongue pressure (from as low as
10 kPa to as high as 70 kPa) and maximum oral volume (from as low as 25 mL to
as high as 116 mL) were observed. Further analysis showed that gender had no sig-
nificant influence on tongue pressure and oral volume capacities. For younger
adults (22–64 years), age also appears to have little effect. However, for older
adults (>65 years), both maximum isometric tongue pressure and the oral volume
showed a gradual decrease with the increasing of age. By investigating basic factors
of bolus swallowing, this project aimed to reveal critical controlling factors under-
lining the process and to test the hypothesis that, because tongue pressure pro-
vides the initial driving force for bolus flow, one’s capability to generate tongue
pressure could be related to the ease with which one can swallow. For this
purpose, a selection of subjects with known maximum isometric tongue pressure
was further invited to swallow food (bolus) of varying consistencies. A positive
correlation was observed between maximum tongue pressure and the maximum
consistency of bolus that one can swallow for those who had lower tongue pres-
sure generation capacity (<40 kPa). However, for subjects capable of producing
very high tongue pressures (>40 kPa), a tongue pressure reserve (around a third
of their maximum capability) was observed during bolus swallowing.
PRACTICAL APPLICATIONS
This article investigates a few interesting hypothesis on the bio-mechanics of food
processing, especially tongue pressure for bolus management and transfer during
oro-pharyngeal swallow. Swallowing is the final stage of food oral processing and
is crucial for the transportation of orally processed food (the bolus) to the
stomach for further digestion and nutrient absorption. As such, safe swallowing
is a major concern for many disadvantaged populations, e.g., some elderly
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