老年吞咽障碍人群易吞咽食品研究现状与发展趋势

Research Progress and Development Trends of Easy-to-Swallow Foods for Older Adults with Dysphagia

摘要:

随着人口老龄化加剧,肌少症及神经退行性疾病的临床负担增加,使老年吞咽障碍人群的饮食安全与营养支持需求持续上升。传统软烂化、糊状化和经验性增稠方法虽可在一定程度上降低误吸风险,但常伴随营养密度下降、质构不稳定、外观识别度低和长期依从性不足等问题。围绕老年吞咽障碍人群易吞咽食品开发,系统归纳了吞咽功能衰退、食团流变安全、质构感官适配、营养需求满足、标准评价体系及关键加工技术的研究进展。分析了国际吞咽障碍饮食标准化倡议和国内膳食管理共识在质构分级、现场测试和临床沟通中的应用价值,指出易吞咽食品设计已由单一“软”或“稠”的描述,转向基于黏度、硬度、内聚性、黏附性、流变学特性和消化行为的精准调控。重点总结了增稠流变调控、凝胶软质重构、酶解与温和加工、三维打印及微胶囊功能递送等技术路径,阐明了其在改善食团控制、降低咀嚼负担、提升营养密度和提高感官接受度方面的作用。针对当前实验室静态指标与临床真实健康获益缺乏系统关联证据、产品长期依从性不足等行业瓶颈,提出未来应以患者真实健康获益为导向,构建安全、营养和感官协同的分层设计体系,加强临床效果验证和真实临床数据积累,推动易吞咽食品从风险规避型质构改良向健康促进型精准供给转变,为医院、养老机构和居家照护场景下的老年吞咽障碍营养干预提供理论依据和技术参考。

Abstract:

Population ageing, sarcopenia, and the increasing burden of neurodegenerative diseases have led to a growing demand for dietary safety and nutritional support among older adults with dysphagia. Traditional softening, pureeing, and empirical thickening methods can reduce aspiration risk to some extent, but they are often associated with reduced nutrient density, unstable texture, poor visual recognizability, and limited long-term compliance. Focusing on the development of easy-to-swallow foods for older adults with dysphagia. Recent progress in swallowing function decline, bolus rheological safety, texture and sensory adaptation, nutritional requirements, standard evaluation systems, and key processing technologies were systematically summarized. The application value of the International Dysphagia Diet Standardisation Initiative and domestic dietary management consensus in texture classification, bedside testing, and clinical communication were analyzed, and it was indicated that easy-to-swallow food design had shifted from the simple description of “soft” or “thick” toward precision regulation based on viscosity, hardness, cohesiveness, adhesiveness, rheological properties, and digestive behavior. Technological strategies, including thickening and rheological regulation, soft gel reconstruction, enzymatic hydrolysis and mild processing, three-dimensional printing, and microencapsulation-based functional delivery were further summarized, and the roles of these strategies in improving bolus control, reducing chewing burden, increasing nutritional density, and enhancing sensory acceptability were clarified. In view of current bottlenecks, such as the lack of systematic evidence linking static laboratory indicators with real clinical health benefits and the insufficient long-term compliance of existing products, future research should be oriented toward real health benefits for patients, establish a stratified design system integrating safety, nutrition, and sensory quality, strengthen clinical outcome validation and real-world clinical data accumulation, and promote the transition of easy-to-swallow foods from risk-avoidance-oriented texture modification to health-promoting precision provision. This review aimed to provide theoretical support and technical reference for nutritional intervention in older adults with dysphagia in hospitals, elderly care institutions, and home-care settings.