Innovation in Nutritional Treatment for Dysphagia

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Innovation in NutritionalTreatment for Dysphagia

• Thérèse Dufresne, RD

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Prophagia a network of strategic alliances

• Synergy together, we go faster further
• Convergence of mission quality of nutritional
  care for the Hospital client and LTC Resident
• Complementarity of compentencies

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Our client
Scientific Partner
Research Partners Sainte.Annes Hospital McGill
University
Technology Partner
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Outline

• Overview of Dysphagia
• General Overview
• Prevalence
• Consequence

• Epikura a Novel Treatment for Dysphagia
• Background
• History
• Results

• Introduction to Food Rheology
• Texture Parameters
• Application to Nutritional Treatment of Dysphagia

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Dysphagia dys difficulty phagein eat
Oral Phase - Preparatory -
Transport Pharyngial Phase Oesophagial Phase
from ME Groher, Dysphagia Diagnosis and
Management
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Over 50 nerves and arteries
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Over 45 muscles
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Etiology of Dysphagia

• Neurogenic

Dementia Multiple
Sclerosis CVA - Strokes Muscular
Dystrophy Parkinsons Disease Alzheimers
Disease Huntingtons Disease

• Inadequate dentition

• Psychiatric

Depression

• Iatrogenic Conditions

Medication Induced Injury Chemotherapy
Radiotherapy
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Sainte.Annes Dysphagic Population per
Diagnostic April 2005 March 2006
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Prevalence of Dysphagia

• Acute Care Setting ? 30 to 35

• Chronic Care ? 35 to 75

• In Canada
• 400,000 dysphagic persons
• 98,200 institutionalized dysphagic persons

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Traditional Modified Texture Diet

• Unappealing
• Diluted (?nutrients, ?taste)
• Unrecognizable
• No quantification nor standardization of texture
• No demonstrated efficiency to treat dysphagia

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Consequences of dysphagia

• Dysphagia
• Slow eating
• Choking
• Fear to eat or drink
• Reduced food intake
• Undernutrition, frailness, decreased quality of
  life, decreased autonomy, increased infections,
  pneumopathies and cost of care

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A Revolution in the Nutritional Treatment of
Dysphagia
The Joy of Eating back on the menu!

• 40 main entrees
• Normal looking
• Minced Pureed
• Meats, poultry fish
• Pasta

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Epikuras Fresh Tasting Veggies

• 10 Vegetables
• Cooked Raw
• Puréed

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Epikuras Sweetness

• 9 Cakes
• 6 Fruits
• Puréed

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Tasting Break

• Awareness of 3 phases of swallowing
• Dysphagic swallow
• Food Descriptors - Compaction vs aeration
• Particle size
• Cohesiveness
• Adhesivene
• Syneresis
• Taste profile intensity of flavours

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Randomized Clinical Study 1999 (n17)

• A Demonstrated Efficacy (Germain et al, JADA,
  Oct. 2006)

The BMI of the Treated Subjects increases from
22 to 24 in 12 weeks while the BMI of Control
Subjects remains low
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For the Joy of eating and a taste af life!
After 82 kg
Before 60 kg
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A Unique Technology which offers

• Something for every taste, every day
• Offers the dysphagic clientèle a balanced and
  varied diet
• Competitive prices
• Fresh food, pure ingredient
• Handy frozen individual portions

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Implementation Support

• Expert Team
• Consulting and training

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Objectives and Indicators

• consumption of meals served
• (or food intake protein, energy, )
• variety of foods consumed
• weights (BMI) and nutritional status of
  residents
• meal appreciation by patients

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Strategy, steps and calendar

• Impact analysis
• Identification of operational needs
• equipements
• procedures, recipes, menus,
• Communications
• Operation team
• Admin and multi team
• Nursing team

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Now available for the Canadian Health Centres