连接老年人口腔加工能力、食物质地与食团准备度：亚洲证据图谱与咀嚼质地阈值框架

文献信息

中文摘要

背景： 与年龄相关的口腔功能衰退会改变老年人破碎、粉碎、水合、润滑食物并将其转化为可运输食团的能力，从而增加对质地改良食品的需求。现行食物质地标准为食物和液体的分类提供了共同语言，但并不能确定某一特定食物质地对于个体是否可在口腔内处理。本系统范围综述与证据图谱综合了亚洲关于食物口腔加工、口腔功能、食物质地特性、食团形成、质地改良食品及食物质地标准的证据，以评估支持咀嚼质地阈值（MTT）框架的证据。方法：遵循PRISMA-ScR指导的方法，对来自Web of Science、PubMed及针对性Google Scholar检索的记录进行筛选，最终从5926条识别记录中获得136项符合条件的研究。结果：证据集中于日本、韩国和中国，并以凝胶/模型食品表征、质地改良食品开发和口腔功能评估的研究为主。方向性综合一致地将更高的质地需求与增加的咀嚼努力相联系，将咬合支持降低与咀嚼受损相联系，将舌压和唾液可用性降低与食物处理及食团形成受损相联系，并将包括硬度、黏附性、内聚性、润滑性和黏度在内的多维质地特性与口腔加工和吞咽相关结局相联系。现有标准能有效分类食物质地，但很少将个体特异的口腔加工能力与质地选择相结合，且没有纳入的研究验证了完整的人体层面质地推荐方案。结论：因此，我们提出MTT作为一个框架，用于前瞻性验证可咀嚼食物在个体层面的口腔可处理性，将进食能力、口腔加工能力、多维质地需求、食团准备度及下游营养相关结局相联系。在该框架中，口腔加工能力嵌套于更广泛的进食能力构念之内，而营养相关结局作为下游验证终点，而非定义阈值的标准。未来研究应使用标准化口腔加工终点、真实食物转化及现有质地标准对MTT进行前瞻性验证。

英文摘要

Age-related decline in oral function alters the ability of older adults to fracture, comminute, hydrate, lubricate, and transform foods into transportable boluses, increasing the need for texture-modified foods. Current food-texture standards provide a common language for classifying foods and liquids but do not determine whether a specific food texture is orally manageable for an individual. This systematic scoping review and evidence map synthesized Asian evidence on food oral processing, oral function, food-texture properties, bolus formation, texture-modified foods, and food-texture standards to evaluate the evidence supporting a Masticatory Texture Threshold (MTT) framework. Following PRISMA-ScR-informed methods, records from Web of Science, PubMed, and targeted Google Scholar searches were screened, resulting in 136 eligible studies from 5926 identified records. The evidence was concentrated in Japan, South Korea, and China and was dominated by studies on gel/model-food characterization, texture-modified food development, and oral-function assessment. Directional synthesis consistently linked greater texture demand with increased chewing effort, reduced occlusal support with impaired mastication, lower tongue pressure and saliva availability with compromised food handling and bolus formation, and multidimensional texture properties including hardness, adhesiveness, cohesiveness, lubrication, and viscosity with oral processing and swallowing-related outcomes. Existing standards effectively classify food textures but rarely integrate person-specific oral-processing capacity with texture selection, and no included study validated a complete person-level texture recommendation protocol. We therefore propose MTT as a framework for prospective validation of individual oral manageability of chewable foods, linking eating capability, oral-processing capacity, multidimensional texture demand, bolus readiness, and downstream nutrition-related outcomes. In this framework, oral-processing capacity is nested within the broader construct of eating capability, and nutrition-related outcomes serve as downstream validation endpoints rather than criteria defining the threshold. Future studies should prospectively validate MTT using standardized oral-processing endpoints, real-food translation, and existing texture standards.