饮食改变对成人吞咽困难患者膳食营养摄入、误吸和液体摄入的影响：一项随机对照试验的荟萃分析

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging Pub Date : 2025-01-15 DOI:10.1016/j.jnha.2025.100486

Yu-Hao Chu , Jane C-J Chao

{"title":"饮食改变对成人吞咽困难患者膳食营养摄入、误吸和液体摄入的影响：一项随机对照试验的荟萃分析","authors":"Yu-Hao Chu , Jane C-J Chao","doi":"10.1016/j.jnha.2025.100486","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>To determine and explore the effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake in adults with dysphagia.</div></div><div><h3>Participants</h3><div>Adults with dysphagia.</div></div><div><h3>Design</h3><div>A meta-analysis of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>We conducted a comprehensive literature search in EMBASE, Cochrane Library, Ovid-Medline, CINAHL, Web of Science, PubMed, and reference lists until November 2023. Quality of the included studies was assessed by the Cochrane Risk of Bias Assessment tool 2.0. Data analysis was performed using Comprehensive Meta-analysis 3.0 for pooled Hedges’ <em>g</em> and odds ratios (ORs) with corresponding confidence interval (CI) adopting a random-effects model. A X<sup>2</sup>- <span><math><mtext>b</mtext><mtext>a</mtext><mtext>s</mtext><mtext>e</mtext><mtext>d</mtext></math></span> test using Cochran’s Q (<em>P</em> < 0.10) and <span><math><msup><mi>I</mi><mn>2</mn></msup></math></span> statistics evaluated heterogeneity.</div></div><div><h3>Results</h3><div>In total, 16 RCTs from among 3,854 studies retrieved from the literature search with 1812 adults with dysphagia were included in this meta-analysis. Texture-modified diets revealed a significant small effect on increasing energy intake (<em>g</em>: 0.37, 95% CI = 0.05–0.68) and a medium effect on increasing protein intake (<em>g</em>: 0.56, 95% CI = 0.13–0.99). Thickened fluids revealed a significantly reduced risk of aspiration (OR: 0.59, 95% CI = 0.44–0.79), and thickened fluids combined with water protocol revealed a significant large effect on increasing fluid intake (<em>g</em>: 3.96, 95% C = 0.75–7.16).</div></div><div><h3>Conclusions</h3><div>The findings of this meta-analysis demonstrated that texture-modified diets increase dietary intake of energy and protein for adults with dysphagia. In addition, thickened fluids reduced the risk of aspiration while thickened fluids combined with water protocol increased fluid intake in adults with dysphagia.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 4","pages":"Article 100486"},"PeriodicalIF":4.3000,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trials\",\"authors\":\"Yu-Hao Chu , Jane C-J Chao\",\"doi\":\"10.1016/j.jnha.2025.100486\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>To determine and explore the effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake in adults with dysphagia.</div></div><div><h3>Participants</h3><div>Adults with dysphagia.</div></div><div><h3>Design</h3><div>A meta-analysis of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>We conducted a comprehensive literature search in EMBASE, Cochrane Library, Ovid-Medline, CINAHL, Web of Science, PubMed, and reference lists until November 2023. Quality of the included studies was assessed by the Cochrane Risk of Bias Assessment tool 2.0. Data analysis was performed using Comprehensive Meta-analysis 3.0 for pooled Hedges’ <em>g</em> and odds ratios (ORs) with corresponding confidence interval (CI) adopting a random-effects model. A X<sup>2</sup>- <span><math><mtext>b</mtext><mtext>a</mtext><mtext>s</mtext><mtext>e</mtext><mtext>d</mtext></math></span> test using Cochran’s Q (<em>P</em> < 0.10) and <span><math><msup><mi>I</mi><mn>2</mn></msup></math></span> statistics evaluated heterogeneity.</div></div><div><h3>Results</h3><div>In total, 16 RCTs from among 3,854 studies retrieved from the literature search with 1812 adults with dysphagia were included in this meta-analysis. Texture-modified diets revealed a significant small effect on increasing energy intake (<em>g</em>: 0.37, 95% CI = 0.05–0.68) and a medium effect on increasing protein intake (<em>g</em>: 0.56, 95% CI = 0.13–0.99). Thickened fluids revealed a significantly reduced risk of aspiration (OR: 0.59, 95% CI = 0.44–0.79), and thickened fluids combined with water protocol revealed a significant large effect on increasing fluid intake (<em>g</em>: 3.96, 95% C = 0.75–7.16).</div></div><div><h3>Conclusions</h3><div>The findings of this meta-analysis demonstrated that texture-modified diets increase dietary intake of energy and protein for adults with dysphagia. In addition, thickened fluids reduced the risk of aspiration while thickened fluids combined with water protocol increased fluid intake in adults with dysphagia.</div></div>\",\"PeriodicalId\":54778,\"journal\":{\"name\":\"Journal of Nutrition Health & Aging\",\"volume\":\"29 4\",\"pages\":\"Article 100486\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-01-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nutrition Health & Aging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1279770725000090\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nutrition Health & Aging","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1279770725000090","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的：确定和探讨饮食改变对成人吞咽困难患者膳食营养摄入、误吸和液体摄入的影响。参与者：有吞咽困难的成年人。设计：随机对照试验（rct）的荟萃分析。方法：到2023年11月，我们在EMBASE、Cochrane Library、Ovid-Medline、CINAHL、Web of Science、PubMed和参考文献中进行了全面的文献检索。纳入研究的质量采用Cochrane偏倚风险评估工具2.0进行评估。数据分析采用综合meta -分析3.0，采用随机效应模型，对对冲系数（hedge’g）和相应置信区间（CI）的比值比（ORs）进行汇总。采用Cochran’s Q （P < 0.10）和I2统计量进行基于X2的检验，评估异质性。结果：从文献检索中检索到的3854项研究中，共纳入了16项随机对照试验，涉及1812例成人吞咽困难患者。质地改良饮食对增加能量摄入有显著的小影响（g: 0.37, 95% CI = 0.05-0.68），对增加蛋白质摄入有中等影响（g: 0.56, 95% CI = 0.13-0.99）。增稠的液体显示吸入风险显著降低（OR: 0.59, 95% CI = 0.44-0.79），增稠的液体联合水方案显示对增加液体摄入量有显著的大影响（g: 3.96, 95% C = 0.75-7.16）。结论：本荟萃分析的结果表明，质地改变的饮食增加了成人吞咽困难患者的能量和蛋白质摄入量。此外，增稠的液体降低了误吸的风险，而增稠的液体联合水方案增加了吞咽困难成人的液体摄入量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake for adults with dysphagia: a meta-analysis of randomized controlled trials

Objectives

To determine and explore the effectiveness of diet modification on dietary nutrient intake, aspiration, and fluid intake in adults with dysphagia.

Participants

Adults with dysphagia.

Design

A meta-analysis of randomized controlled trials (RCTs).

Methods

We conducted a comprehensive literature search in EMBASE, Cochrane Library, Ovid-Medline, CINAHL, Web of Science, PubMed, and reference lists until November 2023. Quality of the included studies was assessed by the Cochrane Risk of Bias Assessment tool 2.0. Data analysis was performed using Comprehensive Meta-analysis 3.0 for pooled Hedges’ g and odds ratios (ORs) with corresponding confidence interval (CI) adopting a random-effects model. A X²-

b a s e d

test using Cochran’s Q (P < 0.10) and

I^{2}

statistics evaluated heterogeneity.

Results

In total, 16 RCTs from among 3,854 studies retrieved from the literature search with 1812 adults with dysphagia were included in this meta-analysis. Texture-modified diets revealed a significant small effect on increasing energy intake (g: 0.37, 95% CI = 0.05–0.68) and a medium effect on increasing protein intake (g: 0.56, 95% CI = 0.13–0.99). Thickened fluids revealed a significantly reduced risk of aspiration (OR: 0.59, 95% CI = 0.44–0.79), and thickened fluids combined with water protocol revealed a significant large effect on increasing fluid intake (g: 3.96, 95% C = 0.75–7.16).

Conclusions

The findings of this meta-analysis demonstrated that texture-modified diets increase dietary intake of energy and protein for adults with dysphagia. In addition, thickened fluids reduced the risk of aspiration while thickened fluids combined with water protocol increased fluid intake in adults with dysphagia.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.