國際質地調整食品分級介紹

International Classification Systems for Texture-Modified Foods

2020年全球人口超過65歲者已達7億人|台灣地區為360萬人，以每年18萬人成長，預計於2026年達總人口數20％，進入超高齡社會。高齡者因口腔生理機能改變，影響吞嚥、營養攝食與生活品質，為能輔助咀嚼或吞嚥障礙者攝食，提供調整食物質地與液態飲品稠度，能有效改善飲食安全。為增進醫護人員、照護者與餐食製備供應者之溝通與提升使用者照護品質，各國紛紛建立質地調整食品分級標準，本文將介紹四項常見的質地調整食品分類系統：（1）國際吞嚥障礙飲食標準化委員會（International Dysphagia Diet Standardisation Initiative）：建立之食品與飲品質地分級，為全球參與國最多（計有22國導入），由營養、語言治療、藥師、職能治療、護理、食品科學專家建立之質地調整與增稠液體分級用語、定義與量測方法。（2）日本介護食協議會通用設計食品（Japanese Universal Design Foods）：為全球發展最早，由食品產業主動制定之標準，依硬度與黏度分為四項分級規格，並標示於食品包裝以利使用者選用。（3）日本農林水產省新介護食品（smile care食）：涵括面向最廣，包括介護預防、咀嚼輔助與吞嚥輔助三類不同特性食品。（4）台灣銀髮友善食品質地區分規格（Eatender）：分為容易咀嚼、牙齦咀嚼、舌頭壓碎與無須咀嚼，自2018年建立，可用於國產食材之包裝食品質地分級標示。

In 2020, the older adult population ( > 65 years old) reached 703 million worldwide and 3.6 million in Taiwan. By 2026, Taiwan will become a super-aged society with at least 20 percent of the population in this category and 180,000 new older adults joining this population annually. The consequences of oropharyngeal physiological degradation include dysphagia, malnutrition, and a negative impact on quality of life. The provision of texture-modified foods and thickened liquids assist users with chewing or swallowing disorders, making foods easier to ingest and improving diet safety. The classification of texture modified foods allows for consistent communication among health professionals, care providers, and industry partners to improve quality of care for users. This article reviews the four texture-modified food classification systems currently in use internationally. 1. International Standardization Committee for Dysphagia: 22 countries implemented this framework, which was developed by a wide range of professions, including nutrition & dietetics, medicine, speech pathology, occupational therapy, nursing, food science & technology. This framework provides internationally standardized terminology and definitions for texture-modified foods and thickened liquids for persons with dysphagia. 2. Japanese Universal Design Foods: This voluntary standard established by the food industry addresses the physical properties related to the texture of food. The four categories in this standard are distinguished based on the hardness and viscosity of food. The category-based terms and the universal design foods logo are displayed on foods to facilitate consumer selection. 3. The smile care food-The Japanese Ministry of Agriculture, Forestry and Fisheries reclassified nursing care food into the following three categories: (i) Food for people without eating problems but with nutrition supplement needs| (ii) Food for people with problems with swallowing functions| and (iii) Food for people with problems with chewing functions. 4. Eatender, Taiwan senior friendly food. This standard designates four texture specifications: Easy to chew, gum mashable, tongue mashable, no chewing needed. This standard is used to grade the texture of packaged foods that use agricultural food ingredients sourced in Taiwan.