What's the Rush? How People with Dysphagia Must Wrap Their Head Around the Idea of Slowing Down

Is eating a race against time?

We've all seen it. A person we know, or sitting nearby, literally swallows their food whole. Within a minute or two, the plate shines clean.

Many people don’t intend to rush through dinner, but several habits push us to eat faster: school bells, work deadlines, commute traffic... Meals can easily become fuel stops rather than Zen moments.

Several studies and professionals, including doctors and speech-language pathologists (SLPs), will tell you that speed should be avoided when dealing with dysphagia. Dr. Miguel del Mazo, a bariatric surgeon in Gainesville, Georgia, confirms that "chewing thoroughly aids digestion, as digestion starts with enzymes present in the saliva in your mouth. [...] Chewing also increases blood flow to the stomach and gut, priming the pump so to speak, to better aid digestion."

Chewing has other significant impacts, besides aiding digestion.

1. It's a basic exercise that prevents jaw muscle atrophy.

2. It increases blood flow to the brain, particularly to areas important for cognition.

Re-learning How to Eat

Mastication is considered "semi-automatic." You can consciously begin, pause, or change the speed of chewing. Otherwise, it is performed automatically and does not require attention.

When you have dysphagia, you must suddenly become mindful of chewing. This is no easy task. You have to tell your brain to pay attention to and slow down every chewing movement. It's exhausting and pushes many people to use blenders instead. I totally understand.

Advantages of blended food:

• You can eat anything as quickly as you want.

Disadvantages of blended food:

• Jaw muscles may atrophy.

• There is less saliva due to the lack of chewing.

• There are fewer saliva enzymes, so the initial digestion is bypassed.

• Lower satiety: chewing is linked to fullness signals.

A recent study examined the relationship between eating speed and weight management. Although obesity is rarely a concern for people with dysphagia, using haptic feedback to slow down chewing does show promise.

Turning Food Into a Purée

One might think that any food can be chewed into a purée if you chew long enough. However, not all foods purée equally.

Dysphagia comes in various forms, various levels and is triggered by different health conditions. When purees can be swallowed, the jaws and teeth are functional, and cognition is intact, it is possible to eat "regular" food as long as it can easily turn into a purée through natural chewing.

If you have dysphagia but can still chew properly, here is a list of foods to take note of. In my experience, these foods DO NOT turn into a purée when chewed, and may need to be blended if you wish to include them in your diet.

• Meat, cooked or raw, including cold cuts and sausages

• Fish and seafood, cooked (raw fish and seafood are easier to swallow)

• Some cheeses, especially mozzarella

• Fresh fruits and vegetables, including mushrooms

(except ripe bananas and avocados)

• Nuts, raw or toasted (except nut butters)

• Rice, couscous, and al dente pasta (except overcooked pasta)

• Anything deep-fried

• Industrial bread (except artisan or homemade bread)

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Meal Time as a Pleasurable Pause

The above list is not meant to discourage you. Rather, it is meant to encourage you to turn to "safe" foods that don't need to be pureed outside of your mouth.

If you enjoy cooking and discovering new foods and flavours, your dysphagia just may be the motivation you needed to expand your culinary knowledge and diversify your diet.

My book Give Me a Solid offers recipes for dishes made with easily chewed ingredients that you can prepare at home and serve to your friends and loved ones. They'll never know the difference!

And I believe that by choosing to cook, sit down, and set aside distractions like TV, laptop or phone screens at meal time, you will slow down and become mindful... naturally.

Bon appétit!

Joanne

To purchase or learn more about Give Me a Solid, click here.