The use of color-changeable chewing gum in evaluating food masticability

• Published in: European geriatric medicine 2024-04, Vol.15 (2), p.497-504
• Main Authors: Yashiro, Toshihiro, Wada, Shinichi, Kawate, Nobuyuki
• Format: Article
• Language: English
• Subjects: Geriatrics/Gerontology; Internal Medicine; Medicine; Medicine & Public Health; Research Paper
• ISSN: 1878-7649; 1878-7657; 1878-7657
• DOI: 10.1007/s41999-023-00916-5

Key summary points Aim Our study aimed to examine the validity and reliability of visual measurement by assessing chewing gum color, using an existing color scale compared to that assessed using a colorimeter to determine masticable foods. Findings The assessment of masticatory performance by the color scale was in agreement with that by colorimeter. The inter-rater reliability was also high. Message Visual inspection using a color scale makes it possible to determine masticable food without the use of a colorimeter. Purpose We assess masticatory performance using color-changeable chewing gum, which shifts from yellow-green to red upon chewing. Previous studies used a colorimeter to reveal the cut-off a * values of the gum’s color ( a * represents the degree of color between red and green) to determine which foods are masticable (masticable meat, masticable soft side dish, and inadequate masticatory performance). Since a more convenient method is required, we examined the validity and reliability of visual measurement using a color scale to indicate masticable foods by observing the chewing gum’s color. Methods Fifty patients (male, 48%), aged ≥ 65 (mean, 82.6) years were enrolled. Using color-changeable chewing gum, three groups were formed according to the cut-off a * values: masticable meat, masticable soft side dish, and inadequate masticatory performance. For the color scale classification, one physiatrist and one dietitian simultaneously, individually, and visually determined the chewing gum color and classified it into one of the three groups. Criterion-related validity was evaluated using the kappa coefficient of agreement between the results from the two methods. Inter-rater reliability was examined using the kappa coefficient of agreement between the three groups judged by the two raters on a color scale. Results The kappa coefficients of the agreement for the classifications were 0.908 and 0.909 for the physiatrist and dietitian, respectively. The inter-rater agreement between two raters on the color scale was 0.938 for the kappa coefficient. Conclusion The color scale indicated masticable foods without a colorimeter. This method can be useful in older adult facilities and homes.