This cross sectional study investigates how the oral physiological changes during the period of dental transition (6-12 years old) influence on texture preferences, food oral processing behaviour and food bolus properties, for different foods varying in texture and in comparison to the adult population.
Rationale: Eating behaviour develops during childhood, shaping dietary habits that, in the long term, contribute to growth and health. The development of masticatory function during this period plays an important role in food preferences for different textures and in consumption during meals. Furthermore, chewing transforms food into a bolus for swallowing, and the physical properties of this bolus play a role in digestion and nutrient release. To date, very little data exists on bolus formation in children. The period from 6 to 12 years of age is an important period of maturation of masticatory function, during which the 20 primary teeth are gradually replaced by 28 permanent teeth. The impact of this dental transition on children's eating behavior and nutrition is currently poorly understood. Objective: The purposes of this study will to determine (1) how food texture preference, oral processing behaviour and food bolus properties evolve in children during the dental transition period and in comparison to adults (2) how these variables are associated with each other (3) how they are predicted from individual oral physiology (dentition, tongue strength, masticatory performance), food familiarity and parent-reported appetitive traits parameters. Study design : Ninety children (n=30 per theoretical stage of mixed dentition (first transitional stage: 6-8 years, inter-transitional stage: 8-10 years, and second transitional stage: 10-12 years)) and 30 adults (25-35 years) will be recruited . Their dentition and oral abilities (tongue strength and masticatory performance) will be characterized. Their oral processing behaviour (duration, number of chews and Oro-sensory exposure time) while consuming different foods (standard pieces of carrot, rice, cheese and biscuit) will be studied using video recordings. Food boluses will then be collected at the time of corresponding to swallowing (swallowing threshold) and characterized for their particles size and number, saliva uptake, and hardness. Texture preferences of all participants, as well as familiarity with the studied foods and the children's appetitive traits will be characterized using questionnaires. Study population: Healthy children aged 6-8 (n=30), 8-9 (n=30), 10-12 (n=30) years old and 30 adults aged 25-35 years old. Exclusion criteria : dental and orthodontic treatment ongoing
Study Type
OBSERVATIONAL
Enrollment
120
UMR CSGA
Dijon, France
RECRUITINGOral processing duration (seconds)
Oral processing duration (sec) measured with video recording and automated video analysis
Time frame: Baseline (single timepoint only)
Number of chews (chews/gram)
Number of chews measured with video recording and automated video analysis
Time frame: Baseline (single timepoint only)
Oro-sensory exposure time (second/gram)
Oro-sensory exposure time (s/g) measured with video recording and automated video analysis
Time frame: Baseline (single timepoint only)
Saliva uptake (%) in food bolus
Saliva uptake (%) of bolus collected at swallowing, measured from food and bolus mass (g) and dry matter (g)
Time frame: Baseline (single timepoint only)
Bolus hardness (Newton)
Hardness (N) of bolus collected at swallowing obtained from simple compression test with texturometer compression test
Time frame: Baseline (single timepoint only)
Average size of bolus particles (mm)
Size of the particles (mm) measured from a scan of the bolus diluted in glycerol and automated image analysis
Time frame: Baseline (single timepoint only)
Number of particles in the food bolus
Number of bolus particles measured from a scan of the bolus diluted in glycerol and automated image analysis
Time frame: Baseline (single timepoint only)
Number of Posterior Functional Unit (PFU)
Number of teeth stained after biting down on blue paper (3 times) measured by visual assessment
Time frame: Baseline (single timepoint only
Number of teeth
Total number of teeth in the mouth measured from visual assessment
Time frame: Baseline (single timepoint only
Dental transition stage
Stage of primary dentition (first transitional stage, inter-transitional stage and second transitional stage) assessed from teeth photographs by dental professionals
Time frame: Baseline (single timepoint only)
Tongue strength (kPa)
Maximum strength (kPa) measured with the Iowa Oral Pressure Instrument (IOPI)
Time frame: Baseline (single timepoint only
Masticatory performance (index)
Ability to mix two colored chewing gum after 15 chewing cycles, measured with gum scan and automated image analysis
Time frame: Baseline (single timepoint only)
BMIz
BMI z-scores (BMIz) obtained from body weight (kg; measured using a weighing scale) and height (cm; measured using a stadiometer) transformed into corrected for age and sex according to the WHO child growth reference for school-aged children and adolescents
Time frame: Baseline (single timepoint only)
Food frequency consumption (child report)
Child oral self-report of consumption frequency of offered food consumption ('not at all'; 'from time to time'; 'often'; 'very often')
Time frame: Baseline (single timepoint only)
Food frequency consumption (parental report)
Parent report on the consumption frequency by the child for the offered food. Report collected in questionnaire ('never'; 'less than once a month'; 'two to three times a month'; 'once a week'; 'two to four times a week'; 'once a day'; and 'two or more times a day')
Time frame: Baseline (single timepoint only)
Food familiarity
Oral self-report of the familiarity with the offered food (0 : not familiar/1 : familiar)
Time frame: Baseline (single timepoint only)
Food chewing difficulty
Oral self-report whether the offered foods is or not difficult to eat (0 : not difficult/1 : difficult)
Time frame: Baseline (single timepoint only)
Food texture preferences
Self-report on a food texture preference questionnaire. The questionnaire is composed of 17 pairs of soft/smooth and hard/particulate foods. For each pair, the participant chose the preferred one (forced-choice). Soft/Smooth versions will have a value of 1 and hard/particulate version a value of 2. Cumulation of the values provides a Texture preference index. Higher score means higher preference for textured foods.
Time frame: Baseline (single timepoint only)
Children chewing abilities
Parent-reports of their child chewing abilities using a questionnaire (Schwartz et al., 2021). The questionnaire is composed of 5 questions. Parents answer by one of the 'yes', 'no' and 'I don't know'. Questions are grouped in two dimensions : 'difficulty of coping with hard/difficult textures' (higher score means lower difficulty) 'extend to which children chew their food before swallowing' (the higher the score, the better the child chews the food before swallowing)
Time frame: Baseline (single timepoint only)
Child Eating Behaviour and Appetitive traits
Parent-reports on the Child Eating Behaviour Questionnaire (CEBQ) will be used to characterize the appetitive traits of the participants (Wardle et al., 2001). The questionnaire is composed of 35 items. Parent answers to each item using 5- point Likert scale ranging from never (1) to always (5) (never, rarely, sometimes, often, always. The items are then grouped to define 8 dimensions: 'food responsiveness', 'enjoyment of food', 'emotional over-eating', 'desire to drink', 'satiety responsiveness', 'slowness in eating', 'emotional undereating' and 'food fussiness'. Higher scores mean higher behaviours.
Time frame: Baseline (single timepoint only)
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