Oral Transit Time: When Is It Slow?

Oral transit time is a critical parameter observed during the clinical assessment of the swallowing function. There is no consensus in the literature about oral transit time in healthy subjects, but it is valued during swallowing assessments due to its negative impact on swallowing dynamics, which can cause high energy expenditure during feeding. Oral transit time is defined as the time required for the passage of a bolus through the mouth to the exit from the oral cavity. The time taken varies depending on the volume and consistency of the food, ranging from 0.35 seconds to 1.54 seconds for liquids, 0.39 seconds to 1.05 seconds for pasty foods, and 1 second to 12.8 seconds for solid foods.

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Oral transit time varies by food consistency

Oral transit time is a critical parameter in the clinical assessment of the swallowing function. It is defined as the time required for the passage of a bolus through the mouth to the beginning of the swallowing reflex. The oral transit time varies depending on the consistency of the food and the individual's age, gender, and anatomical structure.

Liquids have the fastest oral transit time, ranging from 0.35 seconds to 1.54 seconds. Pasty foods, such as porridge or yoghurt, take slightly longer, ranging from 0.39 seconds to 1.05 seconds. Solid foods have the longest oral transit time, ranging from 1 second to 12.8 seconds. These times can vary depending on the individual and the specific food consistency. For example, the oral transit time for 5 ml of liquid was found to be 0.97 seconds for a control group and 0.98 seconds for a study group, while the time for 5 ml of pasty food was 0.76 seconds for the control group and 1.10 seconds for the study group.

The oral transit time also varies between men and women, with women taking longer to swallow the same amount of food. For example, the TTO for 10 ml of pasty barium was 0.35 seconds for men and 0.38 seconds for women. This difference may be due to anatomical and physiological variations between genders. Additionally, oral transit time increases with age, as elderly individuals have significantly longer oral transit times than adults, regardless of the volume or consistency of the food.

Oral transit time plays a crucial role in the total duration of a meal and can impact nutritional intake. A slower eating rate, achieved through smaller bites or sips and longer oral transit time, has been associated with lower energy intake compared to a faster eating rate. This effect has been observed across various food textures, including harder and softer versions of meals, without impacting post-meal fullness or food liking.

While oral transit time specifically refers to the time food spends in the mouth, it is important to note that the overall digestion process involves food moving through the entire gastrointestinal (GI) tract, which can take up to 28 hours on average. The rate of digestion also depends on the type of food consumed, with high-fiber foods promoting efficient digestion and high-protein foods taking longer to break down.

Oral transit time differs between men and women

Oral transit time, defined as the time required for a bolus of food to pass through the mouth to the exit of the oral cavity, is one of the parameters observed during the clinical assessment of the swallowing function. The time taken for food to pass through the mouth is important as it impacts the total duration of a meal, which can result in an unfavorable nutritional prognosis.

There is no consensus in the literature about oral transit time in healthy subjects. However, studies have shown that oral transit time differs between men and women. For example, the oral transit time (TTO) for 10 ml of liquid barium was 0.36 seconds for men and 0.35 seconds for women. The TTO for 5 ml of pasty barium was 0.39 seconds for men and 0.59 seconds for women. The TTO for 10 ml of pasty barium was 0.35 seconds for men and 0.38 seconds for women. These studies concluded that there is a significant difference between men and women in terms of swallowing, with women taking longer to swallow a 5 ml bolus of doughy food.

Another study found that the TTO for 5 ml of liquid was 0.97 seconds for a control group and 0.98 seconds for a study group of men aged 26-83, with no significant difference between the two groups. The TTO for 5 ml of pasty food was 0.76 seconds for the control group and 1.10 seconds for the study group, again with no significant difference.

The impact of gender on oral transit time is also observed in studies of gastrointestinal transit. One study found that colonic transit was faster in men, and postlag gastric emptying was also more rapid. However, other studies have found that small bowel transit, gastric emptying, and colonic transit were significantly slower for women.

In summary, while there is no clear consensus on the oral transit time for healthy individuals, studies have shown that oral transit time differs between men and women, with women generally taking longer to swallow certain types of food boluses. These differences in oral transit time can impact the total duration of meals and have potential nutritional implications.

A longer oral transit time reduces ad libitum intake

There is no universally agreed-upon definition of what constitutes a slow oral transit time. Oral transit time is one of the parameters observed during the clinical assessment of the swallowing function. The time it takes for food to pass through the mouth and exit the oral cavity is referred to as oral transit time (OTT). The literature defines this term in various ways, and the times found varied from 0.35 seconds to 1.54 seconds for liquids, 0.39 seconds to 1.05 seconds for pasty foods, and 1 second to 12.8 seconds for solid foods.

Two ways to slow down the eating rate (g/s) and increase orosensory exposure per gram of food, thereby decreasing food intake, are to prolong the transit time of food in the oral cavity or decrease bite/sip sizes. A study by Bolhuis et al. (2014) found that harder foods led to a 13% lower energy intake at lunch compared to softer foods, with a net 11% reduction in energy intake for the day. The harder foods were consumed with smaller bites, longer oral duration per gram of food, and more chewing per gram of food.

In another study, 56 healthy male subjects consumed soup with different numbers of sips and oral transit times. A higher number of sips and longer oral transit time reduced ad libitum intake by approximately 22% and 8%, respectively. A greater orosensory exposure to food due to a higher number of sips and longer oral transit time may explain the effects on satiation. Designing foods to be consumed with smaller bites or sips and longer oral transit times may be an effective way to reduce energy intake.

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Oral transit time increases with age

Oral transit time (OTT) is a critical parameter in the clinical assessment of the swallowing function. The time taken for food to pass through the mouth and exit the oral cavity varies depending on the volume and consistency of the food. For example, the oral transit time for liquids ranges from 0.35 seconds to 1.54 seconds, while for pasty foods, it ranges from 0.39 seconds to 1.05 seconds, and for solid foods, it can take anywhere between 1 second and 12.8 seconds.

There are several factors that can influence oral transit time. One factor that has been identified is age. Studies have shown that oral transit time in elderly individuals is significantly longer than in younger adults, regardless of the volume or consistency of the food. This suggests that as people age, their oral transit time tends to increase.

The impact of increased oral transit time in the elderly can have important nutritional implications. It has been associated with a higher energy expenditure during feeding, which can influence the total duration of a meal and subsequently affect nutritional intake. Additionally, a slower oral transit time may lead to a reduction in ad libitum intake, as individuals may feel fuller sooner due to prolonged orosensory exposure to food.

Furthermore, the difference in oral transit time between men and women has also been observed. Studies have found that women tend to have a longer oropharyngeal transit time compared to men, particularly for doughy foods. However, it is important to note that there is no consensus in the literature regarding oral transit time in healthy individuals, and the values mentioned above may vary based on age, gender, and other factors.

In conclusion, oral transit time is an important parameter that can provide valuable insights into an individual's swallowing function and overall nutritional health. While it increases with age, the clinical significance of this parameter goes beyond just age-related changes, and it is an essential consideration in the assessment of swallowing disorders and nutritional interventions.

Oral transit time is a clinical parameter for dysphagia assessment

Oral transit time (OTT) is a critical parameter observed during the clinical assessment of the swallowing function. OTT is defined as the time interval required for the passage of the bolus through the mouth until it exits the oral cavity. This parameter is essential as it impacts the total duration of a meal, which can result in an unfavorable nutritional prognosis.

Dysphagia is a condition that affects the swallowing function, and its evaluation includes the analysis of oral functions and structures in the pharyngeal and upper digestive system. Clinical evaluation for dysphagia typically includes anatomical and postural assessments of the face and neck structures, as well as physiological observations of the muscles involved in swallowing. One of the key clinical parameters in this assessment is OTT.

The literature defines OTT in various ways, but it generally refers to the interval between the onset of bolus propulsion and the firing of the swallowing reflex. Accurate data on OTT is crucial in dysphagia management as it is linked to the nutritional status of the patient. While an increase in OTT does not predict aspiration, it does negatively affect nutritional intake.

Studies have shown that a longer OTT can reduce ad libitum intake, possibly due to increased orosensory exposure to food. This suggests that prolonging the transit time of food in the oral cavity can decrease the amount of food consumed. Additionally, the hardness of food can impact energy intake, with hard foods resulting in a lower energy intake compared to soft foods, partially due to longer oral duration per gram of food.

In summary, OTT is an essential clinical parameter in the assessment of dysphagia. It influences the duration of meals and has implications for the nutritional status of individuals, particularly those with dysphagia. Further research and standardized definitions of OTT are needed to fully understand its role in clinical practice.

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