Mastication in children and adolescents with overweight or obesity: a systematic review

SANTOS, Renata Emmanuele Assunção; LACERDA, Diego Cabral; SILVA, Maria Giselda da; BARBOSA, Danielly Alves Mendes; PINHEIRO, Isabeli Lins; FERRAZ PEREIRA, Kelli Nogueira

doi:10.1590/1678-9865202134e190201

Brasil

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Review • Rev Nutr 34 • 2021 • https://doi.org/10.1590/1678-9865202134e190201 linkcopy

Mastication in children and adolescents with overweight or obesity: a systematic review

Mastigação em crianças e adolescentes com sobrepeso ou obesidade: uma revisão sistemática

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Studies have shown that changes in mastication are related to overweight in children and adolescents as these changes influence the increase in food consumption. The objective of this article was to characterize, through a systematic review, the mastication in children and adolescents with overweight or obesity. For this, two independent authors performed a systematic review of the electronic databases: Medical Literature Analysis and Retrieval System Online, Scopus, Cumulative Index to Nursing and Allied Health, Web of Science and Latin American and Caribbean Literature in Health Sciences. Masticatory characteristics were considered as primary outcomes; the methods of analyzing mastication, the physical characteristics of the foods/materials used in the analyses and the fasting time were considered as secondary outcomes. This review was prepared in accordance with the items of the preferential reports for systematic analysis and meta-analysis. The systematic review protocol was submitted to the International Prospective Registry of Systematic Reviews. Nine articles were included in this review. The reviewed articles suggest that children and/or adolescents with overweight or obese present masticatory damages because they have worse masticatory performance and altered orofacial myofunctional characteristics.

Keywords
Adolescent; Child; Mastication; Obesity; Stomatognathic system

Author	Domains
Author	Study Question	Study Population	Comparability of Subjects	Exposure/ Intervention	Outcome Measure	Statistical Analysis	Results	Discussion	Funding
Pedroni-Pereira et al. [¹⁵]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Sun et al. [²⁴]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Berlese et al. [¹⁹]	⬤	⬤	◯	⬤	⬤	⬤	⬤	⬤	⬤
Araujo et al. [²²]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Soares et al. [²³]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Soares et al. [¹³]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
Souza & Guedes [²⁰]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	◯
Sato & Yoshiike [¹⁴]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤
De Morais Tureli et al. [²⁵]	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤	⬤

Author	n	Age (years)	Methods of mastication analysis	Parameters analysed	Results
Pedroni-Pereira et al. [¹⁵]	231	14 to 17	• Qualitative evaluation of mastication/Questionnaire “Quality of Masticatory Function” • Orofacial myofunctional evaluation. • Evaluation of masticatory performance • Bite Force Assessment • Oral Clinical Evaluation	• Food Consistency and eating Habits • Color change in a chewing gum • Maximum bite force • Protocol OMES-e, domain “mastication” • Presence of dental caries and malocclusion.	Girls with overweight/obesity (compared to normal weight girls): • Need to add liquid to food and consumption of fruit in small pieces. • Unilateral mastication. Girls and boys with overweight/obesity (compared to normal weight boys and girls): • There were no changes in masticatory performance. • They did not show differences in maximum bite force. • There were no differences related to the presence of dental caries and malocclusion.
Araujo et al. [²²]	204	8 to 10	• Qualitative evaluation of mastication/Questionnaire “Food Type Verification Protocol” • Bite Force Assessment • Oral Clinical Evaluation	• Food Consistency and eating Habits • Maximum bite force • Presence of dental caries and malocclusion	Girls and boys with overweight and with obesity (compared to eutrophic boys and girls): • There were no changes in the consistency of the food consumed. Girls and boys with higher BMI (through a correlation test). Less bite force. • Greater need for orthodontic treatment.
Soares et al. [²³]	279	3 to 5	• Qualitative evaluation of mastication/Food Registry for three days • Evaluation of masticatory performance • Oral Clinical Evaluation	• Food Consistency • Median particle size (X50) of a chewable material for masticatory function tests (Optocal) • Presence of cavitated teeth and malocclusion	Girls and boys with higher BMI (through a regression test): • Those who consumed more liquid foods presented worse masticatory performance. • Larger median food particle size (X50) expelled after twenty masticatory cycles. • Greater number of cavitated teeth (both anterior and posterior)
Sato & Yoshiiken [¹⁴]	61	5 to 6	• Qualitative evaluation of mastication/Questionnaire formulated by the authors • Evaluation of masticatory performance • Bite Force Assessment • Oral Clinical Evaluation	• Eating Habits • Number of masticatory cycles, meal time and masticatory frequency • Maximum bite force • Presence of dental caries and malocclusion	Girls and boys with higher degree of obesity (through a correlation test): • They spent more time swallowing food and swallowing without chewing properly. • Less meal time and fewer masticatory cycles. • No changes were observed in the occlusion force. • There were no differences related to the presence of dental caries and malocclusion.
Sun et al. [²⁴]	577	13 to 16	• Bite Force Assessment	• Maximum bite force	Girls with obesity: • Higher bite force than underweight and normal weight girls Overweight Boys: • Higher bite force than underweight, normal weight and obesity boys
Berlese et al. [¹⁹]	28	8 to 16	• Orofacial myofunctional evaluation • Electromyographic evaluation	• Protocol OMES – All domains • Electromyographic activity of the masseter and temporal muscles	Girls and boys with obesity (Compared to each other): • Orofacial myofunctional characteristics within normality • There was no difference in the mean electric activity of the muscles during rest, mastication, and swallowing
Soares et al. [¹³]	285	3 to 5	• Evaluation of masticatory performance • Evaluation of the deglutition threshold • Oral Clinical Evaluation	• Median particle size (X50) of a chewable material for masticatory function tests (Optocal) • Median particle size (X50) expelled before the desire to swallow the chewable material (Optocal) • Presence of dental caries and malocclusion	Girls and boys with higher BMI (through a regression test): • Larger median food particle size (X50) expelled after twenty masticatory cycles • Larger median food particle size (X50) during the evaluation of the swallowing threshold Girls and boys with lower BMI (through a regression test): • Less amount of dental caries
Souza & Guedes [²⁰]	50	9 to 18	• Orofacial myofunctional evaluation	• Protocol OMES-e – All domains	Girls and boys with obesity (compared to eutrophic boys and girls): • Worse performance in the aspects of tonicity and mobility of the cheeks
De Morais Tureli et al. [²⁵]	97	8 to 12	• Evaluation of masticatory performance	• Median particle size (X50) of a chewable material for masticatory function tests (Optocal)	Girls and boys with overweight/obesity (compared to boys and girls with normal weight and underweight): • Larger median food particle size (X50) expelled after twenty masticatory cycles

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[1] Note: ⬤: Yes;◑ : Partial;◯ : No information. Kappa: 0.8518.