Living Well

3,000 Times a Day… Be Mindful

It's something we do thousands of times a day...

And most of us rarely think about this semi-involuntary action.

Each day, we swallow about one to two times every waking minute to get rid of extra saliva (and a few more times per minute while enjoying a meal).

Swallowing seems to just come as naturally as breathing. But when something goes wrong... it spells disaster.

Lots of us understand the typical hazards of not swallowing properly... You could choke if the wad of food (i.e., bolus) you swallow goes down the wrong chute and blocks your airway.

Or you may end up aspirating food or liquid into your lungs. And if an infection develops there, you get aspiration pneumonia. (This type of pneumonia is behind 87% of pneumonia cases in older people.)

But up to a third of us will develop a long-term danger, dysphagia. This most often occurs with age, as we gradually start losing muscle mass and strength due to a process called sarcopenia. It typically starts in our 40s and accelerates once we hit 60. (By age 80, it's possible to lose up to roughly 50% of muscle mass.)

Left untreated, you can end up with malnutrition and dehydration.

The causes of dysphagia include:

  • Neurological problems that damage the brain and/or nervous system... like a stroke, dementia, Alzheimer's disease, Parkinson's disease, and multiple sclerosis, as well as brain tumors.
  • Muscular problems that weaken the muscles around your esophagus... like, for example, stiffened muscles from scleroderma and weakening from Parkinson's.
  • Obstructive problems that narrow your esophagus... like mouth and esophageal cancer, scarring from radiation treatment, and inflammation and scarring from chronic acid reflux and diseases like tuberculosis, as well as damage caused by surgical complications.

Older folks have a higher risk of developing many of the neurological conditions mentioned above. Dysphagia affects up to about 93% of patients with moderate-to-severe Alzheimer's and 60% of Parkinson's patients.

Dental problems can contribute to dysphagia, too. Like a food processor with missing or poorly fitting blades, missing teeth or poorly fitting dentures can prevent food from getting chopped into bits prepped for swallowing.

You'll want to make an appointment with your doctor if you start seeing symptoms like...

  • Being unable to swallow... or coughing, gagging, or vomiting while trying to swallow.
  • Swallowing becoming painful.
  • Backups in food or stomach acid.
  • Losing weight.
  • Feeling like food is getting stuck in your throat and/or chest. (If it's causing breathing problems, that's a medical emergency.)

Treatment will focus on the primary cause behind your dysphagia. That may include medications, surgeries, or therapy with a speech-language pathologist.

For instance, a therapist might have you perform exercises to strengthen your throat muscles. A 2021 systematic review found that chin-tuck-against-resistance exercise improved swallowing function and reduced incidents of aspiration in stroke survivors with dysphagia. (The gist of the simple exercise is to put an inflatable ball between your chin and chest and just tuck down your chin to squeeze the ball.)

Your doctor might have you make lifestyle changes like adding thickener to liquids, avoiding sticky foods and going for soft, moist ones, or limiting caffeine and alcohol (which can lead to a dry mouth if you're not hydrated).

There's one change that benefits people with and without dysphagia alike...

And that's applying my favorite form of "brain training" to your eating… practicing mindful eating.

With mindfulness, it's all about concentrating on the present moment, or deepening your awareness of your feelings and surroundings. Doing so can calm and relax your nervous system.

Here are some of my favorite tips for eating mindfully instead of inhaling your food...

  • Eliminating distractions like your phone or TV.
  • Sitting up straight.
  • Using all of your senses to appreciate the food. That means looking at all of the colors and shapes of the food, inhaling the aromas that waft up, listening to the crunching sounds as you chew, and assessing the texture and various tastes.
  • Chewing each bite of food 25 to 30 times or more.
  • Putting your fork, spoon, or chopsticks down between each bite.

The thorough chewing ensures that you digest and absorb all of the nutrients from the food. Plus, we know that increased levels of cortisol, the stress hormone, can increase appetite and lead to overeating. But slowing down and letting yourself appreciate every aspect of the meal allows you to relax, which takes some stress off your plate.

Retirement Millionaire subscribers, be sure to check out my issue on oral health if you haven't already. If you're not a subscriber, you can sign up for my flagship newsletter right here.

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Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team

August 6, 2024