Eating and breathing: interactions between respiration and feeding on solid food

Chewed solid food accumulates in the oropharynx prior to swallowing. The mechanism for preventing aspiration during this interval is unknown, but may be related to respiration. The purpose of this study was to determine how eating, especially bolus formation in the pharynx, affects respiration. We examined nasal air pressures, masseter electromyography (EMG), and videofluorography (VFG) of four normal young adults eating 8 g each of banana and cookie (two trials each food). Resting respiration was recorded for 30 s before eating. Respiratory cycles (RCs) were classified as prefeeding, feeding (excluding cycles with included swallows), and swallowing cycles. RC duration was greater for swallowing than for feeding and prefeeding RCs (P < 0.001). There were up to three swallows in a single RC, but the increase in swallowing RC duration was greater than swallow duration. Swallow apnea began before bolus transport through the hypopharynx and ended as the bolus tail entered the esophagus. There were semirhythmic perturbations in nasal air pressure associated with masseter activity during chewing, suggesting that there was oronasal airflow during jaw closing via the velopharyngeal isthmus. The most important finding was that bolus aggregation in the valleculae usually occurred during an extended plateau in nasal air pressure following active expiration. This suggests that aspiration during eating is prevented by inhibiting respiration during bolus formation in the oropharynx.