Addressing Nutrient Density in the Context of the Use of Thickened Liquids in Dysphagia Treatment

Abstract

Thickening liquids has become a standard of practice for managing children with oropharyngeal dysphagia. A variety of commercial products have been developed from guar gum, xanthan gums, and modified corn starch. Practitioners and families are also trying to thicken liquids with available foods, such as infant rice cereal, yogurt, strained baby foods, and instant potato flakes. Throughout this process little consideration is given to the impact of the use of different thickeners on the nutrient density of human milk, formula, or other beverages. Various fluids were thickened by the author using different products to achieve National Dysphagia Diet nectar-like, or honey-like consistencies. Nutrient analysis of the calorie effect of the thickeners was calculated using the USDA Agriculture Research Service Nutrient database, manufacturer information, and displacement factors to evaluate the effects on calories per ounce of the thickened fluids. Considerations of thickener choice on other nutrients are discussed, including potential for toxicity of nutrient loads with specific thickeners. No one thickener is appropriate for all patients, but the characteristics of the various thickeners need to be understood. The assessment of the individual patient by an interdisciplinary team, including a registered dietitian should determine the patient’s specific needs before recommending a thickener.