Thickener Information…..

Dukes Memorial Hospital Speech Language Pathology

Department of Speech Language Pathology

Thickener Companies

AliMed~ 800-225-2610~ www.alimed.com

Bernard Food Industries~ 800-325-5409~ www.edietshop.com

Bruce Medical Supply~ 800-225-8446~ www.brucemedical.com

Carbotrol Leahy/IFP~ 800-669-8346~ www.leahy-ifp.com

Healthcall~ 800-431-1119~ www.thickitdelivered.com

Hormel Products (CVS)~ 888-607-4287~ www.cvs.com

Med-Diet Laboratories, Inc~ 800-633-5550~ www.med-diet.com

Resource ThickenUp Nestle Nutrition~888-240-2713~

www.nestlenutritionstore.com/dysphagia

Novartis~ 800-828-9194~ www.novartisnutrition.com

Nutra Balance~~ www.nutra-balance-products.com

Variety Med~ www.varietymed.com

Thick and Easy~ 800-827-6763~ www.dcdistributors.com/beverages.mgi

Phagia Gel Technologies, LLC~ 800-205-7115~ www.simplythick.com

Thickening Guidelines

Starch thickeners are thicker in cold and thinner at warm temperatures, cold liquids
require less thickener and hot drinks require more thickener.

As tap water sits out, it warms causing it to become thinner and require more thickener.

When thickening supplements such as Boost or Ensure, they tend to thicken better when
at room temperature.

Try storing thickener in the freezer when there is high humidity.

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 Thickener Information…..Dukes Memorial Hospital Speech Language Pathology

High acidity in beverages (juices) with a high sugar content causes a need for less
thickener.

Carbonated beverages will foam as you thicken them. Try thickening half the soda, then
add the rest of the soda slowly and thicken to the appropriate thickness.

Take into consideration time, such as how long the drinks will be sitting out when you
thicken drinks on trays.

Smoother textures can be achieved using a blender, wire wisk or electric whip.

When mixing individual servings, larger glasses allow for more space for mixing.

When adding liquid to thickener, blend or whip product right away to prevent lumping.

One tablespoon of thickener can add approximately 1/3 fruit exchange or four grams of
carbohydrate, monitor calorie-controlled diets.

Naturally thick liquids (tomato juice for nectar thick liquids) can be used.

Items such as gelatin, ice cream, sherbet, ices and milk shakes should be discussed with
the SLP to determine if they are safe for the patient on thickened liquids.

Thickened ice cubes-Thicken water to appropriate thickness and freeze.

When on thickened liquids *no straws* unless otherwise advised by the SLP.

 Thickened liquids-people on thickened liquids should have no:

o Oranges
o Grapes
o Watermelon
o Jell-o
o Scrambled eggs
o Ice cream
o Ice cubes
o Sorbet
o Popsicles
o Sherbet

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 Thickener Information…..Dukes Memorial Hospital Speech Language Pathology

Brands of Thickeners

 Thick-It
 Thick-N-Easy
 Thixx
 Thick and Easy
 Simply Thick (gel)
 HydraAid
 Thik & Clear
 Thicken Up

 Sharpe et. Al reported that all of the starch and gum based thickeners released
95+% of the fluid content to the subject’s system. Use of thickeners will not
contribute to dehydration.
 Mertz Garcia and colleagues (2008):
o Remarkable instability for preparations created with the starch-based
products.
o Some starch-based nectar preparations increased in viscosity as much as
from 260 centipoise (cP) to 830 cP over the intervals tested (post mixing, 10
minutes and 30 minutes after.)
o Honey liquids based on starch-based increased from 200 cP to nearly 3,000
cP.
o Significant increases in viscosity of starch-based preparations as
temperature increased, from starch particles characteristic to “gelatinize”
when heat is applied.
o When Xanthan thickener mixed into a variety of base liquids, the viscosity
remained relatively stable across a 24 hour period. The same with cellulous
gum-based thickener.

Common Thickeners

 Banana flakes
 Cooked cereals (cream of wheat/rice)
 Cornstarch
 Custard Mix
 Gravy
 Instant potato flakes

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 Thickener Information…..Dukes Memorial Hospital Speech Language Pathology

 Mashed potatoes
 Plain, unflavored gelatin powder
 Pureed fruits
 Pureed meats
 Pureed vegetables
 Rice cereal (baby food)

Liquid Consistencies

Thin liquids-Regular liquids. No restrictions on liquids unless otherwise stated by physician

or SLP. Water, soda, fruit juices, hot beverages, tea, milk, jello, ice cream, soups, broth,
thin gravies and sauces, supplements (Boost, Ensure, etc.)

Nectar Thick Liquids-easily pourable, comparable to tomato juice, apricot nectar or

thicker cream soups. Coats and drips off spoon. Can have any thin liquid thickened to the
proper consistency, fruit nectars, tomato juice.

Honey Thick Liquids-Slightly thicker, less pourable, drizzle from a cup or bowl. Drizzles
from a spoon in a ribbon. No liquids are naturally honey thick.

Pudding Thick Liquids-hold their own shape, not pourable, eat with a spoon. Stays on spoon
in a mass and “plops” off. No liquids are naturally pudding thick.

 If a patient is on thickened liquids, all liquids and medications must be thickened.

Pills need to be taken with liquids thickened to the appropriate consistency.
 A patient who is on thickened liquids should not be eating ice cream, sherbet or
milkshakes. They should also not be given jello.
 NPO status means nothing by mouth, including ice chips. When using a toothette to
swab a patient’s mouth, make sure and squeeze out all the excess water before
using it in the patient’s mouth. The swab should be damp. A good alternative to use
is lemon swabs, as they are wet and do not contain excess liquid.
 Foods of mixed consistencies should be avoided, including cereal with milk,
vegetable soup and other soups with chunks or pieces, and canned fruit with syrup.
 Magic cups can be used with all levels of thickness and are an excellent supplement
with 290 calories and 9gm protein per 4 ounces. www.hormelhealthlabs.com
 Do not thicken liquids with ice in them as the ice will melt and change the liquid
consistency.


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 Thickener Information…..Dukes Memorial Hospital Speech Language Pathology

Nectar Thick Liquid Recipes

Chocolate Milk

Mix in a blender:

¼ cup milk

½ cup chocolate pudding

Chocolate, Peanut Butter, Banana Shake

Mix in a blender:

½ small banana

1 tbsp peanut butter

3 tbsp baby rice cereal

½ 8 oz chocolate flavored Boost

Maple Pumpkin Cinnamon Shake

Mix in a blender:

½ cup canned pumpkin pie filling

4 tbsp maple syrup

½ cup vanilla ice cream

½ tsp cinnamon

½ of 8oz can vanilla Boost

Mixed Fruit Juice

Mix in a blender:

½ banana

¼ cup canned or fresh pineapple

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 Thickener Information…..Dukes Memorial Hospital Speech Language Pathology

¼ cup fresh strawberries

½ cup pineapple juice

Fruit Juice

Any strained fruit juice

Peanut Butter Protein Shake

1 cup vanilla ice cream

1 tablespoon peanut butter

½ cup milk

Mix together in blender and serve. May also add ½ banana to the blend as many
geriatrics ate peanut butter and banana sandwiches.

Fruit Sorbet (great for patients on pureed diets or those patients who have chronic
sonstipation)

1 cup puree fruit (peach, pear, apple, banana, pineapple, prunes)

1 cup of orange juice or apple juice

Blend and serve

Sherbet Sorbet

1 cup orange sherbet

1 cup orange juice or apple juice

Blend and serve

Carbohydrate Shake

½ cup of bettered mashed potatoes (or mashed potato flakes)

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 Thickener Information…..Dukes Memorial Hospital Speech Language Pathology

½ to 1 cup of any flavor ice cream

1 packet of sugar or sugar substitute

Blend and serve. The sugar and ice cream mask the potato taste, while allowing the
patient with texture aversion to receive adequate carbohydrates and calories.

Cool Whip Blast

2 cups Cool Whip

½ ounce cream cheese

1 packet French vanilla pudding (dry)

½ cup confectioners sugar

½ to 1 cup milk

1-2 tablespoons of any flavoring

Blend all ingredients and serve.

Yogurt Blast

1 cup of yogurt

Add fruit desired (any)

1 ½ cup vanilla ice cream

Blend ingredients together and refreeze. Serve the next day.

Mocha Latte

1 cup ice cream (almond or nut flavored)

3 tablespoons coffee (already brewed with water)

Milk to taste

Blend and serve.

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 Thickener Information…..Dukes Memorial Hospital Speech Language Pathology

Sources:

www.asha.org

Sharpe, K. Ward, L., Cichero, J. Sopade, P. and Halley, P. (2007). Thickened Fluids and
water absorption in rats and humans, Dysphagia, 22, 193-203.

Mills, R.H. (2008, October 14). Dysphagia Management: Using Thickened Liquids. The
ASHA Leader.

www.upmc.com/HealthAtoZ/patienteducation/Documents/NectarThickLiquids.pdf

Tiffani L. Wallace, MA, CCC-SLP 765-475-2160 Page 8