Thick liquids are often prescribed for individuals with swallowing disorders. Nectarlike honeylike spoonthick food textures for ndd level 1. Nectarlike honeylike spoonthick food textures for ndd level 3. Of those receiving thickened liquids, on average 60% received nectarsyrup thick, 33% received honey thick, and 6% received puddingspoon thick, although the frequencies with which each thickness was. Pudding thick holds own shape cannot pour usually eaten. Avoid juices that separate such as, pineapple juice, tomato juice, apricot nectar, orange juice that has pulp. This helps the fluids go through your mouth and throat more slowly. As a general rule, four ounces of a thin liquid can be thickened to nectar thick consistencymildly thick by stirring in one tablespoon of traditional powdered thickener into the liquid vigorously. Nectarlike honeylike spoonthick food textures for ndd level 2. Thin, nectarlike, honeylike, and spoonthick modification levels, which remain in practice today 5. Pureed foods and thickened liquids for people with dysphagia.
Members often ask if asha has any policies about dysphagia diets. The recommended thickness for liquids is specific to the individual with a swallowing problem. Slowly add thickit instant food and beverage thickener to the liquid while stirring briskly with a spoon, fork or whisk until thickener has dissolved. How to thicken liquids nectarthick upmc healthbeat. Evidence against thickened liquids dates back to 1994, when a comparative effectiveness trial of stroke patients found that family instruction on appropriate compensatory swallowing techniques without the use of thickened liquids carried no increased risk of pneumonia, dehydration, malnutrition, or death when compared with thickened liquids. Nectar syruplike consistency honey like cold honey on a spoon pudding. National dysphagia level 1 pureed nutrition therapy. People who have trouble swallowing thin liquids often thicken their liquids to help prevent choking and stop fluids from entering the lungs. Unfortunately, she does not like the consistency or taste of the thickened fluids and. Some foodsfluids are naturally thick but others need to be thickened with either natural or commercial thickeners. Why does it matter how thick or thin the liquids i have are. Dysphagia pureed beverages recommended any smooth, homogenous beverages without chunks or pulp. Nectarthick mildly thick honeythick moderately thick puddingthick extremely thick thickening liquids at home you can thicken liquids at home with thickening powders or gels. Beverages may need to be thickened to appropriate consistency.
Nectarthick liquids are easily pourable and comparable to apricot nectar or thicker cream soups. Milk, juices, coffee, tea, sodas, carbonated beverages, alcoholic beverages if allowed, nutritional supplements. Usage chart for more information, visit or call 800. Pdf viscosity measurements of nectar and honeythick. Centipoise cp measurements of the samples were compared across products and. This particular agent provides a very smooth and homogeneous result that doesnt. Guidelines for consistency modifications of foods and liquids. Simplythick gel food and beverage thickener for dysphagia. This level has been incorporated into the iddsi framework as level 1 slightly thick. Mar 29, 2016 the three consistencies of thickened liquids are. Read below for tips on getting your liquids nectar thick, as well as common thickeners and recipes. The iddsi model expand and separate out the liquids to offer more choices to increase freedom to patients when appropriate. Add level measured thickener into a dry, empty glass.
Goldfield ec, smith v, buonomoc, perez j, larson k. Serving temperature viscosity measurements of nectar and honey thick liquids. Product, liquid, and time comparisons article pdf available in dysphagia 204. Pdf serving temperature viscosity measurements of nectar. Your doctor and speech pathologist have found that it is safer for you to drink thickened liquids. This study reports the viscosity thickness of nectar and honey thick liquids measured at a typical serving temperature.
One tablespoon equals fruit exchange which equals 4 grams of carbohydrates. Modification of the diagrams or descriptors within the iddsi framework is discouraged and not recommended. Mar 18, 2006 this study compared the viscosity thickness of five different liquids thickened to nectar or honeylike consistencies with a variety of thickening products. Asha has not established diet levels or terminology nor does asha have any guidelines about the types of foods that should be on a particular diet level. Pureed foods and thickened liquids for people with dysphagia read this booklet to learn about. Thickened liquids your healthcare team will check one box to show you how thick your liquids should be. To atthicken liquids see can instructions for amount of thickener. Your speech pathologist swallowing specialist has recommended that you drink only thickened liquids and avoid thin liquids. Home first,obtainathickeningagentatyourlocaldrugstore.
You will learn how to buy and prepare pureed foods and thickened liquids to make. Simplythick is a food and beverage thickener designed to improve the lives of people living with swallowing disorders, otherwise known as dysphagia. People with swallowing problems may find it difficult to swallow thin fluids such as water, milk, tea, coffee etc. Instead of thin, nectar, honey and pudding, the nectar is separated into two categories with slightly thick liquids including items such as drinkable supplements.
Thickened fluids winnipeg regional health authority. Thickening liquids can impact the amount of liquid intake and may result in dehydration if the individual is not able to take in adequate amounts. Beverages recommended all beverages with minimal amounts of texture, pulp, etc. Pdf viscosity measurements of nectar and honeythick liquids. Level 1 slightly thick drinks has also been verified as distinct from other thickness levels in the literature, however, as with all other thickened liquids, this level lacks data to. Remember that all thickening agents, whether commercial thickit, thick, and easy or noncommercial food items instant potatoes, baby fruits, baby cereal, etc. To prevent dehydration you will need to drink 68 cups of thickened fluids each day. Although she cannot swallow thin liquids, she tolerates nectarthick liquids well. Frazier j, chestnut ah, jackson a, barboncea, steele cm, pickler l.
Thickened liquids are used to protect people who have had a stroke, head injury, cancer, etc. Centipoise cp measurements were compared for three products two starch. The signs of dehydration include being thirsty, having a dry mouth, peeing less often and confusion. Honeythick liquids are slightly thicker, less pourable, and drizzle from a cup or bowl. Understanding the viscosity of liquids used in infant dysphagia management. We have a few more tools in our toolbox that we can explore first before we resort to the oprah thickened liquids method and you discharge everyone on your caseload so that you can get to happy hour on time. Please refer to the table below to learn about the different liquids.
Nectar consistency honey consistency pudding consistency directions. Preterm infant swallowing of thin and nectar thick liquids. The foodservice industry is already starting to dual label their products, so be sure to check for the new labeling. Fluid slowly drips in dollops off the end of the spoon. Use of thickened liquids in skilled nursing facilities. Sample thickened liquids care plan health and human services.
As a clinician, you can start using dual labeling in your documentation to get familiar using the terminology. For example, when recommending the liquids of nectar thick, add. These are nectar thick, honey thick, and spoon thick. Dysphagia mechanically altered includes all foods on ndd level 1. Examples of thin fluids that need to be thickened and mixed consistency foods to avoid are provided. Dysphagia advanced beverages recommended any beverages, depending on recommendations for liquid consistency. Liquids that are thickened may be called slightly thick, mildly thick or moderately thick.
Pdf this study compared the viscosity thickness of five different liquids thickened to nectar or honeylike consistencies with a variety of. Nectar thick liquids are the consistency of apricot nectar. Any texture should be suspended in the liquid and should. A clinical dietitians guide to iddsi dietitians on demand. Avoid any beverages with lumps, chunks, seeds, pulp, etc. They are usually easier to control while swallowing. Liquids are thick enough to be given by spoon, but, when spoon is placed upright, it will not stay upright. Samples were prepared using manufacturer guidelines and viscosity was measured at the recommended time to thicken standard and also after 10 and 30 min.
Thickeners can also alter thetaste of the fluid causing individuals to refuse to drink it. Your health care team recommends that you follow a puree and thickened liquid diet for dysphagia. Alterations to elements of the iddsi framework may lead to confusion and errors in diet texture or drink selection for patients with dysphagia. Thickening liquids to nectar consistencymildly thick you or someone you care for has been identified has having a swallowing problem. Your healthcare team will check one box to show you how thick your liquids should be. The categories of consistencies are slightly thick, mildly thick, moderately thick and extremely thick cichero et al. Viscosity measurements of nectar and honeythick liquids. Jefferson county care transitions coalition presents. Dysphagia liquid consistency intermountainphysician. Our dieticians and our slps have had multiple discussions on this topic. May need to be thickened if on thickened liquids creambased soups are naturally nectar thick but will need thickener if on honey thick liquids brothbased soups need thickener added for nectar and honey consistencies level 2 chunks must be very tender and smaller than. To be used in conjunction with advice from a registered dietitian. Thickener instructions will vary depending on the thickener brand. Honey thick slightly thicker and not as easy to pour as nectar.
Suitable for people with feeding or swallowing problems and makes swallowing safer. And, in a collaborative effort, we prefer a gelbased thickener as our first choice. Theyre not pourable and usually require a spoon to. You may need to avoid juicy foods like watermelon, apples or oranges. National dysphagia level 3 advanced nutrition therapy. Dont hand out thickened liquids like oprah a compensatory. Your speech pathologist has recommended either nectar thick or honey thick liquids.