Nutrition and Lifestyle: Latest Food Products for Dysphagia Patients
Dysphagia is a common condition among older adults. Those with dysphagia often experience anxiety and panic during mealtimes, which may lead to social isolation, reduced food intake, and/or avoidance of meals altogether.1 If untreated, malnutrition, dehydration, respiratory infections, and silent aspiration can result.2
However, geriatricians play an important role in optimizing nutrient intake in patients with this condition. There are several food products on the market formulated specifically for dysphagia to make mealtimes easier—and safer—for patients. It’s important for those who work with older adults to become familiar with the products on the market, know how to use them, and understand their nutrient content.
This article provides an overview of some of the more popular dysphagia-specific food products to help geriatricians make informed recommendations to patients and their families.
What Is Dysphagia?
In older adults, physiological changes may trigger impaired swallowing function, such as reductions in muscle mass and connective tissue elasticity. In addition, dysphagia may result from age-related illnesses, such as stroke, dementia, and Parkinson’s disease, that affect the swallowing mechanism.4
Despite how common it is among older adults, dysphagia isn’t a normal part of aging, but its management in this population is especially important to maintain nutrition status and overall quality of life.4
The prevalence of dysphagia seems to be higher among older adults living in nursing homes and assisted living facilities, where up to 60% of residents have been reported to have difficulties related to food intake.3
Diet modifications are frequently recommended, which require intervention from geriatricians to optimize their success. Dietary strategies for dysphagia management may include altering food textures and modifying liquid consistencies. These are known to help improve swallowing safety while promoting oral intake, which may in turn improve patients’ ability to meet their nutritional needs.
The National Dysphagia Diet Task Force has established standardized nutrition therapies for dysphagia management, such as the National Dysphagia Diet, which includes specific guidelines outlining three levels of food textures and four different types of liquids best suited for patients with mild to moderate to severe dysphagia.6
The levels of solid foods include ground/purée (level 1), mechanical soft/chopped (level 2), and regular/advanced (level 3), which help patients compensate for chewing difficulties or fatigue and improve swallowing safety.7 Liquids typically are thickened to help patients avoid aspiration and control the speed, direction, duration, and clearance of the bolus while improving transit through the esophagus.6 The four thickness levels of liquids are thin, nectar thick, honey thick, and spoon thick.
Several studies have shown that offering more food choices for dysphagia patients can lead to greater nutritional intake.4 This can be challenging, especially for those who require modified food textures, as they aren’t always accessible, appetizing, or convenient for patients and their caregivers outside of long term care facilities. In recent years, food products formulated specifically to address these struggles have become more readily available. Those who work with older adults can recommend these as an intervention for dysphagia to help improve food intake and quality of life.
The following is a sampling of hundreds of available products, including information about nutrient content and price ranges.
NutraBalance products are available at https://nutra-balance-products.com/shop/pre-thickened-liquids. They range in price from $57.16 to $60.27 per case of eight 32-oz bottles.
They’re available at http://thickit.com/products or at any pharmacy. Nutrition information, which varies for each beverage, can be found online. Price ranges depend on where the products are purchased.
One of its most popular products is EasyMix premeasured thickening packets, available in nectar and honey consistencies. Packaged in individual servings, they’re designed to thicken 4 oz of liquid. Patients on the go and looking for convenience will benefit from these products.
Simply Thick products are available at www.simplythick.com. One honey-thick packet contains 10 kcal, 45 mg sodium, and 3 g carbohydrate, while one nectar-thick packet contains 5 kcal, 20 mg sodium, and 1 g carbohydrate. One hundred individual packets cost $59.95 to $69.95.
Purathick is available at the Parapharma Tech website (www.healthierthickening.com/purathick), Amazon, or pharmacies in bulk or in individual packets. One scoop contains 10 kcal, 2 g carbohydrate, and 1 g fiber. A 4.4-oz jar costs $19.95, and a box of 30 individual serving sticks costs $16.95.
Hormel Health Labs
Individual patients and health care professionals can order these products online from homecarenutrition.com or food- servicedirect.com. Nutrition information and prices are available online at www.hormelhealthlabs.com/condition/dysphagia/pureed-foods.
These products can be purchased directly from the company’s website at www.katefarms.com/conditions/dysphagia as either a one-time purchase or a monthly subscription. One 325-mL carton contains 325 kcal, 12 g fat, 225 mg sodium, 38 g carbohydrate, 5 g fiber, and 16 g protein. A case of 12 cartons costs $46.
ThickenUp Clear, a powder made from maltodextrin, xanthan gum, and potassium chloride, is also available in 4.4-oz canisters or 1.4-g sticks. One scoop or stick thickens to nectar consistency, two to honey consistency, and three to pudding consistency. A single canister costs $9.99, and each scoop or stick contains 5 kcal and 1 g carbohydrate.
ThickenUp products are available from Nestlé Health Science (www.nestlenutritionstore.com) or Amazon.
Whether patients need prethickened beverages, frozen puréed meals, or oral nutritional supplements, there are products on the market that address almost every challenge dysphagia patients may face.
— Brianna Tobritzhofer, MS, RD, LD, is the senior manager of nutrition and client services for a nonprofit meal delivery program in Minneapolis. She’s also a freelance health and nutrition writer and author of her blog Fresh Fit Flourish.
2. Cichero JAY. Age-related changes to eating and swallowing impact frailty: aspiration, choking risk, modified food texture and autonomy of choice. Geriatrics. 2018;69(3):1-10.
3. Aslam M, Vaezi MF. Dysphagia in the elderly. Gastroenterol Hepatol (N Y). 2013;9(12):784-795.
4. Sura L, Madhavan A, Carnaby G, Crary MA. Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging. 2012;7:287-298.
5. Nawaz S, Tulunay-Ugur OE. Dysphagia in the older patient. Otolaryngol Clin North Am. 2018;51(4):769-777.
6. Cichero JA, Steele C, Duivestein J, et al. The need for international terminology and definitions for texture-modified foods and thickened liquids used in dysphagia management: foundations of a global initiative. Curr Phys Med Rehabil Rep. 2013;1:280-291.
7. Cichero JA, Lam P, Steele CM, et al. Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: the IDDSI framework. Dysphagia. 2017;32(2):293-314.