Lack of Standardization in Commercial Thickeners Used in the Management of Dysphagia

Abstract

Introduction: Oral feeding safety is necessary to provide nutrition, hydration, and eating pleasure for patients with dysphagia. Commercial thickeners are prescribed for these patients to change food viscosity and may alter the proper preparation of modified food. Objective: Analyze composition, employed terminology, preparation instructions, recommended amount and weight of provided measuring spoons, nutritional information, and viscosity of 7 commercial thickeners. Methods: The sample comprised all thickeners from different brands available in Brazil, named A to G. Products were submitted to viscosity analysis using viscometer and the International Dysphagia Diet Standardization Initiative (IDDSI) test. Samples were prepared with mineral water (25°C) and with the amount of thickener recommended to obtain intermediate viscosity (level 2) according to the manufacturer’s instructions. Results: Products B, C, and E presented similar composition. Manufacturer’s information about the amount and preparation procedure, time, temperature, and base liquid was incomplete. Viscosity tests revealed that thickener C was basically solid while D displayed results out of the desired viscosity level. Conclusions: The study showed differences in components and viscosity, beyond the lack of label details. There was no established correlation between viscosity classifications provided by National Dysphagia Diet and IDDSI.

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