18 July, 2017
Honey-Thickened Liquid Diet
A honey-thickened liquid diet is most appropriate for individuals that experience, to some degree, difficulty swallowing. Disordered swallowing function or dysphagia patients require altered consistency liquids to avoid aspiration when drinking. Dependent upon the degree of dysphagia, there are several different levels of consistency, ranging from unthickened to pudding thick. Honey-thickened liquids are those that stick to the sides of a cup like honey and pour very slowly.
According to “ASHA Reader,” viscosity is a property of solids, liquids and gasses that represents their resistance to flow. While nearly all dietary fluids are considered "thin," or have low viscosity, they pose the greatest risk for aspiration into the airway. SpectrumHealth.org says honey-thickened liquids are defined as liquids that coat the spoon. They are pourable, but not runny. Almost all liquids can be thickened to this consistency. You can purchase commercial or home-thickening agents to achieve the desired honey-thick consistency. Home-thickening ingredients include items such as baby cereal, banana flakes, cornstarch, instant potato flakes, plain unflavored gelatin powder and pureed fruits such as baby foods.
As explained by the National Institute on Deafness and Other Communication Disorders, individuals suffering from dysphagia have difficulty swallowing. There are varying levels of dysphagia; while some individuals may be completely unable to swallow, others can swallow specific consistencies better than others. Dysphagia is the result of any condition that weakens or damages the muscles and nerves used for swallowing. Parkinson’s disease, cerebral palsy, cancer, stroke, infections and birth deformities are all associated with dysphagia. Regardless, eating and drinking becomes a challenge, making it difficult to consume enough calories and fluids to nourish the body.
Dysphagia patients often require a modification in not only liquid but also food consistency. The University of Virginia Health System states that individuals that experience difficulty swallowing liquids do not always get enough daily fluids. Therefore, it recommends drinking between six and eight cups of fluids every day. Even though a liquid may be thickened, it is still considered a part of total fluid intake. Another recommendation for patients is to consume both foods and beverages slowly while in an upright position. Continued drinking for 15 to 30 minutes after a meal will ensure all food particles have been swallowed. A straw should not be used as it may cause choking or further inhibit the swallowing process.
Jackson Siegelbaum Gastroenterology reports that thickened liquid diets are nutritionally adequate; however, some patients have difficulty consuming enough food and fluid to obtain their energy and nutrient needs. The process of eating simply becomes difficult and tiring. In many cases, an adjustment to the diet or treatment will be required. Calorie and protein intake may be increased through fortification of foods. For example, milk can be fortified by adding 1 cup dry powdered milk to 1 qt. liquid milk, which can be used in cooking and baking. Strained baby fruit can be added to cooked cereal, juices or milkshakes. Or, a jar of strained baby meat can be added to soups, vegetables, sauces and gravies to increase caloric consumption.
Individuals that require thickening of liquids in order to ensure a safe, aspiration-free swallow should always consult a language-speech pathologist first. This health care professional will perform a swallow evaluation to determine the most appropriate consistency for the patient and then recommend both products and safe foods for consumption. One key recommendation, according to the University of Virginia Healthy System, for individuals requiring a honey thickened-liquid is to avoid any consistency that will be liquid at room temperature such as ice cream, ice cubes, gelatin and milkshakes.
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