Thickened Liquid Diet

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If you have difficulty chewing or swallowing, you may need a thickened liquid diet. Your doctor may suggest you be evaluated by a speech language pathologist before changing the consistency of your liquids, according to the National Institutes on Deafness and Other Communication Disorders. Difficulty chewing or swallowing is known as dysphagia.


Dysphagia occurs when there is a problem with the swallowing process, such as a weakened tongue muscle or the inability to stimulate the swallowing reflex. Strokes and diseases of the nervous system, such as cerebral palsy, are the most common causes of dysphagia. If you have dysphagia, you are at risk for aspiration pneumonia and malnutrition, according to the National Institute on Deafness and Other Communication Disorders. Modified diets, like thickened liquids, minimize your risk.

Levels of Thickness

There are four levels of liquid thickness, according to the Ohio State University Medical Center. Thin liquids include water, soda, juice and broth. Nectar thick liquids include fruit nectar, maple syrup, eggnog, Ensure, tomato juice and cream soups. Honey thick liquids include honey and liquids thickened to a honey consistency. A spoon thick liquid is a pudding. The speech language pathologist and doctor determine the thickened liquid you need.

Thickening Liquids

Some liquids, such as eggnog, are naturally thickened to the appropriate consistency. Other liquids need a thickening agent to reach the right consistency. There are two types of thickeners, starch thickeners and gel-based thickeners, according to the Ohio State University Medical Center. Starch thickeners come in powdered form. Starch thickeners work best when limiting the liquid amount to 4 ounces, says the OSU Medical Center. Gel-based thickeners are more costly than starch thickeners but work more quickly and consistently. Thickeners can be found over the counter at most pharmacies. It is important to closely follow the directions on the package when mixing the liquids to the correct consistency.

Adequacy of the Diet

Thickened liquid diets provide adequate nutrition. However, when you have dysphagia you may have some difficulty taking in enough nutrients to meet your needs. You need 6 to 8 cups of fluid a day, according to Jackson/Siegelbaum Gastroenterology. Taking in less than 4 cups may require medical intervention. If you are unable to eat enough calories and protein, you can add calorie and protein boosters, such as dried milk powder and strained baby food, to increase the caloric density of your food.


If you are having difficulty swallowing and need thickened liquids, there are some guidelines regarding safe swallowing. First, it is important to eat all meals in an upright position; this will make sure food goes into the stomach and not the lungs, according to Jackson/Siegelbaum. Take small bites and eat slowly. Try to eat in a relaxed environment and do not talk when you have food in your mouth. After each meal, try to stay in your upright position for at least 30 minutes.