title: Nutrient intake from thickened beverages and patient-specific implications for care.
abstract: Dysphagia, or difficulty swallowing, affects more than 15 million Americans and can result in adverse and potentially fatal consequences, including poor quality of life, depression, dehydration, malnutrition, aspiration pneumonia, and airway obstruction. Although many treatment options are available, provision of thickened liquids is a common intervention for achieving slower, more controlled bolus manipulation and propulsion. To meet this therapeutic demand, commercially available products containing starch and/or gum-based components have been developed for use by patients and institutions. The nutrient content of thickened products has been neglected, although dysphagic patients are often at significant nutrition risk. Thus, there are no clinical guidelines for selection of thickened products based on patient characteristics. To consider whether such guidelines are warranted, it is necessary to quantify nutrition differences among common thickened beverages. An analysis was conducted to quantify energy, carbohydrate, and sodium provided through daily consumption of thickened beverages. To determine the relevance of these nutrition contributions in the context of total dietary intake, we compared values with dietary recommended intakes. This analysis revealed that there are substantial disparities in the nutrient content of thickened beverages. These differences suggest that product selection can be optimized based on patient-specific characteristics such as weight status and presence of comorbidities. Future research focusing on the effect of this strategy on patient outcomes will facilitate the development of evidence-based recommendations to elevate the standard of care for this population.
authors.affiliation: Essentia Health Duluth Clinic, Duluth, Minnesota Amanda.Joyce@essentiahealth.org.
authors.forename: Amanda
authors.initials: A
authors.lastname: Joyce
authors.affiliation: Department of Medicine and Public Health, University of Wisconsin-Madison, and Clinical Center, Madison, Wisconsin.
authors.forename: JoAnne
authors.initials: J
authors.lastname: Robbins
authors.affiliation: University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Hind
mesh_terms: D000328:Adult; D000368:Aged; D001628:Beverages / Q000032:analysis*; D015992:Body Mass Index; D003680:Deglutition Disorders; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009753:Nutritive Value; D011788:Quality of Life; D057185:Sedentary Behavior; D012982:Sodium, Dietary / Q000008:administration & dosage
chemical_list: D004040:Dietary Carbohydrates; D012982:Sodium, Dietary
keywords: carbohydrates; deglutition disorders; dietary sodium; dysphagia; thickened liquids