Nutrition How to Thicken Liquids: Nectar-Thick By Ear Nose and Throat, March 29, 2016 People who have trouble swallowing thin liquids often thicken their liquids to help prevent choking and stop fluids from entering the lungs. Read below for tips on getting your liquids nectar-thick, as well as common thickeners and recipes. What Are Thickened Liquids? The three consistencies of thickened liquids are: Nectar-thick liquids — are easily pourable and comparable to apricot nectar or thicker cream soups. Honey-thick liquids — are slightly thicker, less pourable, and drizzle from a cup or bowl. Pudding-thick liquids — hold their own shape. They’re not pourable and usually require a spoon to eat. Your doctor or speech therapist should tell you what consistency your liquids should be. Basic Tips for People Who Need to Thicken Liquids Avoid thin liquids and some foods. Thin liquids often cause choking and are harder to swallow than thick liquids. Examples of thin liquids are water, coffee, milk, soda, broth, and soup. Do not eat anything that melts, such as ice cream or ice cubes. Do not add ice cubes to thickened liquids. When the ice melts, it makes the drink too thin. You may need to avoid certain moist and juicy foods. Common examples are oranges, grapes, and watermelon. These have thin juices that can easily enter the lungs. You may also need to avoid gelatins (like Jell-O®) and scrambled eggs. Talk to your doctor, speech therapist, or dietitian to help decide which foods and fluids you tolerate best. Drink enough daily fluids. People who have problems swallowing liquids often don’t get enough daily fluids. You should drink 6 to 8 cups of fluid every day, unless your doctor restricts your fluids because of a health condition. Thickened liquids are still part of your fluid intake. It’s important to drink enough fluid so you don’t get dehydrated. When thickening hot drinks, be aware that the beverage tends to get thicker as it cools off. You can thicken carbonated drinks, but the drink will lose its carbonation through the stirring process. See below for ideas on how to thicken these beverages. Take your time. Remember, it’s very important to take your time eating and drinking. Stay in an upright position while drinking. Stay upright for 15 to 30 minutes afterward. Do not use a straw. It may cause you to choke or have trouble swallowing. Know the best thickness. Know the best thickness for you, so you can tell when a drink is too thick or too thin. Do not “under thicken” liquids. It’s better to drink a liquid that is too thick than too thin. Most commercial thickeners include directions for getting the right consistency. If your brand of thickener doesn’t have directions, use the following as a guideline for nectar-thick liquids: Add 1 1/2 teaspoons of commercial thickener to 1/2 cup of thin liquid. Stir vigorously for 20 seconds. Allow the drink to sit for at least one to two minutes to get the right thickness before serving or drinking. If the liquid is too thick, you can add thin liquid to reduce it to a thinner consistency. If the liquid is too thin, add a small amount of thickener. Commercial Thickeners You can buy commercial thickening powders at your local drug store (ask your pharmacist) or from companies that make them. Brand names include Thick It, Thick n’ Easy, and Thixx. You may also be able to buy pre-thickened beverages — such as juice and milk — from various companies. Commercial thickener companies AliMed® 800-225-2610 www.alimed.com eDietShop, Bernard Food Industries 800-325-5409 www.edietshop.com Bruce Medical Supply 800-225-8446 www.brucemedical.com Leahy-IFP 847-904-5250 www.leahy-ifp.com Med-Diet® 800-633-3438 www.med-diet.com Nestlé Nutrition Store 888-240-2713 www.nestlenutritionstore.com Thick-It® 800-333-0003 http://thickit.com/ Common Liquid Thickeners If liquids are too thin, add one of the following common thickeners to get your liquid nectar-thick. Banana flakes Cooked cereals (like cream of wheat or cream of rice) Cornstarch Custard mix Gravy Instant potato flakes Mashed potatoes Plain, unflavored gelatin powder Pureed fruits (baby food) Pureed meats (baby food) Pureed vegetables (baby food) Rice cereal (baby food) What thickeners work best for certain types of liquids? For hot, milk-based liquids use: Baby rice cereal Plain, unflavored gelatin For other hot liquids (soups, sauces, and gravies) add: Potato flakes Mashed potatoes Flaked baby cereal For cold liquids, add: Plain, unflavored gelatin Pureed fruits Banana flakes Nectar-Thick Liquid Recipes The following recipes include basic ingredients that you can conveniently make at home using a blender. None of the products listed contain commercial thickening agents. Some do contain baby rice cereal in order to make the right consistency. Baby rice cereal has a neutral flavor and does not affect the taste of the final product. It’s also less expensive than commercial thickening agents. Unlike products made with commercial thickening agents, most of the products listed do not change consistency after refrigeration. So, you can make these recipes in larger quantities and store them in the refrigerator. Diet and nutrition notes about these recipes Note to people watching their weight: Some of these recipes include high-fat and high-calorie ingredients that may cause weight gain. Examples of high-fat or high-calorie ingredients include: Ice cream Whole or 2 percent milk Peanut butter Pudding made with whole or 2 percent milk Nutrition drinks, like Boost and Sustacal Maple syrup Pie filling If you don’t want to gain weight, you can make substitutions. To reduce calories and fat, try using light versions of these foods and 1 percent or fat-free milk. You can also try decreasing portion size. Note to people with diabetes: Some of the ingredients in these recipes contain sugary foods. When possible, we provide a substitution. If there is no substitution available: Use the product sparingly (two to three times per week). Always drink these recipes with a source of protein — such as meat, peanut butter and crackers, nuts, or legumes. You may also choose to drink them along with a meal. Eating sugary foods alone may cause your blood glucose (sugar) to rise too high, too quickly. Note to people with lactose intolerance: Some of these recipes contain milk or ice cream that may upset your stomach. Before eating these foods try: Replacing regular milk with Lactaid milk. Using the Lactaid pill (follow directions on the bottle). Chocolate milk Mix in a blender: 1/4 cup milk 1/2 cup chocolate pudding (prepared) People with diabetes: Use sugar-free pudding. Chocolate, peanut butter, banana shake Mix in a blender: 1/2 small banana 1 tablespoon peanut butter 3 tablespoons baby rice cereal 1/2 of an 8-ounce can of chocolate-flavored Boost or Sustacal People with diabetes: Replace Boost or Sustacal with sugar-free Carnation Instant Breakfast (CIB). Maple, pumpkin, cinnamon shake Mix in a blender: 1/2 cup canned pumpkin pie filling 4 tablespoons maple syrup 1/2 cup vanilla ice cream 1/2 teaspoon cinnamon 1/2 of an 8-ounce can of vanilla-flavored Boost or Sustacal People with diabetes: Replace Boost or Sustacal with sugar-free CIB, and use diet maple syrup. Fruit juice (any flavor) Any flavor of strained fruit juice is already a nectar-thick consistency. Mixed fruit juice Mix in a blender: 1/2 banana 1/4 cup canned or fresh pineapple 1/4 cup fresh strawberries 1/2 cup pineapple juice People with diabetes: Use pineapple packed in juice or water.