Dysphagia is estimated to affect between 8-67% of residents in residential settings. Of this 43% are more likely to have dementia. Texture-modified foods and thickened drinks are commonly used in dysphagia, to reduce the risks of choking and aspiration.
Student project (2017)
Student Dietitian: Katrina Bach- Bond University
Supervisor: Elizabeth Newsham-West APD
The goal of a modified texture diet is one that is safe, provides adequate nutrition & hydration, while preserving quality of life. However, this is often hard to achieve, as many residents on this diet are more likily to lose weight and more likely to be dehydrated, therefore making them more at risk of infection and poor health which may even reduce swallow further.
Many factors contribute to this poor nutrition status, primary diagnosis and co morbidities, anorexia of aging, slow to eat and drink, require hand feeding, perception of poor palatability of diet, food refusal, sensory changes of the food making it disliked, medications affecting alertness where they may sleep through meals or mid meals.
Fluid is frequently thickened with a gum or a starch based thickener to the the correct consistency recommended by the Speech Pathologist, on this diet . However these may have side effects like bloating , have a laxative effect or gastrointestinal obstruction if insufficient fluids are taken.
Therefore one approach when it comes to thickened fluids, for better nutrition and hydration may be to use REAL FOOD to ensure nutritional needs and quality of life are considered, especially for ‘at risk’ residents. Less food may be rejected when more accepted foods are used that are naturally of the required consistency such as puddings and yogurt or this NEW drink we have designed, that is equally well handled.
With this knowledge, Katrina Bach, Student Dietitian, Bond University designed two high protein and energy drinks that were suitable for those requiring mildly thick ( level 150) and extremely thick (level 400) high protein drinks using only REAL foods. The nutrional intake was high, with each 120ml drink providing 180kcal/760KJ ( 1.5kcal/ml) and 6-8gm protein.
Her objectives were to produce a drink that prioritised the use of natural food products over starches/gum-based thickeners that was tasty with age appropriate flavours that did not thicken or thin on standing.
The drink was cost effective and easy to prepare, being only 32c per 120ml drink. This was considerably less than a high protein drink in which a gum or starch thickener was added, being more than 60c per 120ml drink or a ready to drink commercial drink may be as much as $2.00 for an similar product.
Whenever making thickened fluids either with commercial thickeners or real foods it is important to check the final consistency against the Australian standards and correct as required.
Dietitians Association of Australia and The Speech Pathology Association of Australia Limited (2007), Texture-modified foods and thickened fluids as used for individuals with dysphagia: Australian standardised labels and definitions. Nutrition & Dietetics, 64, S53–S76. doi: 10.1111/j.1747-0080.2007. 00153.x
