Thick-It is a commercial brand of food and beverage thickener, typically available as a powder, designed with one immediate purpose: to make liquids safer for individuals to swallow. It is mixed into water, juice, coffee, or pureed foods to increase their viscosity without altering the taste. By modifying the texture of thin liquids, Thick-It allows people with certain medical conditions to consume fluids and maintain hydration and nutrition. This creates a more cohesive substance that moves slower through the mouth and throat.
The Medical Necessity of Thickened Liquids
The need for thickened liquids arises from dysphagia, the medical term for difficulty swallowing. Swallowing is a complex process involving over 50 muscles that must coordinate perfectly to move food or liquid from the mouth to the stomach. When this coordination is impaired, liquids may enter the airway instead of the esophagus, an event known as aspiration.
Aspiration is a serious concern because it can lead to aspiration pneumonia, a lung infection caused when foreign material enters the lungs. Thickened liquids slow the fluid’s flow rate, providing the individual more time to safely initiate the swallow reflex. This slower movement helps direct the liquid past the open airway and into the esophagus, significantly reducing the risk of aspiration.
Types of Thickening Agents and Standardized Consistency Levels
Thick-It and similar products generally rely on one of two main chemical bases: modified corn starch or xanthan gum. The original Thick-It is cornstarch-based, working by having its granules swell and absorb water to build viscosity. Starch-based thickeners can be broken down by amylase, an enzyme present in saliva, which may cause the liquid to thin out over time.
Xanthan gum-based thickeners, such as Thick-It Clear Advantage, offer a more stable viscosity because they are not affected by salivary amylase. This stability means the liquid’s thickness remains consistent over a longer period, even with varying temperatures and acidity levels.
Professionals recommend the specific thickness level based on a formal swallowing assessment, often using the standards set by the International Dysphagia Diet Standardization Initiative (IDDSI). The IDDSI framework classifies liquid thickness into four main levels:
- Mildly thick liquid (Level 2), historically called nectar thick, runs quickly off a spoon but leaves a thin coating, and can be sipped from a cup.
- Moderately thick liquid (Level 3), or honey thick, drips slowly in dollops from a spoon and is difficult to drink from a cup.
- Extremely thick liquid (Level 4), or pudding thick, holds its shape and does not flow off a fork, requiring consumption by spoon.
Achieving Proper Thickness Through Preparation
Achieving the correct and safe thickness requires careful adherence to preparation instructions, which vary based on the desired consistency. Using the provided measuring scoop and a level-off technique ensures the correct amount of powder is added for the volume of liquid. The process begins by adding the measured thickener slowly to the liquid while stirring briskly with a fork or whisk. Rapid and thorough stirring is necessary to prevent clumping and ensure the powder fully dissolves and disperses.
After mixing, the liquid must stand for a specific amount of time for the thickening agent to fully hydrate and reach its final viscosity. Water and juices typically require at least one minute, while thicker liquids like milk may need five to ten minutes to reach optimal thickness. The type and temperature of the liquid can influence the final result, often requiring minor adjustments in powder amount. It is important to check the consistency before serving, as the liquid should be consumed within 30 minutes of mixing for the best texture and safety.
Addressing Common Issues and Safety Concerns
One significant concern with a regimen of thickened liquids is the risk of dehydration. Many individuals find the altered texture unappealing, which leads to a reduced overall fluid intake. Caregivers must actively monitor fluid consumption to ensure the person meets their daily hydration needs.
Preparation errors, such as inadequate stirring or incorrect powder-to-liquid ratios, can result in an inconsistent thickness. Liquids that are too thick may increase the amount of residue left in the throat after swallowing, while liquids that are too thin increase the aspiration risk. Furthermore, some studies suggest that when a thickened liquid is aspirated, it may lead to a more intense inflammatory response in the lungs compared to thin liquid.
The specific thickness level must be determined by a qualified health professional, such as a Speech-Language Pathologist (SLP). The SLP uses specialized assessment tools to diagnose the swallowing difficulty and prescribe the safest consistency. Any change to the recommended thickness level or introduction of new liquids must be discussed with the clinician to maintain safety.