The behavior of lemon-based thickened fluids submitted to the IDDSI flow test as a strategy for dysphagia treatment

Abstract

Dysphagia is a health condition that causes swallowing difficulty, which may be treated by many techniques. Feeding modified foods should be a usual protocol for these individuals, as it will rarely be a diet of choice but a diet necessary to maintain a safe oral intake of nutrients. All people who suffer from changes in swallowing have difficulty in oral feeding, which compromises their nutritional status, mainly due to dehydration. Thickening of fluids is a well-established management strategy for oropharyngeal dysphagia. Thus, this research aimed to evaluate commercial lemon-based beverages (juices and flavored waters) with the addition of thickeners through the gravity flow test, according to the protocol established by the International Dysphagia Diet Standardization Initiative (IDDSI). Eight commercial beverage samples, categorized as flavored carbonated water (L01, L02, L03, L04), isotonic beverage (L05), liquid soft drink (L06) and powdered soft drink (L07 and L08), in addition to two thickeners based on xanthan gum were used. A 10 mL slide-tip syringe with a barrel length of 61.5 mm was employed for the flow test. thickening agents to lemon-based beverages caused substantial changes in their rheological properties. Differences between samples and treatments were observed according to the type and amount of thickener. Samples L05 and L08 showed 8.55 and 8.05 mL retention in the syringe, respectively, classifying them as moderately thickened liquids, while the others samples were classified as slightly thickened liquids. The ideal treatment for the dysphagic patient aims to ensure a safe intake and a correct nutritional and water supply, in addition to the consequent improvement of the patient’s general clinical condition. According to their nutritional profile, the inclusion of these beverages may be interesting in increasing some micronutrients such as sodium, potassium, calcium, phosphorus and magnesium. The flow properties of lemon-based beverages can be a good option for patients with dysphagia when improved using low amounts of thickening agents to suit their diets.