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Thickened Liquids: Honey-Thick

People who have difficulty swallowing thin liquids often must drink thickened liquids. Drinking thickened liquids can help prevent choking and stop fluid from entering the lungs.

The 3 common consistencies of thickened liquids are nectar-thick, honey-thick, and pudding-thick. Your doctor or speech therapist should tell you what consistency your liquids should be. As a general rule:

  • Nectar-thick liquids are easily pourable and are comparable to apricot nectar or thicker cream soups.

  • Honey-thick liquids are slightly thicker, are less pourable, and drizzle from a cup or bowl.

  • Pudding-thick liquids hold their own shape. They are not pourable and are usually eaten with a spoon.

Basic Guidelines for People using Thickeners

  • All liquids must be thickened. Avoid thin liquids. 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.

  • People who have difficulty 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 medical condition.

    Even though they are thickened, thick liquids are still considered part of your fluid intake. It’s important to drink enough fluid so you don’t get dehydrated.

  • Remember, it is very important to take your time eating and drinking. Stay in an upright position while drinking and for 15 to 30 minutes afterward. Talk to your doctor, speech therapist, and dietitian to help determine which foods and fluids you tolerate best.

  • You may need to avoid certain moist and juicy foods. Common examples are oranges, grapes, and watermelon.

    These have thin juices, which can easily enter the lungs. You also may need to avoid gelatins (like Jell-O) and scrambled eggs. Ask your doctor about these foods.

  • Do not use a straw. It may cause you to choke or have trouble swallowing.

  • Commercial thickening powders can be purchased at local drug stores (ask your pharmacist) as well as from companies that make them. Brand names include Thick It, Thick n’ Easy, and Thixx. You may also be able to purchase pre-thickened beverages such as juice and milk from various companies. See the list of companies below.

  • Know the best thickness for you, so you can tell when a drink is too thick or too thin. Most commercial thickeners include directions for getting the right consistency. If your brand doesn’t, use the following as a guideline:

      • Nectar-thick:  1  1/2 teaspoons of commercial thickener to 1/2 cup of thin liquid

      • Honey-thick:  1  1/2 tablespoons of commercial thickener to 1/2 cup thin liquid

      • Pudding-thick:  2 tablespoons of commercial thickener to 1/2 cup thin liquid

  • Add the thickener to the liquid, and stir vigorously for 20 seconds. Allow the drink to sit for at least 1 to 2 minutes to get the right thickness before serving or drinking.

  • If the liquid is too thick, thin liquid can be added to reduce it to a thinner consistency. If the liquid is too thin, a small amount of thickener can be added. Do not “under thicken” liquids. It’s better to drink a liquid that is too thick than too thin.

  • When thickening hot drinks, be aware that as the beverage cools off, it tends to get thicker.

  • Carbonated drinks can be thickened. However, the drink will lose its carbonation through the stirring process.

Commercial Thickener Companies

 

AliMed
800-225-2610
www.alimed.com

Bernard Food Industries
800-325-5409
www.edietshop.com

Bruce Medical Supply
800-225-8446
www.brucemedical.com

Carbotrol Leahy/IFP
800-669-8346
www.leahy-ifp.com

 

Healthcall
800-431-1119
www.thickitdelivered.com

Hormel Products (CVS Pharmacy)
888-607-4287
www.cvs.com

Med-Diet Laboratories, Inc.
800-633-5550
www.med-diet.com

Novartis
800-828-9194
www.novartisnutrition.com

 

 

Thickened Liquid Recipes

The recipes listed below were created with your convenience in mind. All of the recipes include basic ingredients and can be made at home using a blender.

None of the products listed contains 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 is 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.

Some of these recipes include high-fat and high-calorie ingredients that may cause weight gain.

Examples of ingredients that are high-fat and/or high-calorie are 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, and 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.

If You Have Diabetes

Some of these recipes are made with sugary ingredients that may not be advised for patients with diabetes.

When possible, a substitution is provided. If there is no substitution available, use the product sparingly (2 to 3 times per week), and always drink it with a meal or a small, high-protein snack (like peanut butter and crackers, meat, nuts, or legumes).

If foods that contain sugar are eaten alone, your blood glucose (sugar) may rise too high, too quickly.

If You are Lactose Intolerant

Some of these recipes contain milk or ice cream, which may upset your stomach. Try replacing regular milk with Lactaid milk. You can also try using the Lactaid pill (follow directions on the bottle) before eating these foods.

Common Thickeners

If liquids are too thin, add 1 of the following common thickeners to get the desired consistency:

  • 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)

If you’re preparing a hot, milk-based liquid, you’ll find that baby rice cereal or plain, unflavored gelatin works best.

For other hot liquids (soups, sauces, and gravies), potato flakes, mashed potatoes, and flaked baby cereal are most useful.

If you’re preparing cold liquids, add plain unflavored gelatin, pureed fruits, or banana flakes for the best results.

For questions about your diet after discharge, please call our Outpatient Nutrition Counseling Services at _________________________.

Honey-thick Liquid Recipes

Chocolate milk

Mix in a blender:

  • 1 cup chocolate pudding (prepared)

  • 1/3 cup milk

  • 4 tablespoons baby rice cereal

People with diabetes: Use sugar-free pudding.

Apple, peanut butter shake

Mix in a blender:

  • 1 cup natural chunky applesauce

  • 1/2 cup vanilla ice cream

  • 1/4 cup milk

  • 1 tablespoon peanut butter

People with diabetes: Use sugar-free ice cream.

Mixed fruit juice

Mix in a blender:

  • 1/2 banana

  • 1/4 cup canned or fresh pineapple

  • 1/4 cup fresh strawberries

  • 1/4 cup pineapple juice

People with diabetes: Use pineapple packed in juice or water.

Fruit juice (any flavor)

Mix in a blender:

  • 1/2 cup baby strained fruit

  • 2 tablespoons baby rice cereal

Strawberry, banana, and cranberry shake

Mix in a blender:

  • 1/2 of an 8-ounce can of strawberry flavored Boost or Sustacal

  • 1/2 cup canned cranberry sauce

  • 1 small banana

  • 2 tablespoons baby rice cereal

People with diabetes: Replace Boost or Sustacal with sugar-free Carnation Instant Breakfast (CIB), and use unsweetened cranberry sauce.

Note to People with Diabetes:

Some of the ingredients in these recipes contain sugary foods. If foods that contain sugar are eaten alone, your blood sugar may rise too high, too quickly. Be sure to drink these recipes with a source of protein, such as meat or peanut butter and crackers. You may also choose to drink them along with a meal.

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