How Xanthan Brings Much-Needed Variety to the Dysphagia Diet

Once, dinner out with friends was a relaxing experience. Holiday meals meant enjoying familiar comfort foods with loved ones. And a glass of wine was an evening treat. But for millions of people, the enjoyment found in simply eating and drinking can change overnight.

The reality is that, for those living with dysphagia, favorite foods and beverages bring the risk of aspiration and hospitalization—and sometimes even death. As favorite foods become off-limits and the social aspect of dining fades, eating and drinking can become a chore rather than a fun, anticipated break.

When one’s regular diet presents the risk of aspiration, a modified diet of thickened foods and beverages may be the safest choice. But a “safer” diet is rarely the most appealing. Faced with the choice, many people with dysphagia fail to comply with their recommended thickened diets, increasing the risk of malnutrition, dehydration, and dangerous aspiration.

The Importance of Palatability

In a Today’s Geriatric Medicine article by Sharyl Samargia, PhD, CCC-SLP, a survey by Garcia, Chambers and Molander (2005) showed that nearly one-half of survey participants indicated they strongly disliked thickened liquids 1. According to a separate study, 48% of survey respondents following a modified diet reported that eating was no longer an enjoyable experience 2. But there’s more to the numbers than simple aversion and lack of enjoyment. The key to compliance with a modified thickened diet is palatability. And the keys to palatability are taste, texture, appearance, and stability.

Xanthan Brings New Hope

After years of studying dysphagia and thickening agents to create a convenient, affordable, and palatable solution, Doug Stetzer, inventor of Thick-It® AquaCareH2O® and Director of Innovation at Kent Corporation, developed a proprietary approach to working with xanthan gum, resulting in the first-of-its-kind tasteless, colorless thickened water. Extending the science to develop thickened juices, coffee, and tea, Thick-It delivered taste-accurate, ready-to-drink beverages with a clean, clear flavor and texture that makes them palatable and appealing to dysphagia patients.

Stetzer expanded his research to develop a xanthan powder thickener that mixes with supplements without altering the desired consistency. While competitive post-thickened starch products fell outside the appropriate viscosity range, AquaCareH2O maintained its intended viscosity over time 3, helping to support patients’ health, quality of life, and well-being.

How It Works

The bacteria Xanthamonus campesteris secretes a thickening agent called xanthan. Xanthan thickens liquids at a faster rate than a starch-based agent. Even with changes in temperature or pH level, xanthan’s viscosity remains stable, allowing diners to enjoy a glass of ice water, a frozen juice pop, or a hot cup of one’s favorite tea—safely. What’s more, xanthan can be frozen and thawed several times without losing its viscosity.

Bringing New Variety to the Dysphagia Diet

Because water thickened with this proprietary xanthan process is so clean, clear and smooth in flavor and texture, it can be mixed into a wide range of flavored beverages, broths, and soups, opening up a new world of dietary variety for people with dysphagia. Use Thick-It AquaCareH2O ready-to-drink water or Clear Advantage powdered thickener to brew up your favorite blend of coffee or tea. Prepare homemade or packaged soups. Enjoy your favorite soda, juice, or an occasional adult beverage and chill with ice cubes made from Thick-It. The xanthan formula will not grow thicker over time, so you can safely freeze, thaw, or reheat beverages and foods as desired.

For all cultures, mealtime is a great source of connection and enjoyment, enjoyment too often lost for people with swallowing disorders. By expanding the possibilities of the dysphagia diet, xanthan products like Thick-It AquaCareH2O and Clear Advantage bring comfort, variety, and improved quality of life for patients with dysphagia and the people who love them.

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1. Garcia J, Chambers E, Molander M. Thickened liquids: practice patterns of speech-language pathologists. American Journal of Speech-Language Pathology, 2005; 14:4-13.

2. Ekberg O, Hamdy S, Woisard V, Wuttage-Hanning A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002; 17(2): 139-146.

3. Kemboi, J. and Karunanithy, C. The addition of supplements to different brands of nectar consistency thickened water and their effect on viscosity over time: An overview. University of Wisconsin.


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