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How to Maintain Proper Nutrition and Hydration on a Dysphagia Diet

For many people, maintaining proper nutrition and hydration may be nothing more than eating fruits and vegetables and remembering to drink water. But for individuals with swallowing disorders, maintaining proper nutrition and hydration can be more challenging.

Individuals with dysphagia often require their foods and liquids to be thickened before consuming, as thickened foods and liquids are often safer and easier for them to swallow than non-thickened foods and beverages. One way to ensure this is by following a modified diet.

A modified dysphagia diet should be designed on a case-by-case basis by a speech language pathologist or health care professional trained in treating swallowing disorders. Typically, modified dysphagia diets feature beverages and foods of varying textures and levels of thickness that make it easier for the patient to chew and move food in the mouth. This reduces the risk of food or liquid going into the windpipe or trachea, which leads to the lungs.[i]

According to a study, dehydration is a common concern for people with dysphagia[ii]. Dehydration is a serious medical condition that can lead to heart failure, kidney failure, seizure, or death.[iii] Similarly, Medscape explains that dysphagia can have a profound effect on the patient’s nutrition status, because “as the patient’s ability to swallow becomes impaired, adequate dietary intake becomes a challenge.”[iv] Further, malnutrition is a risk factor for pneumonia and “may also lead to lethargy, weakness, and reduced alertness, all of which may increase the probability of aspiration.”[v]

The key to maintaining optimal nutrition and hydration in people with dysphagia is following guidelines for both appropriate texture and thickness and safe oral feeding practices.

Recently, the International Dysphagia Diet Standardisation Initiative (IDDSI) developed a framework that helps standardize common language terminology and definitions to describe texture modified foods and thickened liquids. Liquids and foods are categorized in a number of ways (a number, a color and a descriptor) according to thickness, making it easier to identify the appropriate texture for someone with dysphagia. (Read more about the evidence-based IDDSI framework, which is endorsed by both the Academy of Nutrition and Dietetics and the American Speech-Language-Hearing Association in the U.S.)

Thick-It® brand is a gold sponsor of IDDSI.


For safe oral feeding practices, consider the following tips:[vi]

  • Sit upright at 90 degrees when eating and drinking
  • Do not eat or drink when slouched or lying down
  • Take small bites of food
  • Take small sips of fluid
  • Do not gulp drinks
  • Eat slowly
  • Chew foods well before swallowing
  • Make sure you have swallowed your food or drink before taking more
  • Don’t wash down your food with drinks
  • Don’t talk when you have food in your mouth

Remember, staying hydrated doesn’t mean just drinking beverages. Consuming foods with a high liquid content, such as soups, purees or popsicles, can also deter dehydration. Also, thickeners can be added to a desired flavored drink, allowing patients and caregivers to customize flavors to their liking while also supporting hydration.

To find Thick-It® products, including ready-to-drink beverages, purees, and food and beverage thickeners, near you, check our product locator.

[i] Sue Grossbauer, “Medical Nutrition Therapy for Dietary Managers,”, 2014.
[ii] Finestone HM, Foley NC, Woodbury GM, Greene-Finestone L. Quantifying fluid intake in dysphagic stroke patients: a preliminary comparison of oral and nonoral strategies. Arch Phys Med Rehabil. 2001;82:1744–1746. doi: 10.1053/apmr.2001.27379. [PubMed] [CrossRef] [Google Scholar]
[iii] Nutr Healthy Aging. 2017; 4(3): 227–237, Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR, USA. Dec. 7, 2017.
[iv] Nam-Jong Paik, MD, PhD. “How is malnutrition managed in patients with dysphagia?” Medscape, Feb. 23, 2018.
[v] Ibid.
[vi] Linda Nazarko, West London Mental Health NHS Trust, “Maintaining or improving nutrition and hydration in dysphagia,” Independent Nurse. Sept. 14, 2018.

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