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. 2022 Sep;59(9):3627-3633.
doi: 10.1007/s13197-022-05369-5. Epub 2022 Feb 3.

Flow test by the International Dysphagia Diet Standardization Initiative reveals distinct viscosity parameters of three thickening agents

José Vergara  1 , Heloisa Sant'Ana Teixeira  2 , Cinthia Madeira de Souza  3 , Janaina Artem Ataide  4 , Felipe de Souza Ferraz  5 , Priscila Gava Mazzola  4 , Lucia Figueiredo Mourão  2
Affiliations

Flow test by the International Dysphagia Diet Standardization Initiative reveals distinct viscosity parameters of three thickening agents

José Vergara et al. J Food Sci Technol. 2022 Sep.

Abstract

The International Dysphagia Diet Standardization Initiative (IDDSI) flow test is useful for the global standardization of food consistencies of dysphagia patients. In clinical practice, different compositions of food thickeners are commonly used, directly influencing viscosity parameters and swallowing physiology. We aimed to compare the IDDSI thickness levels, remaining volume in the syringe (RVS), and viscosity parameters of three different food thickeners. As a secondary objective, we compared the cost of preparing 100 mL of thickened drinks using the studied thickeners. Thickeners A (xanthan gum), B (corn starch, tara gum, xanthan gum, and guar gum), and C (corn starch) were prepared in increasing concentrations from 1 to 7 g/100 mL and were assayed in quintuplicate using the IDDSI flow test. Thickeners A, B, and C presented statistically different results for the IDDSI levels, RVS, and viscosity parameters at all concentrations. Thickener A reached higher levels in the IDDSI framework, RVS, and viscosity parameters compared with thickeners B and C. A large range of RVS was observed at different concentrations for thickener B compared with C. Regarding viscosity, thickeners B and C, with corn starch in their composition, showed exponential behavior as concentrations increased, while thickener A presented a linear trend. The thickener composition was significantly influenced by IDDSI classification, RVS, and viscosity parameters. The study shows that xanthan gum thickeners present less variability in IDDSI, RVS, and viscosity compared with starch-based thickeners.

Keywords: Deglutition disorders; Thickened liquid; Thickening agent; Viscosity.

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Conflict of interest statement

Conflict of interestThe authors declare that they do not have any conflict of interest.

Figures

Fig. 1
Fig. 1
Flow test of all concentrations of thickener A (A), B (B) and C (C). Bars represent average volume of remaining liquid in syringe (RLS) in mL, and error bars represent standard deviation of quintuplicate. Bars are pattern-filled according to IDSSI level
Fig. 2
Fig. 2
Cost estimation to prepare 100 mL of a thickened drink reaching each IDDSI level for studied thickeners in US dollars. *Cost of preparing 100 mL of a thickened drink.
Fig. 3
Fig. 3
Comparison of viscosity in all concentrations for thickeners A, B and C. Each value is represented as an average with the standard deviation (error bars) of quintuplicate
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