CNS- Campus Neurológico Sénior, Torres Vedras, Portugal.
Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Nutr Clin Pract. 2020 Aug;35(4):649-654. doi: 10.1002/ncp.10408. Epub 2019 Sep 5.
Clinical management options for dysphagia include the use of thickeners to increase the consistency of liquids. Health professionals may not be aware of the nutrition value of these products, since there are no such recommendation in clinical guidelines. Our aim was to estimate the added nutrition value of the 2 types of commercial thickeners (starch and xanthan gum) to daily nutrition intake and compare their nutrition value for nectar, honey, and pudding consistencies. Additionally, we compared the nutrition value of both thickeners with a high-energy powder, since they share the same main ingredients.
We collected recommended dosages for obtaining the 3 different consistencies and nutrition content from the technical food labels. Daily intake of fluids was estimated from the Portuguese National Food, Nutrition and Physical Activity Survey. Total daily amount of thickener needed was estimated, as well as their correspondent nutrition contributions.
Estimated daily fluid intake was 2439 mL. Starch thickeners provide significantly more energy at all consistencies than xanthan gum provides (423-846 kcal, P < 0.05, and 103-308 kcal, P < 0.05, respectively). Significantly more fiber is provided by xanthan gum thickeners (9 g in nectar and 27 g in pudding consistencies, P < 0.05). Median energy and carbohydrate values per 100 g of high-energy powder modules and starch thickeners are similar.
The nutrition value of thickeners should be routinely considered in the nutrition assessment and planning of patients with dysphagia for liquids, since they contribute significantly with energy, carbohydrate, and fiber.
吞咽困难的临床管理选择包括使用增稠剂来增加液体的稠度。由于临床指南中没有此类建议，健康专业人员可能不知道这些产品的营养价值。我们的目的是估计 2 种商业增稠剂（淀粉和黄原胶）对日常营养摄入的附加营养价值，并比较它们在花蜜、蜂蜜和布丁稠度下的营养价值。此外，我们将这两种增稠剂与高能粉末进行了比较，因为它们含有相同的主要成分。
我们从技术食品标签中收集了获得 3 种不同稠度和营养成分的建议剂量。从葡萄牙国家食品、营养和体力活动调查中估计了日常液体摄入量。估计了每天所需的增稠剂总量及其相应的营养贡献。
估计的日常液体摄入量为 2439 毫升。在所有稠度下，淀粉增稠剂提供的能量明显多于黄原胶增稠剂（423-846 千卡，P<0.05 和 103-308 千卡，P<0.05）。黄原胶增稠剂提供的纤维明显更多（花蜜中 9 克，布丁中 27 克，P<0.05）。每 100 克高能粉末模块和淀粉增稠剂的能量和碳水化合物中位数值相似。
在对液体吞咽困难患者进行营养评估和计划时，应常规考虑增稠剂的营养价值，因为它们会显著增加能量、碳水化合物和纤维的摄入量。
