↓ Skip to main content

Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety

Overview of attention for article published in Nutrition Journal, May 2013
Altmetric Badge

About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (97th percentile)

Mentioned by

2 news outlets
31 tweeters
1 patent
7 Facebook pages
1 Google+ user


126 Dimensions

Readers on

278 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety
Published in
Nutrition Journal, May 2013
DOI 10.1186/1475-2891-12-54
Pubmed ID

Julie AY Cichero


Dysphagia is the medical term for difficulty swallowing. Thickened liquids are often used in the management of dysphagia to improve bolus control and to help prevent aspiration. A range of starches and gums has historically been used to thicken liquids. Although thickened liquids improve swallow safety, they appear to have a great potential for unintended physiological consequences. Initial concerns were raised about the impact of thickeners on water binding due to the high prevalence of dehydration amongst individuals with dysphagia. Thankfully, regardless of thickening agent, thickeners do not affect water bioavailability. This effect holds true even for extremely thick fluids. However, bioavailability of medication is impaired with viscous substances. Liquids thickened to as little as 150 mPa.s retards drug release. In addition, feelings of satiety and thirst increase with increasingly viscous fluids. Flavour deteriorates with increasing thickness regardless of thickening agent. Therapeutically clinicians often prescribe small volumes of thickened liquids, consumed often. Yet small volumes of thick substances consumed with a long oral processing time, which is common for individuals with dysphagia, reduces the amount consumed. A combination of poor flavour, and increasing feelings of fullness result in little motivation and poor physiologic drive to consume thickened liquids.This review provides evidence from the dysphagia, pharmaceutical and food technology literature to show unintended side effects of thickened liquids that contribute to dehydration and potential sub-theraputic medication levels for individuals with dysphagia. The physical property of viscosity rather than a particular thickening agent appears to be key. Provision of "spoon-thick" or "extremely thick liquids" is particularly likely to contribute to dehydration and poor bioavailability of solid dose medication. Clinicians are encouraged to prescribe the minimal level of thickness needed for swallowing safety. Consultation with pharmacy and dietetic staff is essential for optimum management of individuals with dysphagia. Given the aged population forecasts for the year 2050, improved dysphagia management should be a high priority.

Twitter Demographics

The data shown below were collected from the profiles of 31 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 278 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 <1%
Unknown 277 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 51 18%
Student > Bachelor 44 16%
Other 26 9%
Student > Ph. D. Student 25 9%
Researcher 22 8%
Other 52 19%
Unknown 58 21%
Readers by discipline Count As %
Nursing and Health Professions 70 25%
Medicine and Dentistry 50 18%
Agricultural and Biological Sciences 26 9%
Pharmacology, Toxicology and Pharmaceutical Science 11 4%
Engineering 9 3%
Other 46 17%
Unknown 66 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 47. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 April 2021.
All research outputs
of 18,382,898 outputs
Outputs from Nutrition Journal
of 1,330 outputs
Outputs of similar age
of 165,680 outputs
Outputs of similar age from Nutrition Journal
of 1 outputs
Altmetric has tracked 18,382,898 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,330 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.2. This one has done well, scoring higher than 86% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 165,680 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 97% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them