If you’re caring for someone with dysphagia or dealing with swallowing difficulties yourself, you’ve probably heard healthcare providers throw around terms like liquidized foods vs. thickened liquids. At first glance, they might seem like the same thing; aren’t they both just thick, modified textures? However, some important differences can make a significant impact on daily life, even affecting nutrition, ingredients, and meal satisfaction.
Luckily, the International Dysphagia Diet Standardisation Initiative (IDDSI) provides a comprehensive framework that helps clarify these distinctions, and today, in this article, we will break down the explanation for you.
Differences Between Liquidized Foods and Thickened Liquids
While liquidized foods and thickened liquids might look similar when you’re staring at them in a bowl or cup, the differences become pretty clear once you understand what you’re looking at. Here are the main ways liquidized foods vs. thickened liquids differ from each other.
1. Thickness Level
The IDDSI system works like a numbered scale from 0 to 4, where 0 is regular thin water and 4 is extremely thick. What’s cool is that liquidized foods at levels 3 and 4 actually have the same thickness as thickened liquids at those same levels, as explained on this infographic below:
According to Cichero et al. (2017), this standardization ensures that individuals with dysphagia receive appropriate texture modifications regardless of their location or care provider.
2. Texture and Flow
When healthcare providers refer to thickened liquids, they typically mean levels 1 (slightly thick) or 2 (moderately thick). These maintain liquid properties while providing increased viscosity for safer swallowing. The texture flows smoothly off a spoon but moves more slowly than regular liquids.
For thickened liquid levels 3 or 4, people often call them liquidized foods instead. Level 3 liquidized foods should be smooth and liquid-like with no lumps. You can’t eat it with a fork, but it flows off a spoon.
Level 4 is more like a pudding consistency that holds its shape on the spoon but still spreads when you apply pressure.
3. Preparation Methods
Both liquidized foods and thickened liquids can use commercial thickening products, but how you make them is pretty different. For thickened liquids, you’re typically just mixing a thickening powder into drinks like water, juice, or coffee. It’s straightforward and quick.
Commercial thickeners can also work effectively on liquidized foods, but they often require blending real ingredients like flour, cream, or butter to achieve the desired consistency. A lot of people prefer this option too, as it can make the food tastier!
4. Food or Drink Preferences
Individual preferences play a significant role in choosing between these options. Some people love their fruits and vegetables as smoothies or thickened drinks because they get that fresh, natural flavor. It’s like having a healthy, fresh smoothie, but safer to swallow.
However, when someone prefers foods with complex flavors and familiar comfort meals (like potato mash, curry, or pie fillings), they typically prefer liquidized food preparations.
The choice depends on how severe someone’s swallowing difficulties are and what they can handle safely, which is why understanding your severity level of dysphagia is important.
Here’s a table to sum up the differences between liquidized foods and thickened liquids:
| Aspect | Thickened Liquids (Levels 1-2) | Liquidized Foods (Levels 3-4) |
| Consistency | Slightly to moderately thick | Smooth liquid to pudding-like |
| Preparation | Add thickener to beverages | Blend foods, and may add a thickener |
| Texture | Flows readily, liquid-like | May hold shape, spoon-thick |
| Use Cases | Beverages, medications | Complete meals, complex flavors |
| Chewing Required | No | No |
| Utensils | Drink from a cup/straw | Spoon feeding typically |
How to Analyze When You Need Liquidized Foods or Thickened Drinks
The truth is, you shouldn’t be guessing about this stuff. A speech-language pathologist needs to do a proper swallowing assessment to figure out what’s safest. They’ll look at how severe the dysphagia is, which part of swallowing is affected, and what someone can tolerate.
Key considerations to choose between liquidized foods or thickened liquids usually include:
- Swallowing assessment results: Professional evaluation determines safe consistency levels
- Nutritional needs: Liquidized foods may provide better nutritional density for complete meals
- Personal preferences: Some individuals tolerate certain textures better than others
- Practical considerations: Preparation time, cost, and availability of ingredients
- Medical stability: Changes in condition may require consistency adjustments over time
Do You Need To Use a Food Thickener?
The decision to use commercial food thickeners needs careful consideration of both benefits and limitations. While thickened liquids improve swallow safety, they can affect medication effectiveness and may affect your satisfaction after eating (Clave et al, 2013).
However, you don’t need to worry much, because products like SimplyThick can be really helpful because they give consistent results every time. You measure, mix, and know exactly what thickness you’re getting. If you don’t like using thickeners on your foods/drinks, alternative approaches like using naturally thick foods or pureed ingredients may work better. These are the pros and cons of using either commercial or do-it-yourself thickener:
Commercial Thickener Pros and Cons
Pros:
- Consistent thickness every time
- Scientifically tested, safe and proven with multiple clinical tests
- Quick and easier to prepare
- Usually lasts longer than natural ingredients
Cons:
- Can affect medication absorption
- May taste artificial
- Additional costs to buy a thickener (instead of using ingredients at home)
DIY Thickener Pros and Cons
Pros:
- Better taste acceptance
- More flexibility to modify taste
- Cost-effective with proper preparation
Cons:
- Thickness may be inconsistent
- Requires practice and repetition before getting it right
- Longer preparation time
- Limited shelf life
Living with dysphagia doesn’t mean giving up on enjoying food and drink. Whether you end up with liquidized foods or thickened liquids, the goal is finding solutions that keep you safe while still making mealtime something to look forward to. The key is working with professionals who understand your specific situation and can help you navigate the options available.
For more practical tips and strategies that make living with dysphagia easier and more enjoyable, check out DysphagiaLiving.com. You’ll find comprehensive guides that help turn the science into real-world solutions that work in everyday life.
Need more guidance? This article might also help you: How To Do IDDSI Flow Test at Home (Using Syringe and the Alternatives).
References
- Cichero, J. A., Lam, P., Steele, C. M., Hanson, B., Chen, J., Dantas, R. O., … & Stanschus, S. (2017). Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: The IDDSI framework. Dysphagia, 32(2), 293-314. Available at: https://link.springer.com/article/10.1007/s00455-016-9758-y
- Clavé, P., De Kraa, M., Arreola, V., Girvent, M., Farré, R., Palomera, E., & Serra-Prat, M. (2013). Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety. Nutrition Journal, 12(1), 54. Available at: https://pubmed.ncbi.nlm.nih.gov/23634758/
- Leonard, R. J., Ayala, G., Sánchez, E., Alcala, J., & García, J. (2021). Thickened liquids using pureed foods for children with dysphagia: IDDSI and rheology measurements. Dysphagia, 36(5), 851-862. Available at: https://pubmed.ncbi.nlm.nih.gov/33954811/
