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[DYSPHAGIA] thickeners and dehydration...help!

I'm really interested in the topic of thickeners and their relationship 
to dehydration.  I was recently given a sample package of SimplyThick by 
a therapist who had learned of the product at ASHA.  I have had a lot of 
problems with the cornstarch-based thickeners because they change 
consistency as the liquid sits and it is very hard for the parents of the 
kids I work with to get them smooth and unlumpy.   So, when I learned 
about SimplyThick, I wanted to find out more about it.  My major concern 
was the one raised by Irene about its potential to bind with the water in 
liquid rather than release it for use in the system.   I e-mailed the 
company the following question:

>Has SimplyThick been tested to evaluate any limitations from
>binding with the liquid in the sense that it reduces the amount of free
>liquid that the body can utilize? Does it contribute to dehydration?
> This is the problem with using some foods as thickeners.  
>Other products that are specificially recommended for
>thickening liquids etc. promote that they do not create this problem and
>that all of the liquid is freely available to the body.  What can you tell
>me about your product?

I received an immediate response from Matt Knehans one of the founding 
partners of Phagia-Gel Technologies LLC, the developers of SimplyThick.  
He stated:

>There is no evidence that SimplyThick binds liquids.
>There are several studies that have shown that using 23 grams of the
>thickener used in SimplyThick did not cause dehydration in the group tested.
>The group was on the study for over 3 weeks.  To put it in perspective there
>is 1 gram of thickener in one 25 g "Honey" package and 4/10g of thickener in
>a 10g  "Nectar" package.  We believe the claims about the free liquid from
>our competitors is the same as their claims on taste.  We have not been able
>to find similar studies on their "free water" like we found on ours.
>SimplyThick is based on xanthan gum.  Xanthan gum is a fermented product
>from Corn syrup.  It is regarded as non allergenic but a physician should
>make the ultimate decision.  SimplyThick mixes most beverages.  I say most
>because there might be one but we have not discovered it yet.  Our beverage
>claims include; soda, milk, beer, water, hot chocolate.  With Hot Chocolate
>heat the water first, add Simplythick, stir, add hot chocolate mix, stir,
>done.  That is the only product that has a different mixing protocol.  Also
>SimplyThick maintains it's thickness over temperature ranges from freezing
>to boiling.  When a frozen Simplythick ice cube melts is does not separate
>into thick and thin.  It stays SimplyThick.
>Also the Europe just authorized the use of our thickener at a rate of 20g
>per kilogram (2.2 lb.) of infant weight.  We do not claim that our product
>is meant for infants but it does thicken breast milk and formula.

Matt was presenting information on SimplyThick at a meeting at the 
University of Virginia Hospital in Charlottesville last Saturday, and I 
met with him prior to his meeting for several hours to learn more about 
the product firsthand.   I, too, had experienced the "swimming jelly 
fish" phenomenon the first time I mixed SimplyThick with my hot tea, but 
got a very smooth mix when I stirred it into my orange juice the next 
day.  I learned that the product does not mix well when you stir it into 
the liquid with a SPOON.  Since this is how most of us mix in the 
powdered thickeners, using a spoon to stir it is almost automatic. That's 
what I did with my tea.  I got the smooth blend with my orange juice 
because I usually mix a powdered food supplement in my juice and use 
either a fork or small whisk blender to do this.  In response to my 
e-mail request for samples, Phagia-Gel Technologies LLC sent a very 
detailed description of the product and how to mix it successfully.  
(This arrived after my initial trials and meeting with Matt.)   They will 
be including this information with product samples in the future.  Their 
claim that SimplyThick is tasteless is very accurate.   I drank 
nectar-thick and honey-thick water (shaking it up in a bottle to mix it 
well).   I found it very palatable and the thickener did not alter the 
taste at all.  The initial sips challenged my inner belief-filter about 
water always being thin. . . but if I shifted to the belief that water 
could be any thickness, I was very comfortable drinking it.  For me 
that's quite a statement because I'm very picky about the water I will 
drink and can't stand most city water because of the taste of the 
chemicals that are added.

Matt called me this afternoon as a follow-up to our Saturday meeting.   I 
shared with him the concerns that have been expressed on this list about 
the possible binding effect and risk of dehydration with xanthum gum.  
Matt stated again that there was a difference in the way in which xanthum 
gum interacted with water because it is a fermented sugar 
(polysaccharide) product rather than a straight vegetable gum.  However, 
he felt that these questions could be addressed in greater detail by John 
Holahan who is the President of the company.  John has a degree in 
chemical engineering and many years working with companies involved in 
the manufacturing and research on xanthum gum in food applications.   
Matt and John will review the recent questions and comments on thickeners 
in the Dysphagia Mailing List Archives and will join the list in order to 
share research and other knowledge that would help us learn more about 
xanthum gum-based thickeners.  They are also interested in learning more 
from list members about our questions and concerns about these thickeners 
and their use with individuals with dysphagia.

Suzanne Morris
New Visions

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