Swallowing Solutions for Everyday Life

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Swallowing Solutions for Everyday Life Specialized nutritional products and tips to help manage dysphagia. An advanced thickener for people suffering from dysphagia The Power of Nutrition

The Power of Nutrition Solutions to help manage your dysphagia. Mealtime should be a pleasant experience one that is social, relaxed and natural. However, swallowing difficulties (dysphagia) can make it challenging. Nestlé Healthcare Nutrition is here to help. Through science-based nutritional solutions, we strive to enhance the quality of life for people suffering from swallowing difficulties (dysphagia). Nestlé Healthcare Nutrition offers nutritional products to help modify your diet and make swallowing easier. It is important to speak with a healthcare professional to determine the most appropriate diet for you. Let us help you rediscover the joys of mealtime. We hope you find the following information helpful. Review of dysphagia Breakthrough food & drink thickening powder Thickened beverage products Everyday eating tips

What is dysphagia? Dysphagia (pronounced dis-fay-ja ) is a medical term for the difficulty or inability to swallow safely and efficiently. The swallowing process is made up of 4 phases the first phase starts with your lips and the last phase ends when food enters your stomach. Swallowing dysfunction along any point from your mouth to your throat (phases 1 to 3) can result in food and liquids entering the wrong tube and into your airway. This is known as oropharyngeal dysphagia (or simply dysphagia). Conditions that may cause dysphagia include: Stroke Progressive neurologic diseases, such as Parkinson s, Multiple Sclerosis, ALS or Alzheimer s disease Cerebral palsy Brain injury or tumors Head and neck cancer Injury or surgery to the head and/or neck Symptoms of dysphagia: Difficulty swallowing foods, liquids or saliva Frequent coughing or choking before or after swallowing An urge to swallow repeatedly A wet or gurgly voice, especially after swallowing Unintended weight loss Feel like you have a lump in your throat Food that gets stuck in your cheeks or the roof of your mouth What is Dysphagia? [ ] If you or someone you care for has experienced any of these symptoms, speak with a healthcare professional.

What is Dysphagia? Is dysphagia serious? With the proper diagnosis and healthcareprofessional-recommended dietary modifications including nutritional solutions, dysphagia can be managed. However, if left untreated or undiagnosed, dysphagia can compromise your health, cause less enjoyment of eating and drinking, and lead to embarrassment or isolation in social situations involving eating. Potential health risks if untreated or undiagnosed: Poor nutrition and dehydration: Because weak throat muscles can make eating and drinking challenging, some people skip meals or avoid drinking beverages. This could result in the inability to consume enough foods and/or liquids to maintain proper nutrition and hydration. Aspiration pneumonia or chronic lung disease: Muscles in the throat typically block food and saliva from entering the airway and lungs. But as muscles weaken, food might go down the wrong way into the lungs instead of the stomach and may lead to pneumonia.

Can dysphagia be managed? Yes, but first you must talk to your healthcare professional regarding your swallowing difficulties so that they can properly diagnose your condition. If you ve been diagnosed with dysphagia, you will be given a customized plan that may include exercises to improve swallowing function and a modified diet to make eating and drinking more manageable to help you find pleasure in mealtime again. Types of food that may require modification: Some foods are more difficult for people with dysphagia to swallow, such as: Foods that require a lot of chewing Foods that have many small particles, like seeds Dry and/or crumbly foods Foods that combine liquids and solids Thin liquids such as water and juice Foods that become liquid in your mouth, such as ice cream But that shouldn t stop you from enjoying meals with your friends and family. You might have to avoid some items, but by making small changes you can often continue to enjoy your favorite foods and beverages. 5

Ways to modify food and beverages: With these types of modifications, swallowing can be much safer and more comfortable, and help assure you get the nutrition and hydration you need to maintain your health. Thickening your drinks to a more manageable consistency, reducing your chance of unsafe swallowing Pureeing your food to make it easier to swallow Adding moistening agents, such as gravy, to your food

Based on your condition and the standards set by the National Dysphagia Diet, your healthcare professional will be able to create your diet modification plan, including which liquid and solid food consistencies are right for you. Use this consistency guide to help assure your food and beverages are the proper consistency. Liquid Consistencies 1 : Thin: All beverages are acceptable (no modifications required) Nectar-like: The beverage coats and drips off a spoon, similar to unset gelatin Honey-like: The liquid is thicker than nectar-like and flows off a spoon in a ribbon, just like actual honey Pudding-like: Liquid stays on the spoon in a soft mass and plops off the spoon like pudding Solid Food Consistencies 1 : Regular diet (Level 4): All foods are acceptable Dysphagia advanced (Level 3): Most foods are acceptable with the exception of hard, crunchy, stringy or sticky foods Dysphagia mechanically altered (Level 2): All food should be moist and easily mashed with a fork meats can be ground or chopped into 1/4 pieces or smaller; vegetables should be well cooked and easy to chew Dysphagia pureed (Level 1) All solid foods should be pureed to a smooth cohesive texture without lumps 7

Starch-based thickeners can Complicated to mix May alter the appearance of Clearly, a solution is needed. A non-starch based thickening powder for people suffering from dysphagia.

present many challenges: beverages May give beverages a starchy taste A clearly advanced solution for swallowing needs. The benefits are clear. Tasteless and lump-free No over-thickening with time Mixes clear in clear liquids Improves swallowing safety* 2 Easy to measure Products & Availability * By reducing the risk of aspiration in dysphagia patients compared to thin liquids Consider RESOURCE ThickenUp Clear for adults & children 3 years and older. Learn more at ThickenUpClear.com

Experience the benefits of An advanced thickening powder. Improves swallowing safety: RESOURCE ThickenUp Clear is clinically shown to improve swallowing safety in people suffering from dysphagia by reducing the risk of aspiration compared to thin liquids 2. Easy to use: Easy measuring*: Products & Availability *when mixed with 4 fluid ounces of liquid Easy to consume: No over-thickening over time Easy to serve: No long waiting time; many beverages are ready to drink within 5 minutes Advanced Product Benefits: Mixes and dissolves easily in a wide range of foods and beverages: RESOURCE ThickenUp Clear can be used in beverages hot or cold, protein-containing and acidic Tasteless and odorless: Liquids mixed with RESOURCE ThickenUp Clear do not have alterations in taste or odor 4 Lump-free: It dissolves fully and easily without creating lumps in a wide variety of foods and beverages Remains clear when mixed in water: Starch-based thickener No thickener RESOURCE ThickenUp

RESOURCE ThickenUp Clear. Where to Buy: RESOURCE ThickenUp Clear is also available at NestleNutritionStore.com and select retailers, including: Visit ThickenUpClear.com for a store location For more information call 1-800-422-ASK2 (2752) AMAZON.COM is a registered trademark of Amazon Technologies, Inc CVS/PHARMACY is a registered trademark of CVS/PHARMACY, Inc. drugstore.com is a trademark of drugstore.com, inc. RITE AID is a registered trademark of Rite, LLC Walgreens is a registered trademark of Walgreen Co.

Stay strong with proper nutrition. Nestlé Healthcare Nutrition helps you manage dysphagia through a comprehensive line of nutritional products with modified consistencies. RESOURCE ThickenUp Thickened Water Naturally refreshing with a hint of lemon Fresh water taste with a twist of lemon Can be mixed with instant flavor crystals for flavor variety Honey-like and Nectar-like consistencies Available in 8 fl oz cartons (case of 6 or 24)

RESOURCE ThickenUp Thickened Juice Real fruit refreshment Offers convenience and variety Available in Apple, Orange or Cranberry Juice Cocktail Fortified with vitamin C Good source of calcium to help maintain healthy bones Honey-like and Nectar-like consistencies Available in 6 pack of 8 fl oz cartons or 64 fl oz bottles Find these RESOURCE thickened products and more on www.nestlenutritionstore.com 13

Everyday Tips for More Enjoyable Meals Enjoy Your Meals, Every Day. Rediscover the joys of mealtime. Get pureeing howto s and additional food tips to help make every meal easier and enjoyable. Visit our site for helpful hints and great recipe ideas: www.thickenupclear.com 14

Learn how to puree properly. When pureeing foods, the final consistency should be smooth and thick enough to scoop with a fork or spoon (very similar to that of mashed potatoes). To puree foods properly you ll need the right equipment common items which are probably already in your kitchen. A food processor works best for pureeing foods and achieving the desired consistency. However, a heavy-duty blender or hand mixer will also do the trick. Helpful tips for pureeing to perfection: Make sure the food is tender and cut into small chunks so it can be pureed evenly Drain canned foods thoroughly, but save the liquid in case the consistency needs adjusting during pureeing Use hot, cooked meats, vegetables, casseroles and soups when pureeing. They re softer and easier to puree to the proper consistency If needed, puree with additional liquid until a smooth consistency or paste is formed (typically required for meats, breads and desserts) Add powdered thickener (such as RESOURCE ThickenUp Clear instant thickening powder) if necessary While pureeing, scrape down the sides of the bowl or container to help incorporate any ingredients that get stuck to the side After pureeing, reheat or cool the meal before serving (as necessary) Everyday Meal Tips 15

Know which foods you can eat. This may come as a surprise, but many of your favorite foods can still be part of your diet. Soft foods are a natural choice, but with some simple preparation, many food items can be pureed to a consistency that s safe but more importantly enjoyable. Foods you may be able to consume without any modification or added thickeners: Cereals: grits (creamy), cream of wheat or rice (pudding thickness) Dairy: yogurt (custard style), whipped topping, pudding, thick milkshakes (add thickener to maintain thickness when melted) Fruits: mashed bananas, canned pumpkin, applesauce, smooth canned pie fillings (no chunks of fruit) (continued on following page) Everyday Meal Tips 16

Vegetables: cooked mashed squash, mashed white or sweet potatoes Soups: smooth cream soups (e.g., tomato, cheese, creamy potato); should be thickened to appropriate liquid consistency recommendations Condiments: mayonnaise, sour cream, taco sauce, BBQ sauce, molasses, ketchup, mustard, honey or thick syrups, hollandaise and other cream-based sauces (e.g., cheese, white or smooth tomato) Miscellaneous: refried beans, polenta or corn meal mush, baby food (not runny), jellied cranberry sauce, baby rice cereal (a quick alternative for pureed rice) Some foods that require pureeing before you consume them : Various cooked meats Various cooked vegetables Fresh, frozen or canned fruit Prepared casseroles (e.g., macaroni and cheese, goulash) Meat or egg salads used for sandwich fillings (e.g., chicken, tuna) Soups or stews with soft vegetables and/or meat (e.g., chili, corn chowder) Soft pasta salads Soft cookies, brownies and moist cakes (without nuts, coconut or baking chips) To ensure the correct consistency is achieved, you may need to add a thickener, such as Nestlé Healthcare Nutrition s RESOURCE ThickenUp Clear instant food and drink thickening powder

Visit Us Online. For more tips and information, go to www.thickenupclear.com: Recipes Dysphagia education RESOURCE ThickenUp Clear product description and benefits Product availability at your local retailers 18

A wide range of products to help meet hydration needs and provide consistencies that meet the National Dysphagia Diet standards Many ready-to-use products available in color coded packaging to easily distinguish between honey-like and nectar-like consistencies

Swallowing Solutions for Everyday Life Specialized nutritional products and tips to help manage dysphagia. Reference: 1. National Dysphagia Diet Task Force. National Dysphagia Diet: Standardization for Optimal Care, American Dietetic Association, 2002. 2. Leonard R et al. Poster presentation at the 1st Congress of the European Society for Swallowing Disorders, Leiden, The Netherlands, Sept 9-10, 2011. 3. Nestlé Health Science. Data on file. www.nestlehealthscience.us 1-800-422-ASK2 (2752) Unless otherwise noted, all trademarks are are owned by Société des Produits Nestlé S.A., Vevey, Switzerland. 2013 Nestlé. THCK-11679-1013