Updated: Apr. 27, 2021
TikTok's thickened water challenge involves drinking Thick-It, a hydration solution for people with swallowing disorders. Here's why Thick-It may help some people—and why it's a bad idea for the rest of us.
Drinking thickened water: A TikTok challenge
TikTok trends like the viral “nature’s cereal” recipe and Benadryl challenge frequently raise questions about the health and safety of peer pressure on social media.
The latest example is the “thickened water challenge,” which encourages teens and tweens to consume a product called Thick-It, then comment on its taste and texture—often disparagingly.
The challenge shines a spotlight on a nutritional product that many healthy Americans have never noticed, let alone ingested, until now.
Unfortunately, buying up products that seniors and people with swallowing disorders rely on for daily living can cause harm by reducing availability. Viral trends centered around making fun of products with medical use can also add to the stigmatization of certain medical conditions.
Here’s what you need to know about Thick-It, its common uses, and whether doctors recommend it.
What is Thick-It?
Thick-It is a major brand of food and drink thickener. According to the company, the cornstarch-based powder “dissolves instantly in your favorite foods and beverages.” Thick-It is also available as a pre-blended thickened water.
Thick-It is designed for people with dysphagia, a medical term for trouble swallowing.
Thickening agents like Thick-It “help take a thin liquid which is hard to control in your mouth … to a slow-moving, thick substance that stays together, making it easier to control and clear during a swallow,” says Brian Wolfman, MD, a gastroenterology specialist and partner at Coastal Gastroenterology in New Jersey.
Varieties
There are a variety of liquid thickening agents on the market. You can buy Thick-It in many forms:
- powdered thickener
- premixed thickened water
- ready-to-drink bottles of thickened tea, coffee, or juice
Thick-It is also available in two levels of coagulation: nectar (mildly thick) and honey (moderately thick).
Thick-It nutrition facts
Most thickened waters share a similar nutritional profile that uses cornstarch to help liquids gel. Because the thickener is made to be used with a variety of beverages, from water to hot cocoa, the product is usually unflavored.
One cup (8 ounces) of mildly thick ready-to-drink Thick-It contains the following nutrients and Daily Value (DV):
Calories: 5
Fat: 0 g (0 percent DV)
Sodium: 45 mg (2 percent DV)
Carbohydrates: 1 g (0 percent DV)
Calcium: 42 mg (4 percent DV)
mikroman6/Getty Images
Who needs thickened water?
Thickened water is designed to make hydration easier for people with dysphagia, which affects 1 in 25 adults, according to the American Speech-Language-Hearing Association.
Struggling to swallow can manifest in a few ways, according to Dr. Wolfman. He says that for some people, the challenge is directing food toward the back of your throat to start swallowing. For others, dysphagia means that food feels stuck in the throat or chest while swallowing.
Many short-term and long-term medical issues can cause dysphagia, according to Dr. Wolfman.
People with the following conditions might have dysphagia and benefit from Thick-It or similar products:
- Stroke (this is one of the most common, according to Wolfman)
- Neurological disorders
- Some cancers
- Infections
- Anatomical abnormalities
- Damage from swallowing pills the wrong way
- Treatments such as chemotherapy or radiation
It might prevent aspiration
Aspiration is the medical term for inhaling foreign objects such as water or food into your airway. You might think of it as when you start coughing because something “went down the wrong pipe.” Aspiration is a constant concern for people with dysphagia.
Thickened water might be safer for people with dysphagia because the viscosity slows the movement of liquid in the mouth, offering patients more control over the swallowing process.
Dr. Wolfman says thickened liquids can also provide a more distinct feeling of swallow completion.
But the jury’s still out on thickened water: A 2017 preliminary study published in the medical journal Dysphagia suggests that hospital patients who are free to switch between thin water and thickened water do not seem to have a higher rate of aspiration.
It may prevent dehydration
“Dehydration comes from a person’s inability to take in enough water,” Dr. Wolfman says. “Drinking is our main way of staying hydrated, so Thick-It becomes very important in preventing dehydration.”
A 2019 research review in the Journal of Clinical Medicine suggests that though thickened water is a “mainstay” for dysphagia patients, it is only part of the hydration solution. Because thickened water is unappetizing, researchers have found that some patients to avoid drinking it.
Thickened water is no more or less hydrating than thin water. People living with dysphagia simply need to drink enough of it—ideally, the generally recommended minimum of 2 liters (8.5 cups) per day, according to a report in Nutrients—for it to be effective against dehydration.
(These are the things that dehydrate you fast.)
Risks and side effects
“There are no risks to using Thick-It,” Dr. Wolfman says. However, he admits that thickened water is “very unsatisfying” because of its odd texture.
While Thick-It is not inherently dangerous, research published in the Journal of Human Nutrition and Dietetics indicates that the unpleasant nature of thickened water tends to result in dysphagia patients drinking less fluid.
Other ways to stay hydrated if you have dysphagia
In a 2019 research review and opinion piece published in the Journal of Hospital Medicine, one group of doctors countered that thickened liquids are a “[thing] we do for no reason.”
Here’s what they suggest medical professionals should do instead of offering thickened water:
- Allow free access to unthickened water to encourage fluid intake
- Teach people with dysphagia to adapt their posture to facilitate swallowing
- Consider tube feeding when necessary
Water-rich foods can also contribute to overall hydration, according to research published in Nutrients.
Unfortunately, some people with dysphagia have trouble swallowing foods too, according to Dr.Wolfman. Still, for those who can eat solid foods, hydrating foods like these might be helpful:
- Watermelon
- Cucumber
- Mushrooms
- Spinach
- Jicama
Tips for using thickened water
Products such as Thick-It are often stocked in stores based on supply and demand. That means that a surge in demand—like the one triggered by the TikTok challenge—could limit supplies for people who really need the product. So, it’s best not to buy up nutritional liquid thickeners unless you truly need them because of dysphagia.
If you do need liquid thickener, follow the best practices from the University of Iowa Hospitals and Clinics:
- Avoid adding ice cubes to thickened water. Melting ice will affect the remaining liquid’s texture.
- Always follow the instructions and measurements on the thickening agent’s label.
- To thicken broth, instead of using thickened water try adding food items such as instant potato flakes, pureed vegetables, or dairy products such as cream or melted soft cheese.
- Stock up on single-serving powdered thickeners to take with you when traveling or eating out at restaurants.
When to see a doctor
If you’re having trouble swallowing, do not self-diagnose and self-treat with thickened water. Check with your doctor before drinking Thick-It or other thickened beverage products.
Dr. Wolfman says sudden difficulty swallowing could indicate a medical emergency such as a stroke. He adds, “If someone does have issues swallowing, it is never considered normal, even in very elderly people. Seek medical attention as soon as possible.”
Next, find out if you’re drinking too much water.
