“It’s disheartening for my mom to eat bland blended food,” said Singaporean tour guide Siwa Misir, 60, who cared for his mother with dysphagia. “And each time she choked, we panicked.”
His experience reflects two common challenges: choking risks and the loss of dignity when meals are reduced to unrecognisable purées.
Innovations like MAKANsoft, a new food texturant, aim to address both by improving the taste, appearance and safety of texture-modified foods.
A halal texturant for diverse foods
One key gap in the market is the lack of halal-certified texturants suited to Asian foods.
“Asian cuisine is diverse, and seniors with dysphagia still want to enjoy local favourites like nasi lemak, chicken rice and char kway teow. But many existing texturants are not suitable for Muslim consumers because they are not halal,” said Dr Verena Tan, Associate Professor and Programme Leader for Dietetics and Nutrition at the Singapore Institute of Technology (SIT).
Foods like bubur cha cha, once blended, lose their original appearance, while satay and nasi lemak are reduced to coloured purées or liquids.
MAKANsoft aims to change that by allowing puréed dishes to be reshaped into forms that resemble their original appearance, restoring a sense of familiarity to meals.
SIT is now working with B2C and B2B partners to bring such products into retail.
MAKANsoft enables puréed foods to be moulded into familiar shapes while remaining compliant with IDDSI Levels 4 and 5.
It was developed under the DIGNIFIED programme, a multidisciplinary initiative led by SIT and supported by the Agency for Science, Technology and Research (A*STAR), which addresses how seniors with chewing and swallowing difficulties can continue to enjoy meals.
What is IDDSI?
The International Dysphagia Diet Standardisation Initiative (IDDSI) framework classifies food and drinks into eight levels (0–7) to ensure safety for people with swallowing difficulties.
- Level 0 – Thin: Regular liquids such as water, flow quickly
- Level 1 – Slightly thick: Thicker than water, similar to infant formula
- Level 2 – Mildly thick: Sippable with some effort, like nectar
- Level 3 – Moderately thick / Liquidised: Can be drunk or eaten with a spoon
- Level 4 – Extremely thick / Puréed: Smooth, holds shape, no chewing required
- Level 5 – Minced & moist: Soft, small lumps (≤4mm), minimal chewing
- Level 6 – Soft & bite-sized: Tender, bite-sized pieces (≤1.5cm)
- Level 7 – Regular / Easy to chew: Normal foods, adapted for ease of chewing
This standard helps caregivers, healthcare providers and food manufacturers ensure consistency, safety and appropriate nutrition for dysphagia patients.
Market gaps for texture-modified foods
Texture-modified foods address broader gaps in caregiver support, healthcare safety, and ageing-related quality of life.
Support for caregivers
Consistently modified foods remove the guesswork in determining texture, with products labelled according to IDDSI levels.
This is especially helpful for home caregivers, who are often simply told to “blend the food” without clear guidance.
“No one taught us what’s the correct texture. Some maids could be scared because they could be scolded or get into trouble for not blending the food properly,” said Misir, who hired a domestic helper to care for his mother.
It similarly supports healthcare service providers.
For nursing homes and hospitals, they need convenience and consistent quality. It is also a safety issue to feed people with swallowing problems the wrong texture.
“When elderly patients choke, they can die – that’s a medical liability that can be avoided,” said Dr Tan.
This also helps ease the emotional strain on caregivers, who often struggle when loved ones reject food and face nutritional decline.
Addressing malnutrition among the elderly
Malnutrition remains a significant issue among the elderly, with an average global prevalence of 18.6%, according to a Public Health in Practice study.
Africa had the highest percentage of malnutrition at 35.7%, followed by America at 20.3%, Europe at 19.8%, Asia at 18.3%, and Australia at 13.4%.
For seniors with dysphagia, the problem is further compounded.
“People with swallowing problems rely on purée but eating it every day would make anyone lose their appetite eventually,” Dr Tan said.
“We eat with our eyes. Even people with dementia can still recognise good food, so maintaining that sense of identity is important.”
She added that balancing taste and safety is critical, noting that achieving the right consistency required extensive testing and input from a team of experts including speech therapists and sensory scientists.
“We also tested it on an elderly panel to make sure it tastes good, because taste is the number one driver for repeated consumption.”
MAKANsoft offers a way to create safe textures without diluting flavour, unlike conventional puréeing with water.
For Misir, who was part of the MAKANsoft tasting panel, the visual form of food was preserved well during serving and the flavour of each dish were close to the originals.
“Even though the food is soft and melts in your mouth, its shape still shows what you’re eating. For example, the texture-modified satay, you can still taste the spiciness and a bit of the peanut flavour,” he said.
Misir’s mother passed away in 2024, but he never forgot the emotional challenges for his mother and himself. He is hopeful that innovations like MAKANsoft will help restore some enjoyment and dignity to patients with dysphagia, as well as help them get the much-needed nutrition. As populations age, this will become a more pressing issue to address.
Global market potential
Population ageing is accelerating globally. A 2025 WHO report noted that people aged 60 and above already outnumber children under five and will make up 22% of the global population by 2050.
There is strong market potential for texture-modified foods in Asia, particularly in Japan and South Korea, where demand for senior-friendly products is growing, said researchers in The International Journal of Environmental Research and Public Health.
“Texture-modified foods offer food companies the opportunity to tailor-make products with soft textures because the products for this market segment have been slow to appear in Europe,” they said.
Texture-modified foods may also benefit other groups, including post-surgery, cancer or stroke patients with swallowing difficulties.
While innovations like MAKANsoft show promise, adoption remains limited as many markets have yet to prioritise dysphagia nutrition despite rising demand.
Overcoming negative perceptions and raising awareness for elderly nutrition
“Good nutrition reduces infections and hospitalisation, which in turn lowers healthcare costs, so resources should be channelled there,” said Dr Tan.
“However, there is still a perception that investing in elderly nutrition is not important – why spend more to feed an old person who only has a few more years left to live?”
She stressed that this is the wrong mentality – it is important to start paying more attention to how we sustain the elderly because we are essentially future-proofing ourselves.
Dr Tan said improving the quality of texture-modified meals is not prohibitively expensive, costing as little as an additional SG$2 (US$1.6) per person per day in senior care settings, particularly when scaled.
“We’re all going to age and we’re all going to have the same problems eventually,” she said. “Future-proofing ourselves – that’s what I’m trying to do, so I can still enjoy ice cream and satay when I’m old.”
