Effect of 3D-Printed Texture-Modified Foods on Eating and Nutrition for Older Adults in Aged Care Homes

This is a 3-day crossover randomised controlled trial (RCT) with 44 participants will be conducted in aged care homes operated by Brightwater residential aged care sites Inglewood and Onslow Gardens. This design allows each participant to serve as their own control, minimising individual variability. Participants will be recruited from Brightwater age care homes and randomly assigned to one of two groups (namely intervention-control [group A] or control-intervention [group B]. Nutrient dense and visually appealing 3D-printed texture-modified food used in this study will be developed by the research team, ensuring full compliance with the International Dysphagia Diet Standardisation Initiative (IDDSI) guidelines and all aged-care food safety and quality standards. We will enhance the visual appeal of the texture modified food by 3D-printing the texture-modified food into attractive and recognisable shapes specially developed for this study. To further improve nutrition, colour, and flavour, we will use freeze-dried natural fruits and vegetables instead of gums, making the dishes more appealing and wholesome. In addition, the 3D-printed food will be plated with IDDSI compliant smooth puree garnishes to make the plate look presentable and appetising. In the first 3 days of 1st week of 3 week cyclic menu, Group B participants will be given the standard IDDSI Level 4 pureed texture modified food(TMF) appetizer along with their normal meals provided by Brightwater facilities(control), while Group A participants will be given 3D-printed (International Dysphagia Diet Standardisation Initiative) IDDSI Level 4 pureed appetizer and their normal meals provided by Brightwater facilities (intervention) for 3 days. Then 2 weeks washout period will be followed to minimize potential carryover effects related to sensory perception and food preferences. In the second intervention phase (crossover phase) which is 1st week of cyclic menu, the groups will switch to the alternate treatment: group B to intervention and group A to control. The 3D-printed texture- modified food will be provided once daily during lunch on each of the three intervention days, while the control group will receive standard texture-modified food at the same meal. Adherence will be monitored by the research team by weighing and recording the weight of plates before and after lunch to measure the amount of intervention food consumed. All the assessments will be randomized and carefully measured. All materials (e.g. recipes, tip sheets, etc) were specifically developed for this study.