Physicochemical modulation and clinical validation of dysphagia-specific foods: a review and outlook toward precision nutrition.

Oropharyngeal dysphagia (OD) increases the risks of malnutrition and aspiration in ageing and clinical populations. Although texture-modified foods (TMFs) have been extensively studied, their development has largely relied on in vitro rheological and tribological parameters with limited predictive value for in vivo swallowing performance. This review summarizes recent advances in dysphagia-specific foods, including rheological and tribological modulation, multi-component protein-polysaccharide systems, emerging technologies such as three-dimensional (3D) food printing, and recent progress in clinical validation. Current evidence indicates that rationally engineered food structures can improve or maintain swallowing safety. Recent clinical studies have expanded evaluation beyond instrumental swallowing outcomes to include long-term clinical endpoints and real-world implementation; however, robust evidence linking physicochemical properties to patient-centered clinical benefits remains limited. Based on these findings, we propose a translational paradigm linking in vitro material design, instrumental swallowing assessment, and clinical outcome evaluation within the International Dysphagia Diet Standardization Initiative (IDDSI) framework.