Collaboration of design researchers with a) care institutions that see the need for the innovation and b) a company that is interested in upscaling the innovation is key for the innovation to be lifted from being ‘just a concept idea’ towards a breakthrough innovation going to market. The collaboration itself is therefore a key driver for impact.

The project was a combination of:

• Product development: recipe development, 3D design, testing the recipes in the 3D food printer, testing the heating stability of the products, and testing the products with the speech therapists (who are also specialist in dysphagia issues);
• Testing the prototypes with elderly people with dysphagia (due to Huntington’s, Multiple Sclerosis as well as due to an event or accident), and;
• Testing the products and their impact with a broad group of stakeholders in the care homes like nutrition assistants, chefs, speech therapists, and caregivers.

The project focused on a series of results: 

1. Recipes and forms that were acceptable as 3D printable, safe to eat and tasty prototypes. These results were mostly derived from testing in the laboratory of recipes with different food purees, the use of various types of thickeners for water binding, in order to find the best taste and mouthfeel and in order to keep the product from sagging during heating after 3D printing and freezing.
2. Another important result was that the products did not form a skin upon heating, as this is not safe to eat for people with dysphagia.
3. In order to test the prototypes we needed a group of people with dysphagia, willing to test the products. This meant a great deal of time was spent preparing for the test in care homes. This part of the research was focused on organizing all the logistics of the test, informing all the stakeholders about the test, acquiring enough participants for the tests, organizing consent forms, 3D printing enough product for the tests, organizing meal butlers to heat the products before tasting, designing the questionnaires, etc.
4. In order to find out how 3D printed food can impact the wellbeing of people with dysphagia, a group of stakeholders should test the 3D printed products. This meant that we had to find out which people were stakeholders, to interest them in this project and to invite them in separate focus groups, to organize the focus groups, to design the questionnaires, etc. 

The impact of this project was clear from the start: although the resting homes do not have a high number of clients with dysphagia, living with dysphagia means mostly that you eat food that is ground and that is often mixed together. This means that it often tastes and smells like nothing you want to eat (see photo). The participants have told us that they greatly miss good food, and eating is not so enjoyable on the whole, which can result in weight loss and life deterioration. In the past, nursing homes have tried to improve the quality of eating for these people, but there is no easy solution as yet. All the stakeholders told us that 3D printed food could be a solution, when and if the products can be of guaranteed quality. There is a great potential impact therefore on the health and wellbeing of people with dysphagia. 

A different impact comes from the commitment of Gastronology to upscale the production of the 3D printed food for people with dysphagia. The project is of considerable impact on the feasibility of their own venture, and that venture itself is a key factor for the future of 3D food printed food in the Netherlands and the world. 

Evaluating the whole project, good experience was found in involving all stakeholders of people with dysphagia, as well as working with a company that wants to market 3D printed food. After all, that is the reason for doing this research in the first place: to help stimulate innovation in food for those who need it, as a driver for impact. All partners were highly motivated from the start to end, although Covid 19 naturally delayed our project. It was difficult to find enough participants, which meant a change in our original test plan. Due to the highly innovative nature of the project, Gastronology did not wish to exchange their recipes with ours, which meant extra energy in producing recipes and forms. Throughout the project, collaboration with all partners was good, and the tests were performed smoothly mainly due to the central organization by the groups of students working 5 days a week on the project, supervised by HAS researchers and 3D printing experts.

Several challenges that were not solved with this project but which are key for the further success of 3D printed food for dysphagia, is upscaling the speed of printing and the acceptance of the higher cost of 3D printed food products. The CEO of Gastronology reports that upscaling is well underway and the prospects are good. They hope to have a product on the market soon.

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