For 1 in 7 adults, even eating can be a challenge due to dysphagia
There is a silent, often overlooked challenge facing a growing number of Singaporeans—one that strikes at the core of everyday life: the ability to eat.
Many of us look at food as something to enjoy, from its colors and smells to its taste, and we often take it for granted.
But for an estimated one in seven senior citizens in Singapore, or about 174,000 seniors, eating is not always fun. These people suffer from a condition called dysphagia, the medical term for difficulty chewing or swallowing, which can turn eating into a daily challenge.
In recent years, there have been programs that try to make food more included in people with dysphagia, but how effective is it?
When the bite becomes dangerous
Dysphagia is not solved by simply “eating less.”
As the muscles involved in swallowing weaken with age or due to degenerative diseases, food can accidentally enter the airway instead of the esophagus. This can cause suffocation, dehydration, aspiration pneumonia, and, in extreme cases, malnutrition.
Eating, for many seniors, is no longer automatic and requires more attention—the texture, moisture, and composition of the food matter altogether.
By 2030, one in four Singaporeans will be over 65, meaning the number of people affected by dysphagia will grow exponentially—and it can affect anyone.
Food doesn’t just happen in hospitals. It happens in shopping centers, coffee shops, and family dinners. Yet most food places are built on a silent assumption: everyone can chew and swallow. That thinking works until it doesn’t.
Despite its prevalence, dysphagia has remained a silent problem in Singaporean food culture until recently.
Early trials of dysphagia
Singapore has taken steps in recent years to address this problem.
In 2021, speech therapists at Alexandra Hospital are training 24 hawkers in Queenstown to chop, grind, or mix dishes when requested, giving people with dysphagia access to standard vendor food safely and at no extra charge.
This initiative was the first part of a wider awareness and initiative to provide dysphagia-friendly options outside of hospitals.
In 2022, the Ministry of Health’s EatSafe SG program adopts the framework of the International Dysphagia Diet Standardization Initiative (IDDSI) to standardize structure and training, reducing the risk of choking in health care and community care settings.
In addition, from 2023, organizations such as St Lukes Hospital began offering workshops to equip health care workers and food processors with the skills to prepare and test modified foods for people with dysphagia.
In 2024, in line with national initiatives such as EatSafe SG, the Singapore University of Social Sciences (SUSS) is partnering with the Hong Kong-based social enterprise Project Futurus to test the Sensory Restaurant on Wheels initiative, a sensory-led, immersive dining experience for more than 90 seniors, 1260 care sector participants, and 126 volunteers.
Alongside three elderly care workers—Catholic Welfare Services’ St. Joseph’s Home, the Methodist Welfare Services Bethany Nursing Home, and the Salvation Army Peacehaven Nursing Home—SUSS and Project Futurus also launched another initiative: the Captain Softmeal™ program, to teach participants to prepare soft drink versions of the appearance of local flavors and familiar spices.
Using Japanese softmeal enzyme techniques, the local food is safe to swallow and, most importantly, still enjoyable.
General discovery
Despite these efforts, there is no doubt that regular restaurants have provided few options for those with dysphagia who would like to eat, limiting social participation and nutrition.
Earlier this year, Singapore took another step in this direction to change that.
Building on its previous efforts, SUSS tested dysphagia-friendly menus at mainstream restaurants such as Imperial Treasure and 5 Senses Café & Restaurant. Adults enjoyed the classics—Hokkien Mee, bean stew and ground beef, kaya toast—over a two-day pop-up from 12-13 Jan 2026.
Dishes have been thoughtfully reimagined as soft foods by chefs to make them easier and safer to swallow without compromising taste, presentation, or dining experience. Following IDDSI guidelines, chefs adjust the softness, moisture, and consistency so that food doesn’t break down dangerously or run off too quickly.
The impact goes beyond safety. When one person at the table struggles to swallow, the social experience changes.
By adjusting the structure, this initiative allows the elderly to eat out of society, with family and friends, while ensuring that they get enough food and enjoy their meals. This is a promising alternative to regular porridge and oatmeal, and it maintains dignity and participation at the table.
The founder of 5 Senses, Shaun Foo, shared a personal anecdote from his wife’s grandfather, who said, “I’m waiting to die. [because of the lack of food options available for dysphagia patients].”
This is why he believes that food is “more than food” – working on this pilot has allowed the 5 Senses team to better understand the needs of diners with swallowing problems. “It showed us that we can fine-tune our preparation processes and facilities—making food more inclusive without changing its essence,” he added.
Following the pilot, participating restaurants may continue or adapt this offer in ways that best suit their operations and customers.
Widespread adoption is easier said than done
Widespread adoption of dysphagia-friendly foods is easier said than done.
It’s more than processed ingredients—under IDDSI guidelines, foods must hold their shape without spoiling, stay moist enough to swallow safely, and avoid breaking into unexpected pieces.
It’s a lot of work for chefs—they’ll have to adjust cooking times, moisture levels, binding, and plating, all while maintaining flavor and visual appeal. In addition, time needs to be spent on training employees to understand and manage these new requirements.
Given that restaurants often operate in a high-pressure environment, introducing new menu categories or special preparations can pose practical operational challenges. Therefore, whether dysphagia-friendly diets can be widely maintained outside pilot settings remains to be seen.
But there is reason for hope. SUSS efforts have already involved over 3,000 beneficiaries in all its social programs. The pilot showcases proof of concept, drawing on research, care services, and F&B partners to lay the groundwork for mainstream adoption as Singapore prepares for an increasingly aging population.
As Singapore heads towards 2030, the question is no longer whether dysphagia will affect someone we know, but whether our food culture, chefs, and restaurants are ready when it does.
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Featured Image Credit: SUSS/ The Project Futurus
