Gel-Based 3D Food Printing for Dysphagia Management: Advances in Personalized Nutrition, Texture Control, and Clinical Translation.

Dysphagia and age-related oral processing limitations are rising with population aging and the growing burden of neurological diseases. Texture-modified diets remain the most common non-pharmacological intervention, yet conventional pureeing and thickening often yield meals with low visual appeal, variable textures, and diluted nutrient density, which contribute to reduced intake and malnutrition risk. Extrusion-based three-dimensional food printing, especially when combined with gel-derived edible inks, offers a digital route to standardize geometry, portioning, and texture while enabling individualized nutrition and sensory design. In the past three years, the field has progressed from simple single-ingredient pastes to engineered soft-matter systems including emulsion gels, high-internal-phase emulsion gels, Pickering-stabilized gels, bigels, and multi-material constructs enabled by dual and coaxial printing. These advances are underpinned by improved rheological windowing, microstructure engineering, and post-print gelation strategies such as ionic crosslinking, thermal setting, enzymatic bridging, and pH-triggered network formation. Meanwhile, dysphagia-oriented product development has matured from "shape recovery" demonstrations toward clinically relevant texture targets, leveraging the IDDSI tests to anchor swallowability. This review synthesizes the recent literature across materials science, food engineering, and clinical nutrition to connect gel microstructure to extrusion performance, post-processing stability, and oral processing outcomes that are relevant to older adults and dysphagia patients. We propose design principles for gel network selection, phase structuring, and process control that simultaneously satisfy print fidelity and swallowing safety targets.