Rheological and Technological Design of Texture‐Modified Food Systems for Dysphagia Management in Amyotrophic Lateral Sclerosis

ABSTRACT

Amyotrophic lateral sclerosis (ALS) is frequently accompanied by progressive dysphagia, weight loss, and hypermetabolism, which complicate the maintenance of adequate nutritional status. For these patients, food systems must not only provide sufficient energy and protein within a limited volume but also exhibit textural and rheological properties that support safe swallowing. This review analyzes technological and rheological approaches to the design of texture‐modified food systems for nutritional support in ALS. Particular attention is given to apparent viscosity, shear‐thinning behavior, yield stress, structural homogeneity, and storage stability as parameters affecting bolus formation, swallowing safety, and product performance. The relevance of the International Dysphagia Diet Standardization Initiative framework for classifying food textures and liquid consistencies is also considered. The review further examines the functional and technological roles of animal‐ and plant‐based raw materials, including regional raw materials, in the formulation of energy‐dense and structurally stable foods. Proteins, lipids, hydrocolloids, starch gels, and polysaccharide networks are discussed as key components for controlling texture, viscosity, gelation, emulsion stability, and nutritional density. Technological strategies such as homogenization, emulsification, protein‐based structuring, hydrocolloid thickening, high‐pressure homogenization, and 3D food printing are considered in relation to their potential for developing safe, acceptable, and locally adaptable products for patients with ALS‐related dysphagia. The findings highlight the need to integrate food texture science, rheological control, nutritional adequacy, sensory acceptability, and regional availability in the development of clinically relevant texture‐modified foods.

This review summarizes technological and rheological approaches to designing texture‐modified food systems for patients with dysphagia in amyotrophic lateral sclerosis. Key parameters such as viscosity, stability, and energy density are identified to support safe swallowing and effective nutritional support.

1. Introduction

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterized by the degeneration of upper and lower motor neurons, leading to muscle weakness, atrophy, and loss of motor function (Feldman et al. 2022). As the disease progresses, most patients develop dysphagia (Raheem et al. 2021; Hadde and Chen 2021; Schmidt et al. 2021; Sungsinchai et al. 2019), which significantly limits oral food intake and increases the risk of malnutrition.

Malnutrition in ALS is considered not only a consequence of the disease but also an independent prognostic factor associated with faster disease progression and reduced survival (Marin et al. 2011). Patients with ALS often exhibit hypermetabolism (Dupuis et al. 2011), characterized by increased energy expenditure even at reduced levels of physical activity. In combination with dysphagia, fatigue, and decreased appetite, this leads to a persistent negative energy balance that is difficult to compensate for with conventional diets (Dupuis et al. 2011).

In clinical practice, nutritional support for ALS patients is primarily provided through commercial enteral formulas intended for oral or tube feeding (Muscaritoli et al. 2012; Burgos et al. 2018; Wills et al. 2014). These products are characterized by standardized composition, controlled rheological properties, and high energy density. However, their use is associated with several limitations, including high cost, limited accessibility, and insufficient adaptation to regional dietary habits, particularly in home‐care settings.

There is a growing need for the development of specialized food products for the nutritional support of ALS patients in non‐clinical settings, which represents an important challenge in food science and technology. Such products should combine high energy and protein density with controlled textural properties to ensure safe and comfortable consumption in the presence of swallowing disorders.

Texture‐modified foods play a key role in this context. The International Dysphagia Diet Standardisation Initiative (IDDSI) provides a standardized framework for classifying food textures and liquid consistencies (IDDSI 2019), enabling the development of products tailored to the needs of patients with dysphagia. Ensuring appropriate rheological properties, structural stability, and homogeneity is critical for both safety and consumer acceptability (Raheem et al. 2021; Hadde and Chen 2021; Schmidt et al. 2021; Sungsinchai et al. 2019).

At the same time, the use of regional raw materials represents a promising approach for developing accessible and culturally adapted specialized products. Central Asian countries, including Kazakhstan, possess a diverse raw material base, including horse meat, dairy products, cereals, and vegetable oils with significant nutritional and technological potential (Lorenzo et al. 2014; Lorenzo et al. 2017; Nayik et al. 2024; Rout et al. 2024; Wang and Ellis 2014). However, their application in the development of texture‐modified foods for dysphagic patients remains insufficiently explored.

Figure 1 illustrates the conceptual framework linking ALS pathophysiology with the development of malnutrition and the main approaches to its correction from the perspectives of clinical nutrition and food technology (Muscaritoli et al. 2012; IDDSI 2019; Raheem et al. 2021).

FIGURE 1.

Conceptual framework for the design of texture‐modified food systems for nutritional support in patients with amyotrophic lateral sclerosis.

This review is based on an analysis of contemporary scientific publications indexed in international databases, including Scopus and Web of Science, focusing on nutritional support in ALS, dysphagia management, and technological approaches to the development of texture‐modified food systems. Despite the growing body of research on dysphagia diets and rheological properties of texture‐modified foods, there remains a lack of systematized approaches linking rheological parameters, nutritional design, and locally adaptable raw material selection for patients with ALS.

The aim of this review is to analyze and systematize current technological and rheological approaches to the development of texture‐modified food systems for nutritional support in ALS patients, with particular attention to regional raw materials, swallowing safety, and the practical applicability of such products in clinical and home‐care settings.

2. Nutritional Requirements and Support in ALS

2.1. Nutritional and Textural Aspects of ALS Dietary Support

Nutritional support is a critical component of the management of ALS, primarily aimed at maintaining body weight and correcting metabolic imbalance. Weight loss in ALS is recognized as an independent prognostic factor associated with accelerated disease progression and reduced survival (Desport et al. 1999; Marin et al. 2011). In addition, malnutrition negatively affects functional status, immune response, and overall quality of life, making early nutritional intervention a key element of multidisciplinary ALS care.

Hypermetabolism is frequently observed in ALS and is associated with increased energy requirements even at reduced levels of physical activity (Desport et al. 2001; Dupuis et al. 2011). The mechanisms underlying hypermetabolism are not fully understood but are thought to involve mitochondrial dysfunction, increased resting energy expenditure, and systemic metabolic alterations. Therefore, high‐energy nutritional strategies are essential, particularly in patients with dysphagia, where oral intake is significantly limited (Wills et al. 2014; de Carvalho Vilar et al. 2025; D'Antona et al. 2021).

From a food technology perspective, this challenge is addressed through the development of energy‐dense food systems that provide sufficient caloric intake within a reduced volume. Such systems are particularly important in clinical conditions characterized by reduced appetite, early satiety, and impaired swallowing function.

In parallel, ensuring safe consumption requires the formation of homogeneous and structurally stable systems with controlled rheological properties. Such stability is primarily achieved through interactions between proteins and polysaccharides, which enhance the structural integrity and functional performance of food systems (Abubaker et al. 2026). In addition, the consistency and flow behavior of food systems directly influence oral processing and swallowing dynamics. This aspect is particularly critical in dysphagia management, where structural heterogeneity and inappropriate viscosity may increase the risk of aspiration (Raheem et al. 2021; Hadde and Chen 2021; Schmidt et al. 2021; Sungsinchai et al. 2019; Funami 2011; Wang et al. 2023).

Therefore, the coexistence of hypermetabolism and dysphagia in ALS patients requires simultaneous consideration of nutritional density and basic textural safety. These requirements are summarized in Table 1, while the rheological mechanisms underlying texture modification are discussed in greater detail in the section on texture‐modified foods and rheological aspects of nutritional support in ALS.

TABLE 1.

Requirements for specialized food products for patients with ALS.

Parameter	Requirement	Scientific rationale
Energy density	High (≥ 1.5–2.0 kcal/mL)	Compensation of hypermetabolism
Protein content	Increased	Prevention of muscle mass loss
Texture	IDDSI Levels 3–5	Safety in dysphagia
Viscosity	Controlled, pseudoplastic	Facilitation of swallowing
Homogeneity	Mandatory	Reduction of aspiration risk
Stability	Physical stability (no phase separation)	Prevention of structural breakdown and aspiration risk
Volume	Small	Limited food intake capacity in patients
Sensory properties	Acceptable	Improvement of compliance

In cases where conventional nutrition is insufficient to meet energy and nutrient demands, specialized enteral formulas are used (Muscaritoli et al. 2012; Burgos et al. 2018; Wills et al. 2014). Despite their clinical effectiveness, such products are often associated with limited palatability, reduced dietary variety, and low long‐term patient adherence. While effective, their use is often limited by high cost and restricted accessibility.

Therefore, the development of alternative food‐based solutions represents an important direction in food science, focusing on the creation of accessible, energy‐dense, and safe products tailored to the physiological needs of ALS patients. Such approaches are particularly relevant for improving patient compliance and expanding the availability of nutritional support in both clinical and home‐care settings.

2.2. Industrial Enteral Formulas: Technological Analysis and Limitations

Industrial enteral formulas are widely used for nutritional support in patients with ALS (Muscaritoli et al. 2012; Burgos et al. 2018), providing controlled intake of energy and nutrients and reducing the risk of deficiency conditions. These products are balanced food systems containing proteins, fats, carbohydrates, vitamins, and minerals in an easily digestible form. They are commonly administered orally or via feeding tubes, depending on the stage of dysphagia and the patient's clinical condition.

Recent approaches to nutritional support in dysphagia increasingly include not only standard enteral formulas but also oral nutritional supplements, thickened liquids, ready‐to‐use texture‐modified products, and modular formulations designed to improve energy and protein intake while maintaining swallowing safety. Such products may differ in energy density, protein source, viscosity level, flavor profile, and mode of administration. For patients with ALS, this variability is important because nutritional needs may change as dysphagia progresses, and the choice of product should be adapted to swallowing function, gastrointestinal tolerance, nutritional status, and patient preference.

From a technological perspective, they are characterized by a high degree of homogenization, physicochemical stability, and standardized rheological properties, ensuring safety of consumption and dosing accuracy. Such properties are achieved through advanced processing techniques, including emulsification, homogenization, and stabilization systems based on hydrocolloids.

Key advantages include precise control of caloric intake, high bioavailability of nutrients, and clinically proven effectiveness in maintaining nutritional status (Muscaritoli et al. 2012; Wills et al. 2014). In addition, their standardized composition allows for predictable metabolic responses and facilitates clinical monitoring.

However, several limitations restrict their broader application. High cost significantly reduces accessibility, particularly in resource‐limited settings. Furthermore, long‐term dependence on enteral formulas may reduce dietary variety and negatively affect patient satisfaction and adherence. In addition, standard formulations do not always account for individual metabolic characteristics and sensory preferences (Muscaritoli et al. 2012; Burgos et al. 2018).

From a food technology perspective, an important limitation is the restricted variability of textural properties. Despite the availability of different viscosity levels, these products do not always meet the requirements of patients with severe dysphagia and provide limited sensory diversity (Raheem et al. 2021; Hadde and Chen 2021; Schmidt et al. 2021; Sungsinchai et al. 2019). This may lead to reduced oral intake and decreased compliance, particularly in patients with residual swallowing function.

Another limitation is the insufficient adaptation to regional raw materials, which constrains opportunities for local production. This factor is especially relevant in developing countries, where reliance on imported products increases economic burden and limits availability of nutritional support.

Therefore, alongside the use of industrial enteral formulas, the development of alternative food‐based solutions remains relevant, focusing on accessibility, technological flexibility, and adaptation to patient‐specific and regional needs. Such approaches may contribute to improving both clinical outcomes and patient quality of life.

3. Texture‐Modified Foods and Rheological Aspects of Nutritional Support in ALS

Dysphagia is one of the key factors limiting adequate nutrition in patients with ALS. Under these conditions, the development of specialized food products requires not only nutritional optimization but also strict control of textural and rheological properties. The impairment of swallowing function directly affects bolus formation, transport, and safe passage through the oropharyngeal region, increasing the risk of aspiration and malnutrition.

From a food technology perspective, product texture is determined by a combination of structural and rheological characteristics, including viscosity, plasticity, homogeneity, and structural stability. For patients with dysphagia, it is essential that food systems exhibit predictable behavior during swallowing, remain homogeneous, and do not undergo phase separation or contain solid inclusions (Raheem et al. 2021; Hadde and Chen 2021; Schmidt et al. 2021; Sungsinchai et al. 2019). In addition, appropriate lubrication and cohesiveness of the bolus are important for efficient swallowing and reduced oral residue.

The IDDSI provides a widely accepted framework for the classification of food textures and liquid consistencies (IDDSI 2019; Cichero et al. 2017). For ALS patients, levels 3–5 are of particular relevance, including thickened liquids, pureed foods, and soft cohesive systems. These levels are designed to correspond to different stages of swallowing impairment and should be selected based on individual patient assessment. Compliance with these levels should be ensured using both empirical testing methods and quantitative rheological parameters.

The rheological properties of texture‐modified foods are extensively described in the literature (Raheem et al. 2021; Hadde and Chen 2021; Schmidt et al. 2021; Sungsinchai et al. 2019; Methacanon et al. 2021; Fiszman and Laguna 2023). Key parameters include apparent viscosity, shear‐thinning behavior, and yield stress. Yield stress is particularly important, as it determines the ability of the bolus to maintain structural integrity before swallowing while allowing flow under applied shear. Most systems intended for dysphagia management exhibit non‐Newtonian pseudoplastic behavior, in which viscosity decreases with increasing shear rate, facilitating swallowing and reducing aspiration risk.

Figure 2 illustrates the formation of structural and rheological properties in food systems that determine swallowing safety and functional suitability of texture‐modified products for ALS patients (Raheem et al. 2021; Hadde and Chen 2021; Schmidt et al. 2021; Sungsinchai et al. 2019).

FIGURE 2.

Relationship between raw material composition, structural mechanisms, microstructure development, rheological properties, and functional swallowing outcomes in texture‐modified food systems.

From a technological standpoint, the desired rheological characteristics are achieved through the use of hydrocolloid systems, including starches, pectins, gums, and carrageenans (Schmidt et al. 2021; Methacanon et al. 2021). These components enable precise control of viscosity, enhance structural homogeneity, and prevent phase separation. In addition, hydrocolloids contribute to water retention and improve the cohesiveness of food systems, which is critical for safe swallowing. Their selection should consider interactions with proteins and lipids, as well as stability during processing.

System stability over time is a critical requirement. Phenomena such as syneresis and phase separation significantly increase aspiration risk due to the formation of low‐viscosity regions. Therefore, formulation strategies must ensure high stability of emulsion and dispersed systems (Schmidt et al. 2021; Methacanon et al. 2021). This includes the optimization of ingredient ratios, processing conditions, and storage parameters.

In addition to ingredient composition, the rheological behavior of texture‐modified food systems is influenced by multiple interacting factors, including ingredient type and concentration, physicochemical conditions such as pH and ionic strength, processing parameters, particle size distribution and morphology, and storage conditions. During storage, changes in hydration, network rearrangement, phase separation, or viscosity may occur, potentially affecting texture stability and swallowing safety. Therefore, storage stability should be considered an important component in the development of commercial dysphagia‐oriented products.

Temperature also significantly affects rheological behavior. Variations during serving and consumption may alter viscosity and structural integrity, requiring formulations that remain stable across a range of temperatures. This is particularly relevant in real‐life conditions, where temperature control may be inconsistent.

Overall, the development of texture‐modified food systems for ALS patients represents a complex interdisciplinary task involving rheology, physicochemistry, and food engineering. The integration of standardized approaches such as IDDSI with precise rheological control enables the creation of safe, functional, and clinically relevant food products. Such systems have the potential to significantly improve nutritional intake, reduce aspiration risk, and enhance quality of life in ALS patients.

4. Technological Strategies for Designing Texture‐Modified Food Systems

The development of specialized food products for patients with ALS requires the integration of advanced food engineering approaches aimed at ensuring high nutritional value, safety of consumption, and adaptation to impaired swallowing function. Such approaches must simultaneously address both physiological requirements and technological constraints, making product design a multidisciplinary task.

A key direction is the design of texture‐modified food systems with controlled rheological properties in accordance with the IDDSI framework (IDDSI 2019). Hydrocolloid‐based systems play a central role in regulating viscosity, maintaining structural homogeneity, and preventing phase separation, thereby reducing the risk of aspiration (Schmidt et al. 2021; Methacanon et al. 2021). The selection and combination of hydrocolloids allow for fine‐tuning of flow behavior, yield stress, and stability under varying processing and storage conditions.

Another important approach is the development of energy‐dense formulations capable of compensating for hypermetabolism in ALS patients (Dupuis et al. 2011). This is achieved through macronutrient optimization, particularly by increasing the proportion of lipid components to ensure high caloric intake within a limited volume. In addition, the use of structured lipids and emulsified systems may enhance both energy delivery and digestibility.

Recent technological developments also include high‐pressure homogenization, protein‐based gelation, emulsion structuring, and 3D food printing, which provide additional opportunities for controlling microstructure and rheological behavior in texture‐modified foods. Three‐dimensional food printing has been proposed as a promising approach for producing visually acceptable and personalized texture‐modified foods for people with dysphagia, allowing control of shape, portion size, composition, and consistency (Chao et al. 2024; Shao et al. 2025). High‐pressure homogenization and protein‐based structuring may further improve particle dispersion, smoothness, emulsion stability, and cohesive gel network formation, which are important for swallowing safety and long‐term texture stability (Sungsinchai et al. 2019; Wang et al. 2023).

The main technological approaches used in the development of texture‐modified products are summarized in Table 2.

TABLE 2.

Technological approaches to the development of texture‐modified products.

Technological strategy	Function	Expected result
Mechanical size reduction and structuring	Particle size reduction and structure homogenization	Smooth and homogeneous texture
High‐pressure homogenization	Intensive particle size reduction and dispersion under high pressure	Improved smoothness, dispersion stability, and reduced phase separation
Emulsion and lipid structuring (including emulsion gels)	Formation and stabilization of dispersed lipid phases	Improved lubrication, energy density, smooth mouthfeel, and emulsion stability
Hydrocolloids and thickeners	Flow control, gel strength, and water binding	Controlled viscosity, stability, and prevention of phase separation
Protein‐based structuring and gelation	Formation of cohesive protein networks	Bolus integrity, elasticity, and structural stability
Microencapsulation	Protection of bioactive and sensitive components	Improved nutrient stability and controlled release
3D food printing	Shape, portion, and composition customization	Personalized texture‐modified foods with controlled shape, consistency, and composition

The combined application of these technological strategies, including high‐pressure homogenization, protein‐based gelation, hydrocolloid thickening, and 3D food printing, enables the formation of stable food systems with defined rheological, structural, and sensory properties, meeting the safety and functional requirements of patients with dysphagia (Sungsinchai et al. 2019; Methacanon et al. 2021; Fiszman and Laguna 2023; Wang et al. 2023; Chao et al. 2024; Shao et al. 2025).

Recent reviews highlight that the performance of texture‐modified food systems depends not only on ingredient composition but also on reconstitution processes, including wetting, dispersion, hydration, and matrix development. These factors substantially influence the final rheological behavior and swallowing safety and should therefore be considered during product formulation and validation (Lima and Lannes 2026).

Storage stability should also be considered during the design of texture‐modified foods for dysphagia. Changes in viscosity, phase separation, moisture migration, or structural degradation during storage may alter swallowing safety and product performance. Therefore, formulation strategies should include not only the achievement of target rheological properties immediately after production but also the maintenance of these properties throughout the intended shelf life.

In addition, the integration of regional raw materials expands formulation possibilities and supports the development of cost‐effective and locally adapted products. Localization of production contributes to improving accessibility and reducing dependence on imported enteral formulas (Muscaritoli et al. 2012; Hadde and Chen 2021). This is particularly important in regions with limited healthcare resources, where affordability directly influences the availability of nutritional support.

Overall, these approaches form the basis for the development of personalized and technologically controlled food systems. Promising solutions are focused on creating accessible, safe, and functionally optimized products that combine nutritional adequacy with structural and rheological precision. Future developments are expected to involve digital modeling of food structure, personalization based on patient‐specific parameters, and the use of novel functional ingredients.

5. Use of Regional Raw Materials in the Development of Specialized Products

The development of specialized food products for patients with ALS requires the use of raw materials that combine availability, high nutritional value, and functional technological properties. In Central Asian countries, the use of regional raw materials represents a promising approach for improving the accessibility of medical nutrition and adapting products to local dietary practices. Such an approach also supports the development of sustainable food systems and reduces dependence on imported ingredients.

In addition to availability and nutritional value, regional raw materials may provide familiar sensory characteristics, including taste, aroma, and traditional food associations, which can improve patient acceptance and long‐term adherence to texture‐modified diets. Shorter supply chains may also support more sustainable production by reducing dependence on imported ingredients and improving the feasibility of local manufacturing. However, despite these advantages, regional raw materials alone are unlikely to provide a nutritionally complete solution for patients with ALS and dysphagia. In particular, the intake of certain vitamins, minerals, and other essential micronutrients may remain insufficient without targeted fortification or supplementation. Future product development should therefore incorporate evidence‐based fortification strategies or combine local ingredients with specialized nutritional components to ensure micronutrient adequacy while preserving desirable rheological and sensory properties. In addition, comprehensive nutritional evaluation should accompany formulation development to verify that products meet the specific dietary requirements of patients with ALS.

From a food technology perspective, regional raw materials are of particular interest due to their ability to contribute to the formation of food systems with controlled rheological properties required for safe swallowing in dysphagia. In addition to their nutritional value, such materials can influence viscosity, structural stability, and homogeneity of the final product (Schmidt et al. 2021; Methacanon et al. 2021). These properties are essential for ensuring predictable bolus formation and minimizing the risk of aspiration.

Compared to standardized industrial ingredients, regional raw materials provide greater flexibility in formulation design, allowing consideration of physiological, cultural, and economic factors. This flexibility is particularly important in personalized nutrition approaches, where individual patient needs must be taken into account.

The use of raw materials with pronounced functional properties enables the formation of structured systems with controlled viscosity, stability, and textural characteristics (Table 3) (Schmidt et al. 2021; Methacanon et al. 2021).

TABLE 3.

Functional and technological properties of regional raw materials used in ALS nutrition.

Type of raw material	Main components	Functional properties	Technological role
Horse meat	Proteins	High biological value	Protein base
Dairy products	Casein, whey proteins	Gelation, emulsification	Structure formation
Cereals (e.g., oats)	β‐glucan	Viscosity, water retention	Texture regulation
Legumes	Proteins, fiber	Thickening, stabilization	Texture formation
Vegetable oils	Lipids	Energy density	Caloric value
Hydrocolloids	Polysaccharides	Pseudoplasticity	Rheology control

The presented data demonstrate the significant potential of regional raw materials as a basis for the development of texture‐modified food systems with defined technological and rheological properties. Their application enables the development of nutritionally adequate, culturally acceptable, and economically accessible products, while also improving the sustainability of nutritional support for ALS patients.

5.1. Meat Raw Materials as a Source of Protein Compositions

Meat raw materials, including horse meat widely consumed in Central Asia, are characterized by a high content of complete proteins and a balanced amino acid profile (Lorenzo et al. 2014; Lorenzo et al. 2017). Their high biological value determines their potential as a protein base for specialized food systems. In addition, meat proteins contribute to the formation of structured systems with desirable textural and rheological properties.

Meat‐based raw materials can be processed into homogenized and pureed systems suitable for patients with dysphagia. Technologies such as fine grinding, emulsification, and homogenization enable the formation of products with controlled rheological properties and a homogeneous structure that meets swallowing safety requirements (Schmidt et al. 2021; Methacanon et al. 2021). These processes ensure uniform particle size distribution and improved consistency of the final product.

An important technological aspect is the stability of protein dispersions and the prevention of phase separation. This can be enhanced through the use of protein–polysaccharide interactions and optimized processing conditions. In this context, horse meat can be considered a regionally adapted alternative to standard protein ingredients used in industrial enteral formulas, with the potential to improve both nutritional value and accessibility.

5.2. Dairy Components and Their Structure‐Forming Role

Dairy products are important sources of easily digestible proteins and fats and play a key role in structure formation. Traditional products such as ayran and kefir may serve as a basis for the development of adapted food systems. Their widespread consumption also contributes to higher patient acceptance and compliance.

Milk proteins, including casein and whey proteins, exhibit pronounced gelation and emulsification properties (Nayik et al. 2024; Rout et al. 2024), enabling the formation of stable dispersed systems with defined rheological characteristics. Parameters such as pH and temperature significantly influence gel structure and stability. The ability to form protein networks is particularly important for achieving controlled viscosity and structural integrity.

Protein gel networks provide controlled viscosity and homogeneity, reducing aspiration risk and facilitating swallowing. In addition, the high bioavailability of dairy proteins makes them essential components in nutritional support for ALS patients.

5.3. Plant Raw Materials and Regulation of Textural Properties

Cereals and legumes serve as sources of complex carbohydrates and dietary fiber and contribute to the formation of textural characteristics in food systems (Wang and Ellis 2014). They also provide functional components such as β‐glucans and soluble fibers, which are known to influence viscosity and water‐binding capacity.

Plant‐based ingredients used in texture‐modified foods should not be limited to cereals and legumes. Fruits and vegetables represent valuable components because they provide natural flavors, colors, dietary fiber, vitamins, minerals, and a wide range of bioactive compounds that can enhance both nutritional quality and sensory characteristics (Shao et al. 2025). In addition, starch gels and polysaccharide networks play a fundamental role in texture formation by regulating water retention, gel strength, viscosity, and structural integrity, thereby contributing to cohesive bolus formation and safer swallowing (Wang and Ellis 2014; Methacanon et al. 2021; Sungsinchai et al. 2019). The use of regionally available fruits, vegetables, and cereal crops may further improve patient acceptance because familiar sensory characteristics and traditional flavor profiles are often better tolerated and preferred. Local sourcing may also shorten supply chains, reduce transportation requirements, and support more sustainable food production systems. However, despite these advantages, regional raw materials alone are unlikely to provide a nutritionally complete solution for patients with ALS and dysphagia. In particular, the intake of certain vitamins, minerals, and other essential micronutrients may remain insufficient without targeted fortification or supplementation. Therefore, future product development should combine locally available ingredients with evidence‐based fortification strategies, specialized nutritional components, and comprehensive nutritional evaluation to ensure both technological functionality and nutritional adequacy while preserving desirable rheological and sensory properties.

Plant‐derived components exhibit water‐binding and swelling capacity and may function as natural hydrocolloids, increasing viscosity and stabilizing product structure (Methacanon et al. 2021). These properties are critical for the development of texture‐modified systems.

The formation of viscoelastic systems enables pseudoplastic behavior, in which viscosity decreases with increasing shear rate, facilitating swallowing. Yield stress ensures structural integrity at rest and compliance with IDDSI levels 3–5. Such rheological behavior is essential for balancing ease of swallowing with bolus stability.

The use of plant materials also enhances resistance to phase separation and contributes to texture stability during storage and consumption.

5.4. Lipid Components and the Formation of Energy Density

Vegetable oils such as sunflower, rapeseed, and cottonseed oils are used to increase energy density and to form emulsion systems. Their inclusion allows an increase in caloric value without increasing product volume, which is essential for patients with limited intake. This is particularly important in ALS patients with hypermetabolism and reduced appetite.

Lipid components play a key role in the formation of stable emulsions and dispersed systems. In combination with proteins and hydrocolloids, they contribute to structural stability, homogeneity, and desired rheological properties (Nayik et al. 2024; Rout et al. 2024; Methacanon et al. 2021). The stability of these systems depends on droplet size distribution and interfacial interactions between components.

The use of locally available oils reduces production costs and improves accessibility, while enabling adaptation of formulations to regional dietary conditions. Thus, lipid incorporation supports both technological functionality and nutritional efficiency of specialized products.

6. Conclusion

The development of specialized food products for patients with ALS requires an integrated approach combining nutritional adequacy and controlled rheological properties. Dysphagia remains one of the key factors limiting safe oral intake and significantly affects the quality of life and nutritional status of patients.

The present study highlights the importance of designing texture‐modified food systems that meet IDDSI standards and ensure safe swallowing. The regulation of viscosity, yield stress, and viscoelastic properties plays a critical role in achieving structural stability and bolus control.

Particular attention is given to the use of regional raw materials as a promising basis for the development of specialized products. Ingredients such as horse meat, dairy products, cereals, legumes, and vegetable oils demonstrate significant potential due to their nutritional value, functional properties, and local availability.

The combination of proteins, lipids, and polysaccharides enables the formation of stable dispersed systems with controlled rheological characteristics. This approach allows the development of nutritionally balanced, technologically feasible, and economically accessible products adapted to regional conditions.

Overall, the use of locally available raw materials in combination with modern food technology approaches provides a promising direction for improving nutritional support in ALS patients. Future research should focus on optimizing formulations, clinical validation, and expanding the range of texture‐modified products.

Author Contributions

Zulfiya Konarbayeva: conceptualization, methodology, investigation, writing – original draft, writing – review and editing, visualization.

Ethics Statement

The author has nothing to report.

Conflicts of Interest

The author declares no conflicts of interest.

Data Availability Statement

This article is based on previously published data. No new data were generated or analyzed.