Targeting bakery products for dysphagia, sarcopenia and protein malnutrition management in older adults: a systematic review

Abstract

Bakery products including bread, cookies, biscuits and cake are commonly consumed staples across the life course. They can therefore be targeted for enrichment with protein-rich ingredients which may enhance their textural properties and address age-related nutritional challenges such as dysphagia, sarcopenia, and protein malnutrition in older adults. This systematic review aimed to highlight current advances in the use of bakery products formulated with protein and texture-modulating ingredients as potential vehicles to deliver protein and address age-related nutritional challenges in older adults. A systematic search for relevant articles was conducted on the databases PubMed, Scopus, ScienceDirect and Cochrane Library up to October 01, 2025. Fourteen papers (n = 14) investigated the ease of chew and swallow in older adults. The most frequently reported vehicle was bread (n = 9). Commonly used ingredients for enrichment of the bakery products included soy protein isolate, whey protein isolate, soybean soluble polysaccharide, drum-dried pumpkin flour, inulin, sacha inchi seed cake and chicken protein powder. Most enriching ingredients were good sources of protein. Incorporation into the bakery products resulted in reduction of hardness and improved the subjective ease of chew and swallow. Enriching bread with protein-rich ingredients resulted in a significant increase in the protein intake of older adults. Recipe reformulation, through controlled inclusion of protein isolates, hydrocolloids, vegetable flours, or dietary fibers, can enhance the nutritional value, improve the textural properties and ingestion of bakery products and could address protein malnutrition in older adults. Future studies should explore the use of other underutilized protein-rich ingredients for bakery product reformulation.