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International Journal of Bioprinting 3D-printed diabetic diet

printing of Ink-M1-1 and Ink-M2-1, which are printability- conditions such as type 2 diabetes and CKD. CKD affects
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optimized food ink formulation in their respective group, 30% of patients with type 1 diabetes and 40% of those with
using a dual-nozzle direct ink writing (DIW) printer. All type 2 diabetes. A low-protein diet reduces intraglomerular
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items were plated and served as they were printed (Figure pressure by decreasing afferent arteriolar vasoconstriction,
6E). Each item could be arbitrarily divided into different thereby mitigating glomerular hyperfiltration and delaying
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portions as desired in order to personalize nutritional the progression of CKD toward kidney failure. This study
compositions according to the dietary requirements of demonstrated that the protein content of food can be
diabetic patients with complications. tailored to meet the specific DPI needs of patients afflicted
with diabetes-induced CKD. For instance, a typical 80 kg
The focus of 3D food printing has undergone a significant adult requires a DPI ranging from 0.8 to 1.3 g/kg of body
transformation from merely enhancing the visual appeal to weight, which translates to 64 to 104 g of protein per day.
controlling and personalizing the nutritional composition In contrast, diabetic patients with stage 3–5 CKD are
of food. Through multi-component collaborative 3D food advised to adjust their DPI to 0.6–0.8 g/kg of the body
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printing, macro- and micro-nutrients in food items can be weight per day, amounting to 48 to 64 g of protein for
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tuned to suit individual dietary needs. By slicing the same an 80 kg CKD patient. For illustration, individuals without
3D model into different proportions, the nutrient content CKD would require approximately 470–760 g of the food
can be varied, thereby enabling digital manufacturing of item Ink-M1-1-49.0 per day, while CKD patients would
3D-printed food for achieving personalized nutrition. As have to reduce their food intake to 350–470 g to comply
shown in Figure 6E, the dragon boat was 3D-printed with by the DPI requirements if they choose the same food
Ink-M1-1 and Ink-M2-1 at various ratios. The last figure item. Alternatively, CKD patients may opt for 500–670 g
in the name of each type of dragon boat represents the of the food item, i.e., Ink-M1-1-100, which offers a lower
percentage of Ink-M1-1 in the food item. For instance, protein content per unit weight. Among these two food
the dragon boat labeled as Ink-M1-1-49.0 comprises 49% inks, which have similar protein content, Ink-M1-1-100
Ink-M1-1 and 51% Ink-M2-1 by weight. The macronutrient contains higher carbohydrate and caloric content than
and calorie content of 100 g of the 3D-printed food with Ink-M1-1-49.0, but its fat content is significantly lower.
various percentage of Ink-M1-1 are shown in Table 3. The Thus, patients are free to select the food ink that aligns with
macronutrient content of each dragon boat was calculated their unique nutritional and health requirements.
and listed in Table S4 (Supplementary File) based on a
total weight of 8.2–9.1 g. The difference in weight primarily Meanwhile, diabetic patients are at a higher risk
resulted from the density difference between the two food of developing oral ulcers compared with the general
inks. Notably, the protein content almost doubled as population. Patients suffering from oral ulcers often opt
the proportion of Ink-M1-1 changed from 100% to 0%. for liquid or soft foods to avoid the discomfort caused by
chewing and swallowing. However, such foods may lack
Meanwhile, the fat content increased by almost 6-folds. appeal in terms of appearance and texture, which can lead
However, the content of total carbohydrates showed a to food refusal and malnutrition. 61,62 Currently, texture-
declining trend as the proportion of Ink-M1-1 reduced.
modified food is mainly aimed at elderly patients with
Whole milk powder is a significant protein source in dysphagia. Based on international data, the prevalence of
daily diets and a major contributor to the production of oropharyngeal dysphagia in the general population ranges
endogenous advanced glycosylation end-products (AGEs). from 2.3% to 16.0%. In contrast, oral ulcers affect up to
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Excessive endogenous AGEs can increase the risk of 25% of the global population. In spite of the high demand
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Table 3. Macronutrient and calorie content of 100 g of food 3D-printed with various proportions of Ink-M1-1

Carbohydrate (g) Protein (g) Fat (g) Energy (kJ)
Ink-M1-1-100 25.88 9.59 1.55 659.93
Ink-M1-1-90.2 25.33 10.37 2.24 689.43
Ink-M1-1-75.2 24.49 11.55 3.29 734.31
Ink-M1-1-49.0 23.01 13.63 5.15 813.09
Ink-M1-1-30.6 21.97 15.09 6.44 868.30
Ink-M1-1-9.8 20.79 16.74 7.91 930.80
Ink-M1-1-0 20.24 17.52 8.61 960.30

Volume 10 Issue 2 (2024) 307 doi: 10.36922/ijb.1862