Texture-Modified Food Attitudes and Behaviours Are Culturally Patterned in Community-Dwelling Older Adults

Background/Objectives: Texture-modified (TM) food knowledge, attitudes and behaviours (KAB) among older adults remain poorly characterized in multi-ethnic populations. The study aims: (i) to characterize food liking, consumption frequency, and TM-related KAB among community-dwelling older adults in multi-ethnic Singapore; (ii) to examine whether TM-related KAB differs by ethnicity and other demographic factors, and (iii) to evaluate associations between TM-related KAB and food liking and eating frequency. Methods: A cross-sectional survey was conducted from February to April 2025 among 200 older adults (≥60 years) recruited at nine active ageing centres across Singapore. Participants rated liking and consumption frequency of Chinese, Malay, Indian and Western dishes and completed KAB items related to balanced diets, nutrient importance, TM foods, and sensory attributes of soft foods. Linear mixed-effects models adjusted for age, sex, ethnicity, and body mass index were used to derive liking, frequency, and composite (liking-frequency) scores and to examine associations between KAB and food preferences. Results: Participants (mean age 72.7 ± 6.1 years) were 71.0% Chinese, 19.0% Malay and 10.0% Indian, with a proportion reporting dysphagia-related symptoms (5.0%) and chewing difficulties (10.0%). Compared with Chinese participants, Malay participants placed less emphasis on ease of chewing/swallowing (β = -0.860, Padj = 0.023) and soft-food aroma (β = -0.711, Padj = 0.030) but greater emphasis on maintaining a balanced diet when chewing becomes difficult (β = 0.602, Padj = 0.001). Conclusions: TM-related KAB varied markedly by ethnicity and cuisine but not by self-reported chewing or swallowing difficulty. These exploratory findings suggest that TM nutrition strategies tailored by ethnicity and cuisine may warrant further investigation to support healthy ageing.