The Frontline of Inclusive Food: Making Dining Out Fun for All

Inclusive food refers to foods prepared in a way that is easier to swallow for children with dysphagia. This concept was developed with the goal of creating a society in which everyone can come together to appreciate food.
Children with dysphagia and their families attended the Completion Ceremony of Inclusive Food event. The event was filled with excitement as everyone was able to have the same bento boxes and desserts as well as enjoy conversation.

More than one million people in Japan have dysphagia, a disorder that makes it difficult to chew and swallow food due to aging, neuromuscular diseases, or cerebral palsy, for example. People with dysphagia must have thickeners added to their meals or have their food blended together into a paste to make it easier to swallow and prevent asphyxiation.

In 2022, the Tokyo Metropolitan Government (TMG), Tokyo Medical and Dental University, and the University of Tokyo worked on the development of "inclusive food" so that children with dysphagia can enjoy the same meals as their families without extra processing. Tohara Haruka, professor of Dysphagia Rehabilitation at Tokyo Medical and Dental University, said the following regarding the reason for the focus on children.

"Until now, most nursing-care foods have targeted the elderly, but dysphagia affects other people as well. Recognizing that little focus has been given to the development of these foods for children with disabilities, we aimed to develop inclusive food that both children and their parents can enjoy together."

"Rather than just providing 'delicious' inclusive food, I hope to promote interactions between various people by using inclusive food as a topic of conversation." Photo: courtesy of Tohara Haruka

Expanding Choices and Enjoyment at Meal Time

On February 25, 2023, children with dysphagia and their families participated in the Completion Ceremony of the Inclusive Food event held in Otemachi, Tokyo, where they had the chance to taste inclusive food. The menu featured a lunchbox for children called the Mogumogu Box and three types of sweets.

The soft karaage (fried chicken) was especially popular. This was made by blending deep-fried chicken in a blender to soften it, forming this mixture into the traditional shape of karaage, and then lightly deep frying the surface of each piece until slightly rigid yet edible texture. Some of the children who participated said this was the first time that they were able to eat meat in their life.

In total, six dishes featured in the Mogumogu Box, including Japanese beef sirloin steak, soft fried chicken, and Neapolitan spaghetti. The box's attractive presentation was also well received.

"It was important that we were able to hold a research presentation in the form of the Completion Ceremony of Inclusive Food, attract the attention of local governments and people in various industries, and foster momentum to continue the spread of inclusive food," noted Tohara regarding the significance of the joint project between the TMG and the university.

Some participant comments included, "I'm glad that I could eat the same food as my siblings," and, "Today was fun because I'd never eaten out before."

Special Meal and Service Considerations Growing in Tokyo

The number of restaurants in Tokyo that offer dysphagia-friendly food and services is gradually increasing. In June 2022, Soup Stock Tokyo, located in a commercial complex Lumine Tachikawa started dysphagia-friendly meal service. The menu is selected from the chain's existing soups by inspecting the hardness of the ingredients. Soup Stock Tokyo offers this service at its wheelchair accessible location, following training provided to staff. Advance reservations are recommended if you would like to use this service.

The service is categorized into soups that can be eaten without the need for chewing, soups with fine ingredients that can be crushed with the tongue, and soups with bite-sized ingredients that can be crushed with the gums. Photo: courtesy of Soup Stock Tokyo

If such a service is provided at a restaurant to which the parents of children with dysphagia usually go, these children will have more opportunities to eat out, which in turn will also lead to a better understanding of people with differing food needs.

Ogino Chikako of Soup Stock Tokyo's Quality Control Group, which has been involved in the dysphagia-friendly meal service project since its inception, says, "Tokyo is a city of people with diverse needs and there is the energy and will to meet them, so I think it is meaningful to launch these new services from Tokyo." Despite many issues such as restaurant space and staff training, "We'd like to increase the number of restaurants offering the dysphagia-friendly meal service," she says.

Soup Stock Tokyo's service at Lumine Tachikawa, there are spoons that are safe to chew and kitchen utensils to make food even smaller. Photo: courtesy of Soup Stock Tokyo

Japan as a Pioneer for Other Aging Societies

"I haven't heard much about people outside of Japan researching menu ideas for dysphagia and even attending events such as the Completion Ceremony of Inclusive Food," says Tohara. "With the world's most aging society, we in Japan are in the unique position of being able to develop and spread inclusive food because we have created a variety of nursing-care foods." Inclusive food born and nurtured in Tokyo may help to build a more inclusive society in which everyone around the world can eat the same food and share the same joy.

Joint Projects Between the TMG and Universities

The Office of the Governor for Policy Planning is supporting joint university research projects and other initiatives that contribute to Tokyo's sustainable development and the promotion of the SDGs. The results of the research are meant to be shared with the citizens of Tokyo.
Interview and writing by Onodera Fukumi
Photos by Tanaka Hidenori
Translation by Amitt