A plate refined through verification — Nabeno-Ism
EVIDENCE & RESEARCH

We do not begin
on intuition alone.

The scale of the problem — and the fact that food interventions change outcomes — is already documented by research worldwide. Here is the evidence behind this project, with sources.

~10 yrs

Gap between lifespan and healthspan (Japan)[1]

39%

Inpatients with malnutrition (64 studies worldwide)[7]

>50%

Dysphagia among nursing home residents[9]

30%

Hospital plate waste (median of 32 studies)[10]

THE PROBLEM

The numbers behind a neglected field.

What happens when the joy of eating is left outside medicine shows up clearly in the statistics.

The final decade is not a healthy one

In Japan, the gap between life expectancy and healthy life expectancy is 8.49 years for men and 11.63 for women — roughly a decade of life’s final chapter lived without health and independence. Japan’s aging rate of 29.3% is the world’s highest, headed for 34.8% by 2040.[1] [2] [3]

Malnutrition inside the hospital

A meta-analysis of 64 studies found malnutrition in 39% of inpatients (53% by direct GLIM diagnosis), roughly doubling mortality risk. In nutritionDay, the world’s largest hospital food survey, about half of medical inpatients showed weight loss or reduced food intake.[7] [8]

When swallowing pushes people from the table

Dysphagia affects roughly a third of community-dwelling older adults, about half of hospitalized older patients, and 53.6–58.7% of nursing home residents. Aspiration pneumonia is Japan’s sixth leading cause of death — about 64,000 lives a year.[9] [6]

Thirty percent of what is cooked is left uneaten

Across 32 studies, hospital plate waste has a median of 30%, with 27% of served energy discarded. More than half of inpatients do not finish their meals — and patients eating only about a quarter of their food faced 2.1 times the 30-day mortality risk.[10] [11]

The price of malnutrition is steep

Malnourished inpatients stayed 6.9 days versus 4.6, with one-year mortality of 34% versus 4.1%. The economic burden is estimated at $156.7 billion a year in the US and about €170 billion in Europe.[12] [20]

The limits of “safe but joyless” food

Texture-modified diets — minced, molded, thickened for safety — are associated with weight loss, malnutrition, and lower mealtime satisfaction. In Japan, 22.4% of women over 65 already trend toward undernutrition. Reconciling safety with joy is the next frontier.[14] [5]

A dish — Nabeno-Ism
Beyond the Numbers

Behind every number,
there is a table.

THE COUNTER-EVIDENCE

Food interventions change outcomes.

And research shows the other side of the ledger: improve the food, and the numbers move.

Restore the appearance, restore the appetite

In an RCT of dysphagia cuisine reshaped to look like real dishes, twelve weeks improved energy and nutrient intake, with an average weight gain of 3.9 kg. Looking delicious is nutrition.[15]

Food service improvement works

A systematic review of 36 studies found that multi-component hospital food service interventions — better menus, plating, and delivery — significantly improved intake, satisfaction, and quality of life.[16]

Pleasure of eating is nutrition

In a study of 464 older adults living at home, pleasure of eating was significantly associated with nutritional status. Joy is not a preference — it is an independent factor in nutritional risk.[13]

The right food lowers healthcare costs

Recipients of medically tailored meals had 49% fewer hospitalizations and roughly 16% lower healthcare costs. Modeled nationally, that is 1.59 million admissions avoided and $13.6–23.7 billion saved per year.[17] [18] [19]

GLOBAL PRECEDENTS

The world is already moving.

Lyon, France

Thierry Marx × public hospitals

Starred chef Thierry Marx opened the brasserie “La Villa” inside a Hospices Civils de Lyon hospital (2018) — a pioneering effort to raise the hospital food experience to first-class dining standards.[21]

Singapore

SGH × beloved food brands

Singapore General Hospital co-developed patient meals with famous names like JUMBO, reaching an 89% meal acceptance rate — overturning the assumption that hospital food must be bland.[22]

Herlev, Denmark

A chef's à la carte, in a hospital

Herlev Hospital introduced “Herlevs Herligheder” (2022): some 120 chef-made dishes ordered by tablet. Intake improved on wards with many malnourished patients, while food waste fell.[23]

THE MARKET

The ground is already shifting.

¥2.41T

Medical catering & home meal delivery market (FY2024)[24]

¥1.56T

Prepared care-food & therapeutic meals market (FY2023)[25]

+10.0%

Growth of Universal Design Food output (2024)[26]

World No.1

Japan's aging rate, 29% — the future every nation faces next[3]

OUR COMMITMENT

We will measure as we go.

From its Phase 1 hospital meals onward, Maison de Santé will track these indicators — building evidence from Japan, one plate at a time.

Meal completion

Plate waste, measured — the most honest metric of deliciousness.

Nutritional status

Standard measures such as GLIM and MNA to verify the nutritional effect of co-designed meals.

Mealtime experience

The joy of eating, recorded quantitatively and qualitatively.

Recovery & clinical indicators

Length of stay and recovery, followed together with clinical teams.

A dish by Nabeno-Ism
One Plate at a Time

Evidence begins
with a single plate.

FAQ

Common questions.

What is Clinical Gastronomy?

A methodology in which clinicians share the clinically required parameters (nutrition, swallowing function, disease) and then chefs and clinicians co-design safety, nutrition, and deliciousness as a single dish. Not medicine supervising cuisine — equal expertise working together.

How is this different from “medically correct meals”?

Beyond meeting nutritional standards, we design the joy of eating — aroma, texture, appearance, finish — at the same time. Research links pleasure of eating to nutritional status in older adults, and shaped dysphagia cuisine has been shown to improve intake and body weight.

Is there evidence behind this project?

Worldwide, multi-component hospital food service improvements have improved intake, satisfaction, and quality of life, and medically tailored meals have reduced hospitalizations by 49% and lowered healthcare costs in peer-reviewed studies. Maison de Santé will build its own evidence from Japanese hospital food, measuring intake, nutritional status, and satisfaction.

How can hospitals, companies, and chefs take part?

Hospitals and facilities can start with an adoption inquiry; companies join through sponsorship, co-development, or adoption partnerships; chefs enter the selection for the Chef Council. Use the join pages or the contact form.

REFERENCES

Sources.

  1. [1]厚生労働省「健康寿命の令和4年値について」健康日本21（第三次）推進専門委員会（2024） https://www.mhlw.go.jp/content/10904750/001363069.pdf
  2. [2]内閣府「令和7年版高齢社会白書」（2025） https://www8.cao.go.jp/kourei/whitepaper/w-2025/html/zenbun/index.html
  3. [3]総務省統計局 統計トピックスNo.146「統計からみた我が国の高齢者」（2025） https://www.stat.go.jp/data/topics/pdf/topics146.pdf
  4. [4]厚生労働省「令和5年度 介護保険事業状況報告（年報）」（2025） https://www.mhlw.go.jp/topics/kaigo/osirase/jigyo/23/index.html
  5. [5]厚生労働省「令和5年 国民健康・栄養調査」（2025） https://www.mhlw.go.jp/stf/newpage_45540.html
  6. [6]厚生労働省「令和6年 人口動態統計月報年計（概数）」（2025） https://www.mhlw.go.jp/toukei/saikin/hw/jinkou/geppo/nengai24/index.html
  7. [7]Bian W, et al. Prevalence of malnutrition based on GLIM criteria for completeness of diagnosis and future risk of malnutrition: a systematic review and meta-analysis. Front Nutr. 2023;10:1174945. https://pubmed.ncbi.nlm.nih.gov/37469547/
  8. [8]Hiesmayr M, et al. Patterns of Food Intake in Hospitalized Patients: nutritionDay 2006–2015. J Clin Med. 2019;8(12):2048. https://www.mdpi.com/2077-0383/8/12/2048
  9. [9]Doan TN, et al. Prevalence of Swallowing Disorders in Older Adults: A Systematic Review and Meta-Analysis. J Clin Med. 2022;11(9):2605. https://pmc.ncbi.nlm.nih.gov/articles/PMC9104951/
  10. [10]Williams P, Walton K. Plate waste in hospitals and strategies for change. e-SPEN. 2011;6(6):e235–e241. https://www.clinicalnutritionespen.com/article/S1751-4991(11)00058-8/fulltext
  11. [11]Hiesmayr M, et al. Decreased food intake is a risk factor for mortality in hospitalised patients: The NutritionDay survey 2006. Clin Nutr. 2009;28(5):484–491. https://www.sciencedirect.com/science/article/abs/pii/S0261561409001290
  12. [12]Lim SL, et al. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012;31(3):345–350. https://www.sciencedirect.com/science/article/abs/pii/S0261561411001993
  13. [13]Bailly N, Maître I, Van Wymelbeke V. Relationships between nutritional status, depression and pleasure of eating in aging men and women. Arch Gerontol Geriatr. 2015;61(3):330–336. https://pubmed.ncbi.nlm.nih.gov/26337662/
  14. [14]Wu XS, Miles A, Braakhuis A. Nutritional Intake and Meal Composition of Patients Consuming Texture Modified Diets and Thickened Fluids: A Systematic Review. Healthcare. 2021;9(6):624. https://www.mdpi.com/2227-9032/9/6/624
  15. [15]Germain I, Dufresne T, Gray-Donald K. A novel dysphagia diet improves the nutrient intake of institutionalized elders. J Am Diet Assoc. 2006;106(10):1614–1623. https://pubmed.ncbi.nlm.nih.gov/17000194/
  16. [16]Osman NS, et al. Hospital Food Service Strategies to Improve Food Intakes among Inpatients: A Systematic Review. Nutrients. 2021;13(10):3649. https://pubmed.ncbi.nlm.nih.gov/34684649/
  17. [17]Berkowitz SA, et al. Association Between Receipt of a Medically Tailored Meal Program and Health Care Use. JAMA Intern Med. 2019;179(6):786–793. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2730768
  18. [18]Hager K, et al. Association of National Expansion of Insurance Coverage of Medically Tailored Meals With Estimated Hospitalizations and Health Care Expenditures in the US. JAMA Netw Open. 2022;5(10):e2236898. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577678/
  19. [19]Deng D, et al. Medically Tailored Meals: Cost Savings Projected In 49 States. Health Affairs. 2025;44(4). https://www.healthaffairs.org/doi/10.1377/hlthaff.2024.01307
  20. [20]Snider JT, et al. Economic burden of community-based disease-associated malnutrition in the United States. JPEN. 2014;38(2 Suppl):77S–85S. https://pubmed.ncbi.nlm.nih.gov/25249028/
  21. [21]Hospitalia. « Thierry Marx ouvre la brasserie La Villa à l'hôpital Édouard Herriot (HCL) » (2018) https://www.hospitalia.fr/Thierry-Marx-ouvre-la-brasserie-La-Villa-a-l-hopital-Edouard-Herriot-HCL_a1347.html
  22. [22]Singapore General Hospital. "Bland and boring? Some hospitals seek help from big names to enhance food quality" (2023) https://www.sgh.com.sg/news/patient-care/bland-and-boring--some-hospitals-seek-help-from-big-names-to-enh
  23. [23]Sygeplejersken (Danish Nurses' Organization). "Herlev Hospital går gourmet" (2022) https://dsr.dk/fag-og-udvikling/sygeplejersken/fagbladet-sygeplejersken/sygeplejersken-argang-2022-nr-10/herlev-hospital-gaar-gourmet/
  24. [24]矢野経済研究所「メディカル給食・在宅配食サービス市場に関する調査（2025年）」 https://www.yano.co.jp/press-release/show/press_id/3857
  25. [25]矢野経済研究所「介護食（高齢者食・病者食）市場に関する調査（2024年）」 https://www.yano.co.jp/press-release/show/press_id/3650
  26. [26]日本介護食品協議会 ユニバーサルデザインフード生産統計（2024年） https://www.udf.jp/statistics/production.html

* The studies and statistics cited are the work of independent institutions and researchers, not results of this project. Figures are as of each source's publication. Market sizes are published values from research firms and industry bodies.

On this evidence, we build.

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