Food for special medical purposes (FSMPs) are foods designed for specific illnesses or special nutritional needs. Their target populations include infants, pregnant women, elderly, patients with gastrointestinal disorders, and special populations with metabolic disorders 1, 2. In recent years, with the increasing awareness of people’s health, FSMPs are becoming increasingly important in people’s daily diet. For example, the application of milk-derived bioactive peptides as nutritional supplements in FSMPs can provide precise nutritional support for people with different diseases [3]. Food-grade delivery systems loaded with bioactives can be used to improve the health of people suffering from chronic diseases, such as diabetes, hypertension, etc. [4]. However, with the in-depth development of precision medicine and personalized nutrition concepts, it is difficult for traditional food processing technologies to meet consumer demand for personalized FSMPs.

3D printing is an emerging technology for producing various functional products. Its application in the development of FSMPs has a great potential 2, 5. This technology can not only build a probiotic targeted delivery system to realize the synergistic controlled release of multiple bioactive substances [6] but also precisely regulate the textural properties of food (e.g. hardness, viscoelasticity, etc.) to develop dysphagia-specific foods meeting International Dysphagia Diet Standardisation Initiative requirements. [7]. It is worth noting that with the continuous development of technology, the application of 3D printing in the field of FSMPs has been upgraded from simple structural manufacturing to intelligent functional design [8•]. 4D printed food has the ability to respond intelligently to adjustable changes in shape, color, flavor, and functionality, so as to design new types of food according to individual needs [9••]. Recent advancements have expanded this technology to 5D bioprinting, incorporating bioactive components (e.g. probiotics) that maintain metabolic activity postprinting 10, 11. These living systems exhibit dynamic functional evolution during storage, progressively enhancing nutritional bioavailability and sensory properties through continuous biological interactions [12]. Realizing 4D changes while being indicative of life dynamic changes can open up new possibilities for the design of FSMPs.

Currently, the applications of food 4D/5D printing in providing precise nutrition for patients with chronic diseases [10], soft food for the elderly with dysphagia [13], and the development of food-grade delivery systems with unique release characteristics [14] have made the expected progress in providing precise nutrition while eliciting consumers’ appetite. However, the application of 4D/5D printing in FSMPs is still in its infancy, and there is no review systematically describing the related application and progress. In order to promote the design accuracy required for effective and efficient production, this paper first summarizes the research progress of FSMPs and the application of 3D printing technology. The development of food 4D/5D printing technology and its application in the development of FSMPs are further discussed in detail, with a view to informing the production of targeted, long-lasting, and nutritionally precise FSMPs.