[Life Chapter 3 Companies] No More Nasogastric Tubes for Elderly Meals... Welfare Union Develops Jelly-Type Rice Food

Jang Seong-o, Representative of Welfare Union

According to Statistics Korea, pneumonia is a major cause of death among the elderly, ranking 4th among those in their 70s and 3rd among those aged 80 and above as of 2021. One of the causes of pneumonia in the elderly is the way they eat. Aspiration pneumonia, which occurs when foreign substances are inhaled into the bronchi and lungs, mainly appears in elderly people who swallow food slowly.

Because of this, elderly people with dysphagia (difficulty swallowing) often receive feeding through a nasal tube (nasogastric tube). This method involves inserting a tube through the nose to deliver food directly to the digestive tract.

Nasal tube feeding has the advantage of preventing food from mistakenly entering the airway. However, it also has many drawbacks, such as a high risk of injury to the nose and throat, and the replacement process can be painful for patients. Having to swallow food without properly enjoying tasty meals can also be a factor contributing to psychological depression.

The social enterprise 'Bokji Union' has launched and is selling a dysphagia aid food called ‘Hyoban’ to solve these problems faced by elderly people who have difficulty chewing and swallowing. Hyoban is a viscous, porridge-like food developed so that elderly patients with swallowing difficulties can eat without a nasal tube. On the 11th, Asia Economy met with CEO Jang Seong-o (47) at the Bokji Union office in Seoul, who said, “Eating food through the mouth rather than the nose is also related to the human rights of the elderly. In this era of an ultra-aged society, it is time to think not only about ‘what’ to feed the elderly but also ‘how’ to feed them.”

Jang Seong-o, Representative of the Welfare Union. Photo by Younghan Heo younghan@

The following is a Q&A session.

- What kind of work does Bokji Union do?

▲ We produce and sell the dysphagia aid food ‘Hyoban’ and provide partial outsourced meal services for elderly welfare facilities. Partial outsourced meal service means consulting on nutritional management and meal plans for small-scale nursing facilities and taking over meal provision. Recently, we have also started educational programs. We conduct training for workers and caregivers providing customized care services at welfare facilities, commissioned by local governments. We created a curriculum called ‘Senior Food Coordinator’ and have trained 350 people so far.

- What did you do before starting the business?

▲ I worked as a social worker for about nine years. When I worked at a nursing home before, many elderly people had nasal tubes inserted. I understood that this was to prevent pneumonia caused by improper swallowing, which could lead to institutional liability, but since the elderly often unconsciously wanted to remove the tubes, sometimes their hands had to be restrained. I thought this was a human rights issue. Not eating by mouth also makes dementia more likely. If food is not chewed, the brain is not stimulated, which is like the brain not exercising.

- I heard you went on a study tour to Japan.

▲ When I went in 2010, Japan had already developed foods for people with swallowing difficulties, such as ‘Kumeishiki’ and ‘Jelly-shiki.’ Perhaps because of this, while 50 out of 200 residents in the nursing home where I worked in Korea had nasal tubes, none were used in a 100-person facility in Japan. This was also a motivation for starting the business. I registered the business in November the following year.

- What is the difference between Hyoban and regular porridge?

▲ Our product has a jelly-like viscosity. We even patented a method to make jelly form from rice. The reason it needs to be jelly-like is so that elderly people can eat without the food flowing forward or backward. If it flows backward, it means it goes into the airway. This helps prevent aspiration pneumonia and airway choking deaths.

- Do people feel the effects of the dysphagia aid food?

▲ When we first made the product 10 years ago, we sold about 1 million KRW worth per month. But the fixed monthly cost of the manufacturing facility was 20 million KRW, so it was a complete loss. Since people had not experienced old age, they only thought about feeding good food but not how to feed it properly. To raise awareness, we gave many presentations and training sessions at academic conferences and hospitals.

- How about now?

▲ We now sell about 50 million KRW worth per month. That is 50 times growth since we started. We have outsourced production to a major corporation’s production line. Initially, the product was released as a refrigerated item, but now we have a version that can be stored at room temperature for about a year. Currently, we supply Hyoban to about 100 nursing homes nationwide. We have received a lot of feedback that as residents develop the habit of eating by mouth while consuming Hyoban, they even show rehabilitation effects that allow them to eat regular meals. Some facilities even send us videos.

- Why did you choose the partial outsourced meal service business model?

▲ Nursing facilities with 50 or more residents are required to have a nutritionist, but smaller facilities are not. Even if they have a nutritionist, it is difficult to guarantee perfect meal management, so it is even harder for those without one. That’s why I created a social enterprise, hired nutritionists, and started partial outsourced meal services. I wanted to address the blind spots in the system.

- What is the scale of sales? Do you have investment plans?

▲ Last year’s sales were about 6.3 billion KRW, with 80% from the meal service business and 15% from Hyoban. We expect about 8 billion KRW in sales this year. Recently, we started importing and distributing a care food brand product called ‘Nutri’ from Japan. Our goal is for Nutri products to account for more than 20% of total sales. We recently received angel investment and plan to raise more funds for establishing our own factory.

- Do you have any short- or long-term goals?

▲ We are exploring exports by sending product samples to Japan and Canada. Although results have not yet been achieved, we are continuously pursuing this. Also, we want to expand our business into elderly nutrition and dietary diagnosis and ultimately become a platform for elderly dietary life. As a social enterprise, we also hope to go public (IPO) on the stock market.