Abstract
Background‘Taste’ changes are commonly reported during chemotherapy. It is unclear to what extent this relates to actual changes in taste function or to changes in appetite and food liking and how these changes affect dietary intake and nutritional status.Patients and methodsThis prospective, repeated measures cohort study recruited participants from three oncology clinics. Women (n = 52) prescribed adjuvant chemotherapy underwent standardised testing of taste perception, appetite and food liking at six time points to measure change from baseline. Associations between taste and hedonic changes and nutritional outcomes were examined.ResultsTaste function was significantly reduced early in chemotherapy cycles (p<0.05) but showed recovery by late in the cycle. Ability to correctly identify salty, sour and umami tastants was reduced. Liking of sweet food decreased early and mid-cycle (p<0.01) but not late cycle. Liking of savory food was not significantly affected. Appetite decreased early in the cycle (p<0.001). Reduced taste function was associated with lowest kilojoule intake (r = 0.31; p = 0.008) as was appetite loss with reduced kilojoule (r = 0.34; p = 0.002) and protein intake (r = 0.36; p = 0.001) early in the third chemotherapy cycle. Decreased appetite early in the third and final chemotherapy cycles was associated with a decline in BMI (p = <0.0005) over the study period. Resolution of taste function, food liking and appetite was observed 8 weeks after chemotherapy completion. There was no association between taste change and dry mouth, oral mucositis or nausea.ConclusionThe results reveal, for the first time, the cyclical yet transient effects of adjuvant chemotherapy on taste function and the link between taste and hedonic changes, dietary intake and nutritional outcomes. The results should be used to inform reliable pre-chemotherapy education.
Highlights
Taste is one of the five senses and interacts with smell, touch and other physiological cues to affect the wider perception of flavor
Reduced taste function was associated with lowest kilojoule intake (r = 0.31; p = 0.008) as was appetite loss with reduced kilojoule (r = 0.34; p = 0.002) and protein intake (r = 0.36; p = 0.001) early in the third chemotherapy cycle
The results reveal, for the first time, the cyclical yet transient effects of adjuvant chemotherapy on taste function and the link between taste and hedonic changes, dietary intake and nutritional outcomes
Summary
Taste is one of the five senses and interacts with smell, touch and other physiological cues to affect the wider perception of flavor. Food hedonics, which contributes to flavour perception, encompasses food liking: the immediate experience or anticipation of pleasure from the oro-sensory stimulation of eating a food [3], and appetite: a psychobiologically based sensation related to the maintenance of eating and a desire for specific foods [4]. ‘Taste’ changes are commonly reported by people receiving chemotherapy [7] even among those who do not report nausea. It is unclear to what extent this relates to altered taste function per se or to changes to the sense of smell or touch (including oral dryness) or to hedonic aspects such as food liking, or appetite, described colloquially by patients and clinicians as ‘taste’ [8]
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