Influence of flavour enhancement on food liking and consumption in older adults with poor, moderate or high cognitive status

Abstract

It is important to maintain adequate food consumption in older adults so as to prevent malnutrition, particularly among those with cognitive impairments who represent the majority of patients living in nursing homes. Indeed, these patients may reduce their food intake, which can be explained by a lack of pleasure in eating food. Few studies have tested the efficiency of strategies based on food pleasure to increase food intake in this population. To our knowledge, the influence of flavour enhancement has been widely investigated in non-cognitively impaired older adults, but not in those with cognitive impairments. Our objective was therefore to study the influence of flavour enhancement on food liking and then on food intake in older adults with different degrees of cognitive impairments. To achieve this, two food testing methods were compared: paired comparison and sequential monadic tests.104 subjects were recruited in four nursing homes and clustered into three groups as a function of their cognitive impairments (severe, moderate and without marked cognitive impairments). Two different samples of an appetizer were formulated: a reference sample and a flavour-enhanced sample. These appetizers were offered to the participants before lunch in standardised small portions during three tasting sessions organised at intervals of one week. During one session, the participants received both samples at the same time (paired comparison test) and during the two others, they were given a single sample at each session (sequential monadic test). Food intake and food liking were then evaluated with respect to each participant and each sample.The results showed a positive correlation between food liking and food intake, and a positive influence of flavour enhancement on food intake, regardless of the cognitive status of the participants. The sequential monadic test produced results similar to those of the paired-comparison test in terms of the effects of flavour enhancement. These findings suggest that this method could be used to investigate the influence of food interventions at mealtimes in older adults with cognitive impairments.Finally, this study shows that food intake could be increased by optimising the sensory properties of foods served to cognitively impaired older patients.