“Everything tastes different”

The impact of changes in chemosensory perception on food preferences, food intake and quality of life during chemotherapy in cancer patients

Yfke Carlijn de Vries

Research output: Thesisinternal PhD, WU

Abstract

Taste and smell changes are common side effects during chemotherapy in cancer patient and may have an impact on food preferences, food intake and quality of life. However, these relations have hardly been studied systematically in specific cancer populations. The overall aim of this thesis was to assess how the sense of taste and smell change upon treatment with chemotherapy in breast cancer and oesophagogastric cancer patients, and to investigate their consequences in terms of food preferences, food intake and quality of life.

To measure food preferences for both macronutrients and tastes, the Macronutrient and Taste Preference Ranking Task (MTPRT) was developed. in chapter 2, it was shown that by inducing sensory specific satiety for a standardized sweet and savoury meal, it is possible to detect shifts in preferences for both tastes and macronutrients with the MTPRT, and that these results are reproducible.

In Chapter 3 we studied objective and subjective taste and smell perception and food preferences in advanced oesophagogastric cancer patients undergoing palliative chemotherapy. The result showed that only objective taste function decreases during chemotherapy, but other chemosensory measures were unchanged. A lower subjective taste perception was related to a lower preference for high-protein products. Therefore it is important to consider patients’ taste perception, when providing dietary advice to OGC patients

Chapter 4 describes a study with similar outcome measures as chapter 3, but in breast cancer patients at several time points during and after chemotherapy, and compared to a healthy control group. The study showed that breast cancer patients like high-protein, high-fat, sweet and savoury products less during chemotherapy, thus showing altered preferences for macronutrients, but not for tastes. Furthermore, results showed a temporary decrease in taste and smell perception during chemotherapy. These findings show that patients should be informed prior to treatment on chemosensory changes, and that these changes should be monitored during treatment due to the consequences for nutritional intake and quality of life

In chapter 5 we assessed the dietary intake of breast cancer patients before and during chemotherapy compared to a healthy control group, and associations with experienced symptoms during chemotherapy. It was shown that symptoms induced by chemotherapy were associated with lower total energy, protein and fat intake, which was manifested by a lower intake of specific food groups. Therefore, to ensure an optimal dietary intake during chemotherapy, it is important to monitor nutritional status and symptom burden during chemotherapy in breast cancer patients.

To better understand the impact of chemosensory changes during chemotherapy on daily life, 13 advanced oesophagogastric cancer patients were interviewed (see chapter 6). Patients described a substantial impact of chemosensory and food-related changes on daily life (by changing daily routines), social life (eating being less sociable) and roles in the household (changing roles in cooking and grocery shopping).

Finally, in chapter 7, we assessed the association between self-reported taste and smell perception and quality of life in breast cancer patients. A worse taste and smell perception was associated with a worse global quality of life, role, social and emotional functioning shortly after chemotherapy. In patients treated with trastuzumab, a worse taste and smell perception was still associated with quality of life, social and role functioning half a year after chemotherapy had ended.

From the studies in this thesis we can conclude that chemotherapy mainly affects the sense of taste. The subjective perception of taste was associated with a lower preference for food products and lower energy intake. This indicates that it is not necessarily an actual change in the sense of taste or smell that has an impact on patients, but flavour perception as a whole and potentially a lower enjoyment of food. Moreover, these perceived changes in taste and smell can have a substantial impact on cancer patients’ lives, in a practical way by changing daily patterns of eating, but also socially and in roles in the household. A changed chemosensory perception during chemotherapy may lead to a worsened nutritional status, and could thereby negatively impact the response to chemotherapy. Therefore chemosensory perception should be monitored during chemotherapy. Future studies should further investigate the mechanisms behind chemosensory changes, factors that contribute to subjective taste perception and possible interventions to alleviate chemosensory changes during chemotherapy.

Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Wageningen University
Supervisors/Advisors
  • de Graaf, Kees, Promotor
  • van Laarhoven, H.W.M., Promotor, External person
  • Winkels, R.M., Co-promotor, External person
  • Boesveldt, Sanne, Co-promotor
Award date1 Sep 2017
Place of PublicationWageningen
Publisher
Print ISBNs9789463436090
DOIs
Publication statusPublished - 2017

Fingerprint

Food Preferences
Food Quality
Eating
Quality of Life
Taste Perception
Drug Therapy
Smell
Neoplasms
Breast Neoplasms
Satureja
Nutritional Status
Fats

Keywords

  • perception
  • sensory evaluation
  • food intake
  • quality of life
  • food preferences
  • neoplasms
  • taste
  • macronutrients
  • drug therapy
  • breast cancer

Cite this

@phdthesis{456ddb2aba974a34b36fce18b60c9558,
title = "“Everything tastes different”: The impact of changes in chemosensory perception on food preferences, food intake and quality of life during chemotherapy in cancer patients",
abstract = "Taste and smell changes are common side effects during chemotherapy in cancer patient and may have an impact on food preferences, food intake and quality of life. However, these relations have hardly been studied systematically in specific cancer populations. The overall aim of this thesis was to assess how the sense of taste and smell change upon treatment with chemotherapy in breast cancer and oesophagogastric cancer patients, and to investigate their consequences in terms of food preferences, food intake and quality of life. To measure food preferences for both macronutrients and tastes, the Macronutrient and Taste Preference Ranking Task (MTPRT) was developed. in chapter 2, it was shown that by inducing sensory specific satiety for a standardized sweet and savoury meal, it is possible to detect shifts in preferences for both tastes and macronutrients with the MTPRT, and that these results are reproducible. In Chapter 3 we studied objective and subjective taste and smell perception and food preferences in advanced oesophagogastric cancer patients undergoing palliative chemotherapy. The result showed that only objective taste function decreases during chemotherapy, but other chemosensory measures were unchanged. A lower subjective taste perception was related to a lower preference for high-protein products. Therefore it is important to consider patients’ taste perception, when providing dietary advice to OGC patients Chapter 4 describes a study with similar outcome measures as chapter 3, but in breast cancer patients at several time points during and after chemotherapy, and compared to a healthy control group. The study showed that breast cancer patients like high-protein, high-fat, sweet and savoury products less during chemotherapy, thus showing altered preferences for macronutrients, but not for tastes. Furthermore, results showed a temporary decrease in taste and smell perception during chemotherapy. These findings show that patients should be informed prior to treatment on chemosensory changes, and that these changes should be monitored during treatment due to the consequences for nutritional intake and quality of life In chapter 5 we assessed the dietary intake of breast cancer patients before and during chemotherapy compared to a healthy control group, and associations with experienced symptoms during chemotherapy. It was shown that symptoms induced by chemotherapy were associated with lower total energy, protein and fat intake, which was manifested by a lower intake of specific food groups. Therefore, to ensure an optimal dietary intake during chemotherapy, it is important to monitor nutritional status and symptom burden during chemotherapy in breast cancer patients. To better understand the impact of chemosensory changes during chemotherapy on daily life, 13 advanced oesophagogastric cancer patients were interviewed (see chapter 6). Patients described a substantial impact of chemosensory and food-related changes on daily life (by changing daily routines), social life (eating being less sociable) and roles in the household (changing roles in cooking and grocery shopping). Finally, in chapter 7, we assessed the association between self-reported taste and smell perception and quality of life in breast cancer patients. A worse taste and smell perception was associated with a worse global quality of life, role, social and emotional functioning shortly after chemotherapy. In patients treated with trastuzumab, a worse taste and smell perception was still associated with quality of life, social and role functioning half a year after chemotherapy had ended. From the studies in this thesis we can conclude that chemotherapy mainly affects the sense of taste. The subjective perception of taste was associated with a lower preference for food products and lower energy intake. This indicates that it is not necessarily an actual change in the sense of taste or smell that has an impact on patients, but flavour perception as a whole and potentially a lower enjoyment of food. Moreover, these perceived changes in taste and smell can have a substantial impact on cancer patients’ lives, in a practical way by changing daily patterns of eating, but also socially and in roles in the household. A changed chemosensory perception during chemotherapy may lead to a worsened nutritional status, and could thereby negatively impact the response to chemotherapy. Therefore chemosensory perception should be monitored during chemotherapy. Future studies should further investigate the mechanisms behind chemosensory changes, factors that contribute to subjective taste perception and possible interventions to alleviate chemosensory changes during chemotherapy.",
keywords = "perception, sensory evaluation, food intake, quality of life, food preferences, neoplasms, taste, macronutrients, drug therapy, breast cancer, perceptie, sensorische evaluatie, voedselopname, kwaliteit van het leven, voedselvoorkeuren, neoplasma, smaak, macronutri{\"e}nten, geneesmiddelenbehandeling, borstkanker",
author = "{de Vries}, {Yfke Carlijn}",
note = "WU thesis 6728 Includes bibliographic references. - With summary in English",
year = "2017",
doi = "10.18174/417845",
language = "English",
isbn = "9789463436090",
publisher = "Wageningen University",
school = "Wageningen University",

}

“Everything tastes different” : The impact of changes in chemosensory perception on food preferences, food intake and quality of life during chemotherapy in cancer patients. / de Vries, Yfke Carlijn.

Wageningen : Wageningen University, 2017. 169 p.

Research output: Thesisinternal PhD, WU

TY - THES

T1 - “Everything tastes different”

T2 - The impact of changes in chemosensory perception on food preferences, food intake and quality of life during chemotherapy in cancer patients

AU - de Vries, Yfke Carlijn

N1 - WU thesis 6728 Includes bibliographic references. - With summary in English

PY - 2017

Y1 - 2017

N2 - Taste and smell changes are common side effects during chemotherapy in cancer patient and may have an impact on food preferences, food intake and quality of life. However, these relations have hardly been studied systematically in specific cancer populations. The overall aim of this thesis was to assess how the sense of taste and smell change upon treatment with chemotherapy in breast cancer and oesophagogastric cancer patients, and to investigate their consequences in terms of food preferences, food intake and quality of life. To measure food preferences for both macronutrients and tastes, the Macronutrient and Taste Preference Ranking Task (MTPRT) was developed. in chapter 2, it was shown that by inducing sensory specific satiety for a standardized sweet and savoury meal, it is possible to detect shifts in preferences for both tastes and macronutrients with the MTPRT, and that these results are reproducible. In Chapter 3 we studied objective and subjective taste and smell perception and food preferences in advanced oesophagogastric cancer patients undergoing palliative chemotherapy. The result showed that only objective taste function decreases during chemotherapy, but other chemosensory measures were unchanged. A lower subjective taste perception was related to a lower preference for high-protein products. Therefore it is important to consider patients’ taste perception, when providing dietary advice to OGC patients Chapter 4 describes a study with similar outcome measures as chapter 3, but in breast cancer patients at several time points during and after chemotherapy, and compared to a healthy control group. The study showed that breast cancer patients like high-protein, high-fat, sweet and savoury products less during chemotherapy, thus showing altered preferences for macronutrients, but not for tastes. Furthermore, results showed a temporary decrease in taste and smell perception during chemotherapy. These findings show that patients should be informed prior to treatment on chemosensory changes, and that these changes should be monitored during treatment due to the consequences for nutritional intake and quality of life In chapter 5 we assessed the dietary intake of breast cancer patients before and during chemotherapy compared to a healthy control group, and associations with experienced symptoms during chemotherapy. It was shown that symptoms induced by chemotherapy were associated with lower total energy, protein and fat intake, which was manifested by a lower intake of specific food groups. Therefore, to ensure an optimal dietary intake during chemotherapy, it is important to monitor nutritional status and symptom burden during chemotherapy in breast cancer patients. To better understand the impact of chemosensory changes during chemotherapy on daily life, 13 advanced oesophagogastric cancer patients were interviewed (see chapter 6). Patients described a substantial impact of chemosensory and food-related changes on daily life (by changing daily routines), social life (eating being less sociable) and roles in the household (changing roles in cooking and grocery shopping). Finally, in chapter 7, we assessed the association between self-reported taste and smell perception and quality of life in breast cancer patients. A worse taste and smell perception was associated with a worse global quality of life, role, social and emotional functioning shortly after chemotherapy. In patients treated with trastuzumab, a worse taste and smell perception was still associated with quality of life, social and role functioning half a year after chemotherapy had ended. From the studies in this thesis we can conclude that chemotherapy mainly affects the sense of taste. The subjective perception of taste was associated with a lower preference for food products and lower energy intake. This indicates that it is not necessarily an actual change in the sense of taste or smell that has an impact on patients, but flavour perception as a whole and potentially a lower enjoyment of food. Moreover, these perceived changes in taste and smell can have a substantial impact on cancer patients’ lives, in a practical way by changing daily patterns of eating, but also socially and in roles in the household. A changed chemosensory perception during chemotherapy may lead to a worsened nutritional status, and could thereby negatively impact the response to chemotherapy. Therefore chemosensory perception should be monitored during chemotherapy. Future studies should further investigate the mechanisms behind chemosensory changes, factors that contribute to subjective taste perception and possible interventions to alleviate chemosensory changes during chemotherapy.

AB - Taste and smell changes are common side effects during chemotherapy in cancer patient and may have an impact on food preferences, food intake and quality of life. However, these relations have hardly been studied systematically in specific cancer populations. The overall aim of this thesis was to assess how the sense of taste and smell change upon treatment with chemotherapy in breast cancer and oesophagogastric cancer patients, and to investigate their consequences in terms of food preferences, food intake and quality of life. To measure food preferences for both macronutrients and tastes, the Macronutrient and Taste Preference Ranking Task (MTPRT) was developed. in chapter 2, it was shown that by inducing sensory specific satiety for a standardized sweet and savoury meal, it is possible to detect shifts in preferences for both tastes and macronutrients with the MTPRT, and that these results are reproducible. In Chapter 3 we studied objective and subjective taste and smell perception and food preferences in advanced oesophagogastric cancer patients undergoing palliative chemotherapy. The result showed that only objective taste function decreases during chemotherapy, but other chemosensory measures were unchanged. A lower subjective taste perception was related to a lower preference for high-protein products. Therefore it is important to consider patients’ taste perception, when providing dietary advice to OGC patients Chapter 4 describes a study with similar outcome measures as chapter 3, but in breast cancer patients at several time points during and after chemotherapy, and compared to a healthy control group. The study showed that breast cancer patients like high-protein, high-fat, sweet and savoury products less during chemotherapy, thus showing altered preferences for macronutrients, but not for tastes. Furthermore, results showed a temporary decrease in taste and smell perception during chemotherapy. These findings show that patients should be informed prior to treatment on chemosensory changes, and that these changes should be monitored during treatment due to the consequences for nutritional intake and quality of life In chapter 5 we assessed the dietary intake of breast cancer patients before and during chemotherapy compared to a healthy control group, and associations with experienced symptoms during chemotherapy. It was shown that symptoms induced by chemotherapy were associated with lower total energy, protein and fat intake, which was manifested by a lower intake of specific food groups. Therefore, to ensure an optimal dietary intake during chemotherapy, it is important to monitor nutritional status and symptom burden during chemotherapy in breast cancer patients. To better understand the impact of chemosensory changes during chemotherapy on daily life, 13 advanced oesophagogastric cancer patients were interviewed (see chapter 6). Patients described a substantial impact of chemosensory and food-related changes on daily life (by changing daily routines), social life (eating being less sociable) and roles in the household (changing roles in cooking and grocery shopping). Finally, in chapter 7, we assessed the association between self-reported taste and smell perception and quality of life in breast cancer patients. A worse taste and smell perception was associated with a worse global quality of life, role, social and emotional functioning shortly after chemotherapy. In patients treated with trastuzumab, a worse taste and smell perception was still associated with quality of life, social and role functioning half a year after chemotherapy had ended. From the studies in this thesis we can conclude that chemotherapy mainly affects the sense of taste. The subjective perception of taste was associated with a lower preference for food products and lower energy intake. This indicates that it is not necessarily an actual change in the sense of taste or smell that has an impact on patients, but flavour perception as a whole and potentially a lower enjoyment of food. Moreover, these perceived changes in taste and smell can have a substantial impact on cancer patients’ lives, in a practical way by changing daily patterns of eating, but also socially and in roles in the household. A changed chemosensory perception during chemotherapy may lead to a worsened nutritional status, and could thereby negatively impact the response to chemotherapy. Therefore chemosensory perception should be monitored during chemotherapy. Future studies should further investigate the mechanisms behind chemosensory changes, factors that contribute to subjective taste perception and possible interventions to alleviate chemosensory changes during chemotherapy.

KW - perception

KW - sensory evaluation

KW - food intake

KW - quality of life

KW - food preferences

KW - neoplasms

KW - taste

KW - macronutrients

KW - drug therapy

KW - breast cancer

KW - perceptie

KW - sensorische evaluatie

KW - voedselopname

KW - kwaliteit van het leven

KW - voedselvoorkeuren

KW - neoplasma

KW - smaak

KW - macronutriënten

KW - geneesmiddelenbehandeling

KW - borstkanker

U2 - 10.18174/417845

DO - 10.18174/417845

M3 - internal PhD, WU

SN - 9789463436090

PB - Wageningen University

CY - Wageningen

ER -