Department of Agricultural, Food and Nutritional Science, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
J Pain Symptom Manage. 2011 Apr;41(4):673-83. doi: 10.1016/j.jpainsymman.2010.06.022. Epub 2011 Jan 28.
Taste and smell (chemosensory) alterations are common and distressing among advanced cancer patients, but their specific nature is poorly described and seldom linked to dietary intake. Details of altered chemosensory perception may help to explain food intake behaviors.
Our goal was to characterize chemosensory alterations and their relationship with dietary intake and quality of life (QOL).
Adult advanced cancer patients (n=192) completed a chemosensory self-assessment questionnaire to characterize changes in their sense of smell and four basic tastes (sweet, sour, salty, and bitter) since the onset of cancer, three-day food record, and QOL questionnaire.
Patients experienced either no alteration in any basic tastes and sense of smell sensations (26% of patients) or one of three altered chemosensory phenotypes: 1) stronger sensations overall (42%), 2) weaker sensations overall (18%), or 3) mixed (some sensations stronger and others weaker, 14%). For individual sensations (sweet, sour, salty, bitter, and smell), stronger sensation was twice more prevalent than weaker sensation (P=0.035). Patients reporting chemosensory alteration consumed 20%-25% fewer calories per day (P=0.0018), experienced greater weight loss (P=0.0036), and had poorer QOL scores (P=0.0176) compared with patients with no alterations, but results did not vary by chemosensory phenotype. Chemosensory alterations were not related to tumor type (P=0.884), gender (P=0.286), or nausea (P=0.278).
Chemosensory alterations predict dietary intake and QOL; the identification of chemosensory phenotypes provides a rationale to adjust the properties of foods and dietary recommendations in function of the specific nature of these changes.
味觉和嗅觉（化学感觉）改变在晚期癌症患者中很常见且令人痛苦，但它们的具体性质描述得很差，很少与饮食摄入有关。改变的化学感觉感知的细节可能有助于解释食物摄入行为。
我们的目标是描述化学感觉改变及其与饮食摄入和生活质量（QOL）的关系。
成年晚期癌症患者（n=192）完成了化学感觉自我评估问卷，以描述自癌症发病以来嗅觉和四种基本味觉（甜、酸、咸和苦）的变化、三天的食物记录和 QOL 问卷。
患者要么没有任何基本味觉和嗅觉感觉的改变（26%的患者），要么有三种改变的化学感觉表型之一：1）总体感觉增强（42%），2）总体感觉减弱（18%），或 3）混合（有些感觉增强，有些感觉减弱，14%）。对于个体感觉（甜、酸、咸、苦和嗅觉），感觉增强的情况比感觉减弱的情况更为常见（P=0.035）。报告化学感觉改变的患者每天摄入的卡路里减少了 20%-25%（P=0.0018），经历了更大的体重减轻（P=0.0036），生活质量评分更差（P=0.0176），与没有改变的患者相比，但结果不因化学感觉表型而异。化学感觉改变与肿瘤类型（P=0.884）、性别（P=0.286）或恶心（P=0.278）无关。
化学感觉改变预测饮食摄入和 QOL；化学感觉表型的识别为根据这些变化的特定性质调整食物特性和饮食建议提供了依据。
