Association Between Chemosensory Dysfunction and Diet Quality in United States Adults

Abstract

Background

Evidence suggests chemosensory dysfunction (CSD) patients have altered diet, but population-level evidence assessing diet quality in CSD patients is lacking.

Objective

We examined the association between CSD and diet quality in a representative sample of United States adults.

Methods

This cross-sectional study included 2831 adults aged greater than 40 years from the 2013-2014 National Health and Nutrition Examination Survey who completed the taste/smell questionnaire and examination. Mean nutrient intake in subjects with self-reported olfactory/gustatory dysfunction (sOD/sGD) and measured olfactory/gustatory dysfunction (mOD/mGD) were compared to those without CSD using univariate Wilcoxon rank-sum tests. The Healthy Eating Index (HEI), a validated measure of diet quality, was calculated. The proportion of subjects with CSD with bottom-quartile HEI was compared to those without CSD using multivariate logistic regression, adjusting for demographic and socioeconomic covariates.

Results

The population-weighted prevalence of sOD, sGD, mOD, and mGD was 20.1%, 14.4%, 15.9% and 25.6%, respectively. Subjects with mOD had lower mean intake of total calories, total fat, protein, sodium, and potassium compared to normal subjects (1873.4 ± 49.6 vs 2010.2 ± 24.2 kcal, 72.3 ± 2.7 vs 78.6 ± 1.0 gm, 74.0 ± 2.5 vs 80.4 ± 0.6 gm, 3122 ± 97.2 vs 3353.2 ± 37.0 mg, 2509.8 ± 69.8 vs 2684.7 ± 26.1 mg, P < 0.05 respectively). When controlling for sociodemographic factors and comorbidities, subjects with sOD were more likely to have bottom-quartile HEI compared to normal subjects (OR 1.33, 95% CI 1.04–1.70).

Conclusions

This population-level study suggests an association between poor diet quality and variation in dietary intake in patients with CSD, which warrants further investigation and suggests the possible need for nutritional counseling for CSD patients.

Keywords

chemosensory dysfunction diet gustation NHANES nutrition olfaction smell taste

Get full access to this article

View all access options for this article.

References

Bigman

Age-related smell and taste impairments and vitamin D associations in the U.S. Adults. National health and nutrition examination survey. Nutrients. 2020; 12(4):984.

Chan JYK, Garcia-Esquinas E, Ko OH, Tong M, Lin SY. The association between diabetes and olfactory function in adults. Chem Senses. 2018; 43(1):59–64.

Hur K, Choi JS, Zheng M, Shen J, Wrobel B. Association of alterations in smell and taste with depression in older adults. Laryngosc Investig Otolaryngol. 2018; 3(2):94–99.

Bhattacharyya

Kepnes

LJ.

Contemporary assessment of the prevalence of smell and taste problems in adults. Laryngoscope. 2015; 125(5):1102–1106.

Gallo S, Byham-Gray L, Duffy VB, Hoffman HJ, Hayes JE, Rawal S. Associations of olfactory dysfunction with anthropometric and cardiometabolic measures: findings from the 2013-2014 national health and nutrition examination survey (NHANES). Physiol Behav. 2020; 215:112702. 1

Rawal S, Hoffman HJ, Bainbridge KE, Huedo-Medina TB, Duffy VB. Prevalence and risk factors of Self-Reported smell and taste alterations: results from the 2011–2012 US national health and nutrition examination survey (NHANES). CHEMSE. 2016; 41(1):69–76.

Mattes RD, Cowart BJ, Schiavo MA, Arnold C, Garrison B, Kare MR, Lowry LD. Dietary evaluation of patients with smell and/or taste disorders. Clin Nutr. 1990; 51(2):233–240.

Mattes

Cowart

BJ.

Dietary assessment of patients with chemosensotyr disorders. J Am Diet Assoc. 1994; 94(11):50–56.

Mattes-Kulig

Henkin

RI.

Energy and nutrient consumption of patients with dysgeusia. J Am Diet Assoc. 1985; 85(7):822–826.

10.

Aschenbrenner K, Hummel C, Teszmer K, Krone F, Ishimaru T, Seo HS, Hummel T. The influence of olfactory loss on dietary behaviors. Laryngoscope. 2008; 118(1):135–144.

11.

Griep MI, Verleye G, Franck AH, Collys K, Mets TF, Massart DL. Variation in nutrient intake with dental status, age and odour perception. Eur J Clin Nutr. 1996; 50(12):816–825.

12.

Duffy

Backstrand

Ferris

AM.

Olfactory dysfunction and related nutritional risk in free-living, elderly women. J Am Diet Assoc. 1995; 95(8):879–884.

13.

Stevenson RJ, Mahmut MK, Horstmann A, Hummel T. The aetiology of olfactory dysfunction and its relationship to diet quality. Brain Sci. 2020; 10(11):11.

14.

Schiffman

Graham

BG.

Taste and smell perception affect appetite and immunity in the elderly. Eur J Clin Nutr. 2000; 54(S3):S54–S63.

15.

Gopinath B, Russell J, Sue CM, Flood VM, Burlutsky G, Mitchell P. Olfactory impairment in older adults is associated with poorer diet quality over 5 years. Eur J Nutr. 2016; 55(3):1081–1087.

16.

Zang Y, Han P, Burghardt S, Knaapila A, Schriever V, Hummel T. Influence of olfactory dysfunction on the perception of food. Eur Arch Otorhinolaryngol. 2019; 276(10):2811–2817.

17.

Rasmussen VF, Vestergaard ET, Hejlesen O, Andersson CUN, Cichosz SL. Prevalence of taste and smell impairment in adults with diabetes: a cross-sectional analysis of data from the national health and nutrition examination survey (NHANES). Prim Care Diabetes. 2018; 12(5):453–459.

18.

NHANES Questionnaires, Datasets, and Related Documentation. https://wwwn.cdc.gov/nchs/nhanes/Default.aspx. Accessed April 27, 2021.

19.

Rawal S, Hoffman HJ, Honda M, Huedo-Medin TB, Duffy VB. The Taste and Smell Protocol in the 2011-2014 US National Health and Nutrition Examination Survey (NHANES): test-retest reliability and validity testing. Chemosens Percept. 2015; 8(3):138–148.

20.

Dalton P, Doty RL, Murphy C, Frank R, Hoffman HJ, Maute C, Kallen MA, et al. Olfactory assessment using the NIH toolbox. Neurology. 2013; 80(11 Suppl 3):S32–S36.

21.

Coldwell SE, Mennella JA, Duffy VB, Pelchat ML, Griffith JW, Smutzer G, Cowart BJ, et al. Gustation assessment using the NIH toolbox. Neurology. 2013; 80(11 Suppl 3):S20–S24.

22.

Doty

Shaman

Dann

Development of the university of Pennsylvania smell identification test: a standardized microencapsulated test of olfactory function. Physiol Behav. 1984; 32(3):489–502.

23.

Hoffman

Rawal

, et al. New chemosensory component in the U.S. National health and nutrition examination survey (NHANES): first-year results for measured olfactory dysfunction. Rev Endocr Metab Disord. 2016; 17(2):221–240.

24.

Bartoshuk LM, Duffy VB, Green BG, Hoffman HJ, Ko CW, Lucchina LA, Marks LE, et al. Valid across-group comparisons with labeled scales: the gLMS versus magnitude matching. Physiol Behav. 2004; 82(1):109–114.

25.

Sharafi M, Rawal S, Fernandez ML, Huedo-Medina TB, Duffy VB. Taste phenotype associates with cardiovascular disease risk factors via diet quality in multivariate modeling. Physiol Behav. 2018; 194:103–112.

26.

Guenther PM, Kirkpatrick SI, Reedy J, Krebs-Smith SM, Buckman DW, Dodd KW, Casavale KO, Carroll RJ. The healthy eating index-2010 is a valid and reliable measure of diet quality according to the 2010 dietary guidelines for americans. J Nutr. 2014; 144(3):399–407.

27.

How the HEI Is Scored | USDA-FNS. https://www.fns.usda.gov/how-hei-scored. Accessed April 27, 2021.

28.

Rothman

KJ.

No adjustments are needed for multiple comparisons. Epidemiology. 1990; 1(1):43–46.

29.

Armstrong

RA.

When to use the bonferroni correction. Ophthalmic Physiol Opt. 2014; 34(5):502–508.

30.

Berridge

KC.

Food reward: brain substrates of wanting and liking.

Neurosci Biobehav Rev. 1996;20(1):1–25.

31.

Frank GK, Reynolds JR, Shott ME, Jappe L, Yang TT, Tregellas JR, O'Reilly RC. Anorexia nervosa and obesity are associated with opposite brain reward response. Neuropsychopharmacol. 2012; 37(9):2031–2046.

32.

Ferris

Duffy

VB.

Effect of olfactory deficits on nutritional status does age predict persons at risk?

Ann NY Acad Sci. 1989; 561(1):113–123.

33.

Mccrickerd

Forde

CG.

Etiology and pathophysiology sensory influences on food intake control: moving beyond palatability. Obes Rev. 2016; 17(1):18–29.

34.

Fine

Riera

CE.

Sense of smell as the central driver of pavlovian appetite behavior in mammals. Front Physiol. 2019; 10:1151.

35.

Platte

Gallant

Schweiger

, et al. Olfaction in eating disorders and abnormal eating behavior: a systematic review. Front Psychol. 20156; 6:1431.

36.

Fluitman KS, Nadar HJ, Roos DS, Berendse HW, Keijser BJF, Nieuwdorp M, Ijzerman RG, et al. The association of olfactory function with BMI, appetite, and prospective weight change in Dutch Community-Dwelling older adults. J Nutr Health Aging. 2019; 23(8):746–752.

37.

Rolls

BJ.

Do chemosensory changes influence food intake in the elderly?

Physiol Behav. 1999; 66(2):193–197.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.03 MB