Dietary assessment of patients with chemosensory disorders

To identify individuals who are at nutritional risk because of taste and/or smell disorders.

Patients referred by a private physician for evaluation of a chemosensory complaint underwent an extensive battery of taste and smell tests, otorhinolaryngologic tests, and, in some cases, periodontal examinations and completed a dietary/health questionnaire, a 24-hour recall, and a 2-day diet record.

Patients were interviewed at the Monell-Jefferson Chemosensory Clinical Research Center, Philadelphia, Pa.

We studied 310 patients (142 men and 168 women) with a primary complaint of chemosensory disorder. Mean age was 50.5 +/- 15.7 (range = 15 to 93 years). Normative data were provided by an additional 79 healthy control subjects (42 men and 37 women) with no taste or smell complaint. Their mean age was 48.8 +/- 18.8 years (range = 20 to 83 years).

Chemosensory disorder-related changes in food habits (determined by questionnaire responses), nutrient intake (analysis of 3-day food records), and body weight (self-reported).

Analysis of covariance, followed by post hoc analysis of adjusted means with the Tukey honestly significant difference test, was used to explore group differences in nutrient intake and body weight. chi 2 Analysis and the Pearson correlation coefficient were used to evaluate relationships between variables.

When groups were classified according to chemosensory diagnosis, group differences were observed on global appetitive questions, but complaints were high in all groups. Approximately 65% (203 of 310) of patients had self-reported body weights within 5% of their predisorder weight, but clinically meaningful weight gains or losses were observed in each group. Patients with multiple chemosensory disorders were most likely to lose weight, whereas the incidence of weight gain was highest in patients with anosmia. Patient report of a change in eating patterns was the best predictor of weight change among the variables examined.

Dietary responses to chemosensory disorders vary widely and may place patients at nutritional risk. Until better prognostic indexes are identified, dietitians should query patients about disorder-related alterations in eating patterns and provide appropriate individualized counseling.