Gustation

Gustatory stimulus interventions for older adults with dysphagia: a scoping review

BACKGROUND

Gustatory stimulus interventions have been shown to improve swallowing function in older adults with dysphagia. However, the optimal intervention strategies as well as their effects and safety remain unclear.

AIMS

To explore current evidence regarding gustatory stimulus interventions for dysphagia in older adults.

METHODS

Nine electronic databases (PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, and Sinomed) were searched from their inception to August 2022.

RESULTS

This review identified 263 articles, and 15 met the inclusion criteria. The types of gustatory stimulus interventions included spicy (n = 10), sour (n = 3), and mixed (sour-sweet) stimuli (n = 2), with most studies focusing on spicy stimuli. The most frequently reported spicy stimulus was capsaicin. Further, the most commonly reported intervention frequency was thrice a day before meals for 1-4 weeks. The stimuli concentrations and dosages could not be standardized due to the among-study heterogeneity. These studies reported 16 assessment tools and 42 outcomes, which mainly included videofluoroscopy and swallowing response time respectively. More than half of the included studies reported no adverse effects of gustatory stimulus interventions.

CONCLUSION AND DISCUSSIONS

Gustatory stimulus interventions improved swallowing function in older adults with dysphagia. However, assessment tools and outcomes for dysphagia should be standardized in the future, and explore personalized interventions based on different diseases and their stages, to determine the most cost-effective interventions, and to prevent its complications.

Central neurotoxicity induced by the instillation of ZnO and TiO2 nanoparticles through the taste nerve pathway

AIM

To explore whether nanoparticles (NPs) can be transported into the CNS via the taste nerve pathway.

MATERIALS & METHODS

ZnO and TiO₂ NPs were tongue-instilled to male Wistar rats. Toxicity was assessed by Zn/Ti biodistribution, histopathological examination, oxidative stress assay, quantitative reverse-transcriptase PCR analysis, learning and memory capabilities.

RESULTS

ZnO NPs and TiO₂ NPs significantly deposited in the nerves and brain, respectively. The histopathological examination indicated a slight injury in the cerebral cortex and hippocampus. Ultrastructural changes and an imbalanced oxidative stress were observed. The Morris water maze results showed that the learning and memory of rats were impaired.

CONCLUSION

NPs can enter the CNS via the taste nerve translocation pathway and induce a certain adverse effect.

Taste perception, associated hormonal modulation, and nutrient intake

It is well known that taste perception influences food intake. After ingestion, gustatory receptors relay sensory signals to the brain, which segregates, evaluates, and distinguishes the stimuli, leading to the experience known as "flavor." It is well accepted that five taste qualities – sweet, salty, bitter, sour, and umami – can be perceived by animals. In this review, the anatomy and physiology of human taste buds, the hormonal modulation of taste function, the importance of genetic chemosensory variation, and the influence of gustatory functioning on macronutrient selection and eating behavior are discussed. Individual genotypic variation results in specific phenotypes of food preference and nutrient intake. Understanding the role of taste in food selection and ingestive behavior is important for expanding our understanding of the factors involved in body weight maintenance and the risk of chronic diseases including obesity, atherosclerosis, cancer, diabetes, liver disease, and hypertension.