Weight Loss, Dietary Preferences, and Reduction in the Sense of Smell with the Use of a Novel Nasal Device

A Life Without Smell: Olfactory Function in People Working in Odorless Rooms

OBJECTIVES

Odorous stimulation helps to maintain or to improve olfactory function. In contrast, odor deprivation has been suggested to facilitate olfactory impairment. The aim of this study was to investigate the effects of odor deprivation in people working in an odorless environment.

METHODS

Fifty people working in an odorless environment for extended periods of time and 50 people not working in such environments were recruited. The participants were examined for olfactory function (using Sniffin' Sticks), nasal airflow (using peak nasal inspiratory flowmetry), self-rated olfactory function, self-rated nasal airflow, and well-being. Correlation analyses were used to explore the associations between the duration of working in odorless environment and olfaction, nasal airflow, and well-being.

RESULTS

The cleanroom workers exhibited slightly, but significantly reduced olfactory scores (sensitivity 7.0 ± 2.5, discrimination 11.4 ± 1.8) compared with controls (sensitivity 8.9 ± 2.5, F = 4.33, p = 0.03; discrimination 12.7 ± 1.6. F = 5.50, p = 0.001), even when controlling for age and rated nasal patency, with their self-rated olfactory function being not affected. The years of working in cleanrooms were negatively associated with olfactory function (r = 0.35, p = 0.013). No significant correlations were observed between scores of olfactory function, nasal patency, and well-being.

CONCLUSION

Compared with controls cleanroom workers exhibited slightly, but significantly lower olfactory scores, nasal peak flow, and well-being. Their decreased odor sensitivity was found to be associated with the number of years they had worked in the cleanroom. Overall, these results may suggest that odorous stimulation supports olfactory functioning.

LEVEL OF EVIDENCE

4 Laryngoscope, 134:382-387, 2024.

The Role of the Olfactory System in Obesity and Metabolism in Humans: A Systematic Review and Meta-Analysis

Obesity, linked to chronic diseases, poses a global health challenge. While the role of the olfactory system in energy homeostasis is well-documented in rodents, its role in metabolism regulation and obesity in humans remains understudied. This review examines the interplay between olfactory function and metabolic alterations in human obesity and the effects of bariatric surgery on olfactory capabilities in humans. Adhering to PRISMA guidelines, a systematic review and meta-analysis was conducted, focusing exclusively on original human studies. From 51 articles, 14 were selected for the meta-analysis. It was found that variations in olfactory receptor genes influence the susceptibility to odors and predisposition to weight gain and poor eating habits. Bariatric surgery, particularly sleeve gastrectomy, shows significant improvements in olfactory function (SMD 2.37, 95% CI [0.96, 3.77], I = 92%, p = 0.001), especially regarding the olfactory threshold (SMD -1.65, 95% CI [-3.03, -0.27], I = 81%, p = 0.02). There is a bidirectional relationship between olfactory function and metabolism in humans. Bariatric surgery improves olfactory perception in obese patients, but it is still unclear if impacting the olfactory system directly affects eating behavior and the energy balance. However, these findings open novel avenues for future studies addressing the olfactory system as a novel target to alter systemic metabolism in humans.

Smell, taste and food habits changes along body mass index increase: an observational study

PURPOSE

To evaluate the changes in gustatory and olfactory sensitivity and dietary habits between healthy lean subjects (LS) and participants affected by overweight (OW), stage I and II obesity and to estimate possible impact of these factors on body mass index (BMI).

METHODS

After a general and ear-nose-throat evaluation, taste and olfactory function testing by means of taste strips and sniffin' stick tests, respectively, and food habits analysis by means of food frequency questionnaire (FFQ), 221 participants (68 LS [33 female; mean age = 53.01 ± 7.54 years]; 51 OW [26 female; mean age = 51.5 ± 12.16 years]; 50 stage I obesity [24 female; mean age = 50.78 ± 13.71 years] and 52 stage II obesity [24 female; mean age = 52.21 ± 13.35 years]) were enrolled in the study.

RESULTS

Significant (p < 0.008) reductions in total and subtest taste and smell scores were found in stage I and II obesity when compared to LS and OW participants. FFQ depicted a progressive intake increase of nutrients along the BMI stages. Significant associations were found between BMI and taste/smell subtests sugar taste carbs, saturated, monounsaturated and polyunsaturated fatty acids.

CONCLUSIONS

These data demonstrated for the first time a parallel impairment in smell and taste in a large sample size of participants from lean to stage II obesity and could reinforce those previous theories claiming that the greater the ability in taste or smell qualities perception, the lower the preference for them, resulting in a lower intake of specific foods.

Odor deprivation influences human olfactory function

Odor deprivation leads to anatomical and neurochemical changes in the olfactory system, but its effect on human olfaction has not been systematically explored. The present randomized, controlled study aimed to investigate whether odor deprivation by different methods can affect olfactory function in humans. In the present study, sixty-one healthy participants were randomly assigned into three groups: a nasal device group (wearing an intranasal silicone air diversion system for 6-8 h daily), a mask group (wearing a filtering face piece for 6-8 h daily) and a control group (no special instructions in terms of wearing masks). Before and immediately after a 14-day study phase, all participants underwent assessments of olfactory function, nasal patency and well-being. Following the 2-week observation period, the nasal device group exhibited significantly reduced TDI scores (with especially pronounced reductions for odor threshold scores), and the mask group exhibited a minor increase in odor identification scores compared with the control group. The change in well-being scores was positively associated with changes in odor identification and TDI scores. Olfactory deprivation using an intranasal silicone air diversion device is associated with olfactory impairment (especially for odor thresholds). Highlighting the exposure-driven plasticity of the olfactory system, it may serve as a possible model of hyposmia in future studies. In addition, it may also prove useful in patients with parosmia, possibly reducing the burden of unpleasant odorous sensations.

Smell Impairment in Stage I-II Obesity: Correlation with Biochemical Regulators and Clinical Aspects

OBJECTIVE

To evaluate the differences in olfactory sensitivity, nutritional habits, levels of modulators of feeding and smell, bioelectrical impedance analysis (BIA) measures and metabolic assays between two groups of participants with stage I and II obesity and reciprocal relationships between these parameters.

METHODS

Eighteen participants with stage I (11 female; mean age = 54.3 ± 13.1 years) and 20 participants with stage II (10 female; mean age = 54.5 ± 11.9) obesity underwent a food frequency questionnaire and Sniffin' Sticks® test battery, anthropometric parameters, and BIA measurements as well as metabolic assays (including plasma levels of leptin, insulin, ghrelin, glucose, insulin-like growth factor-1 [IGF-1] and usual laboratory parameters).

RESULTS

The stage II obesity participants demonstrated significant higher levels of insulin and leptin and lower levels of ghrelin and IGF-1, a reduction in odor identification (OI) and in total olfactory score, and an increase in visceral and total fat percentage. Among a mosaic of multiple correlations, ghrelin was found to positively correlate with OI and leptin negatively with odor discrimination.

CONCLUSION

The present study expands the notions positing the olfactory perception - and its connections with metabolic cues, foods habits and BIA measures - changes across the two most important obesity stages. This could ameliorate clinical and research deepening of obesity-related olfactory behavior with possible consequences on diagnosis, treatment and prevention of onset and development of obesity, thus opening possible future strategies involving multidisciplinary contributions.

LEVEL OF EVIDENCE

Level 3 Laryngoscope, 2022.

Olfactory system and energy metabolism: a two-way street

Olfactory perception guides daily decisions regarding food consumption, social interactions, and predator avoidance in all mammalian species. Volatile inputs, comprising odorants and pheromones, are relayed to the olfactory bulb (OB) from nasal sensory neurons cells and transferred to secondary processing regions within the brain. Olfaction has recently been shown to shape homeostatic and maladaptive processes of energy intake and expenditure through neuronal circuits involving the medial basal hypothalamus. Reciprocally, gastrointestinal hormones, such as ghrelin and leptin, the secretion of which depends on satiety and adiposity levels, might also influence olfactory sensitivity to alter food-seeking behaviors. Here, in addition to reviewing recent updates on identifying these neuronal networks, we also discuss how bidirectional neurocircuits existing between olfactory and energy processing centers can become dysregulated during obesity.

Food Neophobia, Odor and Taste Sensitivity, and Overall Flavor Perception in Food

Smell, which allows us to gather information about the hedonic value of an odor, is affected by many factors. This study aimed to assess the relationship among individual factors, odor sensitivity, and enjoyment, and to evaluate how overall flavor perception and liking in actual food samples are affected by odor sensitivity. A total of 749 subjects, from four different Italian regions, participated in the study. The olfactory capabilities test on four odors (anise, banana, mint, and pine), as well as PROP (6-n-prpyl-2-thiouracil) status and food neophobia were assessed. The subjects were clustered into three groups of odor sensitivity, based on the perceived intensity of anise. The liking and intensity of the overall flavor were evaluated for four chocolate puddings with increasing sweetness (C1, C2, C3, and C4). The individual variables significantly affected the perceived intensity and liking of the odors. Even if all of the odor sensitivity groups perceived the more intensely flavored samples as the C1 and C4 chocolate puddings, the high-sensitivity group scored the global flavor of all of the samples as more intense than the low-sensitivity group. The low-sensitive subjects evaluated the liking of the sweeter samples with higher scores than the moderate-sensitive subjects, whereas the high-sensitive subjects gave intermediate scores. In conclusion, odor sensitivity plays a pivotal role in the perception and liking of real food products; this has to be taken into account in the formulation of new products, suitable for particular categories with reduced olfactory abilities.

Safety and Efficacy of a Beverage Containing Lupine Protein Hydrolysates on the Immune, Oxidative and Lipid Status in Healthy Subjects: An Intervention Study (the Lupine-1 Trial)

SCOPE

We have previously demonstrated the anti-inflammatory and antioxidant properties of in vitro administered Lupinus angustifolius protein hydrolysates (LPHs) on human peripheral blood mononuclear cells (PBMCs). This study aims to evaluate the safety and efficacy of a beverage containing LPHs (LPHb) on the immune, oxidative and metabolic status of healthy subjects.

METHODS AND RESULTS

In this open-label intervention, 33 participants daily ingest a LPHb containing 1 g LPHs for 28 days. Biochemical parameters are assayed in fasting peripheral blood and urine samples before, during (14 days) and after LPHb ingestion. Participants' health status and the immune and antioxidant responses of PBMCs are also evaluated throughout the trial. The LPHb ingestion is safe and effective in both increasing the anti-/pro-inflammatory response of PBMCs and improving the cellular anti-oxidant capacity. LPHb also reduces the low-density lipoprotein-cholesterol (LDL-C)/high-density lipoprotein-cholesterol (HDL-C) atherogenic index. LPHb effect is particularly beneficial on decreasing not only the LDL-C/HDL-C index but also serum total cholesterol levels in the male cohort that shows the highest baseline levels of well-known cardiovascular risk factors.

CONCLUSION

This is the first study to show the pleiotropic actions of a lupine bioactive peptides-based functional food on key steps of atherosclerosis including inflammation, oxidative stress, and cholesterol metabolism.