Influences of Age, Sex and Smoking Habit on Flavor Recognition in Healthy Population

Evaluation of the intensity of cigarette odors based on the perception of consumers

INTRODUCTION

We evaluated the tobacco odor intensity of cigarettes based on a large consumer panel and explored the differences of odor intensity perception based on sex, age and smoking habits.

METHODS

The perceived intensity of tobacco odor of cigarettes was evaluated using a consumer group method. A consumer panel of 240 volunteers (80 smokers, 80 ex-smokers and 80 non-smokers) was asked to smell eleven unlit cigarettes and then report their tobacco odor intensity in a specific questionnaire.

RESULTS

All volunteers clearly determined the presence of tobacco odor in all cigarettes. There is a general decrease of the perceived odor intensity with age, for both males and females. Moreover, tobacco odor perceived intensity, among all volunteer groups (smokers, non-smokers, ex-smokers), was higher for females than for males. Non-smokers declared the highest perceived tobacco odor intensities, followed by ex-smokers and smokers, who recorded the lowest perceived odor intensity. Perceived odor intensity decreased with age, with a higher rate for females compared to males, but independently of the smoking habits.

CONCLUSIONS

Regular and untrained consumers confirmed that a tobacco odor of different intensity can be perceived during the smelling of unlit cigarettes. This perceived intensity depends on sex, age and smoking habits.

The effect of nutrition education for cancer prevention based on health belief model on nutrition knowledge, attitude, and practice of Iranian women

Background

In recent years, nutrition has received an increasingly important role in the etiology of cancer. Thus, public education about dietary factors associated with cancer risk or prevention could be an important intervention for cancer prevention, particularly in low- and middle-income countries where the burden of cancer is increasing rapidly and the access to care is limited. The age-standardized incidence of breast cancer was 35.8 among Iranian women in 2020. We aimed to study the effect of nutrition education on the knowledge, attitude, and practice of Iranian women towards dietary factors related to cancer.

Methods

In this interventional study, 229 women from public health centers were recruited and underwent three 75-min sessions of education based on the Health Belief Model (HBM). Participants were interviewed by trained interviewers using a validated and reproducible nutrition-related cancer prevention knowledge, attitude, and practice questionnaire (NUTCANKAP) questionnaire designed based on the HBM. Nutritional knowledge, attitude, and practice of participants were assessed through this questionnaire. Three 24-h dietary recalls (one weekend and two nonconsecutive weekdays) were also collected before and one month after the intervention.

Results

The mean age of the participants was 45.14 years, and the mean BMI was 27.2 kg/m². After the intervention, the participants had a higher intake of whole grain (p = 0.03) and a lower fat dairy (p = 0.009) and nuts (p = 0.04). However, the intake of high-fat dairy (p = 0.001) decreased after the intervention. We indicated significant differences in knowledge (p < 0.001) and nutritional practice scores (p = 0.01) after education. In addition, after the intervention, there were significant differences in the mean score of the HBM components, except for the perceived self-efficacy.

Conclusion

Participation in a nutrition education program positively impacted the knowledge and nutritional practices linked to cancer prevention.

Multisensory mental representation in covid-19 patients and the possibility of long-lasting gustatory and olfactory dysfunction in the CNS

Gustatory (GD) and olfactory (OD) dysfunctions are the most frequent neurological manifestations of COVID-19. We used mental imagery as an experimental psychological paradigm to access olfactory and gustatory brain representations in 80 Italian COVID-19 adult patients (68.75% reported both OD and GD). COVID-19 patients with OD + GD have a significantly and selectively decreased vividness of odor and taste imagery, indicating that COVID-19 has an effect on their chemosensory mental representations. OD + GD length and type influenced the status of mental chemosensory representations. OD + GD were become all COVID-19 negative at the time of testing. Data suggest that patients are not explicitly aware of long-term altered chemosensory processing. However, differences emerge when their chemosensory function is implicitly assessed using self-ratings. Among patients developing OD + GD, self-ratings of chemosensory function (taste, flavor) were significantly lower as compared to those who did not. At the level of mental representation, such differences can be further detected, in terms of a reduced ability to mentally activate an odor or taste mental image. Our study shows that COVID-19 infection not only frequently causes hyposmia and dysgeusia, but that may also alter the mental representations responsible for olfactory and gustatory perception.

International consensus statement on allergy and rhinology: Olfaction

BACKGROUND

The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O).

METHODS

Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus.

RESULTS

The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies.

CONCLUSION

This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.

Gustatory event-related potential alterations in olfactory dysfunction patients

The phenomenon that longstanding impaired olfactory function is associated with the decreased gustatory function was described in present studies, which was seems attributed to mutual chemosensory interactions. And the interaction between olfaction and gustation still needs more research to figure out. The objective of the study was to investigate how the taste was influenced by olfactory impairment in the central pathway. We tested 33 subjects with normal (n = 19) or impaired (n = 14) olfactory function for their gustatory event-related potentials (gERPs). Validated tests were used for olfactory and gustatory testing (Sniffin’ Sticks, gERPs, and three-drop test). This study reported an objective gustatory function decline in olfactory dysfunction participants. However, it also reported the increased gustatory event-related potentials of olfactory dysfunction participants, especially at the frontal electrode (F_Z) and electrode 16 (E16), and the reduced latency of P2 peak of them at electrode 21 (E21), while no obvious difference was observed at the centro-parietal electrode (P_Z). Inferior insula might be the main response area for the increase in gERPs, and this increase averaged amplitude of the P2 component may attribute to compensation of the secondary gustatory response that occurred in the gustatory processing of olfactory-impaired patients.

Characterization of sensory perceptions elicited by white wine spiked with different aroma, taste and mouth-feel active molecules

The present work was aimed at understanding the sensory responses induced by dry white wine modified with increasing concentrations of different sensory active molecules. The tasting panel was composed by 34 trained subjects characterized according to gender, smoking habits, 6-n-propylthiouracil (PROP) taster status, and sensitivity to tartaric acid, tannic acid and sucrose. Additional taste/mouthfeel responsiveness was evaluated in a basal white wine added of tartaric acid, tannic acid and sucrose. The addition of a fruity odorant mixture to the base white wine enabled the assessment of orthonasal aroma and taste intensities (sweetness, sourness, saltiness). The diversity of taste/mouthfeel responsiveness in water or wine enabled to group individuals as high or low sensitives. Likewise, the tasting panel showed two groups responding differently to aroma and flavor. Both high and low aroma sensitivity individuals showed equal (p>0.05) and congruent response to in-mouth sweet flavor perception. Moreover, the high smell sensitive group was less sensitive to sourness and saltiness than the low smell sensitives for the spiked wines across all flavor concentrations. Differences in PROP taster status and sensitivity to other tastants in water solutions were not correlated with the taste/mouthfeel perceptions in wine. The individuals most sensitive to sucrose in wine taste showed higher response to the fruity aroma. In conclusion, taste, mouthfeel and flavor perceptions showed a high variability among individuals evidencing the advantage of grouping tasters with different chemosensory sensitivities to understand cross-modal sensory interactions.

Smoking a Dangerous Addiction: A Systematic Review on an Underrated Risk Factor for Oral Diseases

Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.

Quantitative but not qualitative flavor recognition impairments in COVID-19 patients

Background

Smell and taste dysfunctions (STDs) are symptoms associated with COVID-19 syndrome, even if their incidence is still uncertain and variable.

Aims

In this study, the effects of SARS-CoV-2 infection on chemosensory function have been investigated using both a self-reporting questionnaire on smell and flavor perception, and a simplified flavor test.

Methods

A total of 111 subjects (19 hospitalized [HOS] and 37 home-isolated [HI] COVID-19 patients, and 55 healthy controls [CTRL]) were enrolled in the study. They received a self-evaluation questionnaire and a self-administered flavor test kit. The flavor test used consists in the self-administration of four solutions with a pure olfactory stimulus (coffee), a mixed olfactory-trigeminal stimulus (peppermint), and a complex chemical mixture (banana).

Results

After SARS-CoV-2 infection, HOS and HI patients reported similar prevalence of STDs, with a significant reduction of both smell and flavor self-estimated perception. The aromas of the flavor test were recognized by HI and HOS COVID-19 patients similarly to CTRL; however, the intensity of the perceived aromas was significantly lower in patients compared to controls.

Conclusion

Data reported here suggests that a chemosensory impairment is present after SARS-CoV-2 infection, and the modified “flavor test” could be a novel self-administering objective screening test to assess STDs in COVID-19 patients.

Clinical trial registration no. NCT04840966; April 12, 2021, retrospectively registered

Supplementary Information

The online version contains supplementary material available at 10.1007/s11845-021-02786-x.

Preclinical Dysphagia in Community Dwelling Older Adults: What Should We Look For?

Purpose Traditionally, etiology of dysphagia is thought to be related to multiple medical diagnoses including stroke, head and neck cancer, degenerative neurological conditions, and so forth. However, community dwelling older adults (CDOA) can present with dysphagia in the absence of any specific etiology. The purpose of this research was to develop a multidimensional framework to help identify those CDOA at risk for dysphagia of nonspecific etiology. Method Pertinent literature was examined to identify support for the proposed framework and to explain how the various elements support the model. Results Several factors that are not traditionally thought to be associated with dysphagia can both initiate and exacerbate symptoms of swallowing difficulties. Swallowing difficulties may be subtle and underreported. Monitoring for symptoms related to preclinical dysphagia may be helpful for early identification. Conclusions Dysphagia in CDOA is complex and multidimensional. Clinicians working with older adults will benefit from considering elements described in this multidimensional framework to better understand the etiology of swallowing deficits and improve management. Supplemental Material https://doi.org/10.23641/asha.14150078.

Changes in Motor Skills, Sensory Profiles, and Cognition Drive Food Selection in Older Adults With Preclinical Dysphagia

Purpose Self-selection and self-avoidance of certain foods is one possible indicator of preclinical (prior to any clinical intervention) dysphagia in healthy older adults. Self-selection of food choices is influenced by changes in a combination of factors, including neuromuscular, sensory, and individual patient characteristics. Changes to these factors occur both centrally or peripherally and can be part of typical, healthy aging. Alterations in motor, sensory, or cognitive skills may lead to self-imposed modifications to food choices and, therefore, highlight potential risk for dysphagia. Conclusions For effective screening and assessments procedures in healthy aging adults, the diagnosis of preclinical dysphagia will likely require a multifaceted assessment. A combination of assessment methods using objective and subjective measurements of neuromuscular, sensory, and individual patient factors, as well as knowledge of food avoidance, may provide insight for identifying community-dwelling older adults at risk for dysphagia and allow for earlier monitoring and intervention.

Flavor identification inversely correlates with body mass index (BMI)

BACKGROUND AND AIMS

Dietary choices are influenced by several factors including physiological, social, or genetic factors. Among these, flavor is the most important determinant modulating food preferences. The aim of the present study was to assess flavor identification abilities in patients with obesity (Ob) in comparison with matched normal weight (NW) and over-weight (OW) subjects using a specific and validated chemosensory test.

METHODS AND RESULTS

The flavor test was administered to 140 Ob patients recruited in the obesity outpatient Unit at the Federico II University hospital and to the same number of NW and OW subjects matched by sex, age, and smoking habit. Flavor score (FS) inversely correlated with BMI. Median [Q1; Q3] FS was significantly higher in NW (14.5 [12; 16]) than in Ob (13 [10; 15] p < 0.001) and not significantly different from OW (14 [12; 16]) individuals. FS was also higher in OW than in Ob subjects (p < 0.005). When separated according to age quartiles, the BMI-related differences in FS were still significant in younger quartiles, while they were abolished in the older.

CONCLUSIONS

BMI is a critical factor modulating flavor identification, particularly in young subjects. Further investigations are needed to explore the precise mechanism and the causal relationship between body weight and olfactory dysfunctions.

CLINICALTRIAL ID

NCT03506074.

The opera prevention project

The OPERA (Obesity, Programmes of nutrition, Education, Research and Assessment of the best treatment) PREVENTION PROJECT was a campaign of prevention of obesity that was held on October 11th-13th 2019 in Naples. The project was based on the organization of a medical, athletic, tasting and psychological path with the following objectives: 1) Providing a free medical examination to subjects with obesity; 2) providing athletic advices to perform physical activity; 3) performing a show-cooking in order to teach subjects with obesity to cook healthy food; 4) providing a gustatory and olfactory sensitivity assessment; 4) providing a psychological examination through questionnaires to evaluate obstacles to start a weight loss programme and to psycologically support subjects with obesity on a virtual journey made through a reshaping software programme. In conclusion the OPERA PREVENTION PROJECT could represent a health promotion intervention reproducible in all the countries having high rates of subjects with obesity and overweight.

A New Method for Assessment of Retronasal Olfactory Function

OBJECTIVES/HYPOTHESIS

The aim of the study was to develop a test for the assessment of retronasal olfaction in healthy participants and patients with olfactory disorders using "tasteless" powders.

STUDY DESIGN

Prospective case-control series.

METHODS

A total of 150 participants (110 women, 40 men, mean age = 40 ± 16 years) were recruited for this study; 100 were healthy controls and 50 were patients with olfactory loss due to infections of the upper respiratory tract (n = 25), idiopathic causes (n = 12), sinonasal disease (n = 7), and head trauma (n = 6). Orthonasal olfactory function was evaluated using the Sniffin' Sticks test battery, and retronasal olfaction was evaluated using powders lacking distinctive tastes administered to the oral cavity. To establish test-retest reliability, healthy participants had their orthonasal and retronasal function tested twice.

RESULTS

The validity analyses revealed that the selected 16 stimuli differentiated between normosmic participants and patients with olfactory loss, and that retronasal and orthonasal olfaction were highly correlated.

CONCLUSIONS

The results of the present study indicate that patients with olfactory loss and controls can be clearly separated using a reliable test of retronasal olfaction based on 16 retronasal stimuli.

LEVEL OF EVIDENCE

2b Laryngoscope, 131:E324-E330, 2021.