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Taste quality and neural coding: implications from psychophysics and neurophysiology.

Historically, taste research has often been guided by the concept that there are only four (or possibly five) basic taste qualities (sweet, sour, salty, and bitter, and possibly "umami"). All other tastes have been presumed to be combinations of these basic tastes. This psychophysical concept has been extended to electrophysiological data. That is, the neural code for each basic taste is hypothesized to be coded by a dedicated channel of neurons (the "Labeled-Line" theory); i.e., one group of neurons signals "salty" and another separate group signals "sweet." Numerous psychophysical and electrophysiological findings, however, cannot be accomodated by this quadripartite theory, which limits taste to four basic qualities and four basic neuron types. Rather, the data described in this article suggest that the range of taste is more extensive than four or five basic tastes, and that this breadth of taste quality results initially from the activation of a broad array of ion channels, receptors, and second messengers associated with taste cell membranes. These findings have implications for neural organization and provide support for the "Across-Fiber Pattern" theory in which the neural code for taste is represented by the pattern of activity across all of the neurons, i.e., neurons are not exclusively labeled for a particular sensation but cooperate with the others in the ensemble to encode taste quality.

Animals↗

Lateral ventricular injections of the NK3 agonist senktide affect salt taste-elicited responses.

Central injections of the selective tachykinin NK3 receptor agonist senktide (SENK) suppresses salt appetite. Also, following SENK, intraoral infusions of hypertonic NaCl elicit fewer ingestive taste reactivity responses and more aversive responses than following intraventricular injections of isotonic saline. This pattern of taste reactivity results suggest that SENK affects the oral stimulating properties of salt taste. Before accepting this interpretation, however, alternative explanations need to be examined. The following experiments evaluated whether the effects of intraventricular SENK injection on taste reactivity could be due to: 1) a general oral motor impairment that reduces ingestive responding to tastes (Experiment 1) or; 2) SENK having aversive consequences (Experiment 2). In Experiment 1, the effects of intraventricular injections of SENK (200 ng) on taste reactivity responses to 0.5 M NaCl and 0.1 M sucrose were measured in sodium deficient rats. Intraoral infusions of 0.5 M NaCl elicited fewer ingestive taste reactivity responses following SENK than injections of isotonic saline in sodium deficient rats. Sucrose continued to elicit the same high number of ingestive taste reactivity responses following intraventricular injections of isotonic saline and SENK. Thus, SENK did not cause a general decrease in ingestive responding. A conditioned taste aversion test was employed in Experiment 2 to determine if SENK had aversive consequences. Rats were given 30 min access to alanine (0.3 M) and were then administered either lithium chloride (LiCl) or intraventricular injections of SENK (200 ng) on three consecutive days. Rats avoided alanine that was paired with LiCl, but those rats that had alanine paired with SENK showed no avoidance of the taste even after three pairings. These results replicate findings that intraventricular injections of the NK3 agonist SENK decreases the palatability of NaCl (as measured by taste reactivity) and suggest that its effect on NaCl-elicited taste reactivity is not due to the treatment causing a motor impairment or malaise.

Animals↗

Salient responsiveness of parabrachial neurons to the conditioned stimulus after the acquisition of taste aversion learning in rats.

The pontine parabrachial nucleus is considered to be one of the most critical regions for the acquisition of conditioned taste aversion which is an associative learning of taste and illness. To further clarify the possible involvement of the parabrachial nucleus in conditioned taste aversion, we recorded neuronal responses to taste stimuli from the parabrachial nucleus of rats under deep urethane anaesthesia. Animals were separated into two groups: the conditioned taste aversion group that had acquired a taste aversion to 0.1 M NaCl (conditioned stimulus) after paired presentations of the taste stimulus with intraperitoneal injection of LiCl (unconditioned stimulus), and the control group that had received only the unconditioned stimulus before experiments. Taste-responsive neurons in the conditioned taste aversion group showed larger responses to NaCl at below 0.1 M, but similar responses to 0.3 M and 0.5 M NaCl when compared with those in the control group. Furthermore, hierarchical cluster analyses revealed a strong similarity among responses to sodium salts in neurons of the conditioned taste aversion group compared with the control group. These results suggest that the aversive conditioning to NaCl modified parabrachial units so that the sodium taste was more salient than other tastes. This modification may reflect a long-term plastic change persisting without support of forebrain structures, and would facilitate the gustatory discrimination of the conditioned stimulus, which is required by conditioned animals.

Animals↗

Organization of geniculate and trigeminal ganglion cells innervating single fungiform taste papillae: a study with tetramethylrhodamine dextran amine labeling.

Single gustatory nerve fibers branch and innervate several taste buds. In turn, individual taste buds may receive innervation from numerous gustatory nerve fibers. To evaluate the pattern of sensory innervation of fungiform papilla-bearing taste buds, we used iontophoretic fluorescent injection to retrogradely label the fibers that innervate single taste papillae in the hamster. For each animal, a single taste papilla was injected through the gemmal pore with 3.3% tetramethylrhodamine dextran amine. Fungiform papillae either at the tongue tip (0.5-1.5 mm from the tip) or more posteriorly (1.5-3.0 mm from the tip) were injected. After one to seven days survival, the geniculate and trigeminal ganglia and the tongue were sectioned and examined for labeled cells and fibers, respectively. Analysis of the number and topographic distribution of geniculate cells innervating single taste papillae, shows that: (i) 15 +/- 4 (S.D.) ganglion cells converge to innervate a single fungiform taste bud; (ii) more ganglion cells innervate anterior- (range: 13-35 cells) than posterior-lying buds (range: five to 12 cells), which, in part, may be related to bud volume (microm3); and (iii) ganglion somata innervating a single taste bud are scattered widely within the geniculate ganglion. Analysis of labeled fibers in the tongue demonstrated that two to eight taste buds located within 2 mm of the injected taste bud share collateral innervation with the injected taste bud. Since all buds with labeled fibers were located in close proximity (within a 2-mm radius), widely dispersed geniculate ganglion cells converge to innervate closely spaced fungiform taste buds. Trigeminal ganglion (mandibular division) cells were also labeled in every case and, as with the geniculate ganglion, a dispersed cell body location and collateralization pattern among papillae were observed. This study shows that iontophoresis of tetramethylrhodamine dextran amine, selectively applied to individual peripheral receptor end-organs, effectively locates sensory ganglion cells in two different ganglia that project to these sites. Moreover, the marker demonstrates collateral branches of sensory afferents associated with the labeled fibers and the nearby receptor areas innervated by these collaterals. The labeling of single or clusters of receptor cells, as well as identified sensory afferents, affords future possibilities for combining this technique with immunocytochemistry to establish the relationships of innervation patterns with neurotransmitters and neurotropic substances within identified cells.

Afferent Pathways↗

Role of temporal order and odor intensity in taste-potentiated odor aversions.

The role of the temporal order of odor and taste was studied in two experiments, and a third experiment studied the role of odor intensity in flavor-toxicosis conditioning with thirsty rats licking water spouts in a "wind tunnel." In all experiments, odors and tastes were presented for 2 min to rats, and 30 min later, a toxin (lithium chloride) was intubated. In Experiment 1, an odor was presented 90 s before, during, or 90 s after a taste to independent groups. Experiment 2 was a within-subjects partial replication of the first. Each rat was presented with one odor, then a taste, then a second odor with each stimulus separated by 45 s. The results of Experiments 1 and 2 indicated that (a) odor alone is not associated with illness under our conditions, (b) presenting an odor and a taste at the same time potentiates the odor component so that it is associated with illness, (c) 45-s and 90-s intervals between odor and taste eliminate potentiation, and (d) taste and odor interact asymetrically; that is, odor has little affect on the development of taste-illness associations. In Experiment 3, an odor and a taste were presented simultaneously, and odor intensity varied. As odor intensity increased, the strength of the taste-potentiated odor aversion increased, whereas the aversion to the taste remained constant. However, even at the highest intensity, odor presented in the absence of taste did not result in odor aversions.

Animals↗

Taste-olfactory convergence, and the representation of the pleasantness of flavour, in the human brain.

The functional architecture of the central taste and olfactory systems in primates provides evidence that the convergence of taste and smell information onto single neurons is realized in the caudal orbitofrontal cortex (and immediately adjacent agranular insula). These higher-order association cortical areas thus support flavour processing. Much less is known, however, about homologous regions in the human cortex, or how taste-odour interactions, and thus flavour perception, are implemented in the human brain. We performed an event-related fMRI study to investigate where in the human brain these interactions between taste and odour stimuli (administered retronasally) may be realized. The brain regions that were activated by both taste and smell included parts of the caudal orbitofrontal cortex, amygdala, insular cortex and adjoining areas, and anterior cingulate cortex. It was shown that a small part of the anterior (putatively agranular) insula responds to unimodal taste and to unimodal olfactory stimuli, and that a part of the anterior frontal operculum is a unimodal taste area (putatively primary taste cortex) not activated by olfactory stimuli. Activations to combined olfactory and taste stimuli where there was little or no activation to either alone (providing positive evidence for interactions between the olfactory and taste inputs) were found in a lateral anterior part of the orbitofrontal cortex. Correlations with consonance ratings for the smell and taste combinations, and for their pleasantness, were found in a medial anterior part of the orbitofrontal cortex. These results provide evidence on the neural substrate for the convergence of taste and olfactory stimuli to produce flavour in humans, and where the pleasantness of flavour is represented in the human brain.

Brain↗

Keratin 19-like immunoreactivity in receptor cells of mammalian taste buds.

Three monoclonal antibodies, 4.62, LP2K and 170.2.14, were used to evaluate keratin 19-like immunoreactivity in gustatory epithelia. Keratin 19-like immunoreactivity was restricted to the intragemmal cells for all types of mammalian taste buds examined. These taste buds included fungiform, foliate and vallate taste buds in rat, gerbil and rabbit, and nasopalatine, epiglottal and palatine taste buds in rat. There was no keratin 19-like immunoreactivity in basal cells or in perigemmal cells lateral to the immunoreactive taste receptor cells. Denervation of the rat vallate papilla eliminated all taste buds, as well as all immunoreactive taste cells. That the immunoreactive material in the taste cells was keratin 19 was supported by the comparable staining of rat taste buds with each of three monoclonal antibodies specific for keratin 19. Furthermore, as predicted, these antibodies selectively stained luminal cells of rat bile ducts, bladder, salivary ducts, trachea, ureter and uterus. It was concluded that monoclonal antibodies against keratin 19 can usefully distinguish intragemmal taste receptor cells from keratinocytes, and from the perigemmal and basal cells of gustatory epithelia. Anti-keratin 19 antibodies may serve to identify differentiated taste cells in gustatory epithelia undergoing taste bud development, renewal, degeneration or regeneration.

Animals↗

Autonomic nervous system responses associated with primary tastes.

The hedonic dimension of the taste sensation plays a crucial role in the control of many taste-mediated responses related to food ingestion or rejection. The purpose of this study was to evaluate the emotional reactivity associated with each primary taste (sweet, salty, sour and bitter) through analysis of the variations of autonomic nervous system (ANS) parameters. Thirty-four healthy non-smoker volunteer subjects (17 males and 17 females, mean age = 28 years) participated in the experiment. Taste stimuli were solutions of 0.3 M sucrose (sweet), 0.15 M NaCl (salty), 0.02 M citric acid (sour) and 0.00015 M quinine sulfate (bitter). Evian mineral water was used as the diluent and control (neutral taste). Throughout the test, five ANS parameters (skin potential and skin resistance, skin blood flow and skin temperature, and instantaneous heart rate) were simultaneously and continuously recorded. Results of the ANOVA evidenced a significant effect of primary taste on skin resistance amplitude (P: < 0.001) and duration (P: < 0.0001), skin temperature amplitude (P: < 0.001), skin blood flow amplitude (vasoconstriction) (P: < 0.0001) and instantaneous heart rate increase (P: < 0.0001). Skin resistance and cardiac responses were the most relevant ANS parameters to distinguish among the taste solutions. The four primary tastes could be associated with significantly different ANS responses in relation to their hedonic valence: the pleasantly connoted and innate-accepted sweet taste induced the weakest ANS responses whereas the unpleasant connoted tastes (salty, sour and bitter) induced stronger ANS responses, the innate-rejected bitter taste inducing the strongest ones. Such a neurovegetative characterization of each primary taste could provide references for the hedonic analysis of the more complex gustative sensation attached to foods.

Adult↗

Masking mechanisms of bitter taste of drugs studied with ion selective electrodes.

The masking mechanisms of the bitter taste of propantheline bromide (PB) and oxyphenonium (OB) bromide by native and modified cyclodextrins, saccharides, surfactants, organic acids, nonionic and anionic polymers, and other compounds were investigated with ion selective electrodes. The intensity of the bitter taste for a mixed solution of cyclodextrin with PB or OB was quantitatively explained from the observed electromotive force with the following assumptions: the complex and the masking agent do not have any tastes and the bitter taste is independent of other tastes. Sodium dodecyl sulfate reduced the bitter taste remarkably, and this reduction was also explicable on the basis of the same mechanism. Sodium taurodeoxycholate enhanced the bitter taste, because of its strong bitterness, although it formed 1 : 1 complexes with PB and OB. The masking mechanism of saccharides was ascribed to overcoming the weak bitterness of the drug by the strong sweetness. Lambda-carrageenan suppressed the bitter taste remarkably. This suppression was ascribed to the binding of PB and OB to lambda-carrageenan, the effect of the solution viscosity on the bitter taste, and the covering of the bitter taste receptor by lambda-carrageenan. It was suggested that the moderate masking by other polymers was attributable to the effect of the solution viscosity or the receptor covering. Native and modified beta-cyclodextrins, sodium dodecyl sulfate, lambda-carrageenan, Tween 20, and sodium carboxymethyl cellulose are good masking agents for the bitter tastes of PB and OB. The drug ion selective electrode is a useful tool for understanding of the masking mechanism of the bitter taste, screening of masking agents, and estimation of appropriate concentrations of the masking agents.

Electrochemistry↗

The innervation of taste buds in the soft palate and circumvallate papilla of the rat as revealed by the zinc iodide-osmium tetroxide technique.

The taste buds in the soft palate and the circumvallate papillae of the rat were investigated by the zinc iodide-osmium tetroxide technique. In addition, electron micrographs of taste buds stained with this method were presented for the first time. Differences in taste bud structures were found between the examined regions. The taste buds of the soft palate showed a complicated plexus of intragemmal nerve fibers. Some fibers exhibited terminal polymorphic swellings. Single branches could be traced close to the space of the taste pore. In the soft palate, the taste bud cells remained unstained, whereas in the circumvallate papillae of the tongue, a subpopulation of taste bud cells could be selectively stained and the intragemmal nerve fibers were characterized by large varicosities. The morphological dissimilarities between the taste buds of the investigated regions might be explained by their functional characteristics, or possibly their varying affinities to the taste qualities. Electron microscopic investigation of the stained circumvallate papillae revealed that the electron-dense reaction product had primarily accumulated in a subpopulation of light cells. Dark cells exhibited only a slight labelling. In detail, the precipitate was found loosely distributed in the cytoplasm as well as the nuclei of the cells, and particularly concentrated at the membranes of light vacuoles, this probably being profiles of dilated endoplasmic reticulum. A few roundish accumulations of precipitate were seen in the cytoplasm of taste bud cells, which showed no intensive light microscopic staining. Labelled material was also found within the taste pores outside the apical processes of the cells. The present findings indicate that the zinc iodide-osmium tetroxide technique is applicable to neuroanatomical studies of taste buds.

Animals↗

The bHLH transcription factors, Hes6 and Mash1, are expressed in distinct subsets of cells within adult mouse taste buds.

Taste buds are multicellular receptor organs embedded in the lingual epithelium of vertebrates. Taste cells within these buds are modified epithelial cells as they lack axons and turnover rapidly throughout life, yet have neuronal properties enabling them to transduce taste stimuli and transmit this information to the nervous system. Taste cells are heterogeneous, comprising types I, II, III and basal cells, and are continually replaced during adult life, raising the question of how these different cells are generated. The molecular mechanisms governing taste cell differentiation are unknown, but the Notch signaling system has been implicated in this process based upon recent gene expression data. Here we investigate the expression in mature taste buds of Notch related transcription factors, Hes6 and Mash1, which are among the first genes expressed in embryonic taste buds. We further compare these patterns with those of immunocytochemical markers of discrete taste cell types. We find that Hes6 is expressed in a subset of basally located, possibly progenitor cells, yet is rarely coexpressed with taste cell markers. In contrast, Mash1 is detected in some basal cells and in the majority of differentiated type III taste cells, but never in type II cells. These data suggest a role for Notch signaling in taste cell differentiation in adult taste buds.

Animals↗

[Development and cell dynamics of PLCbeta2 positive cells in mouse taste buds].

Taste buds, the sensory end organs for the sense of taste, consist of taste sensing cells, supportive cells and basel cells. Taste bud cells are heterogeneous in terms of morphology as well as functional profiles. Although the lineage of mammalian taste bud cells is largely unknown, it is generally accepted that undifferentiated epithelial basal cells surrounding taste buds enter the taste buds to form and maintain this specialized corpuscle. To analyze taste bud formation during development, we conducted morphological observations and examined differentiation marker expression. Thickening of epithelia starts at 13 dpc foetus and immunohistochemistry against a neural marker, PGP 9.5, revealed that the change of epithelial morphology precedes neural projection observed at 14 dpc foetus. Taste sensing cells appear 6 days after birth indicated by expression of the single transduction component phospholipase Cbeta2 (PLCbeta2) as differentiation marker. To further investigate the maintenance and cell lineage in the taste buds in adults, we injected 5'bromo-2'deoxyuridine (BrdU) solution to young growing mice for a week. BrdU label retaining cells (LRCs) could be observed even 8 weeks after injection. LRCs were examined the differentiation by PLCbeta2 and proliferative activity by Ki-67. The results suggested two possibilities. (1) Part of PLCbeta2 positive cells retain proliferative activity and multipotentiality, or (2) precursor cells (stem cells) stay in the taste buds and produce at least part of the taste sensing cells through proliferation and differentiation processes.

Animals↗

[Taste disorders in forensic medicine].

Taste disorders can a rise from lesions of peripheral receptors, taste control pathways or cortical area involvement. Among peripheral lesions, trauma of the tongue and oropharynx are the most common. Iatrogenic lesions of facial and glossopharingeal nerves are very important in Forensic Medicine, while there are different opinions about taste alterations due to head injuries; hypogeusia associated to smell disorders are found in 0.4-0.5% of patient after head trauma with good prognosis (90% healing) while qualitative disorders are more common (30%). The Authors describe clinical methodologies for taste evaluation and their application in Forensic Medicine. Forensic estimation of taste disorders con be classified by two main groups: study of cause relation between the occurrence and damage and quantitative valuation of the damage in three different juridical ambits: Penal, Civil, Insurance and foresight. In Penal Right taste damages could be classified among personal lesion crimes and can be classified as serious (permanent injury of taste) ore very serious (complete lost of taste function). Italian Legislation equipare the 5 sense organs. In Civil Right evaluation the so-called "biologic damage" and working ability are considered; this means very different evaluations. In the most recent baremes, generic damage is estimated by different Authors from 0 to 10% while with regard to specific working capacity, common evaluation criteria does not exist. In Insurance taste disorders evaluation is based only on working ability and not on biologic damage. In the previdenzial ambit, taste disorders are not even included in the most recent tables of permanent invalidity estimation. The Authors propose new and more efficacious valutation criteria for taste disorders in all ambits, hoping for more interest in the Forensic aspects of taste, a too often forgotten sensory function.

Adult↗

Relation between acute and late irradiation impairment of four basic tastes and irradiated tongue volume in patients with head-and-neck cancer.

PURPOSE: Taste loss is a major cause of morbidity in patients undergoing head-and-neck irradiation. The relationship between the time course and the degree of taste disorder was studied in both acute and late phases. METHODS AND MATERIALS: Taste ability was measured by the taste threshold for the four basic tastes using a filter paper disc method in patients before, during, and after radiotherapy. The subjects were divided into two groups. In Group A, the radiation fields included most of the tongue (n = 100), and in Group B the radiation fields did not include the tip of the tongue (n = 18). RESULTS: In Group A, there was a significant impairment of the threshold of all four basic tastes at 3 weeks after starting radiotherapy (RT), and this impairment remained at 8 weeks (p < 0.05). This was not seen in Group B. In Group A, there was no significant difference in the patterns of taste sensitivity change between the high-dose (>20 Gy) and low-dose (< or =20 Gy) groups. In the late phase, recovery of taste loss was seen in both groups since 4 months after completing RT. CONCLUSIONS: Unless the anterior part of the tongue was irradiated, taste loss was not observed during RT. When the anterior part of the tongue was irradiated, a difference by radiation dose was not observed in the taste loss pattern. Additionally, radiation-induced taste dysfunction appears to be a temporal effect.

Adult↗

De Gustibus: time scale of loss and recovery of tastes caused by radiotherapy.

PURPOSE: To quantify the prevalence and distress of taste loss at different intervals after radiotherapy (RT) for head and neck cancer. MATERIALS AND METHODS: In four different groups of head and neck cancer patients (73 patients in total), taste loss and distress due to taste loss were evaluated by taste acuity tests and taste questionnaires. Group 1 (n=17) was analyzed prior to RT. Groups 2 (n=17), 3 (n=17) and 4 (n=22) were at 2, 6 and 12-24 months after treatment, respectively. A cross-sectional analysis was performed between these four groups. RESULTS: Prior to initiation of RT (group 1), partial taste loss was observed in 35, 18 and 6% of patients for bitter, salt and sweet, respectively. At 2 months after RT (group 2), taste loss (partial or total) was seen in 88, 82, 76 and 53% for bitter, salt, sweet and sour, respectively. At 6 months (group 3), partial taste loss was seen in 71, 65, 41 and 41% (bitter, salt, sweet, sour) and after 1-2 years (group 4) in 41, 50, 27 and 27% (bitter, salt, sweet, sour). Distress caused by taste loss was most frequent in group 2 (82%). CONCLUSIONS: In this study, loss of taste after RT was found to be most pronounced after 2 months. Bitter and salt qualities were most impaired. Gradual recovery was seen during the first year after treatment. Partial taste loss still persisted 1-2 years after treatment and was responsible for slight to moderate discomfort.

Cross-Sectional Studies↗

Sensitivity of three loci on the tongue and soft palate to four basic tastes in smokers and non-smokers.

The filter paper disk method was used to determine the map of the 4 tastes (sweet, salty, sour and bitter) on the tongue and soft palate in 69 healthy individuals. The equipment used for testing included filter paper disks 8 mm in diameter and taste solutions, which were sequentially diluted (in 13 stages from 80% sucrose, 12 stages from 20% NaCl, 12 stages from 8% tartaric acid and 14 stages from 4% quinine hydrochloride). The threshold at which each taste was recognized in three locations (center of the tongue tip, foliate papillae on the left side and center of the soft palate) was determined by testing increasing concentrations of each solution. We found no difference by sex for sweet taste but women were more sensitive to sour taste on the tongue tip and to salty and bitter tastes on the soft palate. No difference in taste threshold was noted at the different locations for sweet, salty or bitter tastes, but both sexes were less sensitive to sour taste on the soft palate than on the tongue tip, and in men the soft palate was even less sensitive to sour taste than the tongue root. Smoking was associated with increased (worse) taste thresholds for all four tastes, for both men and women.

Adolescent↗

Taste change after laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding.

BACKGROUND: Many patients have described changes in taste perception after weight loss surgery. Our hypothesis was that patients develop postoperative changes in taste that vary by bariatric procedure. METHODS: Patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic adjustable gastric banding (LAGB) completed a 23-question institutional review board-approved survey postoperatively regarding their degree and type of taste changes and food aversion and how these influenced their eating habits. RESULTS: A total of 127 patients participated. After removing the inadequately completed surveys, 82 LRYGB and 28 LAGB patients were included. Of these, 87% of LRYGB and 69% of LAGB patients believed taste is important to the enjoyment of food. More LRYGB patients (82%) than LAGB patients (46%) reported a change in the taste of food or beverages after surgery (P <.001). In addition, 92% of LAGB versus 59% of LRYGB patients characterized the change as a decrease in the intensity of taste (P <.05). Additionally, 68% of LRYGB and 67% of LAGB patients found certain foods repulsive and had developed aversions. Also, 66% of LRYGB and 70% of LAGB patients believed the taste changes were greater than expected preoperatively. Most patients (83% of LRYGB and 69% of LAGB patients) agreed that the loss of taste led to better weight loss. CONCLUSION: Although most LRYGB and many LAGB patients experienced taste changes and food repulsion postoperatively, procedural differences were found in these taste changes. Taste changes need to be investigated further as a possible mechanism of weight loss after bariatric surgery.

Follow-Up Studies↗

Changes in patients' taste acuity after Roux-en-Y gastric bypass for clinically severe obesity.

OBJECTIVE: Patients who have undergone Roux-en-Y gastric bypass (RYGB) for clinically severe obesity often report an aversion to sweet foods and meat. This study was designed to determine whether changes in taste acuity occur after RYGB. DESIGN: This prospective, repeated measures trial evaluated acuity for sweet (sucrose) and bitter (urea) tastes, zinc status, and reported changes in taste perceptions in patients undergoing RYGB for weight reduction. SUBJECTS: Taste acuity and serum zinc level were measured in 14 subjects, 6 men and 8 women (mean preoperative body mass index [calculated as kg/m2] = 60.8 +/- 11.8 and mean age = 38.4 +/- 6 years), before surgery and 6 and 12 weeks after surgery. Inquiries regarding taste preferences were made at each postoperative visit with specific reference to sweets and meat. Serum zinc level was measured at the same visit. A noncontrolled comparison group of 4 subjects who were consuming a very-low-calorie diet also underwent taste acuity testing at similar intervals. MAIN OUTCOME MEASURES: The main outcome measures were recognition taste thresholds, serum zinc levels, and taste preference changes. STATISTICAL ANALYSIS: Analysis of variance with repeated measures over time, Pearson correlation coefficients, and post hoc analysis of variance were used to analyze data. RESULTS: Mean recognition thresholds for sucrose were 0.047 +/- 0.03 mol/L preoperatively and fell significantly to 0.024 +/- 0.01 and 0.019 +/- 0.01 mol/L at 6 and 12 weeks postoperatively, respectively. Overall, there were no significant differences in taste thresholds for urea over time; a significant difference was noted, however, in the pattern of change for urea between patients who reported an aversion to meats and those who did not. Zinc concentrations did not change during the study. APPLICATION/CONCLUSIONS: At 6 weeks postoperatively, all patients reported that foods tasted sweeter, and they modified food selection accordingly. Six patients reported an aversion to meats associated with increased nausea and vomiting. Acuity for sweet and bitter tastes may need to be considered when planning dietary modifications for patients undergoing RYGB.

Adult↗