Between Clinic and Kitchen, New Hope for Patients With Taste Loss

Being diagnosed with cancer 10 years ago was hard. Being bombarded with various illnesses and infections since then has been harder.  But Gina Mullin, 49, says that the hardest days are the ones when she can’t eat.

“Food just doesn’t taste good to me anymore—some things I used to love, I can’t stand the smell of,” Mullin says. She remembers a day when she ordered take out from her favorite restaurants—Cracker Barrel and Waffle House—but by the time she got home with the food, she couldn’t force herself to eat a bite.

“I don’t cry much. I don’t even think I cried when I was diagnosed, but I remember crying that day,” she says.

Mullin’s description of her relationship with food is similar to what many patients with a variety of other conditions—Alzheimer’s, Parkinson’s, and brain injuries—report experiencing after their diagnoses. Their favorite dishes are no longer palatable, familiar smells become overpowering, or alternatively, something has to be incredibly spicy or fragrant for them to notice the flavor.

Doctors and researchers are only recently taking note of the emotional toll this loss of taste takes on patients.

The study of the loss of taste is part of the emerging field called neurogastronomy, which addresses brain and behavior in the context of food. It’s a movement that is prompting scientists and chefs to bridge the gap between kitchen and clinic in unexpected ways. It is being led, in part, by neuropsychologist Dan Han and physiologist Tim McClintock at the University of Kentucky. Han and McClintock launched the inaugural International Society of Neurogastronomy symposium on November 7 at the University of Kentucky.

Yale neuroscientist Gordon Shepherd first coined the term neurogastronomy in a 2006 article in Nature, and then wrote a book about it six years later. Shepherd begins Neurogastronomy with the mechanics of smell, particularly the way it stimulates the nose from the back of the mouth. As we eat, the brain conceptualizes smells as spatial patterns, and from these and the other senses it constructs the perception of flavor. Shepherd analyzes flavor’s engagement with the brain regions that control emotion, food preferences, cravings, and—building on Marcel Proust’s iconic tale of the madeleine—a flavor’s ability to evoke deep memories.

Chefs have been intrigued by the concept for some time. In 2014, Forbes wrote that it was one the the “10 Restaurant Trends that Will Change Your Dining Habits in 2015.” Restaurants were beginning to alter the way in which food was plated or the decor of the restaurant to manipulate diners’ perception of the food (for more examples, see Mind Over Palate: 6 Ways to Make the Science of Taste Work at Home.)

Now a number of chefs who have had personal experience with taste loss are calling for neurogastronomy to move outside the restaurant kitchen. For chef Edward Lee, Top Chef contestant and chef at Louisville’s 610 Magnolia, his personal connection to the science came when his wife was diagnosed with breast cancer last year. Like Mullin, her palate changed.

“You know,we have food industry companies who study how our brains are affected by flavors; the sweet, the salty,” Lee said. “But they study those things for their own benefit—to learn how to better sell their product. I think the main thing that will come out of this field, and the main thing that came out of the ISN symposium, was the desire to use that knowledge for the good of the patient.”

The symposium was designed to bring awareness to taste loss and efforts to address it. It culminated in a competition in the vein of Iron Chef. Regional and national chefs, including Lee, were paired with a researcher and a physician to create a meal for a patient with a specific disorder who judged the dishes. This year’s disorder was chemotherapy dysgeusia. The judge? Cancer patient Gina Mullin.

There are many reasons why people lose their sense of taste. Most people who report taste loss are really experiencing a loss of smell, but smell is a major contributor to how we taste.

“You can try this for yourself at home. Take a piece of food and before you put it in your mouth. Pinch your nose closed,” McClintock says. “Chew it for a while, and then let the nose go, and you can actually experience that distinction between the taste of the food and how the food smells, and for many of the foods, the majority of the sensation is actually the smell.”

Once taste is lost, Han says, “Nobody really asks, ‘Oh, okay, so what do we do about it? How do we address this, and what next?’ That’s what we’re hoping to change.”

For more on the science of taste, see National Geographic‘s December cover story, Beyond Tastebuds: The Science of Delicious.

 

Ashlie Stevens is a freelance food writer. Her work has appeared on Slate, Salon, The Guardian and Eater. Follow her on Twitter @AshlieD_Stevens.