February 2017- Question #2
As mentioned in the continuing education article, there is a
plethora of different side effects that can occur with anticancer treatments
(chemotherapy and radiation therapy). What recommendations would you make for a
patient that is experiencing taste changes, early satiety, and complaints of
intolerance of hot foods?
posted by Unknown @ 4:46 PM
34 comments
34 Comments:
As Dietitians, I think it is up to us to be creative and help patience cope with these changes that often result from therapy. If my patient was experiencing taste changes I would give my patient different ideas to try to adjust their taste buds to their changes. For example, if fruits are too sweet, I would recommend to the patient to try vegetables. If food taste bland or bitter add various spices and marinate meats in citrus marinades to enhance flavor. If food tastes overpowering or mouth sores develop stick with bland foods. If foods taste metallically add a few drops of olive oil to your food and use plastic silverware. If patients have complaints of foods being too hot we can recommend cold foods and freezing fruits like mangos for snacks. The same for foods that become too cold we can recommend switching them out with different hot foods that sound good to the patient. If patients notice a decrease in appetite we can recommend eating smaller meals more frequently, different high protein foods and/or nutritional supplements. Overall, individualizing your recommendations to your patients altered tastes will be key.
Nutrition counseling with a patient experiencing taste changes, early satiety or temperature sensitivity will need to be customized to the individual. As mentioned by Moriah there are multiple MNT recommendations an RD may recommend in altering a patient's diet to increase comfort, flavor and ultimately energy, protein intake. Also, with changes in taste a recommendation may be given to try new foods, allowing for the potential a food that the individual does not usually like, may be preferable during treatment. Methods of intake which may be beneficial for anti-cancer treatment receiving patients include smoothies and milkshakes as well as other over the counter nutrition supplements. Inclusion of small frequent meals, with emphasis on high protein snacks may benefit patients with early satiety. In incidences of constipation resulting from pain medications and decreased activity sufficient fluids, fiber and regular meals may also benefit the patient.
Addressing side effect management was one of the major areas of concern during my rotation at the Peoria Cancer Center. Each patient will experience different side effects, so it is important to gather information form the patient exactly why their appetite has been poor.
For the example given above, if a patient had difficulty with taste changes, early satiety, and hot foods I would suggest: Eat small, frequent meals and avoid drinking liquids with your meals to avoid getting full on water. With taste changes, many patients find success with citrus, so marinade your meat in a citrus vinaigrette, or suck on lemon drop candy prior to eating. Hot foods often give off a strong smell which can make patients nauseous. I would suggest creating high-protein meals and snacks that can be enjoyed cold-- such as a citrus chicken pasta salad, or cold tuna salad with sliced oranges
As mentioned from other comments, patients may be averted from food before even tasting it. Foods heated up have a stronger smell. Finding meals or snacks that for the person undergoing treatment may involve finding alternative meals that taste decent cold (chicken salad sandwich, grilled chicken sandwich, beans and rice, etc). Staying away from foods with a strong odor such as tuna, eggs, etc will be beneficial. With this said, every patient is different. I think it is important to test out many different foods with each patient, because we want them to be happy and to eat as much of the foods that they like. Research also shows it may benefit not to eat 1-2 hours before chemotherapy and up to three hours after therapy. It is common to develop aversions during this time.
While often we prefer patients to eat their food rather than drink it, substituting one meal with a nutritional supplement may be necessary if they cannot eat what they need to sustain body weight/ lean body mass.
I agree with the others that supporting a patient experiencing taste changes, early satiety, and complaints of intolerance of hot foods will have to be individualized. Each person has unique challenges and tastes that RDs can help clients cope with to promote adequate energy and protein intake. In rotation at ABMC, I worked with several cancer patients who had visited the Community Cancer Center RD in the past. She was full of creative, effective methods to increase patient food intake, and was knowledgeable about what tactics worked for different people. One patient, for example, told me he was adding olive oil to his smoothies to get in extra calories and heart healthy oils. It's important to follow these patients and help them learn what does and doesn't work for them.
I agree with Nikki that ideally, patients can get most of their nutrients from foods. This may mean eating smaller frequent meals, incorporating more calorie and nutrient-dense foods, and spacing out food from drink. If necessary, a nutritional supplement may be appropriate to help patients meet their nutrient goals and promote an optimal cancer recovery.
A lot of the comments on here reference great tips as to making food more palatable for an individual who is suffering from taste changes, so thanks for sharing those! I think encouraging and supporting patients through this process is just as important as giving them tips and tricks to avoid poor tasting food. By showing them that there’s some enjoyment to be had with trying new foods, and maybe even trying a few new recipes or options with them can be a good way to keep their morale up during this challenging time. Other tips to share with them may include to keep good oral hygiene and to eat in pleasant surroundings as that may help them enjoy their food more. They may also want to use cups with lids and drinking straws, or try to cook outdoors so their house doesn’t smell. There’s so many pieces that can affect the way an individual feels about food, and aiding them in the adjustments may benefit their attitude.
As for early satiety, working with them to find foods that are high calorie and less filling is a great strategy. I liked Justine’s example with adding the olive oil into smoothies, and other related thoughts may include adding butter or oil to rice, sauces and pasta dishes or pretty much anything fats can mix in. Glucose powders and protein powders can also be successful mix ins. Smaller more frequent meals are also helpful to get adequate calories without pushing them beyond their levels of satiety. Though it may be a puzzle to find food that is the right temperature, enough calories and tastes and smells good, working with the patient to solve this riddle will help them find balance and control within their diet.
My first course of action would be to take care in making sure I understand the specific aversions the patient is experiencing, as like Noel and many others mentioned, side effects and aversions may manifest themselves differently in each patient. It is our job, as Registered Dietitians, to understand and connect with our patients to help them best meet their needs and be comfortable. I would really focus on encouraging the patient to try new foods, even those that they didn’t care for prior to diagnosis and/or treatment as they may be palatable now. This may require a lot of trial and error, but would be essential in helping the patient consume recommended intake levels. If appetite is poor and food seems flavorless I would suggest cooking with or adding more spices and condiments to foods such as Dijon mustard, fresh herbs and marinades to make food more palatable. If food tastes too sweet for them, at breakfast, for example I would recommend going with savory options like eggs and vegetables or another dish regardless of whether it is considered breakfast fare or not, over cereal and fruit. Additionally, aversion to meats can be common with chemo patients so I would suggest trying a variety of plant-based proteins such as beans, cottage cheese, cheese, yogurt, lentils, tofu, eggs, nuts and nut butters to help meet increased protein requirements. Like others said, I would also recommend eating foods cold or at room temperature. One option to do this would be to cook or prepare foods in advance and refrigerate them so at mealtimes the foods would be chilled. Additionally, cooking scents would not be present which may help with appetite and palatability. I would include the patient’s family members or support system in our conversation as they may be able to assist with cooking, meal times and even eat with the patient which may make eating in general, a more enjoyable and successful experience. As far as addressing early satiety, I am in agreement with you all that focusing on smaller, more frequent meals and snacks, limiting fluid intake with meals, and consuming energy-dense, high-calorie, high-protein foods would be the best recommendations, and that this situation would definitely involve some creativity.
Lauren, I really like how you suggested making changes in their tableware or eating/drinking utensils such as using a straw or covered cup. It would be interesting to see if just visually limiting exposure to foods could help lessen the aversion. The idea to make the eating environment more pleasant also warrants a try as this may take the focus off of food and taste aversions and instead put it more on the experience.
While my suggestions are very similar to those mentioned above, I do believe these recommendations would be beneficial for the patient. To help a patient deal with taste changes, I would first try to understand the specifics of the changes and their severity. Based on the patient's aversions, I would attempt to combat each one with an alternative. An example would be a patient with an aversion to the smell of meat (but not the taste). In this case, I may suggest buying meats that do not need to be heated up which would release odors, but instead can be eaten as-is for a good source of protein. For early satiety issues, I would suggest small, frequent meals. I would encourage the patient to eat balanced meals/snacks throughout the day but decrease portions at each meal. I would not want a patient to plan out a larger meal and get full after only eating one component of the meal. Including higher calorie and higher protein items with meals/snacks will also help the patient get more nutritional bang for their buck. For a patient with difficulty stomaching hot foods, I would suggest nutritionally valuable cold foods and beverages. I may also suggest eating a food that is normally hot cold instead, such as a pasta dish, pizza, or even a multi-ingredient casserole. The key in all of these recommendations is addressing the specific and individual needs of each patient. Each patient will have different tastes, cooking abilities, energy levels to prepare food and eat, and supportive resources.
There were many great ideas put forth by everyone who has responded already! Moriah's focus on individualizing recommendations and coming up with creative solutions to the patient's challenges is a necessity. Rachel also focused on customizing recommendations and even suggested the patient try foods they never previously liked. This is an interesting recommendation that could be potentially beneficial if the patient tries a food they previously disliked and decided they can now incorporate it into their diet. Noel made an excellent point about limiting fluids with meals to avoid filling up on low-nutrient liquids instead of nutritious foods. Nikki's attention to managing food odors was an excellent way to try to curb nausea that may be induced by strong scents. Justine's comment about adding olive oil to smoothies is a great way patients can subtly increase their calories. Fortifying milk with powdered milk could also be a good option. Lastly, Lauren's suggestion to change the eating environment is an interesting strategy to attempt to manipulate eating habits/aversions. I also think that altering the visual appearance and textures of foods can be beneficial in improving intakes. For example, mixing meat with a grain or vegetable may be more appealing than eating it on its own if the texture is unappealing. Great thoughts from everyone!
All of your suggestions are spot on and I fully support them. I feel that getting to know the patient and understanding what foods, tastes, smells they have aversions to is important in order to come up with solutions and support. I agree with Kristen’s suggestion of coming up with an alternative for each of the aversions the patient is experiencing. The patient’s energy levels and abilities to prepare their food should be inquired so that adjustments and alternatives can be suggested if more convenient foods are needed or if another is preparing their food. I would want to educate the patient’s family as well if the latter is true and also since eating is a very social activity. Having mealtime companions and sharing an enjoyable food experience will likely help the patient reach and/or maintain appropriate consumption.
As many have mentioned, the patient might need help coming up with food ideas as to how to meet nutritional needs when aversions and early satiety may be hindering it. Being able to provide them with alternatives is important, but I think it is also important to keep supporting and motivating them to keep trying. I agree with Justine’s point that it is important to follow patients and help them learn what does and doesn’t work. If something doesn’t work, the patient should know that it’s okay and that there are other tactics and alternatives.
Everyone has great suggestions, and it sounds like we are all learning different recommendations from each other. Like many areas of dietetics, oncology is one that must be individualized to the particular client/patient. Lauren brings up a great point in regards to support and encouragement as well as the promotion of good oral hygiene.
While not overtly stated, everyone has hinted at recommendations to improve overall quality of life. Food is meant to be pleasurable and beneficial to overall health. It is important to build rapport with the client/patient so that they see you as a confidant and expert with valuable advice.
What are some other ways that the side effects of anticancer treatment may affect nutritional or overall quality of life?
As mentioned in the continuing education article, there is a plethora of different side effects that can occur with anticancer treatments (chemotherapy and radiation therapy). What recommendations would you make for a patient that is experiencing taste changes, early satiety, and complaints of intolerance of hot foods?
In order to address the taste changes, the patient may want to increase the flavorings and seasonings used in food. Often times, red meat causes food aversion due to its strong flavor. I would suggest the patient choose proteins that are not red meat. Although food is the best source of nutrients, I would suggest the patient use supplements as a precaution.
As for the early satiety, I agree with everyone else that small frequent meals would be my number one suggestion. I would also mention that the patient not drink while eating but between meals and snacks.
I admit that I did not know how to address the intolerance of hot foods. I like the suggestions for freezing fruits to use as snacks and providing options for appetizing foods that are served cold or at room temperature.
I would first have a conversation with the patient and see if there are any foods which do seem appetizing to consume, if so then focus on giving those foods to the patient. If the patient cannot tolerate hot foods, we should be giving them cold foods, etc.
I like how Moriah mentioned freezing mangoes for a snack. I think as RDs we need to be creative sometimes to accommodate and help each individual patient. Taking into account their preferences and attitudes towards foods is just as important as taking into account their nutritional needs.
After talking with the patient to determine what foods they can tolerate, what foods taste bad, and how much they can eat before feeling full, I would then provide the patient with ideas and strategies to work around their issues. For taste changes, it would depend on the flavor preferences of the individual, if sweet foods don’t taste good then using things like lemon juice or savory seasons on foods may make foods more appetizing. For those that cannot tolerate salty or savory tastes, then using sweet sauces or pairing fruit with proteins may improve palatability.
For early satiety, I would suggest eating smaller meals or snacks throughout the day. Eating high calorie and protein foods first will help the patient met nutrient needs with early satiety. Things like milkshakes, supplement shakes or smoothies that have protein can help provide nutrition with early satiety and would also be suggestions for someone with hot food intolerance. For hot food intolerance suggest cooling foods to a temperature that is tolerable or consume things like drinks over ice.
In this scenario, it is imperative that a RD is flexible and creative to tailor dietary recommendation to food tolerance and taste issues. First and foremost, regular feedback from the patient will be important for staying on top of what he/she can and cannot tolerate. From there, discussing alternatives with the patient will be important. In tailoring food to changes in taste, I think that having experience in food service will be very beneficial. By this, I mean that one needs to have experience in adding/substituting seasonings to alter flavors. I would also try to use bland foods or mouth rinses as palate cleansers. Additionally, an RD needs to be keen to ways to tailor food temperature to a patient's sensitivity. For example, an RD can serve a supplement over ice.
As it relates to early satiety, I would try to incorporate small, frequent meals as many of you have mentioned above. Additionally, I would try to get a regular source of heme iron if possible, or otherwise try to incorporate grains and seeds to try to maintain iron intake. For example, flaxseed could be incorporated into a milkshake served to the patient to provide iron, minerals, and protein.
Taste changes make it difficult for a pt. to consume an adequate intake of calories because food without taste is not enjoyable. Food is one of the many things that people strongly connect with so it would be important to talk with this pt. about what flavors have been diminished and which, if any, have been spared. As a dietitian, one of the many things we are responsible for is catering to the diet of our patients. In knowing which flavors have been spared, we are better able to highlight those flavors in his/her diet. Other things to highlight taste in the diet would be to increase herbs and spices if this is positively tolerated. Dried herbs, which are more potent, would give a more aromatic feature to his foods and could potentially increase his appetite. Overall, the best thing to do for this patient is to cater to food preferences and provide strategies to make meals more appealing.
Early satiety can be addressed by teaching the patient proper portion sizes as well as small frequent meals. These meals should be calorie dense in order to fulfill calorie needs throughout the day. These meals could consist of protein supplements or calorie dense smoothies. Also, to keep the pt. from consuming less food at meal time, it be beneficial to address fluid intake. Fluids should be avoided during meals and consumed between meal times.
Intolerance of hot foods can be managed by consuming protein shakes and smoothies as stated before. It is imperative to educate pt. on foods that can be consumed at cooler temperatures or at room temperature such as fruits and vegetables, whole wheat breads, yogurt, cottage cheese etc. This will broaden his diet which will hopefully increase his caloric intake.
Pt changes in taste is a major side effect of most chemotherapy treatments. Also, sensitivity to certain smells of food may affect the pt. Speaking with the patient and understanding their food preferences at this time is great way to start. You can create meal plans and recipes that meet the patient’s preferences. Also, it’s important to include the whole family with this process. Say the patient is very sensitive to strong smells of food, the family should all know they may want to avoid making certain meals in the house that can agitate the pt. If the patient lives alone or does not have help, it’s important to educate the pt on easy foods to prepare that don’t require a lot of energy. Pts on both chemo and radiation often suffer from weakness, and expending energy to prepare food makes them tired and have a poor appetite. Also, educating pts on nutrition supplements may be beneficial if the pt isn’t able to consume enough.
Noel, I like how you pointed out each patient has different side effects from the medications/treatments. Individuality is important with patients receiving anticancer treatments. General handouts and education may be helpful, but individualized recommendations for the patient will most likely provide the best outcome.
Many of us brought up the need as RDs to be creative, especially when dealing with appetite changes and food aversions. This conversation, and considering this population, made me think it would be fun and helpful for patients like these to have the opportunity to attend a cooking class or program that specifically addressed their needs and concerns. I am not sure if community cancer/outpatient centers offer these types of classes/programs, but I know cooking classes are offered through various health organizations to promote a general, healthy diet, to teach diet and cooking strategies for DM, etc. and thought it could be a useful strategy for improving intake/nutritional status among the population of cancer patients as well.
Although burdensome for the patient experiencing these side effects, this is a perfect example of why I want to be an RD. I want to help patients who are not just a textbook case we see all the time. I want to work with the patient and be creative in coming up with solutions together to make sure energy and protein intake is where it should be.
Taste change:
I would figure out exactly what has become unacceptable to the patient. Maybe food has become to sweet. I would recommend trying to eat bland foods such as vegetables and unsweetened cold cereals. Metallic tasting food is a relatively common side effect as well. I would recommend that the patient not eat with any time of metal silverware. Try plastic instead. Try this technique first before cutting out any specific food. I would also recommend the patient to try new foods she has not tried and food that she use to not like. Her tastes have changes so she may find acceptable choices if foods she use to not like.
Early satiety:
I would first ask what she is eating a meals when she fills up to fast. If the patient is drinking a lot of liquids I would recommend she not drink while eating that way she can become full with food and not liquid. I would recommend eating smaller meals more frequently that way she does not need to eat as much in one sitting. I would also give her information concerning energy dense meals and snacks that way she would be able to take less bites of food but get the same amount of nutrients.
Intolerance to hot foods:
I have never come across this symptom before. Thank you all for providing really great tips on how to help a patient overcome this one. I really like Noel’s suggestion of making energy dense meals that can be consumed cold like citrus chicken pasta salad.
Lauren, I really like how you point out that supporting the patient is just as important as the nutritional tips we give. You are most certainly correct!
As RDs, I think this could be one of our most challenging populations to work with, but like Reilly said, this is why we are in this career. The challenge of being able to help people experiencing the nutrition related side effects of chemo and radiation is part of why this career is so rewarding. The importance of adequate energy after treatments is vital. Like several people have mentioned, the intervention for people dealing with taste alterations, mouth sores, early satiety ect... will have to be highly individualized. Cancer aside, everyone responds to tastes and flavors differently. I think in this situation it is more of a trial and error. I really like the point that Kirsten brought up saying that patients might have an aversion to the smell of a food but not the taste and that is what is repulsing them. I would first begin with bland foods that normally do not have much flavor or scent (beans, rice, some cooked vegetables). If that does not go over well, adding seasonings and different spices to alter flavors might be beneficial. As for satiety, many people mentioned small frequent meals and snacking. Also, depending on how treatment has affected the patient’s physical mobility, small amounts of exercise could help increase appetite.
Honestly, like Reilly, I never even know that an intolerance to hot food is a symptom of cancer treatments. I agree with everything that was mentioned about dealing with this symptom. I like Austin’s suggestion about incorporating protein shakes and smoothies into the diet to provide a nutrient dense option that is easy to take down.
Everyone has given great comments on this topic already! The symptom of altered taste can be tricky. I would try to work with the pt to come up with alternative foods that are palatable and not hot. With the early satiety, small, frequent meals consisting of nutrient dense foods would be my advice. This would be a great reason to consider nutrition supplements if needed. The pt could take Ensure between meals or before bed just to add in some extra nutrition. This could also be a good way to get nutrition that is not hot.
I really like Justine's comment about adding olive oil to foods to boost the calories. That is a great suggestion as it does not alter food much and provides healthy fats. Protein powder could also be added to many foods since protein is such an important aspect to this pt's diet.
Tessa made a great point about involving the family. A family's support can make all the difference! If the pt is loosing their appetite after smelling a food during cooking, the family could make meals while the pt is in another room to prevent that loss of interest in that food. The family can also encourage good foods and snacks by helping provide these options and encouraging the pt to keep a good spirit.
Jenni, I really appreciated your thought about hosting a cooking class of some kind for this population. Or even just a class where you can present all sorts of different foods and they can just try some new things or new preparations of foods they already enjoy. I think that would be a great way to support the patient during this transition period. Maybe even offering an event similar to the ones held through catering, by inviting in a family to come try either preparing or just sampling foods. It would make for a great supportive atmosphere in which people can just explore new foods without some of the pressure.
I believe that the continuing education article served as an excellent testimony to the powerful impact early, intensive, and individualized medical nutrition therapy intervention can have. It is cool to think that our recommendations related to taste changes, early satiety, and food temperature can lead to outcomes such as weight gain or maintenance, increased attitude/satisfaction, reduced hospital stay/admission, increased appetite, tolerance, energy and protein intake, etc. That being said, I agree with what everyone has previously mentioned. You have some great ideas (and second-year gals, I really appreciate your knowledge from your rotations)! Since Holly’s first question has been more than covered, I will respond to her second question. There are definitely other side effects of CT and RT that we should be aware of and able to address, such as a sore throat/mouth and nausea. To aid patients combating a sore mouth, I would recommend they stick to soft, moist foods as tolerated and avoid acidic and dry or rough foods. Nausea has been touched upon, but I would also suggest avoiding high fat, greasy, spicy, or extremely sweet foods. We know that smell and even sight can make a person nauseous, but I wonder if color plays any role in either making a food look more appealing to a cancer pt or not?
Mike made a good point that experience in food service would be beneficial in this matter. There may be some barriers to overcome, though. Specifically in the hospital setting, I wonder how many facilities are willing (and staffed enough) to tailor foods towards their cancer patients. When I worked on trayline at a rehab hospital, there were instances when people wanted a cold sandwich/side/etc. to be hot or vice versa. I was told that we were not able to honor their request because that would start a “snowball effect” where all the patients would want to special order. I understand when cooking for that many people, and with the particular set-up we had, that could quickly have made things difficult. However, some strategy needs to be in place to help these patients eat what they want to eat! I want to remove every barrier possible for them.
After reading everyone's comments about how to aid in adding flavor to make meals a more enjoyable experience, I remember reading about this supplement called "miracle berry". This pill contains the protein miraculin. It is believed that the miraculin protein binds with taste receptors in the mouth and alters their function to make sour things taste sweet and can also rid foods of having a metallic taste often seen in patients going through chemotherapy. What do you guys think of this?
Here is some extra reading if anyone is interested.
https://blogs.scientificamerican.com/thoughtomics/shapeshifting-protein-makes-sour-taste-sweet/
Jenni and Lauren,
I like both your comments about the cooking classes. I am interested in this topic (cooking demonstrations specifically targeted for cancer patients was almost my thesis topic). I completely agree that this would be a great way to provide a support group for the patients without actually calling it a support group. Getting the patients family involved would be very beneficial as well so they could learn firsthand some of the complications that can arise. (Their family member isn’t just being picky all of a sudden, altered tastes, intolerance to hot foods affect many cancer patients)
Austin,
I have heard of (and tried several times) Miracle berry. I did not know if could get rid of metallic taste as well. The only thing I would be worried about is how extremely sweet it makes some foods. Perhaps, recommend that patient not eat fruit or other sweet products with this?
Reilly,
I have not been able to try this so you would know better than I, but, since the whole point of this miracle berry pill would be to gain those sweet flavors back if they have been diminished by chemotherapy, wouldn't fruit and sweet products be beneficial to give them? Then a pt. with diminished sweet tastes may actually be able to enjoy these flavors again which could increase this pt. intake.
Austin,
What a great suggestion!!! I do not recall hearing about miracle berry. I agree with Reilly that it may be a good idea to consider how sweet a food may be after taking the pill. I imagine that since the tastes are altered so much in patients with chemotherapy this probably will not be an issue, but definitely something to consider. Does anyone know of any studies that focused on this concern?
Austin, I have never heard of this miracle berry! I would defiantly look into further studies on this before recommending it to clients/patients. However, I think this is very interesting new research and would defiantly be something to consider! Way to bring new ideas into the conversation!
I actually recall learning about the miracle berry in food science. My instructor had eaten it as a child to cover the bitter taste of unripened fruit, when living in Ghana during a famine. I could foresee this product being useful for specific patients.
I like everyone's comments about the miracle berry, I think that was a really great suggestion!
I also like that Kandice mentioned providing high calorie and protein foods first, so the patient is more likely to meet nutrient requirements. I think that is really important to think about while also trying to accommodate the patient's preferences. It's a fine balance, but with a little creativity, it's possible to do!
I like everyone's comments about the miracle berry, I think that was a really great suggestion!
I also like that Kandice mentioned providing high calorie and protein foods first, so the patient is more likely to meet nutrient requirements. I think that is really important to think about while also trying to accommodate the patient's preferences. It's a fine balance, but with a little creativity, it's possible to do!
I have never heard of the miracle berry before but I think the concept is absolutely incredible. It does pose some questions for me. At first I was curious to know how long the taste adjustment lasted for. As I skimmed through the article Austin posted, it stated that the sour tasted sweet for about an hour. For those who have actually tried the miracle berry, did you have the same result? Did the taste last shorter or longer? Although miraculin is a protein, could consuming a tablet too often pose any negative effects? Also, micarulin changes sour to sweet but does it alter the taste of other foods? If you are consuming a full meal will it change savory flavors as well?
Kaitlyn,
I think you stated my point about food service experience better than I did! Thank you for sharing your experience working the tray-line at a hospital. I think it shows how RDs need to be concerned with both tailoring diets to patients with altered taste, while not over-burdening the food service staff. I agree that some sort of strategy needs to be explored to allow for a reasonable degree of tailoring meals to these patients. I think it might be worthwhile for all of us to search the existing literature for studies that have examined this dilemma. Also, I think this dilemma highlights the importance of good communication with the food service staff.
Austin, your comments on the “miracle berry” are interesting as I had never heard of this supplement before. However, before suggesting any supplement to a patient I would want to thoroughly consider it to determine if it safe and does not have to potential to adversely affect the chemotherapy or radiation therapy the patient is receiving. In most cases, as Reilly mentioned I would be more inclined to suggest sweeter fruits as to enhance flavor to CA patients or a supplement.
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