DIETARY ASSESSMENT OF PATIENTS WITH CHEMOSENSORY DISORDERS

Objective To identify individuals who are at nutritional risk because of taste and/or smell disorders. Design Patients referred by a private physician for evaluation of a chemosensory complaint underwent an ext ensive battery of taste and smell tests, otorhinolaryngologic tests, a nd, in some cases, periodontal examinations and completed a dietary/ h ealth questionnaire, a 24-hour recall, and a 2-day diet record. Settin g Patients were interviewed at the Monell-Jefferson Chemosensory Clini cal Research Center, Philadelphia, Pa. Subjects We studied 310 patient s (142 men and 168 women) with a primary complaint of chemosensory dis order. Mean age was 50.5+/-15.7 (range=15 to 93 years). Normative data were provided by an additional 79 healthy control subjects (42 men an d 37 women) with no taste or smell complaint. Their mean age was 48.8/-18.8 years (range=20 to 83 years). Main outcome measures Chemosensor y disorder-related changes in food habits (determined by questionnaire responses), nutrient intake (analysis of 3-day food records), and bod yweight (self-reported). Statistical analyses Analysis of covariance, followed by post hoc analysis of adjusted means with the Tukey honestl y significant difference test, was used to explore group differences i n nutrient intake and body weight. chi(2) Analysis and the Pearson cor relation coefficient were used to evaluate relationships between varia bles. Results When groups were classified according to chemosensory di agnosis, group differences were observed on global appetitive question s, but complaints were high in all groups. Approximately 65% (203 of 3 10) of patients had self-reported body weights within 5% of their pred isorder weight, but clinically meaningful weight gains or losses were observed in each group. Patients with multiple chemosensory disorders were most likely to lose weight, whereas the incidence of weight gain was highest in patients with anosmia. Patient report of a change in ea ting patterns was the best predictor of weight change among the variab les examined. Conclusions Dietary responses to chemosensory disorders vary widely and may place patients at nutritional risk. Until better p rognostic indexes are identified, dietitians should query patients abo ut disorder-related alterations in eating patterns and provide appropr iate individualized counseling.