Poor Taste Perception May be to Blame for Bad Eating Habits

A loss of smell, with its subsequent impact on flavor deficit, can lead someone to try to compensate by oversweetening or oversalting food. “The study suggests that a diminished sense of taste may be more common than we realize,” Dr. Seiden said. However, he added, “It is still not clear whether a diminished sense of taste preceded or followed the onset of obesity, which would require further study. How this would impact obesity is not clear, but the implication is that a diminished sense of taste might lead to greater ingestion.”

Aside from obesity, diminished sensitivity may reduce quality of life by interfering with the pleasure and social interaction that people derive from food, said Dr. Pinto. The inability to detect spoiled foods or liquids, particularly among older patients with taste disorders, is also a concern, so safety issues become paramount.

Cause and Treatment

When patients visit an otolaryngologist’s office complaining of taste loss, a scratch-and-sniff smell identification test is typically the first line of assessment, because a loss of smell is suspected as the culprit. If the test detects a diminished sense of smell, a nasal endoscopy and possibly a CT scan would identify or rule out a nasal blockage, said Dr. Leopold. In his clinic, he also tests tasting ability for four different tastants—salt, sweet, sour and bitter.

In general, treating taste and smell disorders is difficult, particularly without an underlying primary cause. Otolaryngologists can help if the problem is really olfaction, prompted by chronic sinus disease, allergic rhinitis or nasal inflammation. “That’s something ENTs are obviously good at,” Dr. Pinto said. “If you improve olfaction, you can improve taste.”

Diminished taste and smell has also been associated with neurodegenerative conditions, such as Alzheimer’s disease and Parkinson’s. Among patients with Sjögren’s syndrome, medication in the form of cholinergic agonists can help stimulate salivary flow, Dr. Pinto said. In these and other instances, he noted, there may be practical ways for patients to enhance the flavor of food by experimenting with a variety of spices, textures, colors and temperatures. All of these factors, Dr. Pinto noted, can play a role in taste perception and quality of life.

Socioeconomic factors also influence taste, the study’s authors acknowledged. Notably, 85 percent of the obese children in this study were from families in lower socioeconomic classes, and parents of obese children were more likely to be obese. “Care must be taken to avoid incorrectly interpreting this data. The authors are not saying that obesity results from a change in taste sensitivity,” said Edmund Pribitkin, MD, a professor and academic vice chairman in the department of otolaryngology-head and neck surgery at Thomas Jefferson University in Philadelphia. “Obese and non-obese children differ in their taste sensitivities, probably as a result of many different factors. An interesting extension of this study would be to examine how taste sensitivities change as subjects gain or lose weight.”