Chemosensory function and food preferences of children with cystic fibrosis

Abstract

A major problem for patients with cystic fibrosis (CF) is the maintenance of adequate nutrition to maintain normal growth. The hypotheses that poor nutrition could be due to smell and/or taste dysfunction has been pursued in several studies with contradictory results. None, however, investigated whether inadequate nutrition is due to CF patients having different liking for foods compared to healthy children and whether liking can be linked to specific changes in smell or taste function. Here, the relationships between food liking, BMI, and smell and taste function in 42 CF and 42 healthy 5- to 18-year olds is pursued. A three-choice 16-item odor identification test and a gustatory identification test involving five concentrations of sweet, sour, bitter, and salty tastes, were used to assess chemosensory function. Food liking was assessed using a 94-item questionnaire. Patients identified significantly fewer odors than controls (89.8% vs. 95.7% correct; P < 0.001). However, only a few patients were affected and their loss of olfactory function was not substantial and unlikely to affect their liking for foods. Taste identification was similar for the two groups (patients 92.6% vs. controls 94.2% correct). There was no correlation between age and odor identification ability, but taste performance improved with age (r = 0.39, P < 0.05), suggesting cognition was the cause. Patients liked several types of foods and high-fat foods more than the controls. Both groups had a similar liking for low-fat foods and both liked high-fat foods more than low-fat foods. No significant relationships existed between FEV(1) and smell or taste function or liking for foods, the BMI of the groups were similar and there was no relationship between BMI and smell or taste function. The results indicate that the abnormal eating behavior reported for many CF patients is not due to changes in chemosensory function which remains normal in most CF patients at least to 18 years of age.

Olfaction before and after initiation of elexacaftor‐tezacaftor‐ivacaftor in a cystic fibrosis cohort

“…If this is true, earlier initiation of ETI in childhood may preserve olfaction by reducing chronic sinonasal inflammation which may have long‐term beneficial effect. Our study was underpowered to detect a difference in olfaction associated with age, however, previous studies report a low prevalence of OD (9.5%) among children with CF, suggesting that olfactory loss does not occur until later in life 9 …”

“…Our study was underpowered to detect a difference in olfaction associated with age, however, previous studies report a low prevalence of OD (9.5%) among children with CF, suggesting that olfactory loss does not occur until later in life. 9 There are several limitations to this study; lack of control group, short duration of follow up, and the small sample size with a wide variation in participant age may have impacted our findings. Additionally, six subjects withdrew from the study due to the COVID-19 pandemic.…”

Taste and smell dysfunction in childhood cancer survivors

“…Previous research in clinical and non-clinical populations using the same taste and smell tests utilised here indicate that the majority of people score towards the high-functioning end of the scale on both of these tests [24,30,22]. Since the underlying distribution of these smell and taste tests are non-normal, and the comparisons between treatment groups involved small and uneven group sizes, nonparametric statistics were considered the most appropriate method of analyses for the current data [31].…”

“…This criteria was established from normative data for children (n=232) and adults (n= 56) older than five years, using the same test procedure [21]. The same criteria for taste impairment has been used with participants with cystic fibrosis [22], chronic kidney disease [23] and healthy school children [24].…”

Development of an International Odor Identification Test for Children: The Universal Sniff Test

“…However, only two tests have gained use, namely the "Smell Wheel" and the Sydney Children's Hospital Odor Identification Test "SCHOT" 27,28 . The "Smell Wheel" has been used to evaluate olfactory function in children with a tracheostomy and the "SCHOT" has been used to study children with cystic fibrosis, otitis media, renal disease, and following bone marrow transplantation [32][33][34][35][36] . These tests have not been used commonly likely because they were developed for children from a single country and are not translatable across cultures, 27,28 and most tests are not commercially available.…”