title: The palatability of milk-based and non-milk-based nutritional supplements in gastrointestinal cancer and the effect of chemotherapy.
abstract: BACKGROUND
  Oral nutritional supplements may have a role in the management of weight loss in patients with cancer. Information on preference for different types of nutritional supplements and the influence of taste changes and chemotherapy is limited.
  
  
  OBJECTIVE
  This study aimed, in patients with gastrointestinal (GI) cancer, to determine the short-term preference for commonly used nutritional supplements compared with controls, to examine whether preference is altered by chemotherapy and to assess the reproducibility of taste assessments conducted using a Visual Analogue Scale (VAS). Patients with GI cancer and controls were asked to rate the acceptability of three oral nutritional supplements on a VAS before starting chemotherapy and after 6 weeks of chemotherapy. Supplements were presented in a random order in sealed containers and subjects were blinded to the type of product. One supplement was repeated at random within each set (four cups) to assess the reproducibility of responses.
  
  
  RESULTS
  Sixty patients and 63 controls were included in the study, 47 patients and 47 controls were available for follow-up. Before the start of chemotherapy, patients had a higher mean preference for Calshake (5.9 cm) than Ensure plus (5.1 cm) and Fortijuce (3.2 cm) (P=0.025 and P<0.001). Calshake was the most preferred supplement in the control group (mean 6.6 cm), with no significant differences in preferences between patients and controls. There were no changes in preference for patients after 6 weeks of chemotherapy. The results for the control group similarly showed no change after 6 weeks. No significant differences were found between scores assigned to the supplement repeated in the random order for any product at either timepoint.
  
  
  CONCLUSIONS
  Patients with GI cancers prefer the taste of fresh milk-based supplements and short-term preferences are not changed by chemotherapy. Preferences are similar between patients with GI cancers and people without cancer. A VAS is a reliable tool to assess taste preference. Further studies are needed to assess the patient compliance over longer periods and the reasons for non-compliance with prescriptions for nutritional supplements.
authors.affiliation: Imperial College Faculty of Medicine, Chelsea and Westminster Hospital, London, UK.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Rahemtulla
authors.forename: Christine
authors.initials: C
authors.lastname: Baldwin
authors.forename: Ayelet
authors.initials: A
authors.lastname: Spiro
authors.forename: Camilla
authors.initials: C
authors.lastname: McGough
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Norman
authors.forename: Gary
authors.initials: G
authors.lastname: Frost
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
authors.forename: H Jervoise N
authors.initials: HJ
authors.lastname: Andreyev
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003131:Combined Modality Therapy; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D005518:Food Preferences / Q000187:drug effects* / Q000502:physiology; D005526:Food, Formulated / Q000592:standards*; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008892:Milk; D010349:Patient Compliance; D013649:Taste / Q000187:drug effects / Q000502:physiology; D015431:Weight Loss
chemical_list: D000970:Antineoplastic Agents