title: The influence of chemotherapy on taste perception and food hedonics: a systematic review.
abstract: OBJECTIVE
  Altered food relationships in people receiving chemotherapy are prevalent and distressing. Whether, or to what extent, taste perception and food hedonics plays in altered food relationships is unknown among people receiving chemotherapy. This two-armed systematic review addressed the question "Does chemotherapy influence taste perception and hedonic experience of food?"
  
  
  METHODS
  A systematic review was undertaken of (1) taste perception and (2) food hedonics. Search phrases used in the taste arm were: "chemotherapy AND taste", and in the food hedonics arm, "chemotherapy AND (liking OR food OR appetite OR hedonic(∗))". Databases searched were PsycINFO, PubMed, Medline, CINAHL, EMBASE and the Cochrane Library. English language, peer-reviewed publications investigating adults (>18years) receiving chemotherapy as the only cancer treatment were eligible.
  
  
  RESULTS
  One hundred and sixty three papers were screened in the taste arm, of which eight (5%) met inclusion criteria. Nine hundred and seventy two papers were screened in the food hedonics arm of which 25 (3%) met inclusion criteria. Chemotherapy had variable influence on both taste sensitivity and perceived intensity of the taste qualities sweet, salty, sour and bitter. Liking of food and drink decreased after chemotherapy treatment commenced. Caffeinated foods and drinks, red meat and citrus fruits or juices were most frequently reported as aversive during chemotherapy. A reduction in appetite was reported between baseline (pre-chemotherapy) and cycles 1-3 of chemotherapy with no further worsening in latter chemotherapy cycles and an improvement after completion of chemotherapy treatment.
  
  
  CONCLUSIONS
  There was a lack of consistency of results between studies due to differences in study design, chemotherapy regimen, tumor type and stage of treatment examined. These results provide insufficient evidence to suggest chemotherapy has a significant or consistent influence on taste. There is a consistent, albeit small, body of evidence indicating food liking and appetite are adversely affected by chemotherapy and some evidence that declines in liking and appetite are reversed over time. Overall, more longitudinal studies of specific classes of chemotherapy drugs are required to accurately define the nature, magnitude and time course of taste, food liking and appetite changes over the treatment trajectory.
authors: Melbourne School of Health Sciences, The University of Melbourne, Carlton, Victoria, Australia. a.boltong@pgrad.unimelb.edu.au
authors: Anna
authors: A
authors: Boltong
authors: Russell
authors: R
authors: Keast