title: A prospective cohort study of the effects of adjuvant breast cancer chemotherapy on taste function, food liking, appetite and associated nutritional outcomes.
abstract: BACKGROUND
  'Taste' changes are commonly reported during chemotherapy. It is unclear to what extent this relates to actual changes in taste function or to changes in appetite and food liking and how these changes affect dietary intake and nutritional status.
  
  
  METHODS
  This prospective, repeated measures cohort study recruited participants from three oncology clinics. Women (n = 52) prescribed adjuvant chemotherapy underwent standardised testing of taste perception, appetite and food liking at six time points to measure change from baseline. Associations between taste and hedonic changes and nutritional outcomes were examined.
  
  
  RESULTS
  Taste function was significantly reduced early in chemotherapy cycles (p<0.05) but showed recovery by late in the cycle. Ability to correctly identify salty, sour and umami tastants was reduced. Liking of sweet food decreased early and mid-cycle (p<0.01) but not late cycle. Liking of savory food was not significantly affected. Appetite decreased early in the cycle (p<0.001). Reduced taste function was associated with lowest kilojoule intake (r = 0.31; p = 0.008) as was appetite loss with reduced kilojoule (r = 0.34; p = 0.002) and protein intake (r = 0.36; p = 0.001) early in the third chemotherapy cycle. Decreased appetite early in the third and final chemotherapy cycles was associated with a decline in BMI (p = <0.0005) over the study period. Resolution of taste function, food liking and appetite was observed 8 weeks after chemotherapy completion. There was no association between taste change and dry mouth, oral mucositis or nausea.
  
  
  CONCLUSIONS
  The results reveal, for the first time, the cyclical yet transient effects of adjuvant chemotherapy on taste function and the link between taste and hedonic changes, dietary intake and nutritional outcomes. The results should be used to inform reliable pre-chemotherapy education.
authors: Cancer Council Victoria, Melbourne, Australia.
authors: Anna
authors: A
authors: Boltong
authors: Cancer Institute NSW, Eveleigh, NSW, Australia; Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; Melbourne School of Health Sciences, The University of Melbourne, Carlton, Victoria, Australia.
authors: Sanchia
authors: S
authors: Aranda
authors: Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Victoria, Australia.
authors: Russell
authors: R
authors: Keast
authors: Melbourne School of Health Sciences, The University of Melbourne, Carlton, Victoria, Australia.
authors: Rochelle
authors: R
authors: Wynne
authors: Breast Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
authors: Prudence A
authors: PA
authors: Francis
authors: Breast Medical Oncology, Eastern Health, Australia.
authors: Jacqueline
authors: J
authors: Chirgwin
authors: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
authors: Karla
authors: K
authors: Gough
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001066:Appetite / Q000187:drug effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D017024:Chemotherapy, Adjuvant; D005260:Female; D005518:Food Preferences / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D013649:Taste / Q000187:drug effects*
chemical_list: D000970:Antineoplastic Agents