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Objective Nutrition components of health risk appraisals (HRAs) aim to rapidly and accurately assess dietary behaviors that increase disease risk. Because cognitive research suggests that recalling food likes/dislikes may be simpler and more accurate than recalling intake, we tested whether a preference measure was predictive of cardiovascular disease risk factors within an HRA. Methods HRA participants (422 primarily non-Hispanic white men, mean age 46±10 years) from a manufacturing company completed surveys to assess fat and sweet food/beverage preference; frequency of consuming fat and sweet foods/beverages, alcoholic beverages, fiber-rich foods (whole grains, fruits, and vegetables); and physical activity. Per measured risk factors, 34% had central obesity (waist circumference ≥102 cm), 32% had hypertension (≥140 and/or ≥90 mm Hg), 52% had prehypertension (≥120 to 139 and/or ≥80 to 89 mm Hg), and 52% had an elevated total cholesterol level (≥200 mg/dL [5.2 mmol/L]). Statistical Analyses Multiple linear regression models explaining variability in waist circumference, blood pressure, and serum lipids were tested. Results Although preference and intake pairs for fat and sweets were significantly correlated, intake of fat and sweets failed to associate significantly with any risk factor. Significant variance in waist circumference was explained by age, fat preference, fiber intake, and physical activity. Those with greater circumferences liked fat more, consumed less fiber, and exercised less. Waist circumference in turn contributed significantly to models predicting serum lipid levels and blood pressure. Alcohol intake explained variability in serum lipid levels—higher intakes were associated with higher high-density lipoprotein cholesterol levels. The models predicting risk were generally more explanatory in younger ( Conclusions Including a preference measure within an HRA appears to enhance cardiovascular disease risk factor assessment. Fat preference, intake of fiber-rich foods, and alcohol proved the best dietary determinants of cardiovascular disease risk factors.

Objective To determine if individuals who taste 6- n -propylthiouracil (PROP), one marker of genetic variation in taste, as exceptionally bitter can also perceive sugars as sweeter, other bitters as more intense, and dietary fats as more creamy and/or viscous than do individuals who taste PROP as weakly bitter. This study examined the association between genetic variation in taste and acceptance for sweet, high-fat, and bitter foods and beverages. Design Genetic variation was measured by perceived bitterness of PROP. (influenced by genetic, hormonal, and pathologic factors) and density of fungi form papillae on the anterior portion of the tongue (influenced primarily by genetic factors). Four sweet, 3 fat, and 3 bitter groups were derived from principal components analyses of questionnaire items. Subjects Convenience sample of healthy adults (24 women, 22 men; mean age±standard deviation=21±6 years) who did not report high dietary restraint. Statistical analyses Pearson product moment correlations between genetic taste measures and food and beverage groups. Results The sample showed diversity in genetic taste measures: perceived bitterness of 0.0032mol/L PROP ranged from "weak" to well above "very strong"; fungi form papillae densities ranged from 33 to 156 papillae per square centimeter. Distribution of perceived bitterness of PROP and fungi form papillae density differed in women and men. The association between genetic taste measures and acceptance of sweet and high-fat groups differed in women and men. In women, liking of sweet and high-fat food and beverage groups decreased with increasing perceived bitterness of PROP. In men, liking of these foods and beverages increased but with increasing papillae densities. Genetic taste measures were not associated with a dislike of bitter food and beverage groups. Applications The influence of genetic variation in taste on food intake depends on how perceptible sweet, fat, or bitter components are in foods and beverages, as well as the value of sensory factors vs other factors (eg, health, convenience) on personal dietary choices. Female supertasters of PROP bitterness may avoid high-fat or sweet foods because these oral sensations are too intense and thus less pleasant. Supertasters may taste more bitterness in vegetables but still enjoy eating them because of their healthfulness and because condiments (especially those that are salt based) can block bitterness. J Am Diet Assoc. 2000;100:647–655.

Objective/design To determine the nutritional risk associated with measured olfactory dysfunction in free-living, elderly women through analytic observational methods. Olfactory perception was measured orthonasally (odor: butanol threshold and odor identification) and retronasally (flavor: orange flavor threshold in sweetened gelatin). Setting/subjects Elderly women were recruited from New Haven, Conn, through posters and direct contact. Screening of 120 elderly women identified 80 with high personal functioning to participate (mean age=76±6 years, range=65 to 93 years). All data were collected in subjects' homes. Main outcome measures Nutritional risk was assessed in several ways: food behavior questionnaire; food preference questionnaire; interviews based on the National Cancer Institute food frequency questionnaire; five nonconsecutive, 24-hour food records; and weight, height, waist, and hip measurements. Statistical analyses Correlation and regression analyses determined the separate association between olfactory perception and nutrition variables. Results Nearly half of the women (37 of 80) had olfactory dysfunction. The following nutritional risk pattern was associated with lower olfactory perception: lower interest in food-related activities (eg, enjoying cooking, eating a wide variety of foods); lower preference for foods with predominant sour/bitter taste (eg, citrus fruits) or pungency (eg, horseradish); higher intake of sweets; less intake of low-fat milk products; and nutrient intake profile indicative of higher risk for cardiac disease. Applications Olfactory dysfunction may make it more difficult for elderly women to maintain a diet to control risk for chronic disease. Practitioners should target nutrition intervention to elderly women with measured or self-rated difficulty in perceiving odors or olfactory flavor. Capitalizing on primary-taste quality and texture may help to compensate for the loss of olfactory flavor perception. J Am DietAssoc. 1995; 95:879-884 .

Adequate folate intake (≥400 μg/d) in women of childbeanng age may decrease the risk of neural tube defects. Assessing folate intake through dietary records is time intensive. Therefore, we designed and conducted initial validity testing on the Folate Intake Tool (FIT). The FIT is a food frequency survey comprised of top folate sources as assessed by frequency of consumption and amount per serving. The original FIT contained 72 items. Twenty-nine females (childbearing aged, mixed ethnic background) were recruited from a university community. Each completed the FIT and a 3-day food record (FR). The FIT was telephone interviewed and subjects reported usual intake over the previous year (average interview time: 12–13minutes). Total intake for FIT and FR was estimated with the 1998 folate fortification levels. For the FIT, total folate intake was calculated from frequency of intake and serving size; for the FR, with the Food Processor (version 7.2). Data were analyzed with nonparametric statistics (significance criterion: p

The ability to taste 6-rt-propylthiouracil (PROP) bitterness is a marker for genetic taste variation. Those tasting PROP as very bitter (i.e., supertasters) also perceive more intense sensations from a variety of taste (e.g., sweet, bitter) and oral somatosensory (e.g., fat, irritants) stimuli. We tested if PROP tasting was associated with sweet intensity and preference. Twenty-two males and 15 females (20-35 years; low dietary restraint) used the labeled magnitude scale (Green et al, 1993) to rate: sweet intensity and degree of liking/disliking for 3 sucrose solutions (5,10,20% w/vol) and 5 sweet foods (2 candies, icing, 2 jellies); and bitter intensity of 5 PROP solutions (.032 to 3.2 mM). This scale has ratio properties and allows expression of a range of sensory and hedonic experiences (i.e., avoids ceiling effects). Data were analyzed with the chi square statistic (significance criterion: p^.05). For sucrose solutions, sweet dislikers and liters were identified based on their hedonic responses to increasing sucrose concentration. Sweet dislikers (n=10) were more likely than liters (n=20) to perceive the 20% sucrose as above "strong" for sweetness and 3.2 mM PROP as above "strong" for bitterness. In all subjects, those who rated the average sweetness of foods as above "strong" were also most likely to rate PROP bitterness as above "strong." Those tasting PROP bitterness as above "strong" were most likely to rate 2 of 5 foods (milk chocolate, icing) as less than "moderate" for liking. In summary, appropriate scaling techniques can reveal associations between PROP tasting and intensity of and preference for sweet solutions and common sweet foods. Supertasters of PROP may find some sweet foods less pleasant because the sweetness is too intense.

LEARNING OUTCOME: To determine if women with a history of hyperemesis gravidarum have a higher response to bitter stimuli than parous women without severe nausea. Humans show an innate dislike of bitter taste. This dislike may aid in the avoidance of bitter poisonous substances. Therefore, we were interested in whether heightened bitter taste perception plays a role in the excessive vomiting seen in women who suffer with hyperemesis gravidarum (HG). Bitter perception is heightened in genetic supertasters (measured by response to 6-n-propylthiouracil or PROP) and can be altered in dysgeusia. Dysgeusia may be a phantom sensation or persistent taste in the mouth. We recruited women who had a history of hospitalization for HG and those without severe nausea and vomiting during pregnancy. Two groups of women were formed based on a vomiting score (vomiting frequency and severity over the course of pregnancy); 15 scored in the high vomiting group and 16 in the low vomiting group. Bitter taste response was measured by: 1) bitterness of PROP impregnated paper; 2) bitterness of .001 M quinine hydrochloride (QHCL) applied to areas of taste nerve innervation. Subjects reported the presence of dysgeusia and the history of taste-related pathology. The perceived bitterness of PROP was similar for both groups. In chi square analyses, women with high vomitting reported significantly higher bitter perception in the back of the tongue (p

LEARNING OUTCOME : To determine if topical capsaicin could be a medical nutrition therapy intervention for patients with the oral pain of cancer-related therapies. Many cancer patients experience oral pain as a side effect of chemotherapy and radiation therapy. Controlling this pain can increase the ability of these patients to maintain adequate food intake and continue with cancer therapies. Capsaicin, responsible for the burn of chili peppers, desensitizes pain receptors. The desensitization is more rapid in the mouth than skin because receptors are closer to the surface. The desensitization requires capsaicin exposure followed by removal of the capsaicin which allows the burn to fade. Capsaicin was delivered to the mucosa via a taffy vehicle (1/2 teaspoon cayenne pepper per pound of taffy) to 5 cancer patients (4 head/neck cancer, 1 bone marrow transplant) receiving radiation alone or with chemotherapy. Patients were recruited if they experienced between a "moderate" and "strong" level of oral pain on a labeled magnitude scale ranging from "barely detectable" (0mm) to "strongest imaginable" (122mm). After rating their pre-therapy pain, patients placed the taffy in their mouth and rated the pain (clinical pain plus capsaicin burn) every 2minutes for 20minutes. Patients were instructed to allow the candy to dissolve completely (between 6 to 10minutes). Average pain rating went from between "moderate" and "strong" (33mm) prior to the treatment, peaked slightly at 6minutes (36mm), and fell to between "barely detectable" and "weak" (5mm) at 20minutes. This was a statistically significant change in reported pain (Friedman Analysis of Variance, p=.0001). The peak pain (clinical pain plus capsaicin burn) showed large variability across subjects. This variability may be related to factors that are known to influence the perceived capsaicin burn (e.g., sex, genetic taste status). In summary, those patients experiencing moderate to strong oral pain may benefit from the capsaicin candy therapy. The dietitian could increase acceptance of this therapy by contacting patients when their initial pain is not too severe to prohibit them trying a therapy that may temporarily increase pain before relieving pain. As well, individualizing the level of capsaicin based patient characteristics may decrease the burn from the capsaicin candy therapy. (Supported in Part by NIH Grant Number M01RR00125.)

Humans show genetic variation in taste perception observable by ability to taste PROP and differences in tongue anatomy. "Supertasters" taste PROP intensely bitter and have more papillae and taste buds on the anterior tongue than "nontasters." This tongue anatomical variation may influence sensory perception of fat and thus dietary behaviors toward fat. We hypothesized a negative association between PROP tasting and fat food preference and intake. Forty-four females (86 screened) met the study criteria of no reported otitis media history (mean age 34±9 years). Otitis media, a taste-related pathology, may confound PROP as a genetic taste measure. A screening determined PROP tasting: subjects rated bitterness of PROP-impregnated paper on a labeled magnitude scale. Fat preference and intake scores were calculated from subject's rating of 22 high fat foods on hedonic and frequency scales. Body mass index (BMI) was calculated from reported height and weight. With Pearson correlation analysis, higher PROP tasting associated significantly with lower fat intake score (r=−.29, p=.05) and lower BMI (r=−.32, p