Flavor alterations in cancer treatment: Extrinsic factors as a means of augmentation

Flavor, comprising taste, smell and somatosensory inputs, is commonly altered in patients undergoing chemotherapy resulting in malnutrition leading to cachexia. A narrative review considered taste and smell alterations associated with malignancies treated using chemotherapy and the various interventions proffered to lessen alterations. Many of the currently used interventions directed towards enhancing intrinsic factors of food appeared ineffective in encouraging intake of adequate nutrition to ward off complications of malnutrition. Counselling is used in some cases with positive results. The use of extrinsic influences commensurate with the principles of food behavior and gastronomy are considered as a means of providing purpose to patients to accommodate flavor loss which when integrated with counseling and appropriate intrinsic factors are potentially a means of curtailing malnutrition and enhancing the psychological status of the patient. The close association between the cephalic phase responses (CPRs) and the control of eating and digestive behaviors is multifaceted, and when the influences of taste and smell are diminished, other contributing factors guiding CPRs may compensate a deficit. The need for the application of a consistent lexicon is essential when describing taste and smell alterations. (C) 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.