Measured olfactory dysfunction and dietary intake: Results from the 2013-2014 national health and nutrition examinationsurvey (NHANES)

ABSTRACT

We identified associations between measured olfactory dysfunction (OD) and dietary parameters in a nationally representative sample of US adults. In NHANES 2013-2014, 3,206 adults 40 and over completed a measured smell exam (8-item odor identification test) as well as a 24-hour dietary recall interview administered by trained interviewers. OD was defined as incorrect identification of 3 or more (out of 8) odors;severe OD was defined as incorrect identification of 5 or more odors. Diet quality was assessed using the Healthy Eating Index 2015 (HEI-2015), where higher scores indicate higher diet quality. Other dietary variables included 24-h energy intake, and % energy from fat, added sugar, and alcohol. Survey-weighted multiple linear regression models estimated independent associations between OD and dietary variables. Models were stratified by sex, and adjusted for age, race/ethnicity, education, income, smoking and chronic disease status. The prevalence rates of OD and severe OD were 12.8% (95% CI 10.8%, 15.2%) and 2.5% (95% CI 1.9%, 3.5%), respectively;the average HEI-2015 score was 52.9 (0.7 SE). In men, severe OD was associated with lower energy intake with an adjusted mean difference of -403.9 (95% CI -710.4, -97.3) between those with and without severe OD. In women, severe OD was associated with lower % of energy intake from alcohol with an adjusted mean difference of -1.71 (95% CI -2.5, -0.95). No significant associations were observed with other dietary variables. These findings are generally consistent with the broader view that disrupted olfactory function often has meaningful dietary implications, a concern with increased public health relevance given the transient and persistent olfactory disruption observed with COVID-19 infections.