Skin carotenoid status measured by resonance Raman spectroscopy as a biomarker of fruit and vegetable intake in preschool children.

BACKGROUND/OBJECTIVE: Dietary assessment in children is difficult, suggesting a need to develop more objective biomarkers of intake. Resonance Raman spectroscopy (RRS) is a non-invasive, validated method of measuring carotenoid status in skin as a biomarker of fruit/vegetable intake. The purpose of this study was to examine the feasibility of using RRS in preschool children, to describe inter-individual variability in skin carotenoid status and to identify factors associated with the biomarker in this population. SUBJECTS/METHODS: We conducted a cross-sectional study of 381 economically disadvantaged preschoolers in urban centers in Connecticut (USA). In all, 85.5% were black non-Hispanic or Hispanic/Latino, and 14.1% were obese and 16.9% were overweight by age- and sex-specific body mass index (BMI) percentiles. Children had their skin carotenoid status assessed by RRS in the palm of the hand. Fruit/vegetable consumption was assessed by a brief parent/guardian-completed food frequency screener and a liking survey. RESULTS: We observed inter-individual variation in RRS values that was nearly normally distributed. In multiple regression analysis, higher carotenoid status, measured by RRS, was positively associated with fruit/vegetable consumption (P=0.02) and fruit/vegetable preference (P<0.01). Lower carotenoid status was observed among younger children, those participating in the US Supplemental Nutrition Assistance Program, and those with greater adiposity (P<0.05 for all). CONCLUSIONS: We observed wide variability in skin carotenoid status in a population of young children, as assessed by RRS. Parent-reported fruit/vegetable intake and several demographic factors were significantly associated with RRS-measured skin carotenoid status. We recommend further development of this biomarker in children, including evaluating response to controlled interventions.

Bitter taste markers explain variability in vegetable sweetness, bitterness, and intake.

Intake of vegetables falls short of recommendations to lower risk of chronic diseases. Most research addresses bitterness as a sensory deterrent to consuming vegetables. We examined bitter and sweet sensations from vegetables as mediators of vegetable preference and intake as well as how these tastes vary with markers of genetic variation in taste (3.2 mM 6-n-propylthiouracil bitterness) and taste pathology (1.0 mM quinine bitterness, chorda tympani nerve relative to whole mouth). Seventy-one females and 39 males (18-60 years) reported prototypical tastes from and preference for Brussels sprouts, kale and asparagus as well as servings of vegetables consumed, excluding salad and potatoes. Intensity and hedonic ratings were made with the general Labeled Magnitude Scale. Data were analyzed with multiple linear regression and structural equation modeling. Vegetable sweetness and bitterness were independent predictors of more or less preference for sampled vegetables and vegetable intake, respectively. Those who taste PROP as most bitter also tasted the vegetables as most bitter and least sweet. The spatial pattern of quinine bitterness, suggestive of insult to chorda tympani taste fibers, was associated with less bitterness and sweetness from vegetables. Via structural equation modeling, PROP best explained variability in vegetable preference and intake via vegetable bitterness whereas the quinine marker explained variability in vegetable preference and intake via vegetable bitterness and sweetness. In summary, bitterness and sweetness of sampled vegetables varied by taste genetic and taste function markers, which explained differences in preference for vegetables tasted in the laboratory as well as overall vegetable intake outside the laboratory.

Valid across-group comparisons with labeled scales: the gLMS versus magnitude matching.

Labeled scales are commonly used for across-group comparisons. The labels consist of adjective/adverb intensity descriptors (e.g., "very strong"). The relative distances among descriptors are essentially constant but the absolute perceived intensities they denote vary with the domain to which they are applied (e.g., a "very strong" rose odor is weaker than a "very strong" headache), as if descriptors were printed on an elastic ruler that compresses or expands to fit the domain of interest. Variation in individual experience also causes the elastic ruler to compress or expand. Taste varies genetically: supertasters perceive the most intense tastes; nontasters, the weakest; and medium tasters, intermediate tastes. Taste intensity descriptors on conventional-labeled scales denote different absolute perceived intensities to the three groups making comparisons across the groups invalid. Magnitude matching provides valid comparisons by asking subjects to express tastes relative to a standard not related to taste (e.g., supertasters match tastes to louder sounds than do nontasters). Borrowing the logic of magnitude matching, we constructed a labeled scale using descriptors unrelated to taste. We reasoned that expressing tastes on a scale labeled in terms of all sensory experience might work. We generalized an existing scale, the Labeled Magnitude Scale (LMS), by placing the label "strongest imaginable sensation of any kind" at the top. One hundred subjects rated tastes and tones using the generalized LMS (gLMS) and magnitude matching. The two methods produced similar results suggesting that the gLMS is valid for taste comparisons across nontasters, medium tasters, and supertasters.

Food acceptance and genetic variation in taste.

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 fungiform 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 0.0032 mol/L PROP ranged from "weak" to well above "very strong"; fungiform papillae densities ranged from 33 to 156 papillae per square centimeter. Distribution of perceived bitterness of PROP and fungiform 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 (e.g., 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.

Bitter taste perception and severe vomiting in pregnancy.

Hyperemesis gravidarum or severe vomiting during pregnancy is a condition of elusive etiology that can harm both mother and fetus. This study examined the association between increased bitter-taste perception and history of hyperemesis gravidarum. Bitter-taste perception varies genetically and can be altered with conditions that damage taste-related cranial nerves. Sixty women were divided into high- (n = 21) and low-vomit (n = 39) groups based on vomiting exposure across all pregnancies and were screened for genetic variation in taste with bitterness of saturated 6-n-propylthiouracil (PROP) delivered on filter paper. Supertasters perceive PROP as intensely bitter; nontasters, as only weakly. Each reported their history of dysgeusia (persistent taste) and taste-related pathology (otitis media and head trauma). The vomit groups did not differ in the frequency of supertasters, but the high-vomit group had fewest nontasters. The high-vomit group also reported dysgeusia most frequently. A subsample (13 high-vomit and 18 low-vomit women) rated the taste intensity of sodium chloride (1 mol), sucrose (1 mol), citric acid (0.0032 mol), and quinine hydrochloride (0.001 mol) applied to areas innervated by cranial nerves VII and IX. The groups only varied significantly in bitterness of quinine hydrochloride. High-vomit women tasted least bitterness on the anterior tongue (chorda tympani branch of VII) and highest bitterness on the posterior tongue (cranial nerve IX) and palate (superficial petrosal branch of VII). In high-vomit women, elevated bitterness on the posterior tongue and palate does not appear related to hydrochloric acid exposure in vomitus; it may explain the occurrence of dysgeusia. This pattern of spatial taste perception may indicate altered oral sensations that if present during pregnancy, could increase the risk of hyperemesis.

Measurement of sensitivity to olfactory flavor: application in a study of aging and dentures.

Olfaction involves a dual sensory process for perceiving odors orthonasally (through the nostrils) and retronasally (through the mouth). This investigation entailed developing a measure of sensitivity to an odor delivered in an orally sampled food (orange flavoring in a sucrose-sweetened gelatin) and examining sensitivity in the elderly. In experiment 1, olfactory flavor sensitivity was 49 times lower in elderly (n = 21) than in young (n = 28) subjects. In experiment 2, with 73 elderly women, higher olfactory flavor sensitivity correlated significantly with higher orthonasal perception (Connecticut Chemosensory Clinical Research Center test). Some women, however, exhibited low olfactory flavor sensitivity despite high orthonasal perception; none had high olfactory flavor sensitivity and low orthonasal perception. Those who wore complete or palatal covering dentures had lower olfactory flavor sensitivity than those who were dentate or wore dentures that did not cover the palate. Through multiple regression analysis, orthonasal perception and denture status were found to be independent contributors to predicting olfactory flavor sensitivity. In summary, elderly subjects showed depressed olfactory flavor sensitivity (i.e. retronasal sensitivity) that related to poor orthonasal olfactory perception and denture characteristic. Thus, while good orthonasal olfaction may be necessary for good olfactory flavor sensitivity, it is not sufficient. Other factors, some associated with oral conditions, may impede release and retronasal transport of odors from the mouth to the olfactory receptors.

PROP (6-n-propylthiouracil) supertasters and the saltiness of NaCl.

Taste blindness to phenylthiocarbamide (PTC) and its chemical relative 6-n-propylthiouracil (PROP) was discovered in the 1930s. Family studies showed that those who could not taste PTC/PROP (nontasters) carried two recessive alleles. In recent years, we have classified tasters into two groups: medium (PROP is moderately bitter) and supertasters (PROP is intensely bitter). With our classification, approximately 25% of Americans are nontasters, 50%, medium tasters, and 25%, supertasters. Studies showed that supertasters form a cohesive group. Anatomical studies showed that supertasters have the most fungiform papillae. Psychophysical studies showed that supertasters perceive the most intense bitterness and sweetness from a variety of compounds, the most intense burn from oral irritants, and the most intense tactile sensations from viscous solutions. Oral burn and touch are presumably perceived to be the most intense to supertasters because taste buds in fungiform papillae are innervated by the trigeminal nerve (pain, touch) as well as the chorda tympani nerve (taste). The psychophysical scaling method used was magnitude matching with NaCl as the control modality. With this method, subjects rated the intensities of a series of NaCl and PROP solutions. The assumption that the taste of NaCl did not vary with PROP status allowed comparisons of the bitterness of PROP across subjects. Early magnitude matching studies, using sound as the control, had suggested that this assumption was reasonable. However, recent studies challenged that conclusion. Larger samples with more diverse populations, using sound as the control, showed that the taste of NaCl varied with PROP bitterness; supertasters perceived the strongest taste and nontasters, the weakest. Thus our earlier conclusions were conservative because differences between nontasters, medium tasters, and supertasters were concealed by using NaCl as a standard. Using magnitude matching with sound as the standard, or using the Green scale, which employs intensity labels, we found that the differences between PROP groups are larger. Note that the association between PROP status and salt taste is interesting in itself, since variability in salt taste may have important nutritional consequences.

Taste changes across pregnancy.

UNLABELLED: We examined taste intensity and preference in 46 pregnant and 41 healthy female controls enrolled in the Yale Pregnancy Study (J. Rodin, PI). Pregnant females were tested non-pregnant (non-pg) and during the first, second and third trimesters; controls, at corresponding time intervals. Subjects rated intensity of and preference for a three-member concentration series of NaCl, sucrose, citric acid (CA), and quinine hydrochloride (QHCl) on a labeled line ('nothing' at the left, 'extremely' at 80%). Variance differences between groups were tested with the F distribution (p < 0.05). Controls had significantly greater variance among overall intensity ratings than pregnant females, most pronounced for QHCl. Controls did not have highest variance among overall hedonic ratings, but did have highest variance for sweet and QHCl ratings. Within pregnancy analyses were tested with the Friedman two-way ANOVA. Significant intensity changes occurred for moderate NaCl and QHCL concentrations (p < 0.005). For NaCl, intensity fell from non-pg and first trimester to second and third trimesters. For QHCl, intensity rose from non-pg to first trimester, and fell from first to second and third trimesters. In the hedonic ratings, significant changes occurred for top concentrations of NaCl (p < 0.05) and 0.001 M CA (p < 0.001), and moderate QHCl (p < 0.005). NaCl preference rose from non-pg to third trimester. Preference for CA fell from non-pg to first trimester and then rose from first to second and third trimesters. QHCl became less disliked from non-pg and first trimester to third trimester. SUMMARY: taste intensity and hedonic variance in controls may associate with menstrual hormone fluctuations. Pregnant women were aligned in pregnancy stage which may explain the lower variance. Taste intensity and hedonic changes across pregnancy could serve to support healthy pregnancy outcomes: increases in bitter intensity in first trimester to protect against ingesting poisons; changes in NaCl, sour and bitter preference later in pregnancy to support ingesting a varied diet.

Supertasting, earaches and head injury: genetics and pathology alter our taste worlds.

Family studies using thresholds showed that PROP (6-n-propylthiouracil) tasting is produced by a dominant allele, T. Nontasters have two recessive alleles and tasters have one or two dominant alleles. The bitterness of suprathreshold PROP and anatomical criteria subdivide tasters into medium and supertasters. Supertasters may be TT tasters, but this has yet to be demonstrated. Supertasters preceive the greatest bitterness and sweetness from many stimuli as well as the greatest oral burn from alcohol and capsaicin. Women are more likely than men to be supertasters. Otitis media and head trauma can alter taste and thus PROP classifications, complicating studies on PROP genetics. Some subjects with a history of otitis media show taste reductions, but others show enhanced tastes and appear to have more taste buds per fungiform papilla. Subjects with head trauma show reduced tastes on some oral loci, but there is evidence that severe reductions on the front of the tongue ameliorate reductions at the circumvallate papillae on the back of the tongue by a release of inhibition mechanism.

Olfactory dysfunction and related nutritional risk in free-living, elderly women.

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 preventing odors or olfactory flavor. Capitalizing on primary-taste quality and texture may help to compensate for the loss of olfactory flavor perception.

PTC/PROP tasting: anatomy, psychophysics, and sex effects.

Taste worlds of humans vary because of taste blindness to phenylthiocarbamide (PTC) and its chemical relative, 6-n-propylthiouracil (PROP). We review early PTC studies and apply modern statistical analyses to show that a higher frequency of women tasted PTC crystals, and were tasters (threshold classification). In our laboratory, scaling of PROP bitterness led to the identification of a subset of tasters (supertasters) who rate PROP as intensely bitter. Supertasters also perceive stronger tastes from a variety of bitter and sweet substances, and perceive more burn from oral irritants (alcohol and capsaicin). The density of taste receptors on the anterior tongue (fungiform papillae, taste buds) correlate significantly with perceived bitterness of PROP and support the supertaster concept. Psychophysical data from studies in our laboratory also show a sex effect; women are supertasters more frequently. The anatomical data also support the sex difference; women have more fungiform papillae and more taste buds. Future investigations of PTC/PROP tasting and food behaviors should include scaling to identify supertasters and separate sex effects.

Nutritional management of patients with chemosensory disturbances.

The effect of a chemosensory disturbance on nutrition and quality of life is not clear and may show individual variance. It is important for the clinician to become sensitive to this relationship and pursue appropriate nutritional management. Nutritional management of an individual with a chemosensory disorder requires nutritional assessment with appropriate dietary intake measurements, dietary and weight history, food behavior questions, and anthropometric measures. A registered dietitian can identify potential nutritional problems and provide guidance for weight control, dietary modification, and use of food-related compensatory mechanisms to maintain the nutritional status and quality of life in the person suffering from chemosensory disturbances.