Investigating oral somatosensory perception and oral symptoms of head and neck cancer patients: insights on eating behaviour.

PURPOSE: Sensory alterations and oral manifestations are prevalent among head and neck cancer (HNC) patients. While taste and smell alterations have been thoroughly investigated, studies on their oral somatosensory perception remain limited. Building upon our previous publication that primarily focused on objective somatosensory measurements, the present work examined self-reported sensory perception, including somatosensation and oral symptoms, in HNC patients and evaluated their link with eating behaviour. METHODS: A cross-sectional study was conducted using self-reported questionnaires on sensory perception, oral symptoms, sensory-related food preference, and eating behaviour among HNC patients (n = 30). Hierarchical clustering analysis was performed to categorise patients based on their sensory perception. Correlations between oral symptoms score, sensory perception, sensory-related food preference, and eating behaviour were explored. RESULTS: Two distinct sensory profiles of patients were identified: no alteration (n = 14) and alteration (n = 16) group. The alteration group showed decreased preference towards several sensory modalities, especially the somatosensory. Concerning eating behaviour, more patients in the alteration group agreed to negatively connotated statements (e.g. having food aversion and eating smaller portions), demonstrating greater eating difficulties. In addition, several oral symptoms related to salivary dysfunction were reported. These oral symptoms were correlated with sensory perception, sensory-related food preference, and eating behaviour. CONCLUSION: This study presented evidence demonstrating that sensory alterations in HNC patients are not limited to taste and smell but cover somatosensory perception and are linked to various aspects of eating. Moreover, patients reported experiencing several oral symptoms. Those with sensory alterations and oral symptoms experienced more eating difficulties.

Oral somatosensory alterations and salivary dysfunction in head and neck cancer patients.

PURPOSE: Patients with head and neck cancer (HNC) are at high risk of malnutrition due to eating difficulties partly mediated by sensory alterations and salivary dysfunction. Clinical studies have mostly focused on taste and smell alterations, while changes in oral somatosensory perception are largely understudied. The study aimed to investigate oral somatosensory (tactile, texture, chemesthetic, and thermal) responses and salivary functions of HNC patients in comparison to healthy controls. METHODS: A cross-sectional study was conducted using psychophysical tests in HNC patients (n = 30) and in age- and gender-matched control subjects (n = 30). The tests included measurements of point-pressure tactile sensitivity, whole-mouth chemesthetic stimulation, food texture discrimination, and temperature discrimination. Salivary functions, including hydration, saliva consistency, pH, volume, and buffering capacity, were also evaluated. RESULTS: HNC patients demonstrated significantly lower chemesthetic sensitivity (for medium and high concentrations, p < 0.05), thermal sensitivity (p = 0.038), and salivary functions (p = 0.001). There were indications of lower tactile sensitivity in the patient group (p = 0.101). Patients were also less sensitive to differences in food roughness (p = 0.003) and firmness (p = 0.025). CONCLUSION: This study provided evidence that sensory alterations in HNC patients extend beyond their taste and smell. The measurements demonstrated lower somatosensory responses, in part associated with their reduced salivary function. Oral somatosensory alterations and salivary dysfunction may consequently impart the eating experience of HNC patients. Thus, further investigations on food adjustments for this patient group seem warranted.

A review on children's oral texture perception and preferences in foods.

Texture properties of foods are particular drivers for food acceptance and rejection in children. The texture preferences follow the developmental progression of the child and these changes modulate the present and future food habits. This paper reviews the development and factors influencing texture preferences in children and the methods in food texture research with children. The child's acceptance of more complex food textures is age-dependent. The progression is indorsed by the development of oral processing skills at an early age and bolstered by repeated exposures to foods with varying textures. Children generally reject foods containing pieces or bits (i.e., geometrical textural properties); however, the impact of mechanical textural properties on food acceptance is less clear. Child characteristics such as food neophobia, picky eating, and tactile over-responsivity, negatively affect the acceptance of more diverse food textures. Depending on the child's age, the prevailing methods of characterizing food texture preferences in children include observational techniques and self-reported questionnaires. Despite knowledge of children's development of masticatory skills, learning, and cognitive abilities, the relationships of these changes to food texture acceptance and the recommended test methodology for evaluating product texture acceptance in this period of life are still limited.

Taste alterations and oral discomfort in patients receiving chemotherapy.

PURPOSE: Taste alterations (TA) and oral discomfort in cancer patients are neglected side effects of the disease and treatments. They contribute to poor appetite, decrease food intake and affect quality of life, leading to adverse outcomes such as malnutrition and depression. The study aimed to explore TAs in relation to other oral conditions causing discomfort in cancer patients. Additionally, the correlation between patients' acidity of saliva and experienced TAs and oral discomfort was evaluated. METHODS: A case study including 100 patients diagnosed with cancer receiving chemotherapy or immunotherapy. Data were collected using two questionnaire forms: the Chemotherapy-induced Taste Alteration Scale (CiTAS) and an additional information questionnaire. Saliva samples were collected for each patient and measured with a pocket pH meter. Data were analysed using descriptive statistics, and comparisons were performed using the Kruskal-Wallis H test, Mann-Whitney U test and Fisher's exact test. RESULTS: The prevalence of reported TAs was 93%. Patient age, oral discomfort and swallowing difficulty were found to be significant factors for experienced TAs (p < 0.05). No correlation between patients' acidity of saliva and reported TAs and oral discomfort was found. CONCLUSION: CiTAS proved to be a convenient tool to collect information about TAs in cancer patients. Using the CiTAS tool, a high prevalence (93%) of reported TAs in cancer patients receiving chemo- or immunotherapy was found. CiTAS provides a fast and cheap recognition of symptoms and causes of TAs that can be addressed.

Variety in snack servings as determinant for acceptance in school children.

Variety within a meal is known to increase intake. However, intake of certain food items (e.g. vegetables) in children is consistently below recommendations, and increasing the consumption of such food would lead to health benefits. This study investigated how different levels of food variety influence children's acceptance. A total of 132 children, aged from 9 to 11 years, were exposed to vegetables, fruits and nut snacks during mid-morning break at school. Two different sets of stimuli were used in a within subject design: Classical Variety (CV), i.e. serving of different foods and Perceived Variety (PV), i.e. serving of the same food in different shapes. For each set, three levels of variety in the servings were tested: low, medium, and high. Intake and liking were determined for each serving set. ANOVA results showed that intake of CV set decreased according to the level of variety, whereas results of PV set only showed an increase of liking with increasing levels of variety. Adding more variations of products appeared to be less successful on consumption despite changing the liking of the products, may be because consumption is more affected by acceptability and familiarity for the stimuli than by variety.

Quinine sensitivity influences the acceptance of sea-buckthorn and grapefruit juices in 9- to 11-year-old children.

The acceptance of novel foods by children is related to a number of factors, and differences in taste sensitivity may form some specific challenges. High sensitivity might be a barrier to the acceptance of sour/bitter products by children. This study investigated the effect of sensitivity to bitter, sour, sweet, and salty tastes on the acceptance of Nordic juices in 9- to 11-year-old children. A total of 328 children were subjected to two taste sensitivity tests for quinine, citric acid, sucrose, and NaCl. Their acceptance of six juices (carrot, rosehip, sea-buckthorn, lingonberry, grapefruit, and aronia) was measured. Bitter sensitivity was found to be significantly correlated to the intake of the sweet sea-buckthorn and lingonberry juices; the most bitter-sensitive children exhibited the highest intake of these juices. The opposite relationship was found for bitter sensitivity and the intake of the bitter grapefruit juice. Sour, sweet, and salt sensitivities did not affect the intake of any of the juices. Liking scores were not affected by sensitivity. In conclusion, bitter sensitivity appears to influence food intake in children to a greater extent than sour, sweet, or salt sensitivity. Bitter-sensitive children exhibited a reduced intake of grapefruit juice and a higher intake of sucrose-sweetened juices. Thus, bitter sensitivity might be a challenge in the acceptance of certain bitter foods.

Stimulus collative properties and consumers' flavor preferences.

The present work investigated consumers' hedonic response to flavor stimuli in light of Berlyne's collative-motivational model of aesthetic preferences. According to this paradigm, sensory preferences are a function of a stimulus' arousal potential, which is determined by its collative properties. The relationship between overall arousal potential and hedonic response takes the shape of an inverted "U", reaching an optimum at a certain level of arousal potential. In three independent studies, using different sets of novel beers as stimuli, consumers reported their hedonic response and rated three collative properties: novelty, familiarity and complexity. Relationships between these collative properties and hedonic ratings were explored by polynomial regression. The results revealed patterns in line with Berlyne's predictions (curvilinear relationship) with regard to perceived novelty, whereas mixed results were obtained for familiarity and complexity. Additionally, in two of the studies, the moderating role of relevant consumer characteristics - product knowledge, food neophobia and variety seeking tendency - was investigated. A consumer's degree of product knowledge was found to significantly reduce perceived complexity and novelty, ostensibly reflecting the learning that occurs with previous exposures.

Influence of changing dentition on food texture preferences and perception of eating difficulty in Australian children.

The transition from primary to permanent dentition is an important phase in children's oral development, yet its impact on texture perception and food acceptance are less explored. This study aimed to investigate how changing dentition and tooth loss influence texture preferences and perception of eating difficulty among children aged 5 to 12 years. Children (n = 475) completed a forced-choice questionnaire featuring drawings of six food pairs, each available in hard or soft texture, and reported whether they had started losing primary teeth and the number of tooth gaps present. They also tasted four samples: chocolate snacks (cake and biscuits) and cheddar cheese (grated and cubes), evaluating their perceived eating difficulty and liking for each sample. Analysis of questionnaire responses showed a general preference for softer food textures among children, with a 36% probability of choosing hard foods. Preferences were not related to child's dental state, including primary teeth loss (p = .13) or number of tooth gaps (p = .45). In the taste test, chocolate biscuits and cheese cubes were perceived as significantly more difficult to eat than chocolate cake and grated cheese, respectively (both p < .0001). Children with more than two tooth gaps reported greater eating difficulty for chocolate biscuits and cheese cubes compared to children with fewer or no tooth gaps. This study demonstrated that children's texture preferences for hardness of foods remained consistent during dentition change, while their perception of eating difficulty could vary based on their dental state at specific points in time.

Finger Food Meals as a Means of Improving Mealtimes for People with Motoric Eating Difficulties: A Pilot Study.

Motoric eating difficulties affecting the ability to eat according to established norms may result in loss of autonomy, reduced food intake and decreased social interaction. Finger food meals may affect the ability to eat independently and were therefore compared to regular meals for older adults >65 years with major motoric eating difficulties. In this pilot study the screening instrument MEOF-II, including additional questions about use of cutlery and fingers, was used to collect data regarding autonomy, food intake and social interaction through observations. Five women and one man participated in the study. Results showed that finger food meals facilitated autonomous eating since the participants were able to eat independently without relying on help from others. Less energy was spent on eating, which allowed for social interaction. However, finger food meals entail unfamiliar norms and culinary rules which may hinder eating; this is an important factor to consider in the implementation of such meals. Further studies on finger foods for older adults may consider larger and diverse cohorts, including healthy older adults, those with motoric difficulties and those with early stages of cognitive decline. Also, a wider variety of finger foods for specific cultural preferences and situations may be considered.

Investigating Taste Perception of Maltodextrins Using Lactisole and Acarbose.

Previous research has demonstrated that complex carbohydrates (maltodextrins) can be perceived in the oral cavity. However, little research has been conducted to thoroughly investigate complex carbohydrate taste perception and contributing factors. This study explored the effects of the degree of polymerization and the concentration of complex carbohydrates on taste perception. Additionally, the impact of lactisole and acarbose on carbohydrate taste perception was investigated. Using a blinded, Latin Square design, participants (n = 40) received samples (control) or samples with acarbose (5 mM) or lactisole (1.4 mM). Per visit, participants received solutions: (1) short chain maltodextrin (average DP 6) (SCM), (2) long chain maltodextrin (average DP 24) (LCM), (3) maltose, and (4) glucose. Samples were evaluated in duplicate, both at low concentration and high concentration. Participants tasted the samples and rated sweetness, starchiness, and viscosity (mouthfeel) perceived on a 10 cm continuous line scale and perceived intensity on a Labelled Magnitude Scale. There was a significant effect of degree of polymerisation on sweetness (p = 0.001) and intensity (p = 0.001). For low concentration samples, no significant differences were found between LCM and acarbose LCM or SCM and acarbose SCM for sweetness, starchiness, or mouthfeel (all p > 0.05). Significant differences were observed between LCM and lactisole LCM for sweetness (1.1 ± 0.1 vs. 2.5 ± 0.3, p = 0.001), starchiness (1.4 ± 0.2 vs. 2.3 ± 0.3, p = 0.005), and mouthfeel (1.4 ± 0.2 vs. 2.3 ± 0.3, p = 0.013). In conclusion, the taste perception of maltodextrins is influenced by the degree of polymerisation. Furthermore, for this study, the sweet taste receptor was not involved in maltodextrin taste perception. While salivary α-amylase did not appear to influence taste perception with low concentration maltodextrins, further investigation is necessary.

A review of assessment methods for measuring individual differences in oral somatosensory perception.

While taste and smell perception have been thoroughly investigated, our understanding of oral somatosensory perception remains limited. Further, assessing and measuring individual differences in oral somatosensory perception pose notable challenges. This review aimed to evaluate the existing methods to assess oral somatosensory perception by examining and comparing the strengths and limitations of each method. The review highlighted the lack of standardized assessment methods and the various procedures within each method. Tactile sensitivity can be assessed using several methods, but each method measures different tactile dimensions. Further investigations are needed to confirm its correlation with texture sensitivity. In addition, measuring a single textural attribute may not provide an overall representation of texture sensitivity. Thermal sensitivity can be evaluated using thermal-change detection or temperature discrimination tests. The chemesthetic sensitivity tests involve either localized or whole-mouth stimulation tests. The choice of an appropriate method for assessing oral somatosensory sensitivity depends on several factors, including the specific research objectives and the target population. Each method has its unique intended purpose, strengths, and limitations, so no universally superior approach exists. To overcome some of the limitations associated with certain methods, the review offers alternative or complementary approaches that could be considered. Researchers can enhance the comprehensive assessment of oral somatosensory sensitivity by carefully selecting and potentially combining methods. In addition, a standardized protocol remains necessary for each method.

Oral size perception and texture preferences for particle-containing foods in children aged 5-12.

Foods containing bits and pieces are often less liked by children; however, there is a limited understanding of how perceptions and preferences for foods with particles change during childhood. This study aimed to investigate preferences and perceptions of particle-containing foods in children aged 5-12 years. Children (n = 485) completed a forced-choice questionnaire on drawings of six pairs of foods, each available with or without particles. Additionally, children tasted yogurts added with muesli differing in particle size (median diameter: 3.9 or 7.5 mm) and evaluated their perception of particle size in mouth and their liking. The questionnaire results showed that children had a clear preference for foods without particles. The average probability of choosing the 'with-particle' foods was 28%, significantly below the midpoint of 50% (p < .0001). Preferences for particle-containing foods were lowest at age six and increased significantly with age (p = .0007). In the taste test, muesli particle size affected oral size perception (p < .0001) but not liking (p = .60). Older children were better able to differentiate particle size than younger children. However, there was no relationship between individual preferences for particle-containing foods and oral size perception of muesli particles. The observation that children's texture preferences changed with age highlights the role of increased experience in shaping preferences for foods with particles.

Carbohydrate Oral Rinsing, Cycling Performance and Individual Complex Carbohydrate Taste Sensitivity.

The aim of this pilot study was to determine the effect of individual complex carbohydrate taste sensitivity on cycling performance with complex carbohydrate oral rinsing. Ten male participants completed five cycling time trials in a fasted state with a seven-day washout period between each trial. Participants completed a fixed amount of work (738.45 ± 150.74 kJ) as fast as possible on a cycle ergometer while rinsing with an oral rinse for 10 s every 12.5% of the trial. An oral rinse (maltodextrin, oligofructose, glucose, sucralose or water control) was given per visit in a randomised, crossover, blinded design. Afterwards, participants had their taste assessed with three stimuli, complex carbohydrate (maltodextrin), sweet (glucose) and sour (citric acid), using taste assessment protocol to determine individual taste sensitivity status. Participants were subsequently grouped according to their complex carbohydrate taste sensitivity and complex carbohydrate taste intensity. There were no significant effects of the oral rinses on cycling performance time (p = 0.173). Participants who did not have improvements in exercise performance with the maltodextrin rinse experienced a stronger taste intensity with complex carbohydrate stimuli at baseline (p = 0.047) and overall (p = 0.047) than those who did have improvements in performance. Overall, a carbohydrate oral rinse was ineffective in significantly improving cycling performance in comparison with a water control. However, when participants were grouped according to complex carbohydrate taste intensity, differences in exercise performance suggest that individual sensitivity status to complex carbohydrates could impact the efficacy of a carbohydrate-based oral rinse.

Solid-State Fermented Plant Foods as New Protein Sources.

The current animal-based production of protein-rich foods is unsustainable, especially in light of continued population growth. New alternative proteinaceous foods are therefore required. Solid-state fermented plant foods from Africa and Asia include several mold- and Bacillus-fermented foods such as tempeh, sufu, and natto. These fermentations improve the protein digestibility of the plant food materials while also creating unique textures, flavors, and taste sensations. Understanding the nature of these transformations is of crucial interest to inspire the development of new plant-protein foods. In this review, we describe the conversions taking place in the plant food matrix as a result of these solid-state fermentations. We also summarize how these (nonlactic) plant food fermentations can lead to desirable flavor properties, such as kokumi and umami sensations, and improve the protein quality by removing antinutritional factors and producing additional essential amino acids in these foods.

Health versus environmental benefits: Does additional information influence consumer acceptance of pulse-based spreads?

Despite the known health benefits and the potential for substituting less environmentally sustainable consumed foods such as meat, the current intake of pulses in developed countries remains less than recommended. Barriers are related to sensory characteristics and lack of knowledge about preparation, while drivers of environmental benefits are intangible. The aim of this study was to investigate the effect of additional information about health or environmental benefits of pulses on the acceptance of novel pulse-based products from chickpeas, black beans, and faba beans. Perceptions of these pulse-based spreads in a blind and informed stage were assessed with 202 consumers in urban and suburban areas of Denmark. In general, the familiar chickpea spread followed by the relatively most unfamiliar black bean spread was liked the most. Only for these two products, additional information increased hedonic perception, regardless of the context (health or environmental benefits). If consumers did not like the spread, as found for the faba bean spread, providing additional information did not significantly alter this perception. Participants' preferences and willingness to pay (WTP) in a discrete choice experiment corresponded to hedonic scores, whereas providing additional information increased the WTP. These findings suggest that extrinsic cues such as health or environmental benefits may only be useful in products with an acceptable baseline taste profile. Moreover, black beans might be investigated as a promising source for further product development due to their acceptance by consumers besides being the comparably most unfamiliar pulse type.

Oral Somatosensory Alterations in Head and Neck Cancer Patients-An Overview of the Evidence and Causes.

Food-related sensory alterations are prevalent among cancer patients and negatively impact their relationship with food, quality of life, and overall health outcome. In addition to taste and smell, food perception is also influenced by somatosensation comprising tactile, thermal, and chemesthetic sensations; yet studies on oral somatosensory perception of cancer patients are lacking to provide patients with tailored nutritional solutions. The present review aimed to summarise findings on the oral somatosensory perception of head and neck cancer (HNC) patients and the potential aetiologies of somatosensory alterations among this population. Subjective assessments demonstrated alterations in oral somatosensory perception such as sensitivity to certain textures, spices, and temperatures. Physiological changes in oral somatosensation have been observed through objective assessments of sensory function, showing reduced localised tactile function and thermal sensitivity. Changes in whole-mouth tactile sensation assessed using texture discrimination and stereognosis ability seem to be less evident. Available evidence indicated oral somatosensory alterations among HNC patients, which may affect their eating behaviour, but more studies with larger sample sizes and standardised assessment methods are needed. Unlike other types of cancers, sensory alterations in HNC patients are not only caused by the treatments, but also by the cancer itself, although the exact mechanism is not fully understood. Prevalent oral complications, such as xerostomia, dysphagia, mucositis, and chemosensory alterations, further modify their oral condition and food perception. Oral somatosensory perception of cancer patients is an under-investigated topic, which constitutes an important avenue for future research due to its potential significance on eating behaviour and quality of life.

Layered food designs to create appetizing desserts: A proof-of-concept study.

Creating layers in foods is a culinary technique commonly used to diversify sensory experiences, but it has not been reported scientifically on its effect on hedonic and appetitive responses. This study aimed to investigate the use of dynamic sensory contrasts in layered foods to stimulate liking and appetite, using lemon mousse as a model. A sensory panel evaluated the perceived sour taste intensity of lemon mousses acidified by various amounts of citric acid. Bilayer lemon mousses with unequal distribution of citric acid across the layers to deliver higher levels of intraoral sensory contrast were developed and evaluated. A consumer panel evaluated the liking and desire to eat lemon mousses (n = 66), and a selection of samples was further investigated in an ad libitum food intake setting (n = 30). In the consumer study, bilayer lemon mousses with a layer of low acidity (0.35% citric acid w/w) on top and higher acidity (1.58 or 2.8% citric acid w/w) at the bottom showed consistently higher liking and desire scores than their corresponding counterparts with identical acid levels equally distributed in a monolayer. In the ad libitum setting, the bilayer mousse (top: 0.35; bottom: 1.58% citric acid w/w) had a significant 13% increase in intake compared to its monolayer counterpart. Modulating sensory properties across food layers with different configurations and layer compositions can be further explored as a tool to design appetizing foods for consumers at risk of undernutrition.

Food Desires and Hedonic Discrimination in Virtual Reality Varying in Product-Context Appropriateness among Older Consumers.

Immersive virtual reality (VR) videos can replicate complex real-life situations in a systematic, repeatable and versatile manner. New product development trajectories should consider the complexities of daily life eating situations. The creation of immersive contexts of a product with varying levels of appropriateness could be a useful tool for product developers in evaluating the extent to which context may influence food acceptance and eating behavior. This study explored virtual reality (VR) as an efficient context-enhancing technology through evaluations of protein-enriched rye breads and compared the effects of a VR-simulated congruent (VR restaurant) and incongruent (VR cinema) contexts on the acceptance in older consumers. A total of 70 participants were immersed in the two VR contexts and a neutral control context in a randomized order. The responses indicating the desire and liking for rye breads were measured, and the extent of immersion during context exposure was assessed by levels of the sense of presence and engagement. Immersive VR induced positive sensations of presence and a heightened level of engagement. The VR restaurant and neutral contexts were perceived as more appropriate for consuming rye breads and induced higher desire and liking for rye breads, which supported the notion of the alignment of congruent contexts with food desire and liking. The study provides new perspectives, practical methodologies, and discoveries in regard to the creation and application of VR-immersed contexts in food product evaluation. Moreover, it focused on a consumer segment (older consumers) that has seldom been investigated in previous relevant studies. The findings suggest that immersive VR technology, as a tool for evaluating contextual factors, is important for new product development. The good user experience among older consumers further indicated the potential value of VR as a context-enhancing tool for product development.

Willingness to replace animal-based products with pulses among consumers in different European countries.

The growing world population and increased meat consumption pose a challenge for current food production systems. While pulses present a promising position in terms of low impacts in primary production and high nutritional quality, it is unclear whether consumers are willing to consume pulses instead of meat. Based on an online survey answered by 4,322 respondents across five European countries, this study examined consumers' willingness to utilize pulses as a plant-based alternative to animal-based products. More than a third of pulse consumers (42%) were, to some extent, already using pulses as an alternative to animal-based foods. Beef was noted as the most frequently replaced type of food, mainly driven by arguments relating to health, environment, and sustainability, especially relevant for German and Danish consumers. Respondents who did not indicate a current replacement of animal-based foods stated a relatively low willingness to change in the future (40%). German pulse consumers were likely to be part of the low willingness segment. In contrast, Polish consumers possessed a relatively higher incidence of using pulses instead of meat, especially pork and poultry. Respondents with a low replacement willingness indicated a high importance of future pulse-based products to be natural, while respondents already using pulses instead of animal-based foods expected convenient and minimally processed foods. Respondents, who already replaced meat with pulses or expressed a low future willingness, stated to prefer plain pulses over processed pulse-based products, and meat-resembling forms considering the former segment, alternatively to meat. These preferences and expectations should be considered for future product development, especially if aiming to attract unwilling consumers to shift to pulse-based foods.

Perceptions and Attitudes about Eating with the Fingers-An Explorative Study among Older Adults with Motoric Eating Difficulties, Relatives and Professional Caregivers.

Difficulties of managing cutlery, manipulating food on the plate and transporting food to the mouth may negatively influence the ability for self-provision and nutritional status among older adults with motoric eating difficulties. The purpose was to explore perceptions and attitudes about eating with the fingers among older adults with motoric eating difficulties, and relatives and professional caregivers of older adults with motoric eating difficulties. Qualitative data was collected through individual interviews with older adults >65 years (N = 14) with motoric eating difficulties and focus groups with relatives (N = 15) and professional caregivers (N = 15). Data was analyzed using deductive and inductive content analysis. Although the older adults had normative ideas about proper eating and culinary rules, they regularly consumed several foods with their fingers without previously reflecting upon this. Using bread to grip or wrap foods and inserting skewers into foods may increase the acceptability of eating with the fingers. However, the importance of the disease causing the eating difficulties, how it was perceived, and its severity were crucial in understanding how eating with the fingers was perceived. Finger foods may be suitable for older adults with major eating difficulties because they have developed a self-acceptance in relation to their condition over time.