Drivers of Dietary Choice After a Diagnosis of Colorectal Cancer: A Qualitative Study.

BACKGROUND: Dietary changes often accompany management of a cancer diagnosis, but how and why patients with colorectal cancer (CRC) make dietary decisions requires further investigation. OBJECTIVE: To learn about patients' food-related beliefs and understand whether and why dietary changes were made by patients starting chemotherapy after a CRC diagnosis. DESIGN: A qualitative semi-structured interview study was conducted as a secondary analysis among a subset of patients with stages II-IV CRC enrolled at baseline in a randomized controlled trial. PARTICIPANTS/SETTING: Twenty-nine patients participated in the interview. Data were collected at the University of Alberta (Edmonton, Alberta, Canada) from 2016-2019 before any trial intervention. QUALITATIVE DATA ANALYSIS: Audio-recorded interviews were transcribed verbatim then coded inductively by two research team members. Qualitative content analysis was applied to capture emergent themes. RESULTS: Patients reported varied degrees of dietary change that stemmed from internal and external influences. Four main themes emerged to describe patients' dietary decisions after a CRC diagnosis: 1) Medical Influences: eating to live; 2) Health Beliefs: connecting lived experiences with new realities; 3) Static Diets: no changes postdiagnosis; and 4) Navigating External Influences: confluence of personal agency and social constraints. CONCLUSION: The extent to which patients altered their dietary choices depended on perspectives and beliefs. These included the degree to which dietary decisions provided some agency (ie, feeling of control) for dealing with physical ramifications of cancer treatment, individuals' personal understandings of healthy foods, and the role of diet in managing their new physical reality postdiagnosis. This information provides registered dietitian nutritionists and health care providers with insight into dietary intentions of select patients being treated for CRC. These findings can guide future research focused on effective strategies for streamlined nutritional support that aligns with patient needs.

Elucidating the role of the gut microbiota in the physiological effects of dietary fiber.

BACKGROUND: Dietary fiber is an integral part of a healthy diet, but questions remain about the mechanisms that underlie effects and the causal contributions of the gut microbiota. Here, we performed a 6-week exploratory trial in adults with excess weight (BMI: 25-35 kg/m2) to compare the effects of a high-dose (females: 25 g/day; males: 35 g/day) supplement of fermentable corn bran arabinoxylan (AX; n = 15) with that of microbiota-non-accessible microcrystalline cellulose (MCC; n = 16). Obesity-related surrogate endpoints and biomarkers of host-microbiome interactions implicated in the pathophysiology of obesity (trimethylamine N-oxide, gut hormones, cytokines, and measures of intestinal barrier integrity) were assessed. We then determined whether clinical outcomes could be predicted by fecal microbiota features or mechanistic biomarkers. RESULTS: AX enhanced satiety after a meal and decreased homeostatic model assessment of insulin resistance (HOMA-IR), while MCC reduced tumor necrosis factor-α and fecal calprotectin. Machine learning models determined that effects on satiety could be predicted by fecal bacterial taxa that utilized AX, as identified by bioorthogonal non-canonical amino acid tagging. Reductions in HOMA-IR and calprotectin were associated with shifts in fecal bile acids, but correlations were negative, suggesting that the benefits of fiber may not be mediated by their effects on bile acid pools. Biomarkers of host-microbiome interactions often linked to bacterial metabolites derived from fiber fermentation (short-chain fatty acids) were not affected by AX supplementation when compared to non-accessible MCC. CONCLUSION: This study demonstrates the efficacy of purified dietary fibers when used as supplements and suggests that satietogenic effects of AX may be linked to bacterial taxa that ferment the fiber or utilize breakdown products. Other effects are likely microbiome independent. The findings provide a basis for fiber-type specific therapeutic applications and their personalization. TRIAL REGISTRATION: Clinicaltrials.gov, NCT02322112 , registered on July 3, 2015. Video Abstract.

Temporal Sensory Profiles of Regular and Sodium-Reduced Foods Elicited by Temporal Dominance of Sensations (TDS) and Temporal Check-All-That-Apply (TCATA).

Temporal sensory methods can be used to highlight the impact of sodium reduction on the dynamic sensory profile of foods targeted for sodium reduction. Study aims were to compare the temporal sensory attribute profiles of regular and sodium-reduced food products elicited by TDS and TCATA, over single and multiple oral intakes. A total of 20 semi-trained participants evaluated commercially available regular and sodium-reduced canned corn, cooked ham (single intakes), potato chips and cream of mushroom soup (5 intakes) using both TDS and TCATA. Regular and sodium-reduced products differed in not only salty but also other sensory attributes, noticeably dry for chips, sweet for corn, bitter and metallic for ham, thick, creamy, sweet, and starchy for soup. TDS and TCATA provided comparable information for the key sensory attributes characterizing and differentiating the regular and sodium-reduced products. TDS profiled significant differences between samples for a larger number of attributes than TCATA, while TCATA profiles were more consistent across intakes. Multiple intakes changed the duration of attribute dominance but not the number of significantly dominant attributes in TDS profiles. The current findings provide insight for applications of temporal profiling to other food products and development of sodium-reduced foods with attribute profiles acceptable to consumers.

Free word association perceptions of red meats; beef is 'yummy', bison is 'lean game meat', horse is 'off limits'.

Reduced consumption of conventional red meats due to environmental and health concerns may create interest in less familiar red meats from alternative animal species. The objective of this study was to identify perceptions of three red meats; beef, a familiar meat, and bison and horse meat, less familiar red meat alternatives. A total of 145 western Canadian participants completed an on-line survey that included a free word association task, food variety seeking and food involvement scales, and meat consumption and demographic questions. The free word association yielded 41 word categories of diverging perceptions of the 3 meats. Beef was described with positive sensory attributes and well-liked foods, yet with environmental, ethical and production concerns, reflecting the 'meat eaters' paradox'. Bison was perceived as a lean game meat, suggesting a lack of awareness of current bison production and retail availability. Horse meat was unfamiliar to 80% of the participants. Horse meat was acknowledged to be consumed in other regions, however as a companion animal and pet, the dominant perception of horse meat was that it was unacceptable for eating. Participants were clustered into four groups based on the combined food-related personality traits of variety seeking and food involvement. The high food involvement cluster associated bison with positive eating quality attributes and may be amenable to its consumption when provided with accurate information about bison production.

Acceptance of oat-based beverages tailored for patients with cancer.

Oat-based beverages are a nutritious product with the potential to support increased nutrient intake of patients with cancer. The aim of this research was to evaluate the sensory acceptance of oat-based beverages and perceptions of oats among patients with cancer as future vehicles for nutrient delivery. In study 1, three flavors of oat-beverages were well accepted without significant difference in liking among flavors or serving temperature, or between patients with cancer and healthy participants. Patients with cancer more frequently rated the beverages as too sweet compared to healthy participants; flavor intensity was just about right for all participants. In the second study, one of two formulations fortified with protein and fish oil was not different in liking compared to the unfortified chocolate product. Patients associated oat food products with specific oat-based food products and oat health benefits in a free-word association task in the third study. Together, sensory acceptance and the perceived health benefits of oats indicate the potential for oats to be incorporated in fortified and unfortified products tailored for patients with cancer. PRACTICAL APPLICATION: The three studies presented here to assess the sensory acceptance of oat-based beverages and perceptions of oats among patients with cancer demonstrate that oats can be incorporated in fortified and unfortified products tailored for patients with cancer. Inadequate nutrition is highly prevalent among oncology patients and there is a lack of available products targeted to improve their nutritional intake. These findings can support product developers and sensory scientists in the development and evaluation of food products acceptable to this population.

The influence of companion foods on sensory attribute perception and liking of regular and sodium-reduced foods.

Among major contributors of dietary sodium intake, many foods are consumed together with companion foods, specifically condiments and carriers. This study compared sensory profiles and overall liking between commercially available regular and sodium-reduced foods consumed with or without companion foods; and examined changes in sensory profiles and overall liking when foods are consumed in condiment-carrier pairs. Three distinct consumer panels evaluated one of the three condiment-carrier pairs, salsa-corn chips (n = 98, 63% female), ketchup-tater tots (n = 100, 69% female), and soy sauce-cooked rice (n = 98, 70% female). For each panel, consumers evaluated five samples; including the regular and sodium-reduced carriers/condiments alone, the companion food alone, and the regular and sodium-reduced foods each with its companion food. Samples were rated for overall liking (9-point hedonic scale) and the intensity of defining sensory attributes (3-point Rate-All-That-Apply scale). Consumers perceived sensory attribute differences between regular and sodium-reduced corn chips (salty) and soy sauce (salty, sweet), but not ketchup. The presence of the companion food reduced consumer ability to discriminate sensory attributes between regular and sodium-reduced products and changed sensory profiles and liking of the foods. Additionally, consumer heterogeneity in hedonic response identified three consumer segments in each consumer panel. Consumer segments differed in their sensory attribute perception. PRACTICAL APPLICATION: It is possible for the food industry to reduce sodium in a range of companion foods without changing consumer preference. The selection of companion foods is important to consumer evaluation of foods under the context of food pairing; corn chips-salsa and ketchup-tater tots are appropriate food pairs. Future sensory studies on food reformulation toward sodium reduction should target specific consumer segments of product liking and sensory attribute perception, which may in turn be influenced by food consumption frequency.

Meeting Minimum ESPEN Energy Recommendations Is Not Enough to Maintain Muscle Mass in Head and Neck Cancer Patients.

The relationship between dietary intake and body composition changes during cancer treatment has not been well characterized. The aim of this study was to compare dietary intake at diagnosis and end of treatment in relation to changes in muscle mass and adiposity in head and neck cancer (HNC) patients. Dietary intakes (three-day food record) and body composition using computed tomography (CT) were assessed at diagnosis (baseline) and after treatment completion (post-treatment). Skeletal muscle (SM) loss was explored as a consequence of energy and protein intake in relation to the minimum and maximum European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines. Higher energy intakes (kcal/kg/day) and increases in energy intake (%) from baseline to post-treatment were correlated with attenuated muscle loss (r = 0.62, p < 0.01; r = 0.47, p = 0.04, respectively). Post-treatment protein intake demonstrated a weak positive correlation (r = 0.44, p = 0.05) with muscle loss, which did not persist when controlling for covariates. Meeting minimum ESPEN energy guidelines (25 kcal/kg/day) did not attenuate SM loss, whereas intakes >30 kcal/kg/day resulted in fewer participants losing muscle. Greater baseline adiposity correlated with greater SM loss (p < 0.001). Energy intakes of 30 kcal/kg/day may be required to protect against SM loss during treatment in HNC patients. The influence of adiposity on SM loss requires further exploration.

Consumer Sensory Comparisons Among Beef, Horse, Elk, and Bison Using Preferred Attributes Elicitation and Check-All-That-Apply Methods.

Despite their nutritional benefits, consumption of red meat from alternative sources such as bison, elk, and horse is low when compared to beef. Sensory attributes and drivers of liking were identified for these meats using the Preferred Attributes Elicitation (PAE) and Check-All-That-Apply (CATA) methods. For the PAE study, 25 panelists evaluated beef, horse, bison, and elk meats in three different group sessions (n = 7, 7, and 11), whereas 63 panelists participated in the CATA study. Consumers in both PAE and CATA studies associated horse meat with dry and fibrous appearance, whereas beef was associated with meaty/beefy flavor and aroma: bison with metallic and livery aroma and intense aftertaste and elk meat with livery, fishy, metallic flavor, musky aroma, and bloody aftertaste. Penalty analysis on the CATA data identified similar drivers of meat liking as the PAE groups. The attributes were juiciness, meaty/beefy aroma, tender texture, meaty/beefy flavor, and mild flavor and aroma. Attributes with significantly negative mean impact on liking were dryness, tough texture, livery flavor, and aftertaste. Association of these attributes with horse and elk meats has implication on drivers of dislike for these meat types. Cluster analysis identified a small group of consumers with preference for horse and elk meats, and this may present niche market opportunities for these meat types. Results showed that the PAE method was comparable to CATA for the evaluation of meat from different species and for identification of drivers of liking and that both methods are effective for meat sensory characterization. PRACTICAL APPLICATION: Lean red meat from unconventional sources such as elk, bison, and horse has unique sensory attributes that may influence acceptance. This study characterized the sensory attributes of these meats and their impact on liking using two rapid consumer descriptive profiling methods-PAE and CATA. Undesirable flavor and aftertaste attributes were identified as the major drivers of disliking for these unconventional meats. Both methods gave similar description of the samples, thus confirming the suitability of PAE for descriptive meat profiling by consumer panels.

A comparison of sensory attribute profiles and liking between regular and sodium-reduced food products.

Few studies have compared consumer sensory product attribute profiles and their influence on liking of regular and sodium-reduced foods. This study compared sensory profiles and overall liking between regular and sodium-reduced foods and examined the influence of consumption frequency of dietary sodium sources (DSS) on consumer sensory perception. One hundred adult consumers (70 women) assessed four pairs of commercially available regular and sodium-reduced products (potato chips, pickles, cooked ham, chicken noodle soup) that contribute substantial sodium to the Canadian diet. Products were assessed for overall liking (9-point hedonic scale), saltiness (5-point Just-About-Right scale) and defining sensory attributes (3-point Rate-All-That-Apply scale). Consumers indicated their consumption frequency of 13 groups of DSS on a DSS Food Frequency Questionnaire (DSS-FFQ). Sodium-reduced foods were perceived with reduced saltiness and intensity differences of other sensory attributes. Saltiness was a key driver of pickle liking; sodium-reduced pickles were liked more than regular pickles. However, decreased intensity in saltiness and several sensory attributes of sodium-reduced chips (oily, flavorful) and ham (seasoning, juicy) did not change liking. Decreased intensity in all evaluated attributes decreased liking of sodium-reduced soup. Penalty analysis revealed opposing sub groups within the study population whose liking decreased or increased with reduced product saltiness, confirming the challenge to please the taste preferences of every consumer. Hierarchical cluster analysis of DSS-FFQ data stratified participants into low (n = 27), moderate (n = 33) and high (n = 40) consumption frequency of DSS. Consumption frequency of DSS influenced sensory perception inconsistently across products and unique liking drivers were identified for each consumer segment. This knowledge can aid development of sodium-reduced foods for targeted consumer segments.

Sensory preferences of supplemented food products among cancer patients: a systematic review.

PURPOSE: Oral nutritional supplements and fortified foods, here considered supplemented food products (SFP), are recommended as part of nutrition therapy guidelines to treat malnutrition among cancer patients. However, their successful use is limited by patients' failure to meet recommended intakes. This systematic review aimed to identify sensory preferences for SFP among cancer patients and evaluate the methodologies employed in sensory preference assessment. METHODS: A systematic search was conducted in several relevant databases yielding 1056 papers of which 19 met the inclusion criteria. Two authors independently selected papers and extracted findings. The included papers were categorized according to the focus of the preference assessment. RESULTS: Studies comparing sensory preferences for SFP of cancer patients with those of a control group suggested that the liking for SFP by cancer patients differs from healthy participants. Patient heterogeneity in site and stage of tumor, variation in study methodologies, and type of treatment complicated a conclusion regarding the effects of cancer treatment and taste changes on taste preferences. However, some general results were observed among the studies, such as the preference for fresh milk-based supplements when compared with other supplement types. CONCLUSION: This review highlighted the need for consistent reporting and control of variables that influence the sensory characteristics of SFP when sensory preferences are assessed in the clinical setting. Attention to these methodological details will enhance the reliability and accuracy of sensory preference assessment among cancer patients for realistic evaluation of SFP targeted to their nutritional needs.

Poor Vitamin Status is Associated with Skeletal Muscle Loss and Mucositis in Head and Neck Cancer Patients.

Mucositis and muscle wasting are two common toxicity effects of cancer treatment in head and neck cancer (HNC). There is limited data evaluating cancer treatment toxicities in relation to vitamin status. This study aimed to assess changes in vitamin status during HNC treatment in relation to body composition, inflammation and mucositis. In this prospective cohort study, dietary intakes (3-day food record), plasma levels of vitamins and C-reactive protein (CRP) were assessed at baseline (at diagnosis) and post-treatment (after 6⁻8 weeks of radiation therapy with or without chemotherapy). Computed tomography images were used to quantify body composition. Mucositis information was collected from health records of patients. Twenty-eight HNC patients (age 60 ± 10 years) completed both study time points. Patients who developed mucositis had significantly lower dietary intake of vitamins and plasma 25-hydroxy vitamin D (25-OHD) and all-trans retinol levels (p < 0.02). Patients lost a considerable amount of muscle mass (3.4 kg) and fat mass (3.6 kg) over the course of treatment. There was a trend toward greater muscle loss in patients with 25-OHD < 50 nmol/L compared to patients with 25-OHD ≥ 50 nmol/L (p = 0.07). A significant negative correlation was found between plasma all-trans retinol and CRP level at the end of treatment (p = 0.03). Poor vitamin status could be a contributing factor in developing treatment-induced toxicities.

Head and Neck Cancer Patients Do Not Meet Recommended Intakes of Micronutrients without Consuming Fortified Products.

This study assessed dietary and micronutrient intakes of head and neck cancer (HNC) patients at key points in the disease trajectory and evaluated the contribution of oral nutritional supplements (ONS) to micronutrient intake. HNC patients (n = 114) completed a three-day dietary record and a tool to assess Nutrition Impact Scores (NIS) at baseline, post-treatment, and follow-up. Foods were classified into food categories. Micronutrient, protein, and energy intakes were compared to European Society for Parenteral and Enteral Nutrition guidelines for cancer patients. The majority of patients did not meet recommended dietary intakes for vitamins D, E, C, folate, and magnesium at any study time point. Relative to baseline, the proportion of calories from milk, soup, and ONS significantly increased at post-treatment, while grain, meat, potato, baked dessert, and oil and sugar decreased (P < 0.03). At all study time points, patients categorized as high ONS consumers (>15% of total daily calories from ONS) had higher intakes of micronutrients (P < 0.003). They also had a higher NIS (P = 0.006) and experienced greater weight loss (P < 0.04) during the study, despite having similar energy intake to patients consuming <15% kcal from ONS. Fortification of usually consumed foods to improve micronutrient intake among cancer patients should be evaluated.

A review of chemosensory perceptions, food preferences and food-related behaviours in subjects with Prader-Willi Syndrome.

Hyperphagia and obsessive preoccupation with food are hallmark characteristics of Prader-Willi Syndrome (PWS). Although hyperphagia in PWS is linked to hypothalamic dysfunction, the underlying mechanisms behind this problem are poorly understood. Moreover, our understanding of how chemosensory perceptions and food choice/preferences relate to hyperphagia in individuals with PWS is very limited. This narrative review synthesizes studies that assessed chemosensory perceptions, food choices and food-related behaviours in PWS individuals and highlights knowledge gaps in research for further exploration. Twenty seven publications from relevant databases met inclusion criteria and were organized thematically by study technique in the review. Results suggested that PWS individuals have consistent preferences for sweet tastes and in most studies have exhibited a preference for calorie-dense foods over lower calorie foods. No firm conclusions were drawn concerning the chemosensory perceptions of PWS individuals and their influence on food preferences or choices; chemosensation among PWS individuals is an understudied topic. Current evidence suggests that eating behaviour in PWS is a complex phenomenon that involves a dysfunctional satiation and not excessive hunger. Food preferences, choices, and related behaviours and the impact of these on obesity management in those with PWS remain poorly understood and require further study using validated tools and methodologies.

Reframing eating during chemotherapy in cancer patients with chemosensory alterations.

PURPOSE: Our purpose was to describe how eating is reframed among cancer patients experiencing chemosensory alterations. METHODS: Using data collection and analysis strategies from a qualitative design called ethnoscience, we interviewed 12 patients experiencing taste and smell alterations during chemotherapy. We asked participants to provide a description of a meal and the process by which they decide what and how to eat. Each person was interviewed twice. We compared participants' descriptions of eating, and used this comparison to identify some core beliefs about eating. Participants also completed measures of dietary intake, symptom burden and quality of life. RESULTS: Based on the interviews, we identified specific constraints to eating, beliefs about the value of eating, and behaviours participants used to work around the constraints to eat during chemotherapy. Chemosensory complaints and other symptoms (i.e. pain, anorexia, tiredness), personal experiences and food preferences were the main constraints. Core beliefs about the value of eating included its social benefits, benefits of eating for health per se, and benefits related to preparing for the next chemotherapy cycle. These beliefs reframed the purpose of eating and were used by participants to develop specific strategies to work around the constraints to eating. CONCLUSION: To date, interventions to promote eating among cancer patients have focused extensively on symptom management and on recommendations for macro/micronutrient intake. This study underscores the importance of understanding beliefs about eating. These beliefs may help clinicians develop patient-centered nutritional interventions.

Blinded taste panel evaluations to determine if fish from near the oil sands are preferred less than fish from other locations in Alberta, Canada.

The oil sands industry is rapidly expanding surface mining and bitumen extraction operations near the Athabasca River in northeastern Alberta, Canada. There are anecdotal comments that the fish from the Athabasca River have an off-taste, implying that the oil sands operations are the cause. This study was done to determine if the taste of wild fishes caught near the Athabasca oil sands was less preferred than the taste of fishes collected from two other river basins in Alberta. In blinded experiments, consumer sensory panels, of 40 to 44 participants, tasted steamed samples of each of three fish species (walleye (Sander vitreus), northern pike (Esox lucius), and lake whitefish (Coregonus clupeaformis)) from three different sources in Alberta (the Athabasca River, Buck Lake, and McGregor Lake). Data analyses showed that there was no evidence from the consumer preference rankings that the taste of the fish from the Athabasca River was preferred less than the taste of fish from two other water bodies in Alberta.

Consumer preferences and willingness to pay for value-added chicken product attributes.

A growing demand for convenient and ready-to-eat products has increased poultry processors' interest in developing consumer-oriented value-added chicken products. In this study, a conjoint analysis survey of 276 chicken consumers in Edmonton was conducted during the summer of 2009 to assess the importance of the chicken part, production method, processing method, storage method, the presence of added flavor, and cooking method on consumer preferences for different value-added chicken product attributes. Estimates of consumer willingness to pay (WTP) premium prices for different combinations of value-added chicken attributes were also determined. Participants'"ideal" chicken product was a refrigerated product made with free-range chicken breast, produced with no additives or preservatives and no added flavor, which could be oven heated or pan heated. Half of all participants on average were willing to pay 30% more for a value-added chicken product over the price of a conventional product. Overall, young consumers, individuals who shop at Farmers' Markets and those who prefer free-range or organic products were more likely to pay a premium for value-added chicken products. As expected, consumers' WTP was affected negatively by product price. Combined knowledge of consumer product attribute preferences and consumer WTP for value-added chicken products can help the poultry industry design innovative value-added chicken products. Practical Application: An optimum combination of product attributes desired by consumers for the development of a new value-added chicken product, as well as the WTP for this product, have been identified in this study. This information is relevant to the poultry industry to enhance consumer satisfaction of future value-added chicken products and provide the tools for future profit growth.

Odor detection thresholds of naphthenic acids from commercial sources and oil sands process-affected water.

Naphthenic acids (NAs) occur naturally in various petroleums and in oil sands tailings waters and have been implicated as potential fish tainting compounds. In this study, trained sensory panels and the general population from a university were used to determine the odor detection thresholds of two commercial NAs preparations (Acros and Merichem) and of NAs extracted from an oil sands experimental reclamation pond (Pond 9). Using the three-alternative forced choice method, a concentration series of NAs were presented to the sensory panels in phosphate buffer (pH 8) and in steamed fish (Sander vitreus). In buffer, the odor detection thresholds of Acros, Merichem and Pond 9 NAs, as evaluated by the trained panelists, were 1.5, 0.04, and 1.0 mg L(-1), respectively. Only the detection threshold for the Merichem NAs was significantly different (p<0.01) than the other two sources. Based on the general population assessments, all three odor detection thresholds were significantly different from one another; 4.8, 0.2, and 2.5 mg L(-1) for Acros, Merichem, and Pond 9 NAs, respectively (p<0.01). The odor detection thresholds of Merichem and Pond 9 NAs in steamed fish were 0.6 and 12 mg kg(-1), respectively and were significantly different from each other (p<0.01). The detection threshold of Acros NAs was estimated to be >21 mg kg(-1). For the steamed fish evaluations, the odor descriptors of all three of the NAs preparations was given as chemical in nature (Acros: oil, plastic; Merichem: gasoline; Pond 9: gasoline, tar). Exposure of live rainbow trout to a non-lethal concentration of Merichem NAs (3 mg L(-1) for 10 d) imparted an odor to the fish flesh. Analyses of the three NAs preparations by gas chromatography-mass spectrometry showed that each had a unique distribution of acids. We conclude that the source of the NAs is important when interpreting odor threshold data and that the two commercial preparations of NAs that were tested do not represent oil sands waters' tainting potential.

Modification and validation of a Macronutrient Preference Checklist for use in North America.

A Macronutrient Preference Checklist (MPC) is a simple tool that assesses momentary macronutrient and taste preferences. The purpose of this study was to modify and validate an existing European 32-item MPC and adapt it for use in North America. A total of 160 subjects completed questionnaires (demographic survey, appetite assessment, MPC, and MPC items rated on a 9-pt hedonic scale) on two occasions (Part 1). The MPC showed good internal consistency (Cronbach's alpha values of 0.76, 0.72, 0.64, and 0.57 for the four macronutrient categories of high protein, high carbohydrate, high fat, and low energy) and high test-retest reliability, with strong correlations for all four macronutrient categories. A larger sample size (n=239) was used to explore the influences of age, gender, and appetite on macronutrient and taste preference (Part 2). Subjects completed study questionnaires once. The influences of appetite, age, and gender on macronutrient preferences assessed with the MPC concur with the literature, confirming the tool's validity. The MPC was found to be a valid and reliable tool that may be used as a simple and efficient method of assessing momentary macronutrient and taste preferences in future research and clinical settings in North America.

Assessing alterations in taste and their impact on cancer care.

PURPOSE OF REVIEW: As the discipline of supportive and palliative cancer care grows, there is increasing acknowledgement of taste and smell alterations (TSAs) as barriers to nutrient intake and detriments to the food-related quality of life and well being of the population. The focus of this brief review is to summarize the recent advances regarding the cause and nature of TSAs and patients' perceptions of TSAs and to identify promising approaches for the alleviation of TSAs. RECENT FINDINGS: Individual variations in the nature of TSAs exist and chemosensory changes have been established as an important quality of life issue associated with prognosis. The development and partial recovery of radiation therapy induced TSAs have been observed in longitudinal studies. Flavor enhancement has been found to improve patient-reported taste and smell capabilities. Patient-reported tools and qualitative methodologies have provided insight into the impact of TSAs on food-related quality of life and have been used with clinical measures to relate patient's perception to objective outcomes. SUMMARY: A variety of approaches to the assessment of TSAs continue to generate a description of the development, duration and recovery of distorted chemosensory perception in cancer patients. Attention to individual variation in the nature and severity of TSAs as well as nutritional support and focus on flavorful foods can enhance patients' well being and food-related quality of life.

Estimating naphthenic acids concentrations in laboratory-exposed fish and in fish from the wild.

Naphthenic acids (NAs) are the most water-soluble organic components found in the Athabasca oil sands in Alberta, Canada, and these acids are released into aqueous tailing waters as a result of bitumen extraction. Although the toxicity of NAs to fish is well known, there has been no method available to estimate NAs concentrations in fish. This paper describes a newly developed analytical method using single ion monitoring gas chromatography-mass spectrometry (GC-MS) to measure NAs in fish, down to concentrations of approximately 0.1mgkg(-1) of fish flesh. This method was used to measure the uptake and depuration of commercial NAs in laboratory experiments. Exposure of rainbow trout (Oncorhynchus mykiss) to 3mg NAsl(-1) for 9d gave a bioconcentration factor of approximately 2 at pH 8.2. Within 1d after the fish were transferred to NAs-free water, about 95% of the NAs were depurated. In addition, the analytical method was used to determine if NAs were present in four species of wild fish - northern pike (Esox lucius), lake whitefish (Coregonus clupeaformis), white sucker (Catostomus commersoni), walleye (Sander vitreus) - collected from near the oil sands. Flesh samples from 23 wild fish were analyzed, and 18 of these had no detectable NAs. Four fish (one of each species) contained NAs at concentrations from 0.2 to 2.8mgkg(-1). The GC-MS results from one wild fish presented a unique problem. However, with additional work it was concluded that the NAs concentration in this fish was <0.1mgkg(-1).