Hematological cancer patients’ taste- and food preferences

​The project ran from November 2012 to August 2013

Background: Since food intake in part is motivated by preference and liking (Rozin et al., 2006) a way to improve nutritional status in hematological cancer patients might be by customizing food items to the patients’ preferences in relation to taste, texture and temperature. Studies have been made on the topic, but the results are inconsistent. Aims: To identify the taste- and food sensory preferences of adult hematological hospitalized cancer patients at Herlev University Hospital, both within and without chemotherapy treatment, through a quantitative questionnaire survey. To investigate how the preferences vary according to different times of the day.

Method: Only patients with symptoms that caused a reduction in appetite were included (Patient-Generated Subjective Global Assessment; Bauer et al., 2002). Patients were requested to answer the questionnaire twice the same day: at 10-11 A.M. and at 01-02 P.M.. The questionnaire consisted of 42 food pictures of Herlev Hospital meals (12 main food categories with 3 pictures in each category), that had to be rated on a 5 point hedonic scale in relation to wanting to eat the certain food (1= lowest wanting). Furthermore, the questionnaire contained an open question regarding which food the patients most wanted to eat, and how the texture, temperature and taste of this food should be.

Results: 59 patients completed the questionnaire survey (59% males) with average age 67±14 years. 54 % (n=32) patients were in chemotherapy treatment. The overall wanting of foods in the morning (3.1) was significantly (p=0.002) higher than in the afternoon (2.8).

The highest preferences were shown for fresh fruit (3.9), cheese (3.7), soup (3.7), mashed potatoes with bacon (3.7) and ice cream (3.6). There was seen a significant difference in the overall average wanting score among the 21-55 years old patients (2.75) and 56-70 years old patients (3.09). Furthermore, there was observed a significant difference when the texture of the foods was divided in liquid, soft and foods with harder texture, with a significantly higher (p = 0.014) wanting of liquid foods (3.3) compared to harder foods (2.9). Also, a tendency to want soft foods (3.06) more than hard (2.9) was observed.
The favorite foods could be categorized to three and included fresh cold drinks (46 % patients), traditional dishes (38 % patients) and easy light meals (11 % patients). When patients were asked more specific questions regarding the taste they wanted the most, 25 % of the petients answered that the food they wanted should taste sweet, 12 % of the patient wanted the taste of salt, and 12 % wanted the umami taste. Regarding temperature, 23 % of the patients wanted something cold, but on the other hand, 20 % wanted something warm, while a few patients wanted ice cold (10 %), lukewarm or hot foods. No differences in any of the preferences between patients within and without chemy therapy were observed.

Conclusion: Hematological cancer patients have preferences for foods with liquid textures. The preferred tastes were sweet, salt or umami. Both warm and cold foods were preferred. The food categories fresh drinks, easy foods and traditional foods were found to be favorite. The patients' overall wanting for food was significantly higher in the morning compared to the afternoon. All the preferences were independent of the chemotherapy treatment status. Thus, a food item to hematological cancer patients should be customized in relation to the morning times, e.g. as an in-between snack before lunch.

References:
 - Rozin P., 2006. The Integration of Biological, Social, Cultural and Psychological Influences on Food choice. In: Shepherd,R., Raats,M. (Eds.), The Psychology of Food Choice. Biddles Ltd, Oxfordshire.

 - Bauer, J., Capra, S., Ferguson, M., 2002. Use og the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer., European Journal of Clinical Nutrition. Number 56: 779-785. 

Signe Loftager Okkels was doing her Master thesis on this project​

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