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Cancer Nutrition Network for Texans

Food Aversion in Cancer Patients

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What is it?

Cancer treatments are known to cause food aversions. Maintaining an adequate nutrition intake is difficult because cancer can alter senses of taste and smell in different ways. Patients commonly reported sensitivity to bitter, sweet, and metallic tastes secondary to therapy. The foods most commonly affected were coffee, tea, citrus fruit and drinks, chocolate and in red meat (primarily beef).

How does it work?

Food avoidance is complex and multifactoral. These aversions can be the result of changes in biochemical pathways, disorders of other regulatory systems, primary or secondary taste disorder, psychological problems, or nausea and vomiting. Cancer and its treatment are known to cause malnutrition in significant number of patients. Cancer and its treatment are known to cause malnutrition in significant number of patients. Another factor that can lead to food aversion is an imbalance of the neurotransmitter (serotonin and norepinephrine) levels in the hypothalamus of the brain.

Is it efficiacious?

Evidence reveals that the nature of food avoidance is different for each patient; therefore, individual assessment of nutritional advice should be given. Data suggests similarities and differences between food aversions formed toward regular dietary items during treatment and suggested possible ways to prevent clinical problems concerning normal dietary items in the treatments with cancer patients.

What is the state of the science?

I At least one randomized controlled trial
II-1 Controlled trials without randomization
II-2 Cohort or case-control studies, usually from multiple centers
II-3 Multiple time series or cross-sectional studies with dramatic results
III Expert opinion or testimonial

The aversions are presumed to develop via conditioning processes as demonstrated in experimental studies of food aversion learning. The present study used a prospective, longitudinal design to evaluate the possible role of conditioning in the formation of aversions to normal dietary items in women receiving adjuvant chemotherapy for breast cancer. Patients were monitored for the development of aversions to food and beverages consumed in the 24 hour period before and after each of eight consecutive chemotherapy infusions beginning with the initial infusion. Changes were noted in the consumption of both sweet and salty foods. In terms of food avoidance no apparent relationships were demonstrated between its incidence and either the type of disease or the drugs used in therapy. Data on the prevalence, course, and prediction of aversions to normal dietary items are reported.

References:

Holmes, S., Food Avoidance in Patients  Undergoing Cancer Chemotherapy. Supportive Care in Cancer. 1(6): 326-30, 1993 Nov.

Jacobsen, P.B., Bovbjerg, D.H., Schwartz, M.D., Andrykowski, M.A., Futterman, A.D., Gilewski, T., Norton, L. Redd, W.H., Formation of food aversions in cancer patients receiving repeated infusions of chemotherapy. Behavior Research & Therapy. 31(8): 739-48, 1993 Nov.

Pettey, C., Ferguson, D., Langford, M.C., What's to eat? Cancer patients help decide. RN. 1(10): 23-6, 1998 Oct. (Abstract Not Available)

Herber, D., Blackburn, G., Go, VL, Nutriitonal Oncology. California: Academic Press.


Mary Bielamowicz, Ph.D., R.D., is the Professor and Extension Nutrition Specialist for the Human Nutrition Section of the Department of Animal Science at Texas A&M University.

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