IMPROVING PLEASURE OF ELDERLY PEOPLE FOR ......1 IMPROVING PLEASURE OF ELDERLY PEOPLE FOR FIHGTING AGAINST MALNUTRITION Claire Sulmont-Rossé, Isabelle Maître, Virginie Van Wymelbeke

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IMPROVING PLEASURE OF ELDERLY PEOPLEFOR FIHGTING AGAINST MALNUTRITION

Claire Sulmont-Rossé,Isabelle Maître, Virginie Van Wymelbeke

Sulmont-Rossé et al., Vitagora 2012, 2

Introduction

Flavor and texture largely contribute to the pleasure associatedwith a meal…

What does happen when aging leads to a decline in ability to taste or smell?

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Introduction


Decline in abilityto taste or smell

Changein food preference

Changein food intake

From Rolls, 1999


Introduction


Epidemiological studies- Seeking for correlation between

sensory capacities and food intake in elderly population

Flavor enhancement- Increasing the concentration of

flavor compounds in food in order to compensate for the decline of chemosensory abilities with ageing

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Epidemiological studies

Seeking for correlations between chemosensory perception and food intake - Duffy et al. (1995)

- 80 elderly women > 65 yo- Odor perception

Assessment of orthonasal perception (butanol threshold + identification of 7 odors)Assessment of retronasal perception (orange flavor threshold in sweetened gelatin)

- Food attitude & behaviorSurvey on food behavior (food belief, food enjoyment, cooking practices…)Food intake of 137 foods (NHANES food questionnaire)


Epidemiological studies

Seeking for correlations between chemosensory perception and food intake - Duffy et al. (1995)

- Some impact of impaired olfaction on interest in food-related activities

Enjoys cooking Likes to spend time preparing food Looks for new recipes Adds herbs and spices to food

- (Very) few impact of impaired olfaction on food intakeSome foods are consumed less frequently (strawberry, grapefruit,cauliflower/brussels sprouts, raw spinach, skim milk, tuna)Some foods are consumed more frequently (pie, ice cream, pastries/cookies)

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Flavor enhancement

Flavor enhancement and preference in elderly- Schiffman & Warwick (1988): which one do you like the best?

22.2 % (apple +++)33.3 % (apple +)44.4 %Appel juice

55.5 % (bacon)27.2 % (tomato/bacon/pea)16.7 %Vegetable soup

36.8 % (bacon)47.4 % (tomato)15.8 %Tomato soup

40.0 % (bacon)20.0 % (chicken)40.0 %Chicken

72.2 % (bacon)22.2 % (beef)5.6 %Beef (ground)

44.4 % (bacon)16.7 % (potatoes)38.9 %Potatoes (mashed)

44.4 % (bacon +++)38.9 % (bacon +)16.7 %Green beans

62.5 % (carrot +++)12.5 % (carrot +)25.0 %Carrots

ENHANCER 2ENHANCER 1STANDARD


Flavor enhancement

Flavor enhancement and food intake in elderly- Mathey et al. (2001)

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Flavor enhancement

M=74 yo

M=85 yo

M=84 yo

> 60 yo

> 65 yo

M=85 yo

M=84 yo

Age

No

Yes

Yes

Yes

Yes

Yes

Yes

Institution

WithinYes + for 1 NoYes +

3 mealsMSG2 soupsRiceMashed potatoes

Bellisle et al., 1991

WithinNo3 mealsFlavorYosaKoskinen et al., 2003

BetweenNo16 weeksAroma and/or MSG

MeatsEssed et al., 2007

BetweenYes +16 weeksFlavorMeatsMathey et al., 2001

WithinNoNoYes +

1 mealFlavorTomato soupQuornYoghurt

Griep et al., 1996

WithinNo5 daysSweet taste

Strawberry jamStrawberry yoghurtOrange lemonade

De Jong et al., 1996

WithinYes + for only 3 foods

3 weeksFlavor

30 various foods (vegetables, gravies, sauces, breakfast food, meats)

Schiffman & Warwick, 1993

DesignImpact on food intake

Exposure duration

Enhanced flavorFoodReference


Flavor enhancement

At first glance…- At the instant t, elderly subjects preferred food with higher flavor

intensity than young subjects…- But increasing flavor concentration in a food does not systematically

lead to an increase in food intake

Actually…- Implicit food memory is well preserved with ageing

But…- The average effect of ageing on chemosensory perception hides a

large variability between elderly

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Implicit food memory and ageing



Effect of age on recognition performance following incidental learning

- Sulmont-Rossé et al. (2008) – comparisons of 58 young participants (18-34) with 56 elderly participants (55-84)

Retention interval

Incidental learning

Is this food identical to or different from the one you

taste in the previous session?

Recognition

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Effect of age on recognition performance following incidental learning

- Sulmont-Rossé et al. (2008) – no significant difference was observed between young and elderly

0

0.2

0.4

0.6

0.8

1

Young Elderly

Rec

ogni

tion

perf

orm

ance



A good new… Implicit food memory is well preserved with ageing- Our food memories may be continuously updated through our life

course while taking into account modification of flavor perceptionI am still liking the veal stew that I am used to cook…

A bad new… Elderly are still able to detect sensory changes in the food they are used to eat

- What does happen when disruption occurs in food habits (meal delivery at home, nursing home)?

What’s about the veal stew provided by catering service?

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Chemosensory variability and ageing



Aupalesens survey- A large survey was conducted including 559 people older than 65

according to pre-specified categories:Category 1: people living at home without any assistance (n=292, 52%)Category 2: people living at home with assistance, except for meal preparation (n=97; 17%)Category 3: people living at home with assistance for meal preparation or meal delivery (n=75; 13%)Category 4: people living in a nursing home(n=95; 17%)

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Chemosensory tests- Olfactory and gustatory tests- Processes ranging from low to high cognitive levels

Short version of the ETOC (6 blocks)Odor discrimination test (3 blocks)Odor categorization test (12 samples)Salt test (12 samples)

European Test of Olfactory Capabilities

6 blocks of 4 vials including 1 odorous vial and 3 blanks

Which vial contains an odor? ETOC detection score

/6

Thomas-Danguin et al. (2001)

Odor discrimination test

3 blocks of 3 vials including 2 vials with the same odor and 1 vial with a different odor (e.g., beef – fish – beef)

Which vial contains the odd odor?

Odor discrimination score /3

Odor categorization test

6 food odors & 6 non food odors Do you perceive an odor?Odor detection score /12 Is it a food or non

food odor?Odor categorization

score / 12

Salt test

6 water solutions of increasing concentrations of NaCl & 2 blanks

Are you tasting water or something else?

Salt detection score/8

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Score distribution



ETOC score

Odordiscrimination

score

Odorcategorization

score

Odordetection

score

Saltdetection

score

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Elderly segmentation

15 (3%)120 (21%)186 (33%)238 (43%)n

0.68 (0.05)0.66 (0.01)0.55 (0.01)0.81 (0.01)Salt detection

0.08 (0.04)0.44 (0.01)0.74 (0.01)0.73 (0.01)Odor categorization

0.04 (0.03)0.53 (0.03)0.81 (0.02)0.79 (0.02)Discrimination

0.17 (0.06)0.76 (0.02)0.93 (0.01)0.93 (0.01)Odor detection

0.08 (0.06)0.41 (0.03)0.77 (0.02)0.77 (0.01)ETOC detection

Cluster 4Cluster 3Cluster 2Cluster 1

3 / 421 / 2233 / 3643 / 38Non-smokers / former smokers

26262727Mini Mental State (MMS©)

24252626Mini Nutritional Assessment (MNA©)

4%25%32%38%% people who are taking drugs liable to impact the chemosensory perception

1%17%34%47%% people who are not taking drugs liable to impact chemosensory perception

5%39%38%18%% people living in nursing home

7%23%33%37%% people living at home with help for meal or meal delivery

2%31%31%36%% people living at home with help excluding help for meal

1%12%33%54%% people living at home without help

85827977Age

2 / 319 / 2734 / 3345 / 37Women / men

15 (3%)120 (21%)186 (33%)238 (43%)Size

AnosmiaOlfaction disorders

Taste disordersPreservedChemosensory ability

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To conclude…


To conclude

Ageing, sensory perception and food pleasure: the challenges of the future…

- How to cope with inter-individual variability? In fact, the failure to observe, on average, an effect of flavor enhancement on food intake in previous studies may hide discrepancies between individual responses

- Should we compensate chemosensory disorders by increasing concentration of flavor compounds in food… or by improving other sensory or psycho-affective dimensions of the food?

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To conclude

Ageing, sensory perception and food pleasure: the challenges of the future…

- If a food has a bad sensory quality, elderly subjects will not like it, as young subjects…

- However, a decrease in food intake will have more drastic consequences for elderly people than for young people

- Improving the sensory appetence of foods dedicated to elderly people remains an important challenge

Do you think that eating is a source of pleasure?

0

5

10

15

20

Cat. 1 Cat. 2 Cat. 3 Cat. 4

F=2.28; p=.08; R2=0.01

Dépendence

How do you likeyour present meals?

F=45.90; p<.001; R2=0.20

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2

3

4

5

Cat. 1 Cat. 2 Cat. 3 Cat. 4

Dépendence

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Thanks to…

HealthSense project (EU project)- EP Köster (Wageningen University & Research, ND) & Per Møller (Copenhagen

University, DK)

Aupalesens project (ANR project)- Marion Amand, Véronique Cariou, Evelyne Vigneau (ONIRIS, Nantes)- Nathalie Bailly (Université François Rabelais, Tours)- Sylvie Issanchou (UMR CSGA, Dijon) & Ronan Symoneaux (ESA, Angers)

Competitiveness unit label - Valorial- Vitagora

Valérie Feyen, Françoise Durey, Cindy Huchon, Judith Henning & Christian Wulff

Elodie Caumon, Jérémy Tavares, Abla Atmani, Celia Crema, GéraldineChaillot & Marion Provost, Julia Ménard & Claire Vaugeois (Défi SantéNutrition, Brest)

And all the participants of the studies !


More on Aupalesens…

General presentation of the project- Improving pleasure of elderly people for better aging and for fighting

against malnutrition (stand INRA)

2 posters on the results of the Aupalesens survey- Tell me what you are eating, I will tell you who you are: the different

eater styles among the elderly population, Maitre et al. - Impact of dependence on the act of food: contributions of sociology,

Crema et al. - poster

Documents

IMPROVING PLEASURE OF ELDERLY PEOPLE FOR ......1 IMPROVING PLEASURE OF ELDERLY PEOPLE FOR FIHGTING AGAINST MALNUTRITION Claire Sulmont-Rossé, Isabelle Maître, Virginie Van Wymelbeke