Eating well whilst experiencing loss of taste and smell

A fever and persistent cough are widely recognised coronavirus (COVID-19) symptoms. However, as of 18th May 2020, the UK government has added a third symptom to the official list of coronavirus symptoms – loss or change to sense of smell or taste ⁽¹⁾. In this blog we will explore strategies to help patients to eat well whilst experiencing this symptom.

What causes loss of/changes to smell and taste?

Changes to our sense of smell (olfactory sense) or taste (gustatory sense) can be broken down into several distinct disorders:

Changes to our sense of smell are fairly common. They’re usually temporary and it can be caused by colds or flu, allergies, sinus infections, or growths in the nose ⁽²⁾. Changes to our sense of taste are less common, but it can arise from nerve damage due to conditions such as hypothyroidism or diabetes, or as a result of chemo or radiotherapy ⁽³⁾.

However, if somebody experiences onset of any of the above symptoms, it could be coronavirus. Therefore, it’s very important that they self-isolate and follow the latest advice from the government and NHS ⁽⁴⁾.

Consequences of loss of/changes to smell and taste

Smell and taste are two important senses when it comes to the eating experience. They are closely linked, meaning that changes to one or both can have a big effect on our experience of food and drink.

Common consequences of changes to smell and taste include ^{(5, 6, 7)}:

• Decreased appetite
• Reduced enjoyment of eating
• Difficulties with cooking
• Loss of interest in food, and subsequent weight loss
• Increased risk of nutritional deficiencies
• Reduced overall quality of life

The exact effects may differ depending on the specific sensory change that occurs. For example, people who experience anosmia (loss of sense of smell) may lose the ability to taste different flavours, but can still distinguish the different tastes of sweet, salty, bitter, sour, and umami, whereas people who experience ageusia (loss of sense of taste) may lose this ability completely ⁽⁸⁾

A loss of, or change to normal smell and taste senses due to COVID-19 is not dangerous, and it’s usually short-lived. However, it can make the eating experience less enjoyable, which could affect a person’s appetite and nutritional intake, putting them at increased risk of malnutrition. Ensuring that someone continues to eat well during COVID-19 infection, despite their symptoms, is important as malnutrition can negatively affect our immune system ⁽⁹⁾.

Strategies for eating well with loss of/changes to smell and taste

People experiencing loss of or changes to their smell and taste may wish to try the following tips to help them to continue to eat well despite their symptoms.

• Use strong flavours. Adding herbs, spices, chutneys and pickles while cooking will add strong flavours to food, enhancing their taste.
• Mix up the temperature. Research has shown that the temperature of food can affect some people’s perception of the taste’s intensity – particularly with bitter and sour flavours ⁽¹⁰⁾. If somebody is struggling to enjoy the taste of hot foods, try cold foods instead – and vice versa
• Keep experimenting. Even if you find that you go off a specific food, keep trying it regularly as you may find that your tastes continue to change.
• Eat mindfully. When experiencing the loss of the senses most associated with eating, it may help to rely on others to enhance the enjoyment of a mealtime. Encourage the individual to focus on other sensations of their meal (i.e. colours, textures). Chewing slowly, another aspect of mindful eating, is a recommended nutritional strategy for people experiencing loss of taste, as this helps to release flavours and increase saliva production ⁽¹¹⁾.
• Create a positive eating environment. Paying attention to the presentation of food, including different textures, and playing relaxing music can help to make the eating experience more enjoyable.
• Don’t forget about hydration. Patients with dysgeusia (abnormal changes in taste) are advised to drink plenty of fluids while eating as this helps to dissolve taste components, helping them reach the taste buds ⁽¹²⁾. We should aim to drink at least 8 glasses of fluid per day and should pay attention to signs of dehydration (i.e. thirst, dark urine, dry lips and mouth).