A relatively common side effect of chemotherapy is changes in food taste: The sweet, salty, sour, and bitter flavors you are used to just don’t taste the same. The name for this is Dysgeusia. What, if anything, can be done to help with this?
With many chemotherapies, our familiar tastes are replaced with metallic, chemical, acidic, or just plain “yuck” taste. Your favorite dishes suddenly taste awful. Even water tastes odd. When described to others it might seem a like small thing, but it really can affect your quality of life.
There are different theories as to why chemo causes dysguesia, including:
- chemo directly affects taste cell receptors
- chemo causes neurotoxicity that damages the nerves involved in taste perception
- chemo reduces the amount of saliva produced, which results in a dry mouth and alters the chemical released from the food
As a result of the precise mechanism still not being understood, the development of effective treatments hasn’t been forthcoming. However, it is important to try to address dysguesia as it can lead to other medical problems such as depressed mood, oral problems, nausea, appetite loss, and weight loss.
Everyone is different, and chemos are different too – resulting in some people being affected more by sweet taste and others by salty. Some people think food tastes like sawdust or other items they’ve never even tasted before!
If you’ve never experienced taste changes, it’s a little difficult to understand. During my time as a client manager for Ceres Community Project, I ran regular liaison training meetings. These liaisons were volunteers who supported our clients (mainly cancer patients) and helped them change their diet and lifestyle (we provided free organic plant-based meals delivered for up to 26 weeks). A large part of the liaison’s role was to help the clients make the most of these meals even if the ingredients weren’t what they were used to eating, and even though their tastes were changing. At one of our liaison meetings, I gave each liaison a raisin to eat and asked them to describe the taste and really think about its taste. Obviously, they all identified well with the sweetness of the fruit and enjoyed it etc. Next I gave them a drink of a herbal tea and asked them to comment on that. After the tea, I gave them another raisin and asked them to again describe the taste of the raisin. This time, none of them enjoyed the raisin. It wasn’t sweet at all, it tasted “all wrong” and ugh! The tea I had made for them contained a herb that affects our taste – and so this was an eye-opening illustration of possibly how our clients were experiencing taste changes. I think it offers a great perspective on how disappointing and unsettling it can be to eat when things don’t taste how you expect them to.
So based on what we know, how can we deal with all these taste changes and not be completely put off eating?
Strategies to deal with changes in food taste
It’s a bit counter-intuitive, but one of the key places to start is to not eat your favorite meals anymore. If you have a couple of favorite dishes that you just love and make you feel a certain emotion – whether that is comfort or memories of some event or a “ritual” meal such as Thanksgiving – avoid that dish for now. The likelihood is that if you are experiencing taste changes, this dish won’t taste good and that can really affect our mind/emotion. In the same way that it is disappointing and disturbing to revisit a favorite sleepy vacation spot after several years only to find it full of high-rise buildings and t-shirt shops…if we have an emotional expectation of a favorite meal and then the emotion of that meal gets destroyed because the food just doesn’t taste right, you can be left feeling much worse than if you hadn’t had the meal in the first place.
Save your favorite meals and dishes for when you have finished chemo and your taste buds have returned to normal. You’ll still love them and you won’t have any bad memories of being disappointed in them. You won’t have to listen to yourself thinking “Yuck, remember when I had this and it tasted like wet cement?”
Rebecca Katz has two cancer fighting cookbooks in which she introduces us to her FASS system to help with altered taste. FASS stands for Fat, Acid, Salt, and Sweet and she uses olive oil as the fat, lemons for the acid, sea salt for the salt, and grade B maple syrup for the sweet.
Basically, her strategy is to find a balance of FASS in every meal, adjusting until it tastes OK to you. So for example, if something tastes metallic, adding just 1/4 teaspoon of maple syrup or a squeeze of lemon can help. Or adding some fat. If something tastes too salty, adding lemon juice can help take that taste away. Rebecca has a sheet that shows which FASS ingredient might help with different tastes.
Here is Rebecca’s FASS worksheet.
The amounts you need to adjust the flavor are typically very small.
You can make this into a fun strategy for the family and see how everyone tastes things differently. Make a meal and then have the four FASS ingredients out on the table. Taste the food and give it a taste score, then try an adjustment using FASS and see if you can improve that score by just using one or two of the four FASS products.
Here are some other strategies that might help:
- Eat foods cold or at room temperature. This might lessen the unpleasant flavors.
- Avoid the use of metallic silverware/cutlery. Buy yourself some pretty picnic-style cutlery that makes you smile. You don’t have to put up with horrid disposable cutlery just because metallic cutlery makes things taste worse.
- Add more seasonings and spices to foods, such as oregano, basil, cinnamon, and ginger. They can become the predominant flavor and mask other tastes.
- Reduce consumption of bitter or metallic tasting foods such as coffee, chocolate, and red meat.
- Marinate meats to change the taste.
- Choose frozen fruits such as melon balls, grapes, or oranges.
- Choose more bland foods.
- Drink more water with meals to help with swallowing or to rinse away any bad taste.
- Eat small meals several times a day.
Remember that our appreciation of food comes from all our senses – so more than taste is involved. If your taste is off, consider pandering a bit more to your other senses, such as presenting the food in a way that pleases you, for instance.