Changes in Patients’ Taste Acuity after Roux-en-Y Gastric Bypass for Clinically Severe Obesity

https://doi.org/10.1016/S0002-8223(95)00182-4Get rights and content

Abstract

Objective Patients who have undergone Roux-en-Y gastric bypass (RYGB) for clinically severe obesity often report an aversion to sweet foods and meat. This study was designed to determine whether changes in taste acuity occur after RYGB.

Design This prospective, repeated measures trial evaluated acuity for sweet (sucrose) and bitter (urea) tastes, zinc status, and reported changes in taste perceptions in patients undergoing RYGB for weight reduction.

Subjects Taste acuity and serum zinc level were measured in 14 subjects, 6 men and 8 women (mean preoperative body mass index [calculated as kg/m2]=60.8±11.8 and mean age=38.4±6 years), before surgery and 6 and 12 weeks after surgery. Inquiries regarding taste preferences were made at each postoperative visit with specific reference to sweets and meat. Serum zinc level was measured at the same visit. A noncontrolled comparison group of 4 subjects who were consuming a very-low-calorie diet also underwent taste acuity testing at similar intervals.

Main outcome measures The main outcome measures were recognition taste thresholds, serum zinc levels, and taste preference changes.

Statistical analysis Analysis of variance with repeated measures over time, Pearson correlation coefficients, and post hoc analysis of variance were used to analyze data.

Results Mean recognition thresholds for sucrose were 0.047±0.03 mol/L preoperatively and fell significantly to 0.024±0.01 and 0.019±0.01 mol/L at 6 and 12 weeks postoperatively, respectively. Overall, there were no significant differences in taste thresholds for urea over time; a significant difference was noted, however, in the pattern of change for urea between patients who reported an aversion to meats and those who did not. Zinc concentrations did not change during the study.

Application/conclusions At 6 weeks postoperatively, all patients reported that foods tasted sweeter, and they modified food selection accordingly. Six patients reported an aversion to meats associated with increased nausea and vomiting. Acuity for sweet and bitter tastes may need to be considered when planning dietary modifications for patients undergoing RYGB. J Am Diet Assoc. 1995; 95:666-670.

Section snippets

Methods

The study protocol was approved by the Biomedical Sciences Human Subjects Review Committee of The Ohio State University. Voluntary informed consent was obtained from each subject before entry to the study.

Results

All 14 RYGB subjects completed sucrose taste measurements, and 12 of them completed urea taste measurements. Plasma zinc levels were available for 10 of the surgery subjects. The mean age of the RYGB subjects was 38.4±6 years; mean BMI was 60.8±11.8 kg/m2. The four subjects who were consuming the VLCD completed taste measurements for sucrose and urea; the mean age of these subjects was 47±6 years and mean BMI was 43±9.

Taste recognition thresholds for sucrose decreased significantly (P<.05)

Discussion

Taste acuity can be determined by means of a variety of methods that measure detection and recognition thresholds, including the three-drop forced-choice method and the staircase method (13). We chose the staircase method to avoid the limitations of the three-drop forced-choice method, for example, limited area exposure to the taste buds, which may be exaggerated in situations where there is an alteration in the surface topology of the tongue.

Distorted taste, by affecting both choice of food

Applications

RYGB results in changes in food preferences and eating patterns that are associated with changes in taste acuity. After RYGB, patients have an increased taste acuity for sucrose. This increased acuity, combined with an increased tendency to exhibit symptoms of the dumping syndrome after sucrose ingestion, may result in an aversion to sweet foods. Postoperatively, aversion to meat in RYGB patients does not appear to be the result of alterations in taste acuity for urea. However, patients who

References (21)

There are more references available in the full text version of this article.

Cited by (142)

  • Sweet taste and obesity

    2021, European Journal of Internal Medicine
    Citation Excerpt :

    In studies conducted to test differences in taste perception following bariatric surgery, threshold estimation was also a common outcome, as shown in Table 2. Here, some[24–26,29], but not all studies[27,28,30], revealed an improvement of taste sensitivity after bariatric surgery, but with inconsistent profiles across taste qualities. Specifically, following RYGB, there are reports of lower detection thresholds (i.e. increase in taste sensitivity) for sweet taste, using the constant stimuli method two months after surgery[26], and also for sweet taste, but not for bitter taste, up to 3 months after surgery, using an up-down/ staircase method[25].

  • Reliability and responsiveness of virtual portion size creation tasks: Influences of context, foods, and a bariatric surgical procedure

    2020, Physiology and Behavior
    Citation Excerpt :

    Sweet, salty, and umami tastes are usually well accepted by humans and contribute to the palatability of foods and promote their intake while bitter and sour tastes reduce palatability of foods [25]. Additionally, decreases in sweet and salt sensitivity are reported in the individuals with morbid obesity after gastric bypass surgery [31,32]. Mixtures of sugar and fat are considered especially palatable by individuals with obesity [33–35].

  • Changes in taste function and ingestive behavior following bariatric surgery

    2020, Appetite
    Citation Excerpt :

    The literature remains divided on whether or not sweet sensitivity measured at threshold levels is changed after RYGB or SG. Research has indicated both increased sweet taste sensitivity (i.e. decreased sucrose detection and recognition thresholds) (Bueter et al., 2011; Burge, Schaumburg, Choban, DiSilvestro, & Flancbaum, 1995) or no change in taste sensitivity (Nance et al., 2017; Pepino, Bradley, et al., 2014; Scruggs, Buffington, & Cowan, 1994) in studies that are relatively comparable in gender distribution and time since surgery. The only difference was in methodology used.

View all citing articles on Scopus
View full text