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Scripps Cancer Center

Taste and Smell Changes

Medical Nutrition Therapy

About

Changes to taste and smell are common side effects from cancer treatment. You may find that certain foods now taste "off," bitter, metallic, too sweet, too salty, or don't have much taste. Taste changes can occur because of treatments that affect the tongue, which is where most of the taste buds are found. This side effect is usually temporary and resolves after treatment ends.

Nutrition Tips

If food or drinks taste…	… Try This
Bitter	If meat tastes bitter, eat it at room temperature or cold Add something sweet to food and drinks Examples: sweet fruit, jam, honey, maple syrup, agave sweeteners Marinate foods Examples: pineapple, lemon, lime, orange, vinegars, mustard, honey, teriyaki, and soy sauce Try other protein foods that may be better tolerated alone or add to soups, stews, and casseroles: Bland chicken, turkey, fish, or tofu Peanut/nut butter Beans and lentils Mild cheese Eggs Milk Examples: cow, soy, oat, and almond Dairy products, if tolerated or try lactose free versions Examples: Greek yogurt and cottage cheese
Metallic	Use plastic or bamboo utensils, instead of metal Avoid canned foods and beverages Avoid storing food in aluminum foil Use glass cookware Add salt, seasonings, and/or a fat (including olive oil, butter, nut butters)
“Off”	Try sugar-free gum or have mints and hard candies to suck on Examples: lemon drops and peppermints Eat plain, starchy foods Examples: bread, potatoes, rice, and pasta Do not add fat to these foods (such as butter or margarine) Choose bland foods instead of foods with flavor Examples: tofu, potatoes, bread/toast, cottage cheese, eggs, beans, pudding, tapioca, custard, rice, cream soups, oatmeal, nuts, and nut butter

If food or drinks taste…	… Try This
Sweet	Replace sweet fruits with vegetables Add water and/or ice to dilute sweet beverages Examples: juices, teas, and sports drinks Add something sour or tart to food and/or drinks Examples: pickles, lemon, lime, orange, vinegar, pickled foods, and plain Greek yogurt Tip: before eating, a couple drops of lemon juice to your tongue Note: not recommended if mouth sores are present Add something slightly bitter to food and/or drinks Examples: cranberries, unsweetened cocoa powder, and decaffeinated instant coffee
Salty	Add something sweet to food and drinks Examples: sweet fruit, jam, honey, syrup, agave nectar, sweeteners Use low-sodium or no salt added products Do not cook with salt
Bland	Add an acid to food, drinks, and meals Examples: vinegar, lemon, lime, and pickles Try using new using herbs, spices, seasonings, and condiments Examples: cilantro, basil, rosemary, garlic, onion, mint, chili powder, cinnamon, ketchup, mustard, ranch, and soy sauce Marinate foods Examples: pineapple, lemon, lime, orange, vinegars, mustard, honey, teriyaki, and soy sauce Slowly chew foods or chew for longer- encourages more contact with the taste buds Try different food textures, such as crunchy, crispy, soft, and chewy

More Nutrition Tips

Managing strong smells
- Consume cold or room temperature foods; hot foods give off the most odor
  - Avoid using slow cookers or instant pots
- Sip through a straw or use a cup with a cover for soups and beverages
- Let someone else prepare the food and stay in another area, if able
- Eat outside or in a well-ventilated area
- Avoid cafeterias or restaurants with strong odors
Fluids
- Stay hydrated and drink beverages during and in-between meals
- Fluid examples:
  - Water and ice chips
  - Juice and popsicles
  - Soups and broths
  - Milk
    - Examples: cow, soy, almond, oat, and lactose free
  - Decaffeinated and herbal tea
    - Examples: peppermint, ginger, chamomile, and green
  - Carbonated beverages
    - Examples: seltzer and ginger ale
  - Sports drinks
    - Examples: Pedialyte®, Gatorade®, and Powerade®
  - Nutrition supplements and shakes
    - Examples: Boost®, Ensure®, Orgain®, and Premier Protein®
- Try flavoring plain or sparkling water with:
  - A splash of juice
  - A flavoring enhancer
    - Examples: Crystal Light®, MiO®, and True Lemon®
  - Try making infused water with fruits, vegetables, and herbs/spices. Here are some ideas (note: wash fruits and veggies well before using):
    - Strawberry, lemon, and mint leaves
    - Lemon, ginger, cucumber, and mint leaves
    - Orange and lime
    - Grapefruit and rosemary
    - Cucumber, lemon, and celery
    - Apple, pear, and a cinnamon stick
General
- Avoid eating favorite foods on infusion day or during treatment to avoid food aversions
- Choose softer foods
  - Why? They require less chewing and therefore have less taste
- Focus on high protein foods and consider supplements if not eating well
- If the nutritional supplement, shake, smoothie or beverage doesn't take good, try drinking it with a straw so it is directed to the back of the mouth and decreases the amount of time on the tongue
- Clear the taste buds with sugar-free gum, mints, hard candies, lemon drops, sorbets (lemon or lime) or frozen fruits (such as grapes, mangoes, and melons)
- Breakfast foods may be better tolerated than others
  - Examples: eggs, pancakes, waffles, French toast, cold/warm cereals, and smoothies
- Cold or frozen foods may taste better than warm or hot food
  - Examples: macaroni, potato, egg salads, deviled eggs, Greek yogurt, frozen fruits, smoothies, and shakes
- Maintain good oral hygiene
  - Brush your teeth and tongue before and after meals
  - Rinse your mouth before and after eating, try using:
    - Unflavored carbonated water (such as seltzer or club soda)
    - Alcohol free mouth wash

*NOTE: avoid citrus or acidic foods if mouth sores are present or if experiencing any pain or discomfort

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