6. Sensory Perception, Preference and Eating ehavior in the context of Obesity and Older Consumer

What drives food intake; Homeostatic vs. Hedonic influences

• We eat to fulfill a physiological need to maintain body weight (set-point)

• Brain-based homeostatic and hedonic eating motives overlap but are nonetheless dissociable

• An increasing proportion of human food consumption appears to be driven by pleasure, not just by the need for calories

Three components of ‘Power of food’ scale

Correlation with power food and BMI

Higher power food score = linked to higher BMI

Factors to identify the different food perceptions

Is there a correlation between sensory preferences and increasing body weight?

No indication of different sensory preferences and discrimination abilities with increasing body weight

Relation fat preference and weight gain

Positive correlation was found between overall fat preference and percent body fat.

Traditional vs Sensory epidemiology

Which ‘Taste’ contributes most to higher daily energy intake?

More savoury fatty foods = higher energy intake

Links between oral processing and BMI

• Chicken or egg situation: do you eat fast to keep up high BMI or do you eat fast and that causes high BMI

Life expectancy and chronic disease

• Life expectancy has gone up, but the age of chronic disease onset has not increased to the same extent

• Implication: people will live longer but will have a longer period of disability/ill health

• A longer “sick-span” = poor quality of life, health care costs etc. Prevention orientated lifecycle approaches add not only to life-span but ‘health-span’ (delay and compress morbidity)

• Nutrition has a major role in preventing the onset of chronic disease

Three levels of prevention of chronic disease

• Primary prevention: e.g. folic acid supplementation to prevent neural tube defects

  • Keeping as many people as possible free from disease risk

• Secondary prevention: e.g. osteoporosis

  • Keeping those already at risk at the lowest risk possible, and delaying disease onset

• Tertiary prevention: e.g. mediterranean diet reduces issues in those with heart disease

  • Treating those already diseased to mitigate disease progression

what do we mean by malnutrition

why does food intake decrease?

• changes in sensory perception, eating pleasure and appetite

• changes in dental satus and oral health

• what are the current approaches to boost nutrition in older consumers

Smell reduction with age

decreases significantly with age

Gustation and age

Changes in appetite with age

• Decreases in all components of energy expenditure

  • Basal metabolic rate

  • Reduced physical activity, which stimulates appetite

• Decreased adaptive ability to shifts in energy intake

  • Poorer componesation for energy deficit in older age

• Motivation to eat

  • Metabolic; decreased hormonal and metabolic signals

  • Food related: decreased food enjoyment, decreased sensory, decreased oral health

  • Psychological; loneliness, depression, isolation

• Medications and disease states/illness suppress appetite

Impact of tooth loss in elderly

Impairment:

• periodontal disease

• Caries

• Losing a body part

Disability:

• Reduced ability to undertake daily tasks (eating, speaking)

• Broader psycho-social impact (avoiding social interaction, life less satisfying)

Impact of tooth loss on nutrition

• Edentate patients have one-sixth chewing power of dentate patients

  • This has a significant impact on food choice and intake

• Edentulous patients tend to have:

  • Higher cholesterol levels

  • lower serum ascorbic acid and beta carotene

  • lower intake of vitamins and folic acid

Food first approaches - to enhance consumption in malnourished elderly

• Flavor enhancement

  • Added tastes

  • Added flavors/spices

  • modified textures

  • combinations

• Increasing intake through increased variety

• Food + oral nutritional supplements

Oral nutritional supplements for malnourished elderly

• 23-60% in acute care settings

• Prescribed by doctor or dietician and used to support a food first approach but boost energy, nutrients and compliance

• Varying reports on compliance and wastage:

  • 37-78% compliance rates

  • wastage estimates: 24-63%

Reasons for non-compliance with oral nutritional supplements