Purpose: To investigate the effectiveness of selective taste steering (STS) to hyper personalize bread and soup for adult cancer outpatients with chemotherapy-induced taste alterations. Methods: This multicentre study included two groups of adult cancer outpatients with CiTA, all receiving dietary advice as standard care. In one group, STS was applied to bread and soups for three months. Outcomes were compared using validated scales and a structured questionnaire at baseline and after one and three months of follow-up. Results: At baseline, 19.3% of all patients (N = 160) had a normal nutritional status. Compared to the intervention group, undernutrition in the control group increased significantly after 1 month (p < .001) and 3 months (p < .001). In the intervention group, the score for 'appetite loss' decreased after 1 month (p < .001) and remained low after 3 months of follow-up (p < .001). The 'fatigue, ' 'nausea/vomiting' and 'diarrhea' symptom scores in the intervention group decreased significantly (p < .001, <.001 and < .002, respectively). Conclusion: STS decreased loss of appetite and improved palatability and food intake as well as food-related symptoms of QOL in adult cancer outpatients with CiTA These findings are clinically relevant and support a hyper-personalized approach to malnutrition in cancer patients.

Purpose: This study aimed to assess whether the application of selective taste steering (STS) to personalize bread and soup recipes had any effect on (1) quality of life, (2) the palatability of these meals, and (3) food intake in patients with chemotherapy-induced taste alterations (CiTA). Methods: This multicentre controlled before-and-after study included two groups of adult cancer outpatients who all experienced CiTA. Both groups received dietary advice as standard care. In one group, STS was applied to bread and soups at home for three months. Both groups were compared using validated scales and a structured questionnaire, at the start of the study and after 1 and 3 months of follow-up. Results: A total of 19.3% of all patients (N=160) had a normal nutritional status (MNA-SF score >11). Compared to that in the intervention group, the number of patients with undernutrition (MNA-SF score <8) in the control group increased after 1 month (p <0.001) and 3 months (p <0.001) of follow-up. Compared to those in the control group, the 'fatigue', 'nausea/vomiting' and ‘diarrhoea’ symptom scores in the intervantion group decreased significantly (p <0.001, <0.001 and 0.002, respectively). In the intervention group, the score for 'appetite loss' decreased after 1 month (p <0.001) and remained low after 3 months of follow-up (p <0.001). Conclusion: STS translates into a significant decrease in the loss of appetite and an increase in palatability and intake of personalized bread and soups. These findings are clinically relevant and support this innovative approach to malnutrition in cancer patients.

The use of texture modified food (TMF) is widely spread in the daily care of patients with oropharyngeal dysphagia (OD). However, TMF have been shown to have a negative impact on the patients’ quality of life. Adherence rates are low, increasing the risk of malnutrition and aspiration in an already vulnerable patient population. The aim of this exploratory study was to gain insight in the feasibility of adding particles to pureed food on tongue strength, swallowing safety and efficiency in patients with OD. Ten adult participants with OD swallowed three different boluses. Bolus 1 consisted of no particles (IDDSI level 4), small and bigger particles were added in bolus 2 and 3. Tongue strength during swallowing (Pswal) was measured using the Iowa Oral Performance Instrument (IOPI). Swallow safety (penetration and aspiration) and swallow efficiency (residu) were quantified during fiberoptic endoscopic evaluation of swallowing by means of the PAS scale and Pooling score. RM Anova and Friedman tests were performed for analyzing the impact of bolus on the outcome parameters. No significant effect of bolus type on Pswal was measured. Neither the PAS nor the Pooling score differed significantly between the three different boluses. Aspiration was never observed during swallowing any bolus with particles. This preliminary study shows that the addition of particles to pureed food had no impact on Pswal, swallowing efficiency or safety in patients with OD. This innovative project is the first step in research to explore the characteristics of TMF beyond bolus volume, viscosity and temperature.

Introduction: Taste changes are common during chemotherapy. Currently, limited evidence-based guidelines exist for the effective management of chemotherapy induced dysgeusia in adult cancer outpatients. In this study, chefs gastro-engineering combine medical and para-medical assessments with innovative insights from gastrological sciences such as selective taste management to improve the taste of bread for cancer outpatients. Method: The oncologists from the participating hospitals referred eligible patients to a chef-led taste center. The chef gastro-engineering carries out a taste assessment and combines these results with the food preferences of the patient as well as any advice of the dietician and/or the speech therapist to develop personalized recipes, in this case a recipe for personalized bread. The patients were asked to bake and consume this personalized bread at home, with the help of their family caregiver. The effects of this innovative self-care intervention were measured after 1 month follow-up. Results: Included patients (N=112) are randomly divided in a bread-baking (intervention) group (N=54) and a control group (N=58). Over 80% of the bread baking patients perceived personalized bread as equally or more tasteful than usual bread despite their stressful chemotherapy-induced dysgeusia. After one month follow-up a significant loss of bodyweight (p .021) and Body Mass Index (p .025) is observed in the control group while in the bread-baking group this loss was not significant (p .968 and p .956 respectively). Only 17% of the bread baking group required some telephone or online assistance in order to correctly apply their personalized recipe. In-depth Interviews with the patients and their caregivers revealed the highly empowering effect of this innovative self-care intervention. In 60% of the cases, the bread was prepared by the family caregiver. Compliance was high and no side effects were reported. Conclusion: A chef-led taste center appears to be able to accurately and safely address the chemotherapy-induced dysgeusia in adult cancer outpatients. Thanks to this integrated and hyper-personalized approach to a stressful side effect of chemotherapy, more than 80% of the participants were able to enjoy tasty bread again despite dysgeusia. Given the positive effect on patient empowerment and since baking personalized bread at home is safe and feasible, this approach should be extended to other meal components. A chef-led taste center should be structurally anchored in the transmural integrated care pathway for adult cancer pati

People in need of care, chronic or acute, often present problematic food intake and special nutritional needs. Integrated, person-centred and pro-active food and nutritional care delivery has been proven effective for people in health care. However, skills mismatches have been reported in different professions involved, which also applies to the role of chefs in healthcare. The EU funded project NECTAR aims at closing this gap by creating a new job profile, called Chef Gastro-Engineering (CGE). The current publication summarizes the status quo in hospitals and gives a perspective on the future role of chefs in integrated healthcare delivery.

AIM:Alterations in taste are distressing side effects for cancer patients receiving chemotherapy. The Center for Gastrology (Belgium) developed a self-care intervention based on taste control. This intervention contains an assessment of the individual taste and food hedonics. It provides recipes based on the individual assessed hedonics profile, so patients can self-prepare personalized meals. This study aims to describe the experiences of oncologic patients with the home baking of personalized bread. DESIGN:A qualitative, descriptive design with individual semi-structured interviews was used. METHODS:In August 2018, eleven face-to-face interviews were conducted until data saturation. RESULTS:The analysis of the interviews revealed five major themes: "Stepping out of your role," "Having something positive to do," "gaining insight," "receiving recognition" and "practical limitations."

Background: We aimed to assess taste disturbances in COVID-19 patients. Additionally, we hypothesized that it is possible to establish a reliable and inexpensive screening method for SARS-COV-2 infection using a flavor test. Methods: The ability to taste the sweet, salty, sour and bitter flavors was assessed in 52 COVID-19 patients and 36 controls using flavor tablets (sucrose, NaCl, ascorbic acid and grapefruit extract-99%

PURPOSE Currently, limited evidence-based guidelines exist for the effective management of chemotherapy induced dysgeusia in cancer outpatients. In this pilot study, we used innovative insights from gastrological sciences such as selective taste management to improve the taste of bread for cancer outpatients. We investigated whether it is feasible for cancer outpatients and family caregivers to bake personalized bread themselves at home, whether such bread is considered tasty and if daily consumption of it has any effect on anthropometric measurements. METHODS Included patients (N=112) are randomly divided in a bread-baking group (BBG) (N=54) and a control group (N=58). Their individual taste thresholds profile is assessed using the innovative O-Box. Anthropometrics and structured questionnaires are used to compare the effects of personalized bread after one month follow-up. RESULTS Only 17% of the BBG required some telephone or online assistance to correctly apply the prescribed recipe. In 60% of the cases, the bread was prepared by the family caregiver. Compliance was high and no side effects were observed. Over 80% of the BBG perceived personalized bread as equally or more tasteful despite their stressful taste alterations. Compared to the control group loss of bodyweight and Body Mass Index in the BBG was not significant (p .968 and p .956 respectively). CONCLUSIONS Baking personalized bread at home appeared to be feasible. Selective taste management based on individual taste thresholds profiles should be studied more in depth using whole meals in a larger cancer outpatients population.

Ageing populations represent a challenge to the sustainability of current healthcare systems. The need to balance these demographic changes with gains in healthy life years and quality of life (QoL) constitutes an additional challenge. Aware of this, the European Commission (EC) launched the European Innovation Partnership on Active and Healthy Ageing (EIPonAHA) in 2012. The EIPonAHA is an interdisciplinary and cross-sector initiative involving more than 3000 partners with two specific objectives: to increase the healthy life expectancy of Europeans by two years by 2020, while increasing their QoL. The initiatives of the EIPonAHA have been organized according to six thematic action groups (AGs), with the A3 group targeting areas relating to the prevention of functional decline and frailty. In addition to the good practices of partners, there are several on-going collaborative works. The involvement of the EC includes support through an elaborated research programme in which the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA) and the Directorate-General for Communications Networks, Content and Technology (DG CONNECT) are the main funding bodies. Screening approaches and preventive interventions constitute most of the initiatives within the A3 AG. Partners are distributed across five sub-groups according to good practices: i) cognitive decline, ii) food and nutrition, iii) physical activity, iv) caregivers, and v) frailty and functional decline. Regular updates of the progression of both good practices and collaborative works are presented in A3 AG meetings. The 2017 meeting in Valencia, Spain, showcased in this paper, provides an up-to-date overview of the current status of A3 activities.

The present document describes a nutritional approach that is nested in the European Innovation Partnership for Active and Healthy Aging (EIP-AHA) and aims to provide the first common European program translating an integrated approach to nutritional frailty in terms of a multidimensional and transnational methodology. The document has been developed by the A3 Nutrition Action Area of the EIP-AHA and aims at providing a stepwise approach to malnutrition in older citizens, identifying adequate interventions based on a unified assessment and ICT-supported solutions. “NutriLive” is an integrated nutritional approach, represented by a structured Screening-Assessment-Monitoring-Action-Pyramid-Model (SAM-AP). Its core concept is the stratification of the nutritional needs, considered by the working group as the key for targeted, effective, and sustainable interventions. “NutriLive” tries to close gaps in epidemiological data within an aging population, creating a unified language to deal with the topic of nutrition and malnutrition in Europe. By assembling all the validated screening, assessment, and monitoring tools on malnutrition in a first pyramid, which is interrelated to a second intervention pyramid, the A3 Nutrition WG identifies a common, integrated vision on the nutritional approach to frailty, which applies to the various health care settings.