Chemotherapy often causes significant changes in the senses of taste and smell, making eating a challenge when adequate nutrition is paramount. This common side effect, known as dysgeusia, affects up to 80% of patients and is characterized by a distorted sense of taste, often presenting as a persistent metallic or bitter flavor. Chemotherapy agents interfere with the rapid turnover of cells, including those in the taste buds and olfactory receptors. While these alterations are temporary and usually resolve after treatment finishes, they can severely limit appetite and lead to inadequate caloric and protein intake.
Counteracting Metallic and Altered Tastes
The unpleasant metallic taste is frequently caused by the circulation of chemotherapy drugs in the bloodstream, sometimes exacerbated by the use of metal cutlery. Switching to utensils made of plastic, bamboo, or ceramic can minimize this direct interaction and reduce the metallic sensation during meals. Avoiding metallic cookware and opting for glass, enamel, or ceramic pots and pans for cooking may also prevent food from taking on an off-flavor.
Clearing the palate immediately before a meal can also help normalize taste perception. A simple rinse made from a teaspoon of baking soda and a quarter teaspoon of salt mixed into four cups of water is an effective neutralizer. Swishing this solution before eating can help cleanse the mouth and improve the flavor of the food that follows.
Food that tastes bitter or metallic often responds well to the introduction of tart or acidic flavors. Incorporating ingredients like lemon juice, lime juice, or vinegar into marinades and sauces can help cut through the bitterness. Marinating proteins in a sweet-and-sour or citrus-based dressing for several hours can make them much more palatable.
For dishes that taste bland, enhancing the aroma and flavor with strong seasonings can stimulate the senses. Spices such as rosemary, basil, oregano, and garlic powder, or pungent ingredients like onion and fresh ginger, can be added generously. If food tastes overly sweet, a small dash of salt or a squeeze of lemon juice can help to balance the flavor profile.
Prioritizing Nutrient Density and Hydration
When appetite is low and only small quantities can be managed, the focus must shift to maximizing the caloric and protein content of every bite. Eating small, high-calorie meals or nutrient-dense snacks every two to three hours is often more effective than trying to manage three large meals. This strategy helps ensure a steady supply of energy and protein for healing and maintaining strength.
Liquid nutrition is frequently better tolerated than solid food, making high-calorie, high-protein smoothies an excellent option. A base of whole milk, Greek yogurt, or silken tofu can be blended with protein powder, nut butter, and frozen fruit for a complete, easily consumed meal. Nutritional supplement drinks, such as commercial meal replacements, are convenient ways to ensure intake of vitamins and minerals.
“Hidden” calories and protein can be added to many common foods without significantly increasing the volume or changing the flavor profile. Powdered dry milk can be stirred into hot cereals, mashed potatoes, or cream-based soups to boost protein and calories. Healthy fats like avocado, olive oil, or nut butter can be blended into soups, sauces, or smoothies for concentrated energy.
Maintaining adequate hydration is important, especially since plain water can sometimes take on a metallic or unpleasant taste. Adding flavor to water with slices of fresh lemon, cucumber, or a splash of fruit juice can make it more appealing. Broths, fruit nectars, and electrolyte-enhanced beverages are good sources of fluid and can help replenish electrolytes lost due to treatment side effects.
Managing Texture and Temperature Sensitivities
Chemotherapy can lead to physical discomfort in the mouth and throat, such as mouth sores (mucositis) or severe dry mouth. Food and beverages served cold or at room temperature are preferred, as they produce less odor and can be soothing to irritated tissues. Avoiding very hot foods is advisable because the heat can exacerbate pain and inflammation.
Soft, moist, and pureed foods minimize the need for chewing and reduce friction against sensitive oral tissues. Examples include scrambled eggs, smooth yogurt, cottage cheese, custards, and well-cooked, mashed vegetables. For protein, tender fish, ground meats mixed with gravy, or silken tofu are good choices that are easy to swallow.
If mouth sores are present, temporarily avoid foods with rough or sharp textures, such as dry toast, raw vegetables, crackers, or nuts. Highly acidic foods, like citrus fruits and tomatoes, and spicy seasonings can cause a stinging sensation and should be limited. Using sauces, gravies, or melted butter to moisten food can help with dry mouth and aid in easier swallowing.