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Chemosensation to Enhance Nutritional Intake in Cancer Patients
Published in Alan R. Hirsch, Nutrition and Sensation, 2023
The use of Synsepalum dulcificum, also known as “miracle fruit,” has received some attention as an alternative method to combat chemosensory alterations, in particular taste changes, in cancer patients. Synsepalum dulcificum contains a natural protein, miraculin, that when consumed in conjunction with other foods masks certain tastes for a short duration of time, making otherwise unpleasant foods more palatable. A small, pilot study examined the effect of Synsepalum dulcificum in cancer patients, where a total of 8 patients took turns receiving the Miracle Fruit or a placebo (dried cranberries) for 2 weeks at a time (Wilken and Satiroff 2012). Patients were instructed to consume the fruit immediately before their meal and to keep a 28-day food diary recording whether typical foods consumed tasted the same, worse, or better than previously experienced. Although the sample size was small, results were promising in that all participants reported improvement in taste with the Miracle Fruit, stating that most foods tasted sweeter compared to their previous complaints of foods tasting bitter, dry, or metallic. Unfortunately, there are no recent publications evaluating the effects of Synsepalum dulcificum in cancer patients.
Taste Modifiers and Sweet Proteins
Published in Robert H. Cagan, Neural Mechanisms in Taste, 2020
Another interesting finding is the strong cross-adaptation between the sweet proteins monellin and thaumatin (described later) and miraculin. Thaumatin seemed to block some of the effect of miraculin since, if a thaumatin stimulation was interspersed between stimulations with acids, the responses to acids were diminished.
Individual Differences in Chemosensory Perception Amongst Cancer Patients Undergoing Chemotherapy: A Narrative Review
Published in Nutrition and Cancer, 2022
Alba Ruiz-Ceamanos, Charles Spence, Jordi Navarra
As already seen, experiencing a bad taste in the mouth or a metallic taste is commonly reported by cancer patients undergoing chemotherapy. A possible course of action to reduce the presumed perception of an ‘excessively’ bitter, metallic or bad taste in food would perhaps involve distracting the patient’s attention from the bitter (and/or metallic/bad). Specific ingredients (e.g., wasabi, horseradish, or mustard) could perhaps be added to food preparations to draw the patient’ attention to their nose. Morevover, the use of certain seasonings may perhaps intensify other tastes and flavors (see NCI recommendations; see 37, 117, 119). Masking the bitterness by adding sweeteners (120) or salt (see 121), masking metallic taste by adding citric fruits (lemon, orange, pineapple, kiwi...) or by drinking mint or lemon tea before and after the meals seem to be good strategies to improve the patients’ experience with food, according to Fundació Alícia (117). Following-up on this idea, a pilot study by Wilken and Satiroff (122) in which dried miracle fruits were given, before food intake, to a group of patients undergoing chemotherapy treatment who were suffering from some alteration in their sense of taste is worth mentioning. The miracle fruit berry contains a protein called miraculin that binds to sweet receptors and, has the ability to temporarily modify sour taste to sweet (123). Apparently, sweet can suppress other basic tastes at medium or high intensities (see 124). With a sour taste is in mouth, miraculin induces an intense sweet taste sensation (see 125). This could probably explain why the berry-induced sweet taste improved, in the study by Wilken and Satiroff (122), the patients’ taste perception, and reduced the excessive bitterness (and metallic sensations) perceived, as measured in a questionnaire administered after food intake. That said, miracle fruit or any products derived from the fruit such as pills, do not seem to have caught on in quite the way that one would imagine, perhaps because of the long-lasting nature of the effects (c. 30 mins − 3 h).