Sensory attributes of craved and aversive foods in healthy women

Sensory attributes of craved a n d aversive foods in healthy women Diedre M Blank ABSTRACT:- This article is an edited version of a paper presented at the Sigma Theta Tau International Nursing Research Congress in Madrid, Spain on June 22, 1993. It explores the sensory characteristics of craved and aversive foods in healthy women. Typically, cravings are characterised as intermittents, sweet-tasting and pleasant-smelling. Aversions are continuous, bad-tasting and unpleasant-smelling. Women reporting aversions tend to have less body mass than women without aversions: p<0.06. The data suggest that craved and aversive foods may exert unequal effects and that sensory characteristics may provide cues for the formation of cravings and aversions. These early findings guide health-care practitioners in helping individuals to improve their nutritional intake.

Diet has long been known to play a critical role in health,

al 1981; De Silva & Rachman 1987) shows that food

but only recently has a systematic review of research

preferences are influenced by factors other than nutrition

been used to document the role of diet in health

and energy content; eg sensory, cultural, environmental,

promotion and disease prevention (US Department of

economic, physiologic, psychologic and social factors.

Health and Human Services [USDHHS] 1988). We can now assume that the daily dietary choices we make not

There is strong support (Mattes 1987) for the important

only

role of the chemical senses in dietary intake and nutrient

contribute

to

selected

diseases

but,

more

importantly, affect our current state of health and help

utilisation. Some studies (Hook 1978; Tierson et al 1985)

prevent certain diseases.

suggest that changes in gustatory (taste) and olfactory

Health-care practitioners are often in a unique position to

cravings and aversions. In other research (Mattes et al

(smell) sensitivity may account for changes in food

assess a patient's diet, not only during disease but also in

1990), abnormalities of taste and smell have been

periods of health (Houldin et al 1987). In assessing the

associated with food-related complaints and changes in

role of diet in promoting health and preventing disease,

body weight.

it is essential that we recognise that health and disease

smell distortions tended to report weight loss, while

are determined by a host of factors. It is uncertain to

individuals with sensory loss tended to report weight

what extent diet plays a direct role.

Specifically, individuals with taste and

Therefore, it is

gain. Additional information is needed to document the

impossible to decide the proportion of disease that could

extent to which sensory properties serve as the basis for

be reduced by dietary changes (USDIII IS 1988). Thus, it

craved a n d / o r aversive foods, and what impact this

is essential that researchers explore - from various

might have on body weight.

perspectives - the factors affecting our selection and rejection of foods, particularly given the magnitude of

Finally, previous reports on craved foods have largely

health and economic consequences resulting from poor

been anecdotal.

dietary practices.

documentation of craving incidence during pregnancy

Research has been confined to either

(Sugiura et al 1983; Worthington-Roberts 1989), the

REVIEW OF LITERATURE

specific

foods

usually craved

or rejected

during

pregnancy (Little et al 1976; Hook 1978; Darwish et al Foods are accepted or rejected for a variety of reasons.

1982; Hdanza & Fidanza 1986) or both (Dickens &

Although

to

Trcthowan 1971; Finley et al 1985; Osman 1985; Tierson et

physiological control mechanisms (Worsley 1980), others

al 1985). Other studies (Baylis et al 1983, Walker et al

suggest more behavioural mechanisms (Fantino 1984;

1985) have concentrated on the relationship of specific

Rozin & Vollmecke 1986). Research (Khan 1981; Togue et

food

. AUSTRALIA

some

attribute

these

preferences

21

practices

to pregnancy-related

symptoms

COLLEGIAN VOLUME 3 (1) JANUARY 1996

-

eg nausea and vomiting. Few studies (Little et al 1976;

the

Brown & Toma 1986; Blank & Mattes 1990a) have

Specifically, women were asked three questions in

addressed the sensory properties attributed to craved

relation to sensory aspects:

and aversivc foods.

sensory

characteristics

of

each

listed

item.

This study explored the sensory

attributes of craved and aversive foods in healthy

•

women.

"Why was this particular item craved (or aversive}?" They were to circle all the listed answers that applied; eg smell, taste, texture, cooling sensation.

METHOD •

"I low would you describe the predominant taste?" Mere they were to circle one response from the listed

Sample

responses of bitter, sour, sweet, salty and other. A convenience sample of 58 healthy, non-pregnant female adults (including 29 paras and 29 nulliparas)

•

"Mow would you describe the smell?" Women were

between the ages of 18 and 50 years (X -- 33.7; SD - 8.4)

to circle all the listed responses that applied; eg

participated in the study.

pleasant, unpleasant, strong, weak.

Women with a history of

pregnancy were included only if they reported a history of full-term pregnancies. Individuals with prior medical

In addition, one question asked, "How would you best

conditions known to affect the chemical senses - eg sinus

describe the frequency of this craving?" Women were to

or taste disorders (Schiffman 1983) - were excluded from

circle one of the following responses:

the study. •

intermittent (coming and going, but not at set times);

•

continuous;

•

only one occurrence;

•

present during part or all of pregnancy, indicating

Instrument and procedure

Women were recruited from two universities by public advertisement. A brief screening questionnaire was used to decide eligibility and collect demographic data. The women completed a two-part dietary questionnaire, which elicited retrospective information based upon each

what, if any, trimesters were involved;

subject's overall past life experiences, without any prompts being given in regard to specific periods in their

•

related to a specific phase of the menstrual cycle,

life. In the first part, subjects responded to the following

indicating whether it was in a 10-day period prior to

questions:

or after the onset of menstruation, or

•

"Have you ever had a craving or strong desire to eat or drink a food, beverage or other

•

other.

substance

(including spices, herbs, seasonings or items not

In the second part, subjects recorded their preferences for

usually thought of as edible), such that you simply

specific tastes - ic sweet, salty, sour and bitter — and their

could not resist consuming the item?" and

use of selected spices: anise, bay, cinnamon, cloves, ginger, nutmeg, salt, spearmint, sugar and vanilla.

•

"I lave you ever developed an aversion or strong

Sweets have been highly targeted for cravings (Smith &

dislike for any previously acceptable food, beverage

Sander 1969; Dickens & Trethowan 1971; Hook 1978) and

or

aversions (Mattes et al 1987).

other

substance

(including

spices,

herbs,

Also, spices have

seasonings or items not usually thought of as edible),

previously been targeted as both craved and aversive

such that you felt it would make you physically ill if

items in the general population (Logue & Smith 1986),

consumed?"

and in response to pregnancy and menstruation (Hook 1978; Snow & Johnson 1978; Darwish et al 1982; Osman

If they answered 'yes' to either question they were asked

1985; Culick et al 1986).

to list all craved a n d / o r aversive items and to prioritize

attributed to the study spices has recently been reported

The degree of sweet taste

their lists. For the three most craved a n d / o r aversive

(Blank & Mattes 1990b).

items, subjects were asked to respond to questions about

collection was approximately 20 minutes.

C^Ui^ftHy^tU^:i- ; (i)j^UAHY1996

.22

The average time of data

ROYAL COLtest'OF NURSING. AUSTRALIA

Statistical analyses

16 (55 per cent) of the nulliparous women reported one or more aversions. A trend was noted for women reporting

Descriptive statistics were used to describe and synthesise

food aversions to have a lower BMI than women without

the data.

aversions: (X2 (1)=3.38, p<0.07).

Pie charts were used to illustrate ungrouped

frequency distributions for food craving and aversion incidence.

Bar charts were used to display grouped

Figure 1 presents a breakdown of the data in terms of

frequency distributions for specific sensory modalities and

relative frequency of food cravings and aversions.

descriptions of food cravings and aversions.

Subjects

comparisons for body

Group

mass index (BMI) (16.2 to

typically

intermittent

characterised

food

in nature, whereas they

cravings found

as food

22.8kg/(M) 2 versus 22.9 to 36.7kg/(M) 2 were made using

aversions to be mainly continuous in nature. Of those

chi square tests. T-tcsts for independent samples were

women reporting cravings and aversions associated with

used to compare spice use.

their menstrual cycle, eight of the nine cravings and all

Tbe level of statistical

three aversions were reported to occur during the 10-day

significance for group comparisons was set at 0.05.

period before menstruation (luteal phase).

RESULTS Figure 2 illustrates the sensory modalities credited to Forty-two {72 per cent) of the 58 subjects experienced at

craved and aversive foods.

While taste was over-

least one food craving, with a total of 100 craved items

whelmingly attributed to craved foods, a combination of

identified. Twenty (69 per cent) of the 29 parous women

taste, odour and chemesthesis (temperature, irritation,

reported one or more cravings, whereas 22 (76 per cent)

texture etc) was attributed to aversive foods.

of the 29 nulliparous women reported one or more cravings. Twenty-eight (48 per cent) of the 58 subjects

Figure 3 lists the specific sensory descriptions assigned to

experienced at least one food aversion, with a total of 48

both

avcrsive items identified. Twelve (41 per cent) of the 29

predominated for craved foods, followed closely by salty

parous women reported one or more aversions, whereas

taste, whereas 'other' tastes mainly characterised aversive

Cravings (per cent) n-100

food

cravings

and

aversions.

Sweet

taste

Aversions (per cent) n=48

2.08

•

Intermittent

Menstrual cycle

Pregnancy

One occurence

Continuous

•

Other (cravings only)

Figure 1. Incidence of food cravings and aversion.

ROYAL COLLEGE OF NURSING. AUSTRALIA

23

COLLEGIAN VOLUME 3 (1) JANUARY 1996

Figure 2. Sensory modalities attributed to food.

foods. 'Other' tastes reported for food aversions included descriptions such as 'rotten', 'fishy', 'oily', 'nauseating' and 'difficult to describe'. Examples of 'other' tastes reported for food cravings included descriptions such as 'spicy', 'spicy-hot', 'peanut-like', 'refreshing',

'crunchy'

and

'bland'. Odours for craved foods were reported mainly as pleasant and familiar, while odours for aversive foods were reported as unpleasant and strong. The major chemesthetic descriptors attributed to craved foods included texture and characteristics related to temperature - ie cooling and burning, whereas texture and irritation were attributed more so to aversive foods.

Finally, there was a trend for parous women to eat more spices than nuiliparous women: t (56) = 1.81, p<0.08. In particular, parous women reported a tendency to consume more salt than nuiliparous women: t (56) = 1.91, p<0.06.

DISCUSSION The incidence of food cravings in this study generally agrees with previous reports of cravings experienced by pregnant women (Dickens & Trcthowan 1971; Tierson et ill 1985; Walker et al 1985) and by non-pregnant women (Blank & Mattes 1990a; Rodin et al 1991). Most healthy women in the study reported at least one craving, despite reproductive history. This finding supports Rodin et al's (1991) view that cravings may represent something other than a physiological need. As expected from previous research (Hook 1978; Blank & Mattes 1990a), food is craved predominantly for its sweet and salty taste.

COLLEGIAN VOLUME 3 0) JANUARY 1996

24

Figure 3. Incidence of food cravings and aversions.

ROYAL COLLEGE OF NURSING, AUSTRALIA

The findings that food cravings are mainly intermittent

The

or transient also agrees with previous literature (Dalvit

continuous and that there is a trend for aversions to be

1981; Tierson et al 1985; Cohen et al 1987; Bancroft et al

connected to a lower BM1 suggests that aversions may

1988; Blank & Mattes 1990a). This finding suggests that

have more immediate implications for individrials.

cravings may not have long-term consequences.

findings

that

food

aversions

are

generally

In

Thus, health-care practitioners must be able to assess an

contrast, the study trend of a lower BM1 with a history of

individual's ability to meet the minimum level of

aversions is consistent with the previous findings of Garb

nutrients needed to achieve or maintain good health.

and Stunkard (1974).

These authors found that both

overweight and underweight subjects, but not subjects of

CONCLUSION

normal weight, tended to report more aversions. I he study findings on craving and aversion incidence The trend for women with a previous history of

present some interesting similarities and differences. Of

pregnancy to eat more spices, particularly salt, supports

particular note, the findings suggest that craved and

in part the previous work of Brown and Toma (1986).

aversive foods may exert unequal effects and that

These authors found

sensory characteristics may provide cues for

that pregnant women

were

the

significantly less able to correctly identify concentration

formation of cravings and aversions.

differences for salt solutions and preferred

using a prospective approach and a larger sample is

stronger

solutions, but that these differences decreased after

Future research

needed to validate these early observations.

pregnancy. The current study is limited in that it does not address when salt intake occurred, nor the period of

ACKNOWLEDGEMENT

past pregnancy. Additional study is needed to sort out conflicting literature on taste changes during pregnancy.

This study was supported in part by a Henry 1: Rutgers

That is, some literature (Schmidt 1925) suggests that taste

fellowship and a grant from the Rutgers University

changes during this period are due to decreased taste sensitivity, while other literature (Brown & Toma 1986) promotes a physiologic mechanism for increasing salt intake during pregnancy. In addition, Rodin et al (1991)

Research Council, #202113.

Linda Flynn MS RN,

doctoral student, College of Nursing, Rutgers University, the State University of New Jersey, is acknowledged for her assistance in the data collection.

found that overweight women reported more consistent preferences for foods high in salt and perceived flavour intensity than did underweight women. These findings, when considered together, suggest that sensory factors as they relate to salt taste and preference may play an important role in times of increased caloric intake.

REFERENCES Bancroft |, Cook A anil Williamson L 1988 Fond craving, mood and the menstrual cycle. Psychological Medicine 18:855-60 Baylis JM, Leeds AR and Challacumbe DN 1983 nausea and food aversions in pregnancy.

Persistent

Clinical Allergy

13:263-69

CLINICAL IMPLICATIONS

Blank DM and Mattes RD 1990a

Lxploration of the sensorv

characteristics of craved and aversive foods. Journal of Sensory

Given that food cravings and aversions are quite common in healthy women, health-care practitioners

should

address early in their nutritional assessment of individuals the effects of sensory factors on the perception of satiety Alternate strategies that individuals might use to satisfy their sense of taste and smell, without having to compromise their caloric intake, need to be examined.

Studies 5:193-202 Blank DM and Mattes RD 1990b Sugar and spice: similarities and sensory attributes. Nursing Research 39(5):290-93 Brown JL and Toma RB 1986 Taste changes during pregnancy. The American Journal of Clinical Nutrition 43:414-18 Cohen IT, Sherwin bb and Fleming AS 1987 mood, and the menstrual cycle.

Food cravings,

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21:457-70 Dalvit SP 1981 The effect of the menstrual cycle on patterns of

Because of such a strong desire for sweet and salty tastes in craved food, health-care workers must be particularly vigilant to healthy foods containing these properties. They also need to be aware of specific disorders and medications (Schiffman 1983) that can affect taste and smell, so they can advise their clients accordingly.

ROYAL COLLEGE OF NURSING. AUSTRALIA

25

food intake.

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Dickens G and Trethowan VVli 1971

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Worsley A 1980 Thought for food: investigations of cognitive aspects of food. Fcology of Food and Nutrition 9:65-80 Worthington-Roberts B, Little KL, Lambert MD et al 1989 Dietary cravings and aversions in the postpartum period. Journal of the American Dietetic Association 89(5):647-51

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Royal College of Nursing

Australia

(Queensland

Chapter)

Distinguished Nursing Service Award Nominations are invited for the 1996 presentation of the Distinguished Nursing Service Award. The award may be given by the Queensland Chapter to a person in recognition of outstanding performance or achievement in nursing and/or outstanding contribution to nursing in Queensland. Nominations close on Friday February 16, 1996. Nomination forms and information regarding the selection procedure and criteria can be obtained from: Ms Jenny Bichel, Honorary Secretary Royal College of Nursing, AListralia Queensland Chapter PO Box 311 Spring Hill, Qld 4004

COLLEGIAN VOLUME 3 (1) JANUARY 1996

26

ROYAL COLLEGE OF NURSING. AUSTRALIA