Here's help maintaining a healthy diet even when your sense of taste or smell is altered.

Christine Byrne
August 27, 2020
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Perhaps one of the most common but least talked about symptoms of illness is the loss of taste and smell. It happens across the spectrum of diseases and can be either short-lived or long-lasting. It's a common long-term side effect of certain cancer treatments, but also happens in the short term for people with bad colds or the flu. And of course, it is now known to be one of the many symptoms associated with COVID-19.

While the loss of taste or smell is usually a symptom of underlying disease and doesn't have immediate health consequences on its own, it can make it difficult for people to eat a healthy and adequate diet. Not being able to enjoy food really dulls the incentive to eat well! The good news? There are things you can do to make sure you're getting the nutrients you need, even if you can't taste food the way you usually do.

Causes for losing your sense of taste and/or smell.

"Our ability to smell comes from the functions of a specific cranial nerve, and taste involves the functions of many nerves including specific cranial nerves," says Caroline West Passerrello, M.S., RDN, LDN, spokesperson for the Academy of Nutrition and Dietetics. "Taste and smell can be impacted individually or simultaneously, and the severity can range from a mild impairment to a complete loss."

Both senses naturally decline as we age, although the rate at which that happens varies from person to person. Smoking also dulls our sense of taste and smell, and chronic smoking can lead to a significant decline in both over time.

But there are other more specific, immediate causes of impaired olfaction (smell) and gustation (taste). "Inflammation of the nasal mucosa and sinuses, which can happen when your body defends itself against viruses like the common cold or coronavirus, is associated with impaired olfaction," Passerrello says. "Tumors, head trauma and certain medications can also impair our ability to taste and smell," she says. This can happen with many medications, but is particularly severe and common in chemotherapy and radiation for cancer treatment.

Loss of taste and smell is associated with poorer diet quality overall.

"From limited studies with aging adults who report a loss of smell, we know they are less likely to conform to dietary guidelines and [more likely to have] poor dietary quality when compared to the guidelines standards," Passerrello says.

Why this happens isn't totally clear, but it's likely because food just isn't as enjoyable when you can't taste or smell it. The subtle bitterness of vegetables might come across more strongly to someone with an impaired sense of taste or smell, while pleasant sweet or salty flavors might be harder to detect. Many older adults also show a preference for very sweet or very salty foods because of dulled tastes, which can lead to an unhealthy diet overall. The same thing likely happens when someone has an impaired sense of taste or smell in the short term.

Tips for maintaining a balanced diet

"Eating with an impaired sense of taste or smell may not be as enjoyable, since taste is still the number one reason most Americans choose to eat the foods they do," Passerrello says. "So, try to set up a meal plan—and environment—that is enjoyable and balanced." She recommends following MyPlate guidelines by filling half of your plate with vegetables or fruits, one quarter with protein and one quarter with starch (preferably whole grains, starchy vegetables, beans or legumes).

Passerrello also warns against adding too much salt or sugar. "Be mindful of the amount of salt or sugar being added to foods—and in this case, do not 'salt to taste' because that may put you well over the daily recommendation for sodium intake." Unfortunately, this may mean that food tastes a little bit bland in the short term.

Instead, try using acids like lemon juice or vinegar to season foods. Acid is a very strong flavor that comes through even when taste or smell is impaired, and it doesn't add any sodium, sugar or calories. Going heavy on the spices can also be helpful. Black pepper, chile pepper (if you like spicy foods), cinnamon, cumin, garlic powder and ginger can all add strong flavors that might come through even with a diminished sense of taste or smell.

Know that taste and smell changes often go away in time.

If you've recently recovered from a cold, flu or another virus, you might be frustrated to find that your sense of taste and smell is still a little off days or weeks later. In these circumstances, it's likely that your senses will soon return to normal.

If you're experiencing taste changes due to aging, smoking, ongoing cancer treatments or medication used to treat a chronic condition, it may be the case that you'll be dealing with those taste changes long term. Experiment to figure out what foods taste good, and build your meal plans accordingly. Be careful not to add too much salt to foods, as getting too much sodium can have negative health effects. And while it's natural to gravitate toward sweet flavors in these circumstances, try to opt for naturally sweet foods whenever possible as opposed to always reaching for desserts or treats with lots of added sugar.