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Changes in food preferences after bariatric surgery may alter its effectiveness as a treatment for obesity. We aimed to compare food reward for a comprehensive variety of food categories between patients who received a sleeve gastrectomy (SG) or a Roux-en-Y gastric bypass (RYGB) and to explore whether food reward differs according to weight loss. In this cross-sectional exploratory study, food reward was assessed using the Leeds Food Preference Questionnaire (LFPQ) in patients at 6, 12, or 24 months after SG or RYGB. We assessed the liking and wanting of 11 food categories. Comparisons were done regarding the type of surgery and total weight loss (TWL; based on tertile distribution). Fifty-six patients (30 SG and 26 RYGB) were included (women: 70%; age: 44.0 (11.1) y). Regarding the type of surgery, scores were not significantly different between SG and RYGB, except for ‘non-dairy products—without color’ explicit liking (p = 0.04). Regarding TWL outcomes, explicit liking, explicit wanting, and implicit wanting, scores were significantly higher for good responders than low responders for ‘No meat—High fat’ (post-hoc corrected p-value: 0.04, 0.03, and 0.04, respectively). Together, our results failed to identify major differences in liking and wanting between the types of surgery and tended to indicate that higher weight loss might be related to a higher reward for high protein-content food. Rather focus only on palatable foods, future studies should also consider a broader range of food items, including protein reward., Les changements dans les préférences alimentaires après une chirurgie bariatrique peuvent altérer son efficacité en tant que traitement de l'obésité. Notre objectif était de comparer la récompense alimentaire pour une variété complète de catégories d'aliments entre les patients ayant subi une gastrectomie en manchon (SG) ou un pontage gastrique Roux-en-Y (RYGB) et d'explorer si la récompense alimentaire diffère en fonction de la perte de poids. Dans cette étude exploratoire transversale, la récompense alimentaire a été évaluée à l'aide du Leeds Food Preference Questionnaire (LFPQ) chez les patients à 6, 12 ou 24 mois après SG ou RYGB. Nous avons évalué le goût et le désir de 11 catégories d'aliments. Des comparaisons ont été faites concernant le type de chirurgie et la perte de poids totale (TWL; basée sur la distribution tertile). Cinquante-six patients (30 SG et 26 RYGB) ont été inclus (femmes : 70 % ; âge : 44,0 (11,1) ans). Concernant le type de chirurgie,p = 0,04). En ce qui concerne les résultats TWL, l'appréciation explicite, le désir explicite et le désir implicite, les scores étaient significativement plus élevés pour les bons répondeurs que pour les faibles répondants pour "Pas de viande - Haute teneur en matières grasses" ( valeur p corrigée post-hoc : 0,04, 0,03 et 0,04, respectivement) . Ensemble, nos résultats n'ont pas permis d'identifier des différences majeures dans le goût et le désir entre les types de chirurgie et tendaient à indiquer qu'une perte de poids plus élevée pourrait être liée à une récompense plus élevée pour les aliments à haute teneur en protéines. Au lieu de se concentrer uniquement sur les aliments appétissants, les études futures devraient également envisager une gamme plus large d'aliments, y compris la récompense protéique.

Changes in food preferences after bariatric surgery may alter its effectiveness as a treatment for obesity. We aimed to compare food reward for a comprehensive variety of food categories between patients who received a sleeve gastrectomy (SG) or a Roux-en-Y gastric bypass (RYGB) and to explore whether food reward differs according to weight loss. In this cross-sectional exploratory study, food reward was assessed using the Leeds Food Preference Questionnaire (LFPQ). We assessed liking and wanting of eleven food categories. Comparisons were done regarding type of surgery and Total Weight Loss (TWL; based on tercile distribution). Fifty-six patients (30 SG and 26 RYGB) were included (women: 70%; age: 44.0 (11.1) y). Regarding the type of surgery, scores were not significantly different between SG and RYGB, except for ‘non-dairy products – without color’ explicit liking (p = 0.04). Regarding TWL outcomes, explicit liking, explicit wanting and implicit wanting, scores were significantly higher for Good responders than Low responders for ‘No meat – High fat’ (post-hoc corrected p-value: 0.04, 0.03 and 0.04, respectively). Together, our results failed to identify major differences in liking and wanting regarding the type of surgery and tended to indicate that higher weight loss might be related to a higher reward for high protein-content food. Rather to focus only on palatable foods, future studies should also consider a broader range of food items, including protein reward.

Food-related sensory alterations are prevalent among cancer patients and negatively impact their relationship with food, quality of life, and overall health outcome. In addition to taste and smell, food perception is also influenced by somatosensation comprising tactile, thermal, and chemesthetic sensations; yet studies on oral somatosensory perception of cancer patients are lacking to provide patients with tailored nutritional solutions. The present review aimed to summarise findings on the oral somatosensory perception of head and neck cancer (HNC) patients and the potential aetiologies of somatosensory alterations among this population. Subjective assessments demonstrated alterations in oral somatosensory perception such as sensitivity to certain textures, spices, and temperatures. Physiological changes in oral somatosensation have been observed through objective assessments of sensory function, showing reduced localised tactile function and thermal sensitivity. Changes in whole-mouth tactile sensation assessed using texture discrimination and stereognosis ability seem to be less evident. Available evidence indicated oral somatosensory alterations among HNC patients, which may affect their eating behaviour, but more studies with larger sample sizes and standardised assessment methods are needed. Unlike other types of cancers, sensory alterations in HNC patients are not only caused by the treatments, but also by the cancer itself, although the exact mechanism is not fully understood. Prevalent oral complications, such as xerostomia, dysphagia, mucositis, and chemosensory alterations, further modify their oral condition and food perception. Oral somatosensory perception of cancer patients is an under-investigated topic, which constitutes an important avenue for future research due to its potential significance on eating behaviour and quality of life.

International audience; This systematic review and meta-analyses aimed to synthesize evidence of the link between bariatric surgery and changes in food preferences, considering the method of assessment. MEDLINE, Cochrane Library, Web of Science, Cinahl, PsychINFO, ProQuest, and Open grey were searched incorporating two blocks of terms ("Intervention" and "Food Preferences"). Interventional or observational studies involving patients (BMI ≥ 35 kg m(-2) ) with sleeve gastrectomy (SG) or Roux-en-Y Gastric Bypass (RYGB) and a control group were included. Meta-analyses were performed comparing the standardized daily mean percentage energy from proteins, carbohydrates, and lipids between preoperative and postoperative patients. Fifty-seven studies concerning 2,271 patients with RYGB and 903 patients with SG met the inclusion criteria, of which 24 were eligible for meta-analysis. Despite a total reduction in macronutrient intakes, the meta-analyses revealed a postoperative increase in percentage energy from proteins at 12 months (0.24, 95% CI: 0.03, 0.46, \I(2) \ = 73%) and a decrease in percentage energy from fat at 1 month (-0.47, 95% CI: 0.86, 0.09, \I(2) \ = 72%), up to 24 months (-0.20, 95% CI: -0.31, 0.08, \I(2) \ = 0%). In conclusion, the present systematic review and meta-analyses showed changes of food preferences in terms of macronutrient, food selection and, overall food appreciation up to 5 years following bariatric surgery.

OBJECTIVES: Monitoring psychosocial, emotional, and hedonic aspects of food behavior is important to understand cancer patients’ distress and help to reduce risks of malnutrition. However, to date, there is no specific tool to measure the impact of diet, eating behavior, and chemotherapy side effects on patients’ food-related quality of life during cancer and its treatments. The objective was to develop and validate a questionnaire that aims to assess the food-related quality of life in cancer patients undergoing chemotherapy. METHODS: Relevant items from the existing food-related quality of life assessment tools were selected to compose the present 46-item questionnaire. The validation of the questionnaire was conducted in 276 healthy volunteers and 173 cancer patients. Exploratory Factor Analysis (EFA) was performed in both groups, construct and discriminant validity, and test-retest reliability were calculated. RESULTS: The questionnaire was perceived as clear and required less than14 minutes for completion (93% complete responses) in a pre-test (n = 156). The EFA allowed the inclusion of 9 dimensions in the food-related quality of life questionnaire. Common patterns between patients and healthy volunteers (factor loadings ≥ 0.4 in both groups) were used to calculate scores by dimension. Scores in the dimensions of adapting diet and sensorial discomfort (taste/odor) were higher in cancer patients, whilst scores in the dimension of discomfort in satiety were higher in healthy volunteers. Among patients with cancer, the total scores in sensorial discomfort, digestive discomfort, and discomfort in satiety were higher under chemotherapy than no treatment. Reproducibility after one week was in increasing order; digestive discomfort 0.6, adapting diet 0.61, products’ quality 0.67, cooking 0.75, healthy diet 0.76, eating and pleasure 0.80, discomfort in satiety 0.82, and sensorial discomfort 0.85. CONCLUSIONS: This 46-item questionnaire can discriminate cancer patients versus healthy volunteers, and patients receiving vs those not receiving chemotherapy. A good to very good reproducibility was found for the most important factors of food-related quality of life of patients with cancer, i.e, eating and pleasure, sensorial discomfort, and discomfort in satiety. FUNDING SOURCES: This study is funded by La Région Auvergne Rhône-Aples and La Métropôle de Lyon.

International audience; PURPOSE: In people with obesity, food addiction (FA) tends to be associated with poorer outcomes. Its diagnosis can be challenging in primary care. Based on the SCOFF example, we aim to determine whether a quicker and simpler screening tool for FA in people with obesity could be developed, using artificial intelligence (machine learning). METHODS: The first step was to look for the most discriminating items, among 152 different ones, to differentiate between FA-positive and FA-negative populations of patients with obesity. Items were ranked using the Fast Correlation-Based Filter (FCBF). Retained items were used to test the performance of nine different predictive algorithms. Then, the construction of a graphic tool was proposed. RESULTS: Data were available for 176 patients. Only three items had a FCBF score \textgreater 0.1: "I eat to forget my problems"; "I eat more when I'm alone"; and "I eat sweets or comfort foods". Naive Bayes classification obtained best predictive performance. Then, we created a 3-item nomogram to predict a positive scoring on the YFAS. CONCLUSION: A simple and fast screening tool for detecting high-disordered eating risk is proposed. The next step will be a validation study of the FAST nomogram to ensure its relevance for emotional eating diagnosis. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study. CLINICAL TRIAL REGISTRY NUMBER: NCT02857179 at clinicaltrials.gov.

International audience; PURPOSE: Changes in food preferences, taste, and smell following bariatric surgery have been previously described but with inconsistent results. We aimed to describe current food preferences and their perceived changes before and after the surgery. We further compared food preferences between patients with and without taste or smell alterations, before and above 2 years follow-up, and concerning the success or failure of their surgery. MATERIALS AND METHODS: This cross-sectional study was conducted with a self-administered online questionnaire. Two years was the cut-off between short- and long-term follow-up. Success was defined as an excess weight loss (EWL) greater or equal to 50%. RESULTS: In total, 220 postoperative patients answered the questionnaire. Patients with taste alterations (64%) had significantly lower preferences for red meat, milk, cheese, desserts, fried foods, and water (all p \textless 0.05) relative to the non-taste alteration group, while those with smell alterations (38%) had significantly lower preference for cheese only (p \textless 0.05) relative to the non-smell alteration group. Patients with a ≥ 2-year follow-up had a higher liking for desserts, fried foods, fat, bread, hot drinks, and alcohol compared to patients with a \textless 2-year follow-up (all p \textless 0.05). Patients having success in surgery had higher liking scores for green vegetables and lower liking scores for starchy foods, milk, and sweet dairy products (all p \textless 0.05). CONCLUSIONS: Our study suggests that patients who underwent bariatric surgery have different food preference patterns according to their sensory perceptions, the duration of their follow-up, and the success of bariatric surgery.

International audience

Chemotherapy-induced taste and smell alterations may have a negative impact on the quality of life and nutritional status. A prominent issue when dealing with taste and smell alterations and their consequences on food behavior and well-being lies in the variation arising from individual differences in chemosensory perceptions. The main aim of this study was to examine the effect of individuals’ variation in the severity of taste and smell alterations relative to the stage of chemotherapy on self-reported food behavior and food perception. Eighty-nine cancer patients completed a questionnaire subdivided into two parts: a chemosensory part that allowed classification of patients in three groups (“no alterations,” “moderate alterations,” and “severe alterations”) and a food behavior part. The results highlighted a negative impact of chemosensory alterations on food perception. Compared with patients without taste and smell alterations, patients with severe chemosensory alterations reported significantly more frequent food perception problems, including modification of the perceived taste of food, finding bad taste in all food, and being unable to perceive food taste. Whereas 72% of patients with severe alterations were in late stage, only 37% of patients were in late stage in the no alterations group, indicating an effect of the treatment stage on taste and smell alterations. Our results underlie the importance of providing specific attention to the severity of chemotherapy-induced taste and smell alterations and considering the individual differences among patients for a better nutritional management.

The prevalence of obesity has reached epidemic proportions globally, and the trend is especially alarming in children and adolescents. Dairy products provide a range of nutrients that are important to health but contribute to overconsumed nutrients such as fat and saturated fat. Data from existing reviews on the role of dairy products in the development of obesity in childhood and adulthood are inconsistent. This chapter reviews the totality of evidence and the justification for the current approach of limiting dairy in the diet to reduce or prevent obesity or weight gain. The majority of data available from longitudinal and intervention studies in adults provide evidence of neutral associations between intakes of milk and other dairy products, and body weight and adiposity measures. Similar results were found for children and adolescents, while there is limited data for older adults. Although the mechanisms have not been clearly elucidated, they include effects on energy and fat balance, fatty acid absorption, appetite, and the metabolic activity of gut microbiota. In conclusion, although inconsistencies exist, there is little evidence to support the justification for limiting dairy in the diet on the grounds that they may promote obesity.

Introduction:Up to day, the most effective treatment for obesity is bariatric surgery. Nevertheless, weight regain may occur in almost 20% of the patients. Furthermore, nutritional complications such as protein malnutrition and vitamin deficiencies remain common. Clinical experience and scientific literature suggest changes in food preferences after bariatric surgery, which may contribute to weight loss and/or weight regain independently of the surgically-induced reduction of energy intake. Yet, there is inconsistency among the studies as they do not always use objective measures to assess food preferences and only few considered and compared the different types of surgical technics. Our objective was to study the impact of the type of bariatric surgery on the liking and wanting of consuming certain foods varying in composition and appearance.Materials and methods:We conducted a cross-sectional clinical trial among 90 patients followed at the Integrated Center for Obesity/Hospital of Lyon. The patients were divided into three groups according to whether they had an unoperated severe obesity (OB), a sleeve gastrectomy (LSG) or a gastric bypass (RYGB). We assessed food preferences using the Leeds Food Preference Questionnaire (LFPQ), a behavioral computer task. Binge eating, impulsivity and food addiction were assessed with self-report questionnaires. Statistical analysis of food preferences included ANOVAs, post-hoc comparisons of groups two-by-two and linear regressions to adjust results for potential confounders. Principal Components Analysis (PCA) and Hierarchical Cluster Analysis (HCA) were performed to determine food preference patterns and groups of individuals with similar food preferences.Results:Our results showed a significant difference in liking scores, with the OB group having higher scores for high-fat savory (HFSA), high-fat sweet (HFSW) and low-fat sweet foods (LFSW) (p < 0.0001) relative to LSG and RYGB groups. Additionally, LSG had greater score of liking for HFSA than RYGB (p = 0.001). There was a high correlation between the binge eating score and the liking scores for HFSA, HFSW and LFSW (p < 0.001).Discussion:Our study expands the knowledge regarding changes in food preferences after bariatric surgery and may help to better understand potential underlying mechanisms by comparing two different surgical technics. This pilot study will be followed by a prospective study of food preferences after bariatric surgery using the LFPQ, a buffet type food in an experimental restaurant and sensory measurements. Eventually, our project may contribute to modulate post-operative nutritional interventions in order to facilitate the adoption of a healthy diet.

IntroductionDespite the well-documented health benefits of a dietary pattern higher in plant-based food such as legumes, their consumption remains low. Knowing that taste is the first factor in consumers’ food choice, flavoring of legumes using blends of herbs and spices (H&S) is an interesting approach to increase their consumption. This study examines the effect of H&S on the appreciation and energy intake of low salt legume-based dishes in a real context ecological environment.Materials and MethodsA 2-step pilot testing was designed to determine the most favorable recipe between 4 different blends of H&S. Firstly, 4 recipes were evaluated in a balanced order of presentation using different blends of legumes (chickpeas and lentils) and H&S by 115 participants (age 18–35) in an experimental restaurant. Overall liking was measured, followed by a preference-ranking test. Secondly, a perception assessment test was performed (n = 54) with the preferred recipe being divided into 4 variants higher (S) or lower in salt (LS) and H&S (S, LS, LSHS, SHS), according to a 2×2 factorial design (2-AFC test). In a randomized cross-over trial, 94 participants (age 18–35) attended 4 sessions 1 week apart and received the 4 variants as a mezze-type starter. Overall liking, food intake and appetite ratings (VAS) were assessed before and after the starter, main dish and dessert during lunch.ResultsParticipants significantly preferred the Spinach recipe compared with the Ginger, Paprika and Curcuma recipes and they could easily determine the different levels for salt and spices (t-test 5%). There were no significant differences in overall liking and taste between the different levels of salt and spiciness, although Principal Component Analysis showed 55% of the participants rating higher scores for the H&S recipes. Similarly, there were no differences in energy intake between S, LS, LSHS, SHS or total energy intake of the complete lunch. There was no difference in the ratings of hunger, desire to eat and prospective consumption although fullness was significantly higher followed by the S compared with LSHS (P < 0.005).DiscussionOverall appreciation was similar after the addition of H&S in low-salt starter to the high-salt starters, implying that reducing salt content without compromising acceptance is a feasible strategy at an ecological setting. However, there was no difference in energy intake of the four variants and overall appetite ratings. Further analysis, on interindividual differences in terms of eating behavior and acceptance, seems prudent.

Flavoring using blends of herbs and spices (H&amp, S) instead of salt may be a promising approach to increase legume consumption and reduce salt content in foods. This study examines the effects of H&amp, S on the appreciation and intake of low-salt legume-based dishes in a real ecological eating environment. Four mezzes with standard (0.8% w/w) (S) or lower (0.4% w/w) (LS) salt level and with or without H&amp, S (LSHS, SHS) were developed. In a randomized cross-over trial, 94 participants attended four sessions, one week apart and received the four variants as a starter during lunch. Overall liking, food intake, and appetite ratings (visual analogue scale, VAS) were assessed during lunch. A follow-up study (n = 130) was performed where the four variants were evaluated, and overall liking was measured at the same session. Overall liking and taste scores of SHS were significantly higher compared with LS (p = 0.04 and p = 0.03, respectively), but there were no significant differences between LSHS and S. However, there were no differences in energy intake or in appetite ratings among the products. Overall appreciation was similar between the low-salt with H&amp, S and the standard-salt mezze, suggesting that the addition of H&amp, S is a feasible strategy for achieving a 50% reduction in salt content without compromising hedonic appreciation.

Spices are rich in distinct polyphenols which might act on the gut by inhibiting glucose uptake and modulating appetite responses. To investigate this hypothesis, healthy adults were randomly assigned to receive isovolumetric (220 ml) spice-based (contained total polyphenol concentration to 185 mg gallic-acid equivalents) or control beverages followed by a standard bread breakfast containing 50 g available carbohydrates in a cross-over trial. Postprandial glucose, insulin, PYY and appetite responses were evaluated. Ultra-high-performance liquid chromatography coupled to electrospray quadrupole time-of-flight mass spectrometry (UHPLC-DAD-ESI-QTOF-MS) was used for polyphenols profiling. Cinnamon and turmeric lowered early blood glucose increment up to 45 min compared to control. Turmeric increased p-PYY and lowered ‘desire to eat’ and ‘prospective consumption (quantity of food wanted to it)’ compared to control. By offering appetite modulation and glucose lowering effects, certain spices (e.g. turmeric and cinnamon) may be important in lowering cardiometabolic risk.

The satiating effect of animal vs plant proteins remains unknown. The present study examined the effects of breakfasts containing animal proteins [milk (AP)], a blend of plant proteins [oat, pea and potato (VP)] or 50:50 mixture of the two (MP) compared with a carbohydrate-rich meal (CHO) on appetite, energy intake (EI) and metabolic measures. A total of 28 males [mean age 27.4 (±SD 4.2) years, BMI 23.4 (±2.1) kg/m2] consumed three isoenergetic (1674 kJ) rice puddings matched for energy density and macronutrient content as breakfast (25% E from protein) in a single-blind, randomised, cross over design. Appetite ratings and blood samples were collected and assessed at baseline and every 30 and 60 min, respectively, until an ad libitum test meal was served 3.5 h later. Free-living appetite was recorded hourly and EI in weighed food records for the remainder of the day. No differences in subjective appetite ratings were observed after consumption of the AP, VP and MP. Furthermore, there were no differences between the AP, VP, MP and CHO breakfasts in ad libitum EI and self-reported EI during the remainder of the day. Although insulin metabolism was not affected, CHO induced a higher glucose response (P = 0.001) and total amino acids concentration was in the order of AP = MP > VP > CHO breakfast (P = 0.001). Manipulating the protein source of foods consumed as breakfast, elicited comparable effects on appetite and EI at both laboratory and free-living environment in healthy men.

Introduction et but de l’etude La chimiotherapie induit divers effets secondaires incluant l’alteration des perceptions olfactives et gustatives. L’olfaction et la gustation permettent la detection des saveurs, odeurs et aromes, et constituent donc des piliers de l’experience alimentaire. Les alterations de ces deux sens, frequentes chez les patients atteints de cancer et traites par chimiotherapie, se repercutent sur leur comportement alimentaire augmentant le risque de denutrition. L’objectif de cette etude est d’observer les alterations olfactives et gustatives chez des patients atteints de cancer bronchique apres 6 semaines de traitement par Cisplatine, et d’examiner l’effet des alterations sensorielles sur le comportement alimentaire des patients. Materiel et methodes Un total de 44 patients atteints de cancer bronchique, programmes pour une chimiotherapie a base de Cisplatine et 44 controles sains apparies en genre et en âge ont ete recrutes. Les capacites olfactives et gustatives des deux groupes ont ete evaluees par l’European Test of Olfactory Capabilities (ETOC) et le Taste Strips respectivement. Les participants ont egalement repondu a un questionnaire sur leurs habitudes et preferences alimentaire. Les mesures ont ete effectuees a deux moment: une premiere session de tests avant le debut de la chimiotherapie (S1) et une deuxieme session apres 6 semaines de traitement, correspondant a 2 cycles de chimiotherapie (S2). Les sujets controles ont ete testes selon le meme protocole. Resultats et analyse statistique Une comparaison entre les patients et les controles a S1 et S2 a montre des scores de detection (D) et d’identification (I) des odeurs et des modalite gustative (sucree, salee, acide, amere) significativement inferieurs chez les patients par rapport aux controles aux 2 sessions de tests (odeurs: (D) p = 0,009, (I) p = 0,001; gouts: (D) p = 0,006; (I) p Conclusion Les patients atteints de cancer bronchique presentent une baisse des capacites olfactives et gustatives avant meme le debut du traitement par chimiotherapie. Ces modifications seraient dues a la presence de la tumeur, qui induirait des modifications metaboliques et hormonales, ou au tabagisme repandu dans la population etudiee. Les patients hyposmiques declarent utiliser plus de condiments pour rendre les aliments a leur gout, ce qui suggere un mecanisme de compensation de l’hyposmie par un assaisonnement plus important des plats. Ces resultats suggerent qu’une adaptation du gout des aliments par manipulation de leurs qualites sensorielles pourrait ameliorer l’appreciation des aliments par les patients presentant des deficits sensoriels.

Introduction et but de l’etude Les alterations olfactives et gustatives sont un effet secondaire frequent des traitements par chimiotherapies. Elles sont correlees a une perte d’appetit et une reduction de la prise alimentaire, et peuvent contribuer a la degradation du statut nutritionnel et de la qualite de vie du patient. Bien qu’environ trois quarts des patients se plaignent d’une modification du gout et/ou de l’odorat pendant la chimiotherapie, peu de travaux ont ete publies sur la relation entre cancer, sensorialite, et prise alimentaire (Drareni et al., 2019). Etant donne l’importance des signaux sensoriels dans la regulation de la prise alimentaire et le plaisir subsequent a celle-ci, il est necessaire de mettre en place des solutions afin de reduire l’impact des alterations olfactives et gustatives sur le plaisir a s’alimenter. Etudier l’effet de divers types d’enrichissements sensoriels sur l’appreciation d’un aliment par un groupe de patientes a differents stades de chimiotherapie. Materiel et methodes Cinq recettes de caviar d’aubergine ont ete developpees pour cette etude : une recette reference (ref) ne contenant aucun assaisonnement, et quatre recettes enrichies en : sel, citron, ail, cumin. Quatre vingt quatre patientes atteintes d’un cancer du sein traite par chimiotherapie ont ete recrutees puis separees en deux groupes : le groupe « stade precoce de chimiotherapie » (P) incluant les patientes ayant eu 3 cycles ou moins et le groupe « stade tardif de chimiotherapie » (L) incluant les patientes ayant eu plus de 3 cycles. Les patientes devaient deguster et evaluer l’appreciation de la recette reference sur une echelle visuelle analogique allant de 0 a 10, puis deguster les 4 recettes enrichies et leur attribuer une note d’appreciation par rapport a la recette reference. Un groupe controle compose de 36 participantes n’ayant ni cancer ni chimiotherapie a ete recrute a titre de comparaison. Resultats et analyse statistique Aucune difference significative n’a ete observee sur les notes d’appreciation de la recette reference entre les 3 groupes. Les evaluations de l’appreciation des recettes enrichies ont ete comparee a celle de la recette reference par un one sample t-test. Le groupe controle a apprecie toutes les recettes enrichies autant que la reference, sauf la recette cumin jugee significativement plus agreable que la reference (p Conclusion Independamment du stade de chimiotherapie, l’enrichissement en sel et en ail a ete apprecie par les patientes. L’enrichissement sensoriel constitue une bonne piste pour maintenir le plaisir a s’alimenter chez les patients sous chimiotherapie. Ces resultats ont introduit une etude plus large sur l’effet d’un enrichissement sensoriel sur l’appreciation et la consommation d’un repas complet (entree, plat, dessert) dans le cadre du projet CANUT (Cance, Nutrition and Taste).

The underlying mechanisms for the effect of proteins on appetite regulation, especially in presence of variable macronutrient composition, are not fully elucidated. The present study investigated the absorption kinetics of proteins after co-ingestion with the other macronutrients and examined the impact of circulating amino acids on appetite and satiety-related gut hormones. A randomized, within-subjects, 2-level full factorial design was implemented, where thirty six healthy subjects consumed seven preloads with similar energy density (3.1 kJ/g) and volume (670 mL) but with varying macronutrient content. The energy from protein (%) and the CHO:fat ratio were the two factors combined in three levels of 9, 24, 40 and 0.4, 2, 3.6 respectively. Blood and appetite parameters were evaluated until the serving of the ad libitum lunch after 210 min and the amino acid concentrations were measured in a subgroup of seven male subjects. The amino acid concentrations peaked at 90 min after all preloads and returned to the baseline values until 210 min. Protein intake affected amino acid profiles (P 0.05), while no differences (P 0.05) were detected between the two high protein preloads despite the different CHO:fat ratio (40%/0.4 CHO:fat and 40%/3.6 CHO:fat), indicating that neither carbohydrate nor fat influenced the profiles. Most of the amino acids were not related to appetite sensations or gut hormones (P 0.05), while glutamate was positively associated with prospective consumption and inversely related to ghrelin (P 0.05). Valine, leucine, isoleucine, lysine and α-aminobutyric acid were inversely associated with energy intake (P 0.05). Overall, postprandial amino acid profiles were solely affected by protein content and were not consistently related to appetite regulation. Further investigation of glutamate's effect on appetite is needed.

Existing reviews suggest that milk and other dairy products do not play a role in the development of obesity in childhood, but they do make an important contribution to children’s nutrient intake. It is thus curious that public health advice on the consumption of dairy products for children is often perceived as unclear. The present review aimed to provide an overview of the totality of the evidence on the association between milk and other dairy products, and obesity and indicators of adiposity, in children. Our search identified forty-three cross-sectional studies, thirty-one longitudinal cohort studies and twenty randomised controlled trials. We found that milk and other dairy products are consistently found to be not associated, or inversely associated, with obesity and indicators of adiposity in children. Adjustment for energy intake tended to change inverse associations to neutral. Also, we found little evidence to suggest that the relationship varied by type of milk or dairy product, or age of the children, although there was a dearth of evidence for young children. Only nine of the ninety-four studies found a positive association between milk and other dairy products and body fatness. There may be some plausible mechanisms underlying the effect of milk and other dairy products on adiposity that influence energy and fat balance, possibly through fat absorption, appetite or metabolic activity of gut microbiota. In conclusion, there is little evidence to support a concern to limit the consumption of milk and other dairy products for children on the grounds that they may promote obesity.

Including nuts in the diet improves appetite control and does not lead to weight gain. However, for pistachios, evidence from randomized intervention studies is limited and there are no data on the effect of pistachios on satiety. The objective of this study was to assess the effect of daily consumption of pistachios as an afternoon snack on satiety, self-reported energy, self-reported nutrient intake, body weight, and body composition. This randomized controlled pilot study included two parallel groups of 30 healthy French women, in a free-living setting. For four weeks, groups were instructed to consume either 56 g (1318 kJ) of pistachios or 56 g of isoenergetic/equiprotein savory biscuits as an afternoon snack. Evening energy intake, changes in anthropometric measures, and daily intake of energy and selected nutrients were assessed. Visual analogue scales (VAS) were used to rate hunger, fullness, desire to eat, and prospective consumption. Satiety effects were not different between groups, as assessed by evening energy intake or VAS scores. Consuming pistachios or biscuits had no impact on body weight. Thiamin, vitamin B6, copper, and potassium intakes were significantly higher in the pistachio group. Consuming pistachios or biscuits as an afternoon snack resulted in similar post-snack food intake and subjective feelings of satiety. A daily pistachio snack for a month did not affect body weight or composition but it did improve micronutrient intake.

International audience; INTRODUCTION: Taste and smell alteration is a frequent side effect of chemotherapy. However, little is known about their influence on patients' food behavior and the mechanisms underpinning their occurrence. This lack of clarity is likely due to a series of factors among which heterogeneity in chemotherapy-induced taste and smell modifications may play a prominent role. The present review provides a critical overview of the evidence on the association between taste and smell alterations and food behavior modifications in cancer patients undergoing chemotherapy. DESIGN: The literature search was performed using PubMed and Google Scholar databases and restricted to literature for English-language articles published between 1990 and June 2018. Sensory-related terms were combined with food behavior-related terms to identify the studies that examined the association between these two terms. The retrieved studies were grouped based on the taste and smell assessment outcomes. RESULTS: Thirteen eligible articles were included in the review. The studies varied in design, length, methodology of assessment, and studied population. The categorization of studies depending on taste and smell assessment outcomes allowed the definition of three patient profiles: unaltered, hypo- and hyperchemosensation (taste and/or smell). Alterations were significantly correlated with patients' energy intake and macronutrient preferences suggesting that sensitivity of each patient to olfactory and gustatory stimuli is likely to play a role in food behavior modulation during cancer and chemotherapy. CONCLUSION: The review summarizes and provides relevant associations between taste/smell alterations and food behavior while receiving chemotherapy considering existing individual variations. Given the sensory influence on food behavior modulation, a better characterization of smell and taste alterations before the launch of chemotherapy seems important for a better understanding and management of patients' food behavior trajectory over the treatment.

The established effect of turmeric and its curcuminoids on appetite sensations was previously shown to be mediated by gut hormones release. In in vitro and preclinical studies, curcumin was shown to induce GLP-1 secretion and improve postprandial glycemia. In humans, consumption of 220 mL turmeric-based beverage (TUR, containing 185 mg gallic acid equivalents (GAE)) prior to white wheat bread (WWB, 50 g available carbohydrate) reduced early postprandial glucose levels and induced peptide tyrosine–tyrosine (PYY) release, as well as lowered ‘desire to eat’ and ‘prospective consumption’ in a postprandial setting, compared to control. In the present study, 12 healthy participants (5 men, 7 women) were admitted. An identical beverage was given and consumed prior to isoenergetic (423 kcal) medium-fat (MF) or high-fat (HF) meals. Appetite sensations including perceived ‘hunger’, ‘desire to eat’, ‘satiety’, ‘fullness’, ‘prospective consumption’, and ‘thirst’ were measured using visual analogue scales. MF induced 18% (p = 0.039) higher ‘satiety’ compared to HF. TUR consumption prior to either MF or HF did not modulate the perceived appetite sensations. Whether macronutrient-induced appetite sensations override the actual turmeric effects warrants further investigation.

International audience

It is recognized that context (all the variables in an eating occasion) influences food acceptance, consumer perception, food intake, and overall eating behavior. Therefore, considering context in experimental food research is central to strengthening the validity of such studies. This chapter discusses the importance of studying natural meals and the role of context when studying food consumers, considering three different perspectives relevant for food research: perception, decisions, and intake. Methodological approaches, from laboratory to free-living settings, have been developed and employed, each with various strengths and limitations. The Living Lab approach is introduced, where researchers base their data collection in an existing eating environment, and have as many relevant contextual factors (i.e., social, environmental, personal) as possible controlled. The chapter ends with case studies using the living laboratories and a discussion of future trends.

OBJECTIVES: The consumption of milk and dairy products makes an important contribution to children's nutrient intake, yet due to relatively high saturated fat content, the health benefits of dairy products have come under question and public health advice is often perceived as unclear. This review aimed to provide an overview of the current available evidence taken from systematic reviews and meta-analyses on dairy product consumption and risk of obesity, type 2 diabetes (T2D) and cardiovascular disease (CVD) in children, adolescents, and adults. METHODS: The literature of English-language systematic reviews and meta-analyses published up to September 2019 was reviewed by searching the following three databases: ISI Web of Science, PubMed, and Google Scholar. Search terms included ‘dairy’, ‘milk’, ‘yogurt’, ‘obesity’, ‘adiposity’, ‘bodyweight’, ‘type 2 diabetes’, ‘cardiovascular diseases’, ‘coronary heart disease’, ‘blood pressure’, ‘insulin resistance’, ‘glucose’, ‘children’, ‘adolescents’, ‘adults’ and combinations of these. Published work on calcium supplementation was excluded. RESULTS: Milk and certain dairy products were found to be not associated with or inversely associated with obesity in children and adolescents. In adults, consumption of milk and dairy products improves body composition and enhances weight loss during energy restriction diets, while it has a neutral effect on body weight in maintenance diets. Prospective cohort studies suggest that the consumption of dairy products, with regular or low-fat content, does not adversely affect the risk of T2D or CVD outcomes and may have a protective effect. The plausible mechanisms underlying the effect of dairy nutrients on obesity and cardiometabolic disease are incompletely understood but may include effects on lipolysis, lipogenesis and fatty acid absorption. CONCLUSIONS: Dairy product consumption, as part of a balanced diet, may protect against the risk of obesity, T2D, and CVD. However, further research is needed to better understand the role of different types of dairy products and of different fat content in obesity, T2D, and CVD. The new and emerging range of products (including plant-based alternatives) being used as dairy milk substitutes has yet to be evaluated in scientific studies. FUNDING SOURCES: None.

OBJECTIVES: Given the influence of sensory signals on food intake regulation and the subsequent nutritional status, it is important to reduce the impact of commonly observed smell and taste alterations on the pleasure of eating during chemotherapy. This study aimed to examine the effect of various types of flavor enhancement on the appreciation of an appetizer by a group of patients undergoing chemotherapy. METHODS: Five eggplant appetizers with no seasoning (REF) or enhanced with either salt, lemon, garlic or cumin were developed. In this cross-sectional study, 36 healthy female subjects (age 58 ± 7 y) (control group) and 84 breast cancer patients (age 56 ± 11 y) treated with chemotherapy were recruited. A hierarchical cluster analysis based on patients' self-reported smell and taste abilities classified the patients in two groups: the ‘unaltered, (high sensory abilities) n = 49’ and the ‘altered, (poor sensory abilities), n = 35’ group. Participants tasted and assessed the appreciation of the reference appetizer on a visual analog scale and performed a randomized comparative liking task, by rating the appreciation for each flavor-enhanced appetizer relative to the REF (one-sample t-test). RESULTS: There was no significant difference in the appreciation of the REF appetizer between the three groups (P > 0.05). In the comparative liking task, the control group rated similarly the appreciation between the flavor-enhanced and the REF appetizers except for the cumin-enhanced appetizer, which was appreciated significantly more than the REF (P 0.05), more the salt and garlic-enhanced appetizers (P ≤ 0.001, P = 0.005, respectively) and significantly less the lemon-enhanced appetizer relative to the REF (P = 0.029), confirming a tendency for patients to reject acid-flavored foods. CONCLUSIONS: The salt and garlic enhancements were appreciated by the patients independent of the stage of chemotherapy or the severity of smell and taste alterations. Flavor enhancement seems a good strategy to maintain the pleasure of eating in patients undergoing chemotherapy. Further research is still needed on the appreciation and intake of a complete meal (starter, main course, dessert). FUNDING SOURCES: APICIL and ELIOR groups.

The association between dairy product consumption and body mass index (BMI) remains controversial. The aim of the present study was to investigate the association between total dairy, milk, cheese, cream and butter consumption and BMI change over a 10-year follow-up by using long-term follow-up cohort data from the Caerphilly Prospective Cohort Study (CAPS). The CAPS included 2512 men aged 45&ndash, 59 years at baseline, who were followed up at 5-year intervals for over 20-year. A semi-quantitative food frequency questionnaire estimated the intake of dairy consumption, including milk, cheese, cream and butter at baseline, 5-year and 10-year follow-up. In total, men free of cardiovascular disease, diabetes and cancer (n = 1690) were included in current analysis. General linear regression and logistic regression were used for data analysis. The results showed higher cheese consumption was associated with lower BMI at the 5-year follow-up (p = 0.013). There was no evidence that higher consumption of total dairy, milk, cream and butter were significantly associated with BMI during the over the 10-year following-up. This study suggest that cheese consumption have beneficial effects on lowering BMI, which needs further investigation.

Pleiotropic effects of spices on health, particularly on glucose metabolism and energy regulation, deserve further clinical investigation into their efficacy. The aim of the current study was to evaluate whether consumption of a black pepper-based beverage (BPB) preload containing 20 mg gallic acid equivalent (GAE) would exert any effect on postprandial glycaemia, appetite sensations, gut hormones, thyroid function, and gastrointestinal well-being after a white wheat bread (WWB) challenge meal containing 50 g available carbohydrates (CHO) compared to a control beverage. Sixteen healthy subjects (10 men; 6 women; 26 ± 0.9 years; BMI 22.93 ± 0.53 kg m-2) completed a randomized, crossover intervention study. The BPB's bioactive compounds were characterized using ultra high-performance liquid chromatography coupled to a quadrupole time-of-flight mass spectrometer with an electrospray ionization source (UHPLC-DAD-ESI-QTOF-MS). Nine compounds tentatively identified in BPB include: dihydroxybenzoic acid hexoside-pentoside, decaffeoyl-acteoside, cynaroside A, apigenin 6,8-di-C-hexoside, luteolin 6-C-hexoside-8-C-rhamnoside, apigenin 8-C-hexoside-C-deoxyhexoside, kaempferol 3-rhamnoside-4'-xyloside, apigenin 7-neohesperidoside, and apigenin-8-C-arabinopyranoside-2''-rhamnoside. Blood glucose and serum insulin responses, insulin sensitivity and β-cell function were not affected during the acute intervention with BPB. Neither were effects on gastrointestinal well-being observed after BPB. However, BPB modulated overall acute appetite by lowering 'hunger', 'desire to eat', and 'prospective consumption', and increasing 'satiety' and 'fullness'. In contrast, there were no changes in gut (peptide tyrosine-tyrosine [PYY] and glucagon-like peptide-1 [GLP-1]) and thyroid (triiodothyronine [T3] and thyroxine [T4]) hormones after BPB compared to the control beverage. In conclusion, inclusion of BPB prior to the WWB challenge meal might be beneficial for appetite modulation, but we did not find supporting evidence in glycaemia, gut and thyroid hormones. Further studies are needed to elucidate the mechanisms of appetite-reducing pungent spices, such as black pepper.

Implications Overall, milk consumption provides health benefits to all age groups. Effects of cheese, butter, and fat-reduced and saturated fat-reduced milk and dairy products are less clear and require more research. Public health nutrition policy related to milk consumption should be based on the evidence presented and not solely on the believed negative effects of dietary fat. Milk is not a white elixir since no study has reported eternal youth from drinking it, but there is certainly no evidence that milk is a white poison!

Dietary protein is considered as the most satiating macronutrient, yet there is little evidence on whether the effects observed are attributed to the protein or to the concomitant manipulation of c...

An increasing number of studies have reported a heritable component for the regulation of energy intake and eating behaviour, although the individual polymorphisms and their ‘effect size’ are not fully elucidated. The aim of the present study was to examine the relationship between specific SNP and appetite responses and energy intake in overweight men. In a randomised cross-over trial, forty overweight men (age 32 (sd 09) years; BMI 27 (sd 2) kg/m2) attended four sessions 1 week apart and received three isoenergetic and isovolumetric servings of dairy snacks or water (control) in random order. Appetite ratings were determined using visual analogue scales and energy intake at an ad libitum lunch was assessed 90 min after the dairy snacks. Individuals were genotyped for SNP in the fat mass and obesity-associated (FTO), leptin (LEP), leptin receptor (LEPR) genes and a variant near the melanocortin-4 receptor (MC4R) locus. The postprandial fullness rating over the full experiment following intake of the different snacks was 17·2 % (P= 0·026) lower in A carriers compared with TT homozygotes for rs9939609 (FTO, dominant) and 18·6 % (P= 0·020) lower in G carriers compared with AA homozygotes for rs7799039 (LEP, dominant). These observations indicate that FTO and LEP polymorphisms are related to the variation in the feeling of fullness and may play a role in the regulation of food intake. Further studies are required to confirm these initial observations and investigate the ‘penetrance’ of these genotypes in additional population subgroups.

Dietary regulation of appetite may contribute to the prevention and management of excess body weight. The present study examined the effect of consumption of individual dairy products as snacks on appetite and subsequent ad libitum lunch energy intake. In a randomised cross-over trial, forty overweight men (age 32 (sd 9) years; BMI 27 (sd 2) kg/m2) attended four sessions 1 week apart and received three isoenergetic (841 kJ) and isovolumetric (410 ml) servings of dairy snacks or water (control) 120 min after breakfast. Appetite profile was determined throughout the morning and ad libitum energy intake was assessed 90 min after the intake of snacks. Concentrations of amino acids, glucose, insulin, ghrelin and peptide tyrosine tyrosine were measured at baseline (0 min) and 80 min after the intake of snacks. Although the results showed that yogurt had the greatest suppressive effect on appetite, this could be confounded by the poor sensory ratings of yogurt. Hunger rating was 8, 10 and 24 % (P P se 226) kJ). Although there was no difference in the postprandial responses of hormones, alanine and isoleucine concentrations were higher after the intake of yogurt than cheese and milk (P

As the incidence of obesity is reaching ‘epidemic’ proportions, there is currently widespread interest in the impact of dietary components on body-weight and food intake regulation. The majority of data available from both epidemiological and intervention studies provide evidence of a negative but modest association between milk and dairy product consumption and BMI and other measures of adiposity, with indications that higher intakes result in increased weight loss and lean tissue maintenance during energy restriction. The purported physiological and molecular mechanisms underlying the impact of dairy constituents on adiposity are incompletely understood but may include effects on lipolysis, lipogeneis and fatty acid absorption. Furthermore, accumulating evidence indicates an impact of dairy constituents, in particular whey protein derivatives, on appetite regulation and food intake. The present review summarises available data and provides an insight into the likely contribution of dairy foods to strategies aimed at appetite regulation, weight loss or the prevention of weight gain.

The hedonic regulation of eating behavior has been shown to be altered in case of obesity, notably the chemo-sensory functions and the reward system. Although bariatric surgery is the most effective treatment for obesity, patients do not all respond the same way to this treatment and some of them might regain weight after a certain time. It is essential to promote an adapted balanced diet for the long-term weight maintenance of bariatric surgery patients. A better understanding of the postoperative modifications of food choices and preferences will enable clinicians to give personalized nutritional advice in the context of a precision bariatric medicine. This doctoral work aims to advance this knowledge, by responding to four objectives. The first objective was to synthesize the evidence for the link between bariatric surgery in relation to changes in food preferences by a systematic and meta-analytical approach. With an original approach considering various methods to assess food preferences our systemic analysis of the evidence showed a change in food preferences in patients with obesity who undergo bariatric surgery at specific times during their weight loss trajectory. The second objective was to study the links between food preferences, taste, smell and the weight loss success of bariatric surgery. To this aim, we used an online questionnaire in a cohort of bariatric surgery patients. We found that food preferences were different between patients with and without sensory alterations. For those who experienced sensory alterations, there was a decreased preference for unhealthy foods. We also found that food preferences were different between patients in a weight loss success and failure. Of importance, a higher appreciation for green vegetables was associated with a weight loss success. The third objective of this thesis was to adapt and use a behavioral computerized task in a clinical setting, to compare food reward (i.e., ‘liking’ and ‘wanting’) between patients with unoperated obesity, a sleeve gastrectomy and a Roux-en-Y gastric bypass. Our results showed that the Leeds Food Preference Questionnaire could be clinically relevant to identify post-operative alterations in food reward and to guide caregivers to give personalized advice in patients. Especially, we found that ‘liking’ for a large range of food categories was lower among post-operative patients compared to non-operative patients with obesity while ‘wanting’ was lower among post-operative patients for certain food categories only, including highly palatable foods. The fourth objective of this thesis was to develop a protocol to study food preferences after bariatric surgery in a more realistic environment. We designed a study using a buffet meal in an experimental restaurant, which will be used to study differences in terms of diet quality, food intake and microstructure of the meal between patients with obesity, with and without a bariatric surgery. This doctoral work is original as it used a multidisciplinary approach and a diversity of methods to move forward knowledge about the issue of modifications of food preferences in the context of bariatric surgery. It also highlighted the importance of a personalized nutritional strategy for the bariatric surgery patients., Des études ont montré que la régulation hédonique du comportement alimentaire est altérée en cas d'obésité, notamment les fonctions chimio-sensorielles et le système de récompense. Bien que la chirurgie bariatrique soit le traitement le plus efficace de l'obésité, les patients ne répondent pas tous de la même manière à ce traitement et certains d'entre eux reprennent du poids après un certain temps. Il est essentiel de promouvoir une alimentation équilibrée adaptée pour le maintien du poids à long terme des patients en chirurgie bariatrique. Une meilleure compréhension des modifications postopératoires des choix et préférences alimentaires permettra aux cliniciens de donner des conseils nutritionnels adaptés et personnalisés dans le cadre d'une médecine bariatrique de précision. Ce travail doctoral vise à faire progresser ces connaissances, en répondant à quatre objectifs. Le premier objectif était de faire l’état de l’art du lien entre la chirurgie bariatrique et l'évolution des préférences alimentaires par une approche systématique et méta-analytique. Avec une approche originale prenant en compte diverses méthodes pour évaluer les préférences alimentaires, notre analyse systémique a montré un changement des préférences alimentaires chez les patients obèses qui subissent une chirurgie bariatrique à des moments précis de leur trajectoire de perte de poids. Le deuxième objectif était d'étudier les liens entre les préférences alimentaires, le goût, l'odorat et le succès pondéral de la chirurgie bariatrique. Pour ce faire, nous avons utilisé un questionnaire en ligne dans une cohorte de patients opérés d’une chirurgie bariatrique. Nous avons constaté que les préférences alimentaires étaient différentes entre les patients avec et sans altérations sensorielles. Pour ceux qui ont subi des altérations sensorielles, la préférence pour les aliments malsains a diminué. Nous avons également constaté que les préférences alimentaires étaient différentes entre les patients en succès et en échec pondéral. De manière importante, une plus grande appréciation des légumes verts était associée au succès pondéral. Le troisième objectif de cette thèse était d'adapter et d'utiliser une tâche informatisée comportementale dans un contexte clinique afin de comparer la récompense alimentaire (c'est-à-dire le « liking » et le « wanting ») entre des patients atteints d'obésité non opérée, ceux opérés d’une sleeve gastrectomie et ceux opérés d’un bypass gastrique avec Roux-en-Y. Nos résultats ont montré que le Leeds Food Preference Questionnaire pouvait être cliniquement pertinent pour identifier les altérations postopératoires de la récompense alimentaire et pour guider les soignants à donner des conseils personnalisés aux patients. Plus particulièrement, nous avons constaté que le « liking » était plus faible chez les patients postopératoires que chez les patients obèses non opérés pour un large éventail de catégories d'aliments, tandis que le « wanting » était plus faible chez les patients postopératoires pour certaines catégories d'aliments uniquement, y compris les aliments très appétissants. Le quatrième objectif de cette thèse était de développer un protocole pour étudier les préférences alimentaires après une chirurgie bariatrique dans un environnement plus réaliste. Nous avons conçu une étude utilisant un repas sous forme de buffet dans un restaurant expérimental, qui sera utilisée pour étudier les différences en termes de qualité de l'alimentation, de prise alimentaire et de microstructure du repas entre les patients atteints d’obésité, avec et sans chirurgie bariatrique. Ce travail doctoral est original car il utilise une approche pluridisciplinaire et une diversité de méthodes pour faire avancer les connaissances sur la question des modifications des préférences alimentaires dans le cadre de la chirurgie bariatrique. Il a également souligné l'importance d'une stratégie nutritionnelle personnalisée pour les patients en chirurgie bariatrique.

Maintaining the pleasure of eating during a chemotherapy treatment is a major challenge for patients, their families and hospital catering professionals to avoid malnutrition. However, the sensory alterations frequently observed in patients and expressed differently from one patient to another can interfere with the taste of food and reduce the pleasure resulting from food consumption. The aim of this work is to contribute to define a model of the effect of chemotherapy during cancer on olfactory and gustatory abilities of patients, and the consequences that this may have on their eating behavior. The first part of this work focuses on understanding the variability of sensory changes and their consequences on patients’ eating behavior. Our results highlighted three main sensory profiles : patients with no sensory impairment, patients with hyposensitivity, and patients with hypersensitivity to olfactory / gustatory stimuli. Patients with impaired olfactory / gustatory abilities expressed also changes in their food behavior.The classification of patients on the basis of their self-reported sensory abilities highlighted the negative impact of hyposensitivity on food taste perception. The classification based on psychophysical assessment of olfactory abilities showed a change in consumption habits in patients with hyposmia. Both approaches found a general downward trend in perceptual abilities of cancer patients treated with chemotherapy.In the second part of this work we examined the effect of food sensory enhancement as a coping strategy to sensory alterations. The results suggest that taste or aroma enhancement increases food liking in patients with decreased olfactory / taste sensitivity, and patients who did not report taste and smell deficits but has no effect on the hedonic rating of food in the group of control subjects. This work highlights the interindividual diversity existing between patients and confirms the involvement of olfactory / taste alterations in patients food behavior modification. Our results stresses the importance of personalized nutritional management of patients considering their sensory alteration profile; Le maintien du plaisir à s'alimenter durant un traitement par chimiothérapie est un enjeu majeur pour les patients, leurs familles et les professionnels de la restauration en hôpital afin de lutter contre la dénutrition. Or, les altérations sensorielles fréquemment observées chez les patients et exprimées différemment d'un patient à l'autre peuvent interférer avec le goût des aliments, impactant négativement le plaisir résultant de leur consommation. L'objectif de ce travail est de contribuer à définir un modèle exhaustif de l'effet de la chimiothérapie pendant le cancer sur les capacité olfactives et gustatives des patients, et des conséquences que cela peut avoir sur leur comportement alimentaire. Une première partie porte sur la compréhension de la variabilité des modifications sensorielles et de leurs conséquences sur le comportement alimentaire des patients. Nos résultats ont conclu à l'existence de divers profils sensoriels chez les patients sous chimiothérapie : les patients ne présentant pas d'altérations sensorielles, les patients présentant une hyposensibilité, et les patients présentant une hypersensibilité aux stimulations olfactives/gustatives. Les patients ayant des altérations des capacités olfactives/gustatives ont également montré des modifications du comportement alimentaire. D'une part, la classification des patients sur la base de leurs capacités sensorielles auto-déclarées a mis en évidence l'impact négatif de l'hyposensibilité aux stimulations olfactives et gustatives sur la perception des aliments. D'autres part, une classification basée sur les capacités olfactives évaluées par des tests psychophysiques a montré une modification des habitudes de consommation chez les patients atteints d'hyposmie. Les deux approches ont conclu à une tendance générale à la baisse des capacités perceptives chez les patients atteints de cancer et traités par chimiothérapie. Une seconde partie plus opérationnelle a permis de tester l'enrichissement sensoriel comme stratégie de palliation des déficits sensoriels. Les résultats suggèrent qu'un enrichissement en saveur ou en arôme augmente l'appréciation de l'aliment pour le groupe de patients ayant reporté une baisse de la sensibilité olfactive/gustative, ainsi que les patients n'ayant pas déclaré avoir de déficits sensoriels mais pas dans le groupe de sujets contrôles. Ces travaux mettent en évidence la diversité interindividuelle existante entre les patients et confirment l'implication des altérations olfactives/gustatives dans la modification du comportement alimentaire. Nos résultats soulignent l'importance d'une prise en charge nutritionnelle personnalisée des patients selon leur profil d'altérations sensorielles

Maintaining the pleasure of eating during a chemotherapy treatment is a major challenge for patients, their families and hospital catering professionals to avoid malnutrition. However, the sensory alterations frequently observed in patients and expressed differently from one patient to another can interfere with the taste of food and reduce the pleasure resulting from food consumption. The aim of this work is to contribute to define a model of the effect of chemotherapy during cancer on olfactory and gustatory abilities of patients, and the consequences that this may have on their eating behavior. The first part of this work focuses on understanding the variability of sensory changes and their consequences on patients’ eating behavior. Our results highlighted three main sensory profiles : patients with no sensory impairment, patients with hyposensitivity, and patients with hypersensitivity to olfactory / gustatory stimuli. Patients with impaired olfactory / gustatory abilities expressed also changes in their food behavior.The classification of patients on the basis of their self-reported sensory abilities highlighted the negative impact of hyposensitivity on food taste perception. The classification based on psychophysical assessment of olfactory abilities showed a change in consumption habits in patients with hyposmia. Both approaches found a general downward trend in perceptual abilities of cancer patients treated with chemotherapy.In the second part of this work we examined the effect of food sensory enhancement as a coping strategy to sensory alterations. The results suggest that taste or aroma enhancement increases food liking in patients with decreased olfactory / taste sensitivity, and patients who did not report taste and smell deficits but has no effect on the hedonic rating of food in the group of control subjects. This work highlights the interindividual diversity existing between patients and confirms the involvement of olfactory / taste alterations in patients food behavior modification. Our results stresses the importance of personalized nutritional management of patients considering their sensory alteration profile, Le maintien du plaisir à s'alimenter durant un traitement par chimiothérapie est un enjeu majeur pour les patients, leurs familles et les professionnels de la restauration en hôpital afin de lutter contre la dénutrition. Or, les altérations sensorielles fréquemment observées chez les patients et exprimées différemment d'un patient à l'autre peuvent interférer avec le goût des aliments, impactant négativement le plaisir résultant de leur consommation. L'objectif de ce travail est de contribuer à définir un modèle exhaustif de l'effet de la chimiothérapie pendant le cancer sur les capacité olfactives et gustatives des patients, et des conséquences que cela peut avoir sur leur comportement alimentaire. Une première partie porte sur la compréhension de la variabilité des modifications sensorielles et de leurs conséquences sur le comportement alimentaire des patients. Nos résultats ont conclu à l'existence de divers profils sensoriels chez les patients sous chimiothérapie : les patients ne présentant pas d'altérations sensorielles, les patients présentant une hyposensibilité, et les patients présentant une hypersensibilité aux stimulations olfactives/gustatives. Les patients ayant des altérations des capacités olfactives/gustatives ont également montré des modifications du comportement alimentaire. D'une part, la classification des patients sur la base de leurs capacités sensorielles auto-déclarées a mis en évidence l'impact négatif de l'hyposensibilité aux stimulations olfactives et gustatives sur la perception des aliments. D'autres part, une classification basée sur les capacités olfactives évaluées par des tests psychophysiques a montré une modification des habitudes de consommation chez les patients atteints d'hyposmie. Les deux approches ont conclu à une tendance générale à la baisse des capacités perceptives chez les patients atteints de cancer et traités par chimiothérapie. Une seconde partie plus opérationnelle a permis de tester l'enrichissement sensoriel comme stratégie de palliation des déficits sensoriels. Les résultats suggèrent qu'un enrichissement en saveur ou en arôme augmente l'appréciation de l'aliment pour le groupe de patients ayant reporté une baisse de la sensibilité olfactive/gustative, ainsi que les patients n'ayant pas déclaré avoir de déficits sensoriels mais pas dans le groupe de sujets contrôles. Ces travaux mettent en évidence la diversité interindividuelle existante entre les patients et confirment l'implication des altérations olfactives/gustatives dans la modification du comportement alimentaire. Nos résultats soulignent l'importance d'une prise en charge nutritionnelle personnalisée des patients selon leur profil d'altérations sensorielles