clinical focus
find ways to improve their quality of life and
food choices so that perhaps they might
have a little bit more pleasure in life.
That was our first study, and from that
we developed two things. The first was a
way of thinking through all of the different
issues from the social, emotional and
physical issues that can impact quality
of life.
Then we also realised that the way we
were doing it was actually useful as a
research method.
We gathered patients together in a
room with a chef and, over the course of
a couple of years with the participants, the
chefs would come up with new ideas about
how to cook and prepare foods – the sorts
of foods that might be more appropriate
for them.
We’ve discovered that sitting around
together, sitting around the table and
playing with food, was actually really
helpful, not just in terms of food but in
terms of gathering together with other
people who had a similar experience.
So we developed what we call a ‘food
play’ methodology for researchers. Both
of those things have become really useful,
not just for participants but for researchers
working in a whole range of different areas
where eating can be affected.
I’m interested about this social aspect
and why it affects people. Why is it
important to eat as a cohort?
For a lot of people, the social engagement
around food is really important for their
sense of wellbeing.
Cooking and sharing food with others
is a really important part of their social
life. We know, for example, as people
age, often the woman may be the person
who’s been doing most of the cooking
in the house. She loses her husband,
and there is this loss of desire to cook
and eat for herself. Bereavement can be
a reason why some ageing people start
losing a lot of weight – they’ve got nobody
to cook for.
You share love through cooking for
other people. That loss can have a major
impact, not just on your social relationships
but also your ability to eat for yourself.
Loneliness is a reason why we sometimes
have an altered eating difficulty.
We’re having some interesting
conversations in our aged care sector
here in Australia, and a lot has been
written about the poor quality of food
in aged care. This is having health and
mental health implications on residents.
Are you seeing similar things in the UK,
and if so, how are you combating them?
I don’t specifically work in aged care, but
we do a lot of events for people of different
ages outside of that sector. I’ve heard lots
of comments about the food not being
good and how to improve it.
There have been lots of different projects
to try to remedy that problem, and there’s a
couple of points to make about that.
Firstly, for a lot of people as they age,
they lose their sense of smell. Now, it’s
not always inevitable that you’ll lose your
sense of smell, because it’s a bit like a
muscle. You can keep working it – research
is showing you can actually improve your
sense of smell.
So one of the things we are involved
with is looking at smell training as a way
of increasing your ability to smell and
therefore your ability to enjoy the full
flavour of food.
“
Smell training is a
really interesting
opportunity to
improve not just
cognitive function
but the enjoyment
of food.
In the ageing, what’s been discovered
is that smell training is really good for
preventing cognitive decline as well.
For example, there’s been a very
interesting study where they randomised
two groups. One did sudoku – the number
puzzles – and the other group did smell
training over the course of several months.
The ‘smell training’ group improved
cognitive function more than the sudoku
group. Smell training is a really interesting
opportunity to improve not just cognitive
function but the enjoyment of food.
If an aged care provider asked for your
top tip to change the way they present
food, what would it be?
I think my best piece of advice would be
that while it’s important to understand
what people’s food preferences are, it’s
also important to understand what their
sensory abilities are.
Some researchers say 80 per cent of
the experience of food flavour is from
smell. If you can imagine having a really
bad cold and you try to eat some food,
the food tastes bland. If you hold your
nose and try eating something, you’ll find
that all you experience is what happens
on your tongue – the sweet, the sour, the
bitter, the salty. Without a sense of smell,
it’s difficult to enjoy the flavours in food.
So, first of all, we need to understand if
people are smelling the food in the way
we hope they would be.
In a sense, a one-size-fits-all approach
to making food more flavourful may not
work if the person doesn’t have the sensory
capacities to actually enjoy it. That’s the
first bit.
In my experience of working with
head and neck cancer, I remember
we went to a hospital once with our
chef and we looked at the food that
was being prepared for head and neck
cancer survivors. The first thing that we
all experienced was this overwhelming
sense that it smelled horrible. So the first
thing we started to do was think about
the smell of the food, because this is so
important.
A top tip would be to start engaging with
the sense of smell and how important that
is to our enjoyment of food. That would be
one top tip.
But if somebody has lost their sense of
smell, there are all sorts of other ways that
we can increase the enjoyment of food by
looking at the other elements and sensory
perception.
The reason we all enjoy the flavour
of foods is because of taste (that’s what
happens on your tongue), smell, colour,
sound – there are all sorts of different
elements that come into it, and once
you understand all these sensory issues,
it’s much easier to adapt or modify
food to suit the person you’re feeding.
If somebody no longer has a sense of
smell, then you can use more colour and
more sound.
So, understand what the experience is
like for them already, to understand what
their sensory experience is. I find that you
have to do a lot of listening and thinking
and playing around with food and seeing
what works for tasting. They might say,
“Oh, I hate coffee. It just tastes awful.” They
can’t smell it. To somebody else, the smell
might be really intense, which means you
need to be able to adapt to it. There’s not
going to be one food that’s going to suit
everybody. ■
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