For many, COVID-19 has led to a loss of smell, a condition also known as anosmia. Prior to the pandemic, anosmia was more commonly associated with signs of neurologic disease, such as dementia and with colds or sinusitis.
Anosmia is an early and common indicator of COVID-19 and may be a better predictor of the disease than other symptoms, such as fever and cough. While olfactory sensory neurons do not express the gene for the ACE2 receptor protein, the host cells for SARS-CoV-2, the cells that provide metabolic and structural support to those neurons, do express ACE2. Researchers suspect it’s this connection that causes anosmia related to COVID-19. Because these cells are critical to the functioning of our sensory neurons, both groups of cells are vulnerable to attack by the virus.
While thousands of taste buds on our tongue work together to register flavor from our food, smell is commonly thought to be responsible for at least 80% of taste perception. Our other senses — hearing, vision and touch — also play important roles in the entire eating experience.
In the case of COVID-19, the sense of smell typically returns after a few weeks. However, this prolonged period of impaired taste presents a cause for concern regarding reduced appetite and dietary intake. Given that Americans have experienced higher rates of food insecurity and poor nutrition (regardless of their COVID-19 status) over the past year, this additional obstacle to eating a balanced diet poses a threat to good physical and mental health at a time when resilience is so important.
The ability for registered dietitian nutritionists to counsel these patients and clients on optimizing their dietary intake is necessary to ensure they are as healthy as possible and to avoid unnecessary hospital admissions, infections and other illnesses. If your patients or clients are experiencing anosmia, you might try the many tactics used with other patients experiencing reduced appetite or taste.
Here are some suggestions for optimizing the overall eating experience in the absence of smell:
- Incorporate a variety of shapes and textures into a dish or meal. Examples of such additions may include chopped nuts, seeds, crumbled cheese, roasted beans or chopped raw vegetables.
- Include spicy foods and the anti-inflammatory benefits capsaicin for a different sensation.
- Eat cool or warm/hot foods instead of foods at room temperature, as this might help maximize flavor detection and introduce more variety across dishes and meals.
- Add new spices, herbs or hot sauces to see if taste buds detect them.
- Incorporate as many colors as possible to maintain visual appeal.
- Eat foods associated with positive memories.
Patients or clients experiencing anosmia also may need supplements to meet their needs during treatment and recovery. Additionally, consider that patients and clients may face barriers to accessing healthy food on a consistent basis — particularly given the widespread loss of employment or income over the past year. Ask if they need help building skills related to cooking, meal planning and shopping; also, offer to connect them to food resources when necessary.
It’s important to remind patients and clients that this condition is likely not permanent, and that most patients are soon able to recover their smell and enjoy all of their favorite foods and scents again. In the meantime, reiterate that you are a key partner in helping them to eat well and stay healthy during this difficult time.
