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5 ways to cope with taste and smell problems after brain injury

5 ways to cope with taste and smell problems after brain injury

The sense of smell/taste is commonly affected after brain injury, and we've put together a list of strategies to help

Loss or changes to taste and smell may be caused by injury to the nasal passages, damage to the nerves in the nose and mouth, or injury to the brain itself. It is most common in more severe brain injuries, and if the effects are due to damage to the brain, recovery is rare. The effects are also reported by some people after minor head injuries, where recovery is more common.

Changes to taste and smell can affect appetite and eating in a number of ways:

  • The smell of food stimulates the appetite, so loss of smell can lead to reduced appetite and lack of interest in food.
  • Loss of smell can also lead to a reduction in saliva production, therefore dry foods, such as biscuits and crackers, may be more difficult to eat.
  • The choice of foods may be limited to those which provide flavour, which can lead to a diet that doesn’t provide a balanced variety of nutrients.
chef smelling herbs
  • Loss of enjoyment of food can lead to avoiding eating altogether.
  • Altered taste may make certain foods, such as meat, taste unpleasant and lead to those foods being avoided. Any of these problems may effect your choice of food and lead to an inadequate diet.

It is very important to maintain a healthy, balanced diet and below are some suggestions to help you do this.

Making meals more interesting

  • Be imaginative. Use varied colours and textures.
  • Under-cook vegetables so that they are crunchy. Have a crunchy base with a smooth topping.
  • Try using seeds, nuts, wholegrain cereals, fresh fruit and vegetables, beans and pulses to add texture.
  • Adding bacon bits or grated strong cheese, such as parmesan, can add flavour to a meal.
  • Experiment with using different herbs and spices.
  • Grate onions, carrots, apples or other suitable fruits and vegetables to add texture.
  • Serve hot and cold foods together. Try ice cream with hot sauce/ stewed fruit or lasagne with salad.
  • Make meals a social time with friends and family.
  • Establish a regular routine. Try to eat breakfast, lunch, evening meals and snacks at the same time every day.
  • Use a cookbook and try new and interesting recipes.

It is important to note that some of these suggestions may not be suitable if you are experiencing difficulty with chewing, swallowing or choking and have been advised to eat a softer diet. Consult your GP, dietitian or speech and language therapist for further advice.

vegetable skewer

Ensuring your diet is varied and nutritious

A good, balanced diet is essential for good health. NHS Choices provides excellent advice on this.

The ’Food Facts’ section of the British Dietetic Association website at www.bda.uk.com is also full of useful information.

All that is really required is to eat sensibly, choosing a range of foods in the correct proportions. Below are some suggestions to help you do this:

  • Try to base your meals on starchy foods such as bread, cereals, potatoes, rice or pasta. Aim to include at least one food from this group in each meal.
  • Try to eat as great a variety of foods as you can.
  • Have at least five portions of fruit and vegetables a day.
  • Try to drink the equivalent of about a pint of milk a day. This includes milk used in tea and coffee. Try to use reduced fat milk and be very careful that milk hasn’t gone off, especially in hot weather.
  • Limit foods containing a lot of fat and sugar.
  • If you avoid certain foods because they taste unpleasant look for alternatives sources of protein and nutrients. For example, if you cannot eat meat replace it with fish, beans, eggs or milk.

If you continue to experience difficulty adjusting your diet or have any other dietary concerns, such as diabetes or Coeliac disease, that make if difficult to vary the foods that you eat, discuss this with your GP.

You can ask your GP or other healthcare professional for an NHS referral to a registered dietitian, who can assess, diagnose and treat diet and nutrition problems. 

Avoiding using too much salt

Loss of sense of taste may make people likely to add too much salt or other flavourings, such as garlic or chillies. To avoid using too much salt try:

  • Following a recipe or routine to avoid over-salting foods during cooking.
  • Try to add less salt in cooking and not to add salt at the table.
  • Vegetables that are steamed, baked, roasted or cooked in the microwave retain their natural flavour better than when they are boiled. This reduces the need to add extra salt in cooking.
  • To add flavour to foods try different herbs and spices, mustards, lemon juice, vinegar, pickles and sauces – follow directions for using additional flavourings and try not to add extra, as over-seasoning foods can cause indigestion.

Drinking

Loss of taste and smell can also affect the amount of fluids you drink, which may result in dehydration. It is also possible to have too much caffeine or sugar in hot drinks to try to make up for an impaired sense of taste.

Government recommendations are to drink 8 glasses (totalling about 1.5 – 2.5 litres) of fluid a day. This includes all drinks such as water, juice, tea, coffee, etc, but not alcoholic drinks, as alcohol dehydrates the body. If exercising heavily you will need to drink more than this.

  • Avoid very strong tea and coffee or try decaffeinated varieties.
  • Avoid adding excess sugar to tea and coffee.
  • Energy drinks often contain large amounts of caffeine and should only be drunk in moderation.
  • Drinking plenty of liquid can help to remove unpleasant tastes from the mouth.

Alcohol

You may have been advised to avoid alcohol because of your brain injury or any medications you are taking. If you are unsure, ask your GP.

  • Tolerance to alcohol can be reduced following brain injury. Try to drink in moderation or not at all.
  • Remember that alcohol will have the same effect on you even if you cannot taste it.
  • Make sure that you know what is in drinks that are bought for you.
  • Try drinking low alcohol or alcohol free beers as an alternative.

Find out more

This information is taken from our factsheet Loss of taste and smell after brain injury (PDF), which contains more information on living with this condition. You can download this below. 

You can also click here to find out more information about diet after brain injury

Contact the Headway helpline on 0808 800 2244 or helpline@headway.org.uk if you would like to discuss any of the issues covered here.

 

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