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Postprandial regulation of the gastric emptying (GE) rate plays an important role in food intake. Although oral sweetening with glucose may accelerate GE, the effects of different sweetness intensities of glucose (10% and 20%, w/v) and other energy sweeteners (e.g. fructose and sucrose) remain uncertain. The purpose of this study was to determine the effects of different glucose concentrations (Experiment 1) and different sugars with the same sweet taste intensity (Experiment 2) on postprandial GE. In both experiments, after ingesting a 200 kcal carbohydrate solution containing 50 g of maltodextrin, participants repeatedly sipped, but did not swallow, one of three (water, 10% and 20%, w/v glucose) or four (water and equally sweet 20%, w/v glucose, 12%, w/v fructose, and 14%, w/v sucrose) solutions for 1 min every 5 min over a 30 min period. GE was evaluated by measuring the temporal change in the cross-sectional area of the gastric antrum using ultrasound. In Experiment 1, oral stimulation with 20% (w/v) glucose resulted in greater GE than the control stimulus (i.e. water), but the effect of stimulation with 10% (w/v) glucose on GE was not different from that of the control stimulus. In Experiment 2, stimulation with 20% (w/v) glucose or 12% (w/v) fructose resulted in greater GE than the control stimulus. However, the effect of stimulation with 14% (w/v) sucrose on GE did not differ from that of the control stimulus. Consequently, oral stimulation with glucose or fructose solutions of moderate to high sweetness following a meal facilitates postprandial GE.

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Aneurysmal subarachnoid hemorrhage (SAH) is a critical condition associated with high mortality rates. Hypertension is a significant risk factor for SAH development and recurrence following coil embolization for a ruptured aneurysm. While reduction of salt consumption is crucial for managing hypertension, it often compromises food taste. Anodal electrical taste stimulation (ETS) has been proposed to enhance taste perception without altering salt content. We present the case of a 69-year-old female SAH patient with a ruptured aneurysm at the anterior communicating artery who underwent coil embolization and in whom we tested ETS's efficacy in enhancing the salt taste perception on day 42 after the procedure. ETS effectively enhanced the salt taste perception threshold and perceived concentration; the threshold for salt taste without electrical stimulation was 0.8% of salt-impregnated filter paper, whereas that with electrical stimulation was 0.6%. The perception of salt taste was enhanced: 0.8% and 1.0% of filter papers were perceived as 0.6% and 0.8% without electrical stimulation and 1.0% and 1.2% with electrical stimulation, respectively. This is the first report describing the salt perception-enhancing effect of ETS in an actual patient. Further studies involving actual patients are required to determine how ETS affects habitual salt intake and blood pressure trends.

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PURPOSE: Neuroplasticity may be enhanced by increasing brain activation and bloodflow in neural regions relevant to the target behavior. We administered precisely formulated and dosed taste stimuli to determine whether the associated brain activity patterns included areas that underlie swallowing control. METHODS: Five taste stimuli (unflavored, sour, sweet-sour, lemon, and orange suspensions) were administered in timing-regulated and temperature-controlled 3 mL doses via a customized pump/tubing system to 21 healthy adults during functional magnetic resonance imaging (fMRI). Whole-brain analyses of fMRI data assessed main effects of taste stimulation as well as differential effects of taste profile. RESULTS: Differences in brain activity associated with taste stimulation overall as well as specific stimulus type were observed in key taste and swallowing regions including the orbitofrontal cortex, insula, cingulate, and pre- and postcentral gyri. Overall, taste stimulation elicited increased activation in swallowing-related brain regions compared to unflavored trials. Different patterns of blood oxygen level-dependent (BOLD) signal were noted by taste profile. For most areas, sweet-sour and sour trials elicited increases in BOLD compared to unflavored trials within that region, whereas lemon and orange trials yielded reductions in BOLD. This was despite identical concentrations of citric acid and sweetener in the lemon, orange, and sweet-sour solutions. CONCLUSIONS: These results suggest that neural activity in swallowing-relevant regions can be amplified with taste stimuli and may be differentially affected by specific properties within very similar taste profiles. These findings provide critical foundational information for interpreting disparities in previous studies of taste effects on brain activity and swallowing function, defining optimal stimuli to increase brain activity in swallowing-relevant regions, and harnessing taste to enhance neuroplasticity and recovery for persons with swallowing disorders.

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BACKGROUND: Improving the quality of life for individuals with severe dysphagia is a priority when considering new areas of dysphagia management, especially if this increases opportunities to participate in social activities associated with eating and drinking. Edible foam is widely researched and available in the food industry; however, the use of edible foam within the field of dysphagia remains unexplored. Despite no research published on effectiveness and safety, a commercial product currently on the market is widely distributed across both Europe and the UK, including 28 NHS Trusts, suggesting that it is increasingly being used in clinical practice. AIMS: To explore the perceptions and experiences of healthcare professionals on the use of stabilized edible foam (SEF) with adults with severe dysphagia in order to inform areas for future research in this novel dysphagia intervention. METHODS & PROCEDURES: Healthcare professionals were recruited using purposeful sampling and snowballing technique. A total of 56 healthcare professionals were initially approached, of which 10 completed the semi-structured interviews. Interview questions were developed from a topic guide and a pilot questionnaire. OUTCOMES & RESULTS: Thematic analysis was used to identify three themes: potential impact, consideration of risk and perceived experiences. Overarching each of these themes was the element of the unknown. CONCLUSIONS & IMPLICATIONS: Use of SEF with adults with dysphagia is in its infancy. Whilst results indicate that some clinicians are embracing this novel approach, others express concerns. Therefore, further research is needed, particularly in relation of direct experience of individuals and contra-indications. WHAT THIS PAPER ADDS: What is already known on the subject The use of SEF with individuals with swallowing problems is a relatively novel area of dysphagia intervention in the UK. There are currently no published studies on its effectiveness and safety profile. What this paper adds to existing knowledge This study provides valuable preliminary work into the area of SEF and adults with severe dysphagia, capturing the experience and perceptions of healthcare professions who have an awareness of SEF. What are the potential or actual clinical implications of this work? Increasing clinicians and researcher's awareness of this novel area of dysphagia management.

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Taste is a key sense that helps identify different food types and most of this work was carried out on primary tastes rather than generating different flavors. In this work, we proposed a plan to create other flavors rather than primary tastes, adjusted the electrical (40-180 µA) and thermal stimulation (20-38 °C and 38-20 °C), and revealed the digital coding for multi-flavors. Our results showed that different combinations of digital coding could generate different flavors and that tastes related to different stimuli are easy to develop. The novelty of this work is to design other types of flavors and primary tastes. The experimental results demonstrated that the novel method proposed for digital taste coding could realize primary tastes (sweet, sour, salty, spicy, and mint) and mixed flavors. Furthermore, some innovative sensations have been realized, which are sprite, soda water, sweet-sour, salty-sweet, and salty-mint sensations. We presume that this innovation could digitally enhance various flavors.

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Time-intensity (TI) dynamic sensory characterization was used to evaluate the temporal sweet and bitter perception of six commonly available steviol glycosides (Rubusoside, Stevioside, Rebaudioside C, Rebaudioside A, Rebaudioside D and Rebaudioside M). All parameters extracted from TI curves significantly varied among the six samples for both sweetness and bitterness. Compared to other compounds, Rebaudioside M and Rebaudioside D had faster onset of sweetness, quicker decay of aftertaste, and were nearly devoid of bitterness. Conversely, Rubusoside and Stevioside demonstrated an immediate distinct bitter taste and lingering aftertaste. Based on these results, a further investigation into the relationship between temporal properties and chemical structures was conducted. It was found that fewer glucosyl groups on C-19 would result in shorter time for initial stimulation and longer perception of bitterness, whereas more glucosyl groups on C-13 could trigger a faster increase and stronger intensity of sweetness. A shorter time to the peak for sweetness was obtained when the ratio of the number of glucosyl groups on C-13 to that on C-19 was lower, although there was no such effect on bitter taste. These relationships were explained by the adsorption and desorption of these compounds on the taste receptors. Higher numbers and larger sizes of substitutions at the C-19 position of steviol glycosides can increase their desorption percentages and lead to a quicker decay of sweetness. Meanwhile, compounds with fewer glucosyl groups, such as Rubusoside and Stevioside, presented lower desorption and thus longer bitter aftertaste. Overall, the addition of glucosyl groups would generate stronger sweetness and less bitterness if the substituent number on C-13 was closer to that on C-19. These findings conveyed insights into how to modify steviol glycosides to enhance their quality as sweeteners.

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Exposure to unpleasant tastes leads to disturbances of interdigestive gastric myoelectrical activity (GMA) and may affect sympathetic/parasympathetic balance (SPB). We made a careful study to determine whether taste stimulation modulates the postprandial GMA, SPB, and gastric emptying (GE) of a solid meal. Eighteen healthy volunteers (9F/9M) entered the study. On six separate days, we recorded a four-channel electrogastrogram from each volunteer during a 35-min fasting period, then for 90 min after ingestion of a solid test meal of 300 kcal. GE was measured using a 13C-octanoic acid breath test. Heart rate variability (HRV) analysis was simultaneously performed. At the start of the 21st min after the test meal, subjects received an agar cube delivering either a sweet, salty, sour, or bitter taste, which they kept in the mouth for 35 min. Control procedures involved sessions performed with a tasteless agar cube, and without any stimulation. There was no effect of the experimental intervention upon the relative power share of particular GMA rhythms. Stimulation with the salty and the bitter taste evoked a statistically significant increase in the dominant frequency, whereas the sweet and sour taste did not affect it. Taste stimulation did not interfere with the meal-induced rise in the dominant power, nor affect slow wave coupling. The kinetics of the solid GE remained unchanged by the intervention. None of the taste stimulations affected the postprandial SPB. Taste stimulation elicited after ingestion of a meal, in contrast to that during a fast, did not adversely modify the postprandial pattern of either the GMA or SPB, nor affect the GE of solids.

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Spicy-food intake has been shown to affect various human physiological systems and diseases. This study tested the analgesia effect caused by stimulation of a spicy sensation (spicy stimulation) and explored the effect of spicy-food consumption on human basal pain sensitivity. A total of 60 healthy undergraduates were included in the primary study. Placebo and sweet stimulation were used as reference interventions. Pressure and cold-pain thresholds were measured before and after taste stimulation. The frequency of spicy-food intake was also evaluated. An additional 100 subjects were recruited to validate the results. Compared to placebo stimulation, both pressure and cold-pain thresholds increased during spicy stimulation (P < .05). The increased thresholds remained, even when the taste stimulation residue was nearly eliminated (P < .05). The pressure (10.0 [2.1] vs 12.7 [3.0] kg/cm2, P < .001) and cold-pain (4.4 [1.6] vs 6.2 [2.7] seconds, P = .003) thresholds in subjects who consume spicy food ≥3 days/week were significantly lower than in those who consume it <3 days/week. In the validation population, the frequency of spicy-food intake was negatively associated with subjects' pressure (ß = -.218, P = .013) and cold-pain (ß = -.205, P = .035) thresholds. Spicy stimulation has an analgesia effect on adults that persists even after the taste stimulation stops. Conversely, a long-term spicy diet can reduce the human basal pain threshold. TRIAL REGISTRATION: The study protocol was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Army Medical University, People's Liberation Army (identification No., 2017-023-01), and it was registered on the Chinese Clinical Trial Registry at www.chictr.org.cn (No. ChiCTR1800015053). PERSPECTIVE: This study directly examined the effects of stimulation of a spicy sensation on adult pain sensitivity and was the first to explore the relationship between long-term spicy-food intake and human pain sensitivity. The results provide evidence for future clinical pain intervention and individualized pain treatment.

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Non-food gustatory stimulation has multiple potential therapeutic benefits for people with dysphagia and xerostomia. This study examined palatability and saliva flow associated with dissolvable flavored films. Taste strips with real-food flavors dissolved on the tongues of 21 persons with dysphagia and/or xerostomia and 21 healthy age- and sex-matched adults while sublingual gauze pads absorbed saliva over randomized 3-min trials. Participants rated taste enjoyment for each trial on a hedonic general labeled magnitude scale. Flavored strips elicited more saliva than baseline for both groups, and production was higher for controls than patients (M = 2.386 and 1.091 g, respectively; p = 0.036). Main effects of flavor were observed for saliva production (p = 0.002) and hedonics (p < 0.001). Hedonic ratings and saliva production were weakly correlated (r = 0.293, p < 0.001). Results support dissolvable taste strips as a tool for providing low-risk taste stimulation in dysphagia and for eliciting an increase in saliva flow that may provide temporary relief from dry mouth symptoms. The preferred flavors were, on average, also the ones that elicited greater saliva production. Taste strips have the potential to be beneficial for swallowing-related neural activity, timing, and safety in dysphagia. Further, they may ameliorate complications of xerostomia.

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Objective To determine the effects of early taste stimulation care in comatose patients with severe traumatic brain injury (STBI). Methods Sixty patients with severe STBI who had been in coma for more than 6 hours and Glasgow Coma Scale (GCS) scored 5-8,were divided into two groups according to random digit table. The control group received conventional care, while the taste stimulation group received both conventional care and early taste stimulation intervention.They were assessed according to GCS at 10, 20 and 30 days after treatment. Results After the intervention, the GCS scores in the taste stimulation group were higher than those of the control group after 20 days (10.70±0.48 vs 8.65±0.58, t=2.714, P<0.05) and 30 days (11.70 ± 0.49 vs 9.60 ± 0.57, t=2.792, P<0.05). Conclusions Early taste stimulation care has a certain wake-promoting effect on comatose patients with STBI.

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PURPOSE: The aim of this study was to compare saliva flow and protein composition induced using five basic taste stimulations between natural and bioengineered salivary glands. MATERIALS AND METHODS: We developed a mouse saliva secretion model using taste stimulation and analyzed the saliva secretion from natural and bioengineered salivary glands using an assay. The protein components and alpha-amylase in the natural and bioengineered saliva were analyzed by gel electrophoresis and Western blotting. RESULTS: The salivary flow responses induced by sour (citric acid) and bitter (quinine-HCl) stimuli were significantly high in the natural and bioengineered salivary glands. Although the protein concentrations in the natural and bioengineered saliva induced using five basic taste stimulations were similar, the protein composition and the amylase concentration in the natural saliva after taste stimulation had different profiles. Sympathetic and non-sympathetic nerves were observed around the acini and ducts in the natural and bioengineered salivary glands. However, the frequency of neuropeptide Y-positive sympathetic nerves in the bioengineered gland was relatively high compared to that in the natural gland. CONCLUSIONS: These results suggest that the signal balance between the sympathetic and parasympathetic components of the efferent nerves in an engrafted bioengineered salivary gland may differ from that in a natural salivary gland.

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