Oral chemoreception of fatty acids and the association with diet and fatty food preferences may enable the identification of mechanisms involved with the development of obesity and why dietary changes may be difficult for many individuals.
Emerging evidence from a number of laboratories indicates that humans have the ability to identify fatty acids in the oral cavity, presumably via fatty acid receptors housed on taste cells. Previous research has shown that an individual's oral sensitivity to fatty acid, specifically oleic acid (C18:1) is associated with body mass index (BMI), dietary fat consumption, and the ability to identify fat in foods. We have developed a reliable and reproducible method to assess oral chemoreception of fatty acids, using a milk and C18:1 emulsion, together with an ascending forced choice triangle procedure. In parallel, a food matrix has been developed to assess an individual's ability to perceive fat, in addition to a simple method to assess fatty food liking. As an added measure tongue photography is used to assess papillae density, with higher density often being associated with increased taste sensitivity.
Excessive dietary fat consumption is a potential contributor to weight gain1-3 and obesity has become a modern day global epidemic. Research suggests higher levels of fat intake, particularly as part of an ad libitum diet, may be associated with a higher BMI2,3, however the factors influencing dietary fat consumption and preference are far from clear. Searching for the mechanisms which underlie fat consumption is therefore an obvious goal and of particular interest is an oral mechanism responsible for fat detection, commonly termed 'fatty acid taste'2.
From an evolutionary standpoint, the taste system presumably served as a gatekeeper of the digestive system, guiding the consumption of energy dense nutrients and expulsion of potentially toxic compounds4. The sense of taste is elicited through specialized taste receptor cells which are distributed within three types of tongue papillae; fungiform, foliate, and circumvallate papillae, which can each contain up to several hundred taste buds5. In addition to the widely accepted five prototypical tastes (sweet, salty, sour, bitter, and umami), it is not entirely surprising that there has been suggestion of an oral mechanism for detecting fat, or more likely their breakdown products fatty acids6.
Previous research has consistently shown fatty acids can be detected in the oral cavity over a range of concentrations7-11, despite the fact that it is not a 'taste' in the traditional sense, as it has no single discernible perceptual quality associated with it (i.e. sweet)12. Work from our laboratory has highlighted functional implications of impaired fatty acid chemoreception, namely on body weight and dietary fat consumption. Those who are less able to detect fatty acids (hyposensitive) appear to have a higher body mass index (BMI) and consume more energy9, while a relationship between oral fatty acid sensitivity and dietary fat consumption has also been observed; that is, fatty acid hyposensitive individuals have been shown to consume more animal fats, including, meat, high fat dairy, and fatty spreads all of which are been implicated as contributors to weight gain13. Additionally, individuals who are more sensitive to fatty acids appear to be better equipped at differentiating between samples with varying fat contents9. While other research groups have failed to find similar associations10,14,15, this growing area of research remains intriguing.
These individual differences in fatty acid chemoreception appear to be somewhat modulated by environmental factors, including diet. Habitual fat intake has been associated with impaired oral fatty acid chemoreception and consequently, a heightened preference for, and increased consumption of dietary fat16. In addition to gustatory adaptation, the gastrointestinal tract (GI) also appears responsive to such changes in fat intake17 and impaired GI fatty acid sensitivity may be implicated in the inability to generate appropriate satiety signaling responses which discourage excess energy consumption18.
In addition to environmental factors, fatty acid chemoreception may also be dictated by genetic or physiological differences between individuals, including the concentration of fungiform papillae density (and presumably taste receptors) on an individual's tongue19. Higher density of fungiform tongue papillae has been linked to heightened oral sensitivity for numerous orally detected compounds including 6-n-propylthiouracil (PROP)20, sugar21, and salt22, while others have also noted an association with creamy perception23. PROP supertasters (who presumably have a higher number of fungiform papillae) are able to distinguish high fat from low fat salad dressings24 and are able to discriminate the fat content and creaminess of dairy foods more accurately than non-tasters23,25. At this stage however, the relationship between fungiform papillae density and oral fatty acid 'taste' detection is unknown.
At the basis of human oral fatty acid chemoreception research is the application of various sensory techniques. Identifying individual variability in oral fatty acid detection is a major focus and largely depends on the determination of fatty acid detection thresholds, that is, the lowest point at which fatty acid is able to be detected in solution9. While the specific testing method and stimulus vehicle used varies across the literature and between research groups, the typical procedure involves presenting a participant with a set of emulsified fatty acid and control (no fatty acid) solutions and identifying which is the 'odd' sample. Here we present an established, reliable and reproducible method for threshold determination10 using emulsified milk solutions and an ascending forced choice triangle procedure.
The extent to which oral fatty acid sensitivity influences diet, namely consumption of fatty foods, and the ability to perceive fat in foods is also of interest and here we also report on two additional established techniques to further extend our understanding of fatty acid chemoreception. Fatty food liking can be identified by providing individuals with samples of commercially available foods, with both a regular and a low-fat option who are asked to indicate liking of each16. In regards to fat perception, a fat ranking task has been developed by our laboratory, designed to evaluate an individual's ability to detect fat in custard, a typical food matrix16. To evaluate genetic or physiological differences between individuals, a commonly used tongue photography method involves staining, photographing and quantifying fungiform papillae26. While using this technique in fatty acid research is in its infancy, increasing application, especially in both lean and overweight/obese population groups may help to identify inherent causes of excess fat consumption.
The following techniques have been approved for use by the Deakin University Human Research Ethics Committee.
1. Demographics and Anthropometry
2. Producing Samples for Oral Fatty Acid Threshold Assessment
C18:1 concentration (mM) | μl/100 ml |
0.02 | 0.56 |
0.06 | 1.9 |
1 | 31.5 |
1.4 | 44.1 |
2 | 63.1 |
2.8 | 88.4 |
3.8 | 119.9 |
5 | 157.8 |
6.4 | 202 |
8 | 250 |
9.8 | 309 |
12 | 380 |
20 | 631.2 |
Table 1. Example C18:1 concentration per 100 ml solution. Increasing concentrations (µl/L) of C18:1 are used to prepare the series of 13 emulsions for oral fatty acid threshold testing.
3. Oral Fatty Acid Threshold Testing
Figure 1. Ascending forced choice triangle procedure used for determining fatty acid detection thresholds. Participants are provided with three solutions (two control solutions and one C18:1 solution at a given concentration) and asked to identify the 'odd sample'. If correct, participants are given a second set of samples with the same C18:1 concentration. If incorrect, the participant is provided with another set of samples with a higher concentration of C18:1. This procedure continues until three 'odd' solutions are correctly identified at a given concentration. This point is deemed the individuals 'fatty acid detection threshold'.
4. Fat Ranking Task
This task involves participants tasting four samples of instant custard, each with different fat contents (0, 2, 6, and 10%) and ranking them in order of perceived ascending fat concentration.
Ranking order | Score |
0, 2, 6, 10 | 5 |
2, 0, 6, 10 | 4 |
0, 2, 10, 6 | 3 |
0, 6, 2, 10 | 2 |
1, 6, 10, 2 | 1 |
6, 0, 2, 10 | 1 |
2, 10, 6, 0 | 1 |
2, 6, 0, 10 | 0 |
6, 2, 10, 0 | 0 |
0, 10, 2, 6 | 0 |
Table 2. Fat ranking task scoring. Participants are given 4 samples of custard with 0, 2, 6, or 10% fat added. Participants are asked to rank samples from lowest to highest fat content and score 0 to 5 points (5 being the maximum).
5. Fatty Food Liking
Figure 2. Hedonic gLMS. The hedonic gLMS30,31 used to assess liking of both regular and low fat commercially available foods. Participants taste and rate each sample and place a vertical line at the point which best represents their like, or dislike of the sample.
6. Tongue Photography
Figure 3. A) Tongue photography setup. Demonstration of the table setup required prior to tongue photography. B) Tongue photography. Demonstration of the tongue photography method
Figure 4. Quantifying fungiform papillae density. Location of the 6-mm area for fungiform papillae assessment. Using photography editing software, numerical figures indicate each fungiform papilla.
The methods detailed above are important as some emerging evidence has indicated that impaired fatty acid chemoreception in the oral cavity and GI tract may be associated with increases in BMI and the development of obesity17. Several studies have used the described protocols to investigate oral fatty acid detection and our recent publication has shown the method is both reliable and reproducible10. Studies using this methodology have been able to reliably determine individual's oral fatty acid detection thresholds by identifying the point at which participants are able to detect a difference between milk samples9. After three testing sessions utilizing this protocol, Stewart et al.9 found that the mean detection threshold for C18:1 was 2.2 ± 0.1, with detection thresholds ranging from 1-6.4 mM (see Figure 5). More recently, we have established a C18:1 detection threshold range from 0.26-12 mM, (mean: 2.64 ± 0.7 mM)10. These results support the notion that fatty acids can be detected in the oral cavity, and that marked individual differences in sensitivity to C18:1 exist. Based on these results, we are able to classify individuals as hypersensitive or hyposensitive to C18:1. Hypersensitive individuals are able to correctly identify C18:1 <3.8 mM, while hyposensitive subjects require concentrations >3.8 mM. Research from our laboratory has found oral sensitivity to C18:1 is associated with dietary fat consumption and BMI (Figure 6), where C18:1 hyposensitive individuals consume more saturated and animal fats and have a higher BMI13. Interestingly, in a study conducted by Stewart and Keast16, it was found that consuming a low fat diet resulted in increased sensitivity to C18:1 for both lean and overweight participants (Figure 7). However, this study also found that when participants consumed a high fat diet, lean individuals had reduced sensitivity to C18:1, while overweight individuals had no change in taste sensitivity (Figure 8). This suggests that habitually consuming a high fat diet, which is more likely for overweight individuals, may result in attenuated fatty acid chemoreception28. However, as there were no differences in baseline sensitivity between lean and overweight participants, these results may indicate that lean individuals are simply more susceptible to dietary changes regarding fat intake. This may also suggest that it was the presence of the specific intervention (high- vs low-fat) that may have influenced outcomes, rather than habitual diets, which may or may not have been different to the intervention diet. Despite this, this study indicates that there are some fundamental differences between lean and overweight individuals regarding fatty acid taste sensitivity, which requires further investigation.
Figure 5. C18:1 taste detection thresholds. Marked variability has been shown in sensitivity to C18:1 with participants able to detect C18:1 across a range of concentrations (1 mM-6.4 mM).
Figure 6. C18:1 taste detection thresholds and association with BMI. An association between the ability to detect C18:1 and body composition has been shown, whereby those with higher detection thresholds (hyposensitive individuals) have significantly higher BMI values (P = 0.002, r2= 0.467).
Figure 7. C18:1 detection thresholds following a low fat diet. Following 4 week consumption of a low fat diet, C18:1 detection thresholds increased for both lean and obese individuals.
Figure 8. C18:1 detection thresholds following a high fat diet. Following 4 week consumption of a high fat diet, lean individuals displayed reduced sensitivity to C18:1 (P = 0.006), while overweight individuals demonstrated no change (P= 0.609).
Similarly to the impact of diet on detection thresholds for fatty acids, there is research to suggest that food liking may be plastic and altered by exposure. For example, it appears that a high fat diet increases preference for a higher fat product, with the opposite occurring following consumption of a low fat diet16. However, these changes have not been consistent in the literature. It appears that changes to preferences are mediated by the length of time the individual has been adhering to a high or low-fat diet. Specifically, Mattes29 found significant changes in participant food preferences after 12 weeks on a reduced fat diet, while Stewart and Keast16 found only sporadic and marginal changes after four weeks on a similar diet. Consuming a high fat diet altered participant preferences for yogurt, with preferences for low-fat yogurt increasing, converse to expected results (Baseline (BL): 19.44 ± 5.73, Week 4 (WK4): 21.94 ± 5.21, P = 0.046). Further, after four weeks on a low-fat diet, preferences for low-fat butter increased in all participants (BL: 6.23 ± 4.26, WK4: 7.32 ± 3.04, P = 0.046). Preferences for low-fat yogurt increased for lean participants only (BL: 2.51 ± 3.26, WK4: 3.68 ± 4.94, P = 0.07) while preferences for low-fat mousse decreased for all participants (P = 0.01).
The ability to detect fat in foods is assessed by asking participants to taste and rank a series of custards with differing fat contents. Fat perception is identified based on how well participants were able to rank the samples. Fat perception has been known to change with diet, for example, following a low fat diet has resulted in improvements to participant's performance in correctly identifying and ranking the degree of fat in each custard sample11. Furthermore, it appears that there is an association between sensitivity to C18:1 and identification and ranking of fat content4. Indeed, individuals who were hypersensitive to C18:1 performed significantly better on the fat ranking task (4.3 ± 0.6) compared to hyposensitive individuals (2.3 ± 0.1, P = 0.02) (scores are out of a maximum of five)9. This indicates that individuals who are more sensitive to fatty acids were also better at differentiating between the four varying fat concentrations in custard. While there was a trend for performance to improve after consuming the low-fat diet for four weeks, this was not a significant change (BL: 1.3 ± 0.3, WK4: 2 ± 0.3, P = 0.077)16.
Papillae density i.e. the number of papillae (and hence taste buds) present on the tongue varies between individuals and is indicative of taste function. Higher fungiform papillae density has been linked to heightened taste sensitivity, for compounds including sucrose21 and the bitter substance PROP20. Tongue papillae density, as determined by tongue photography, varies considerably between subjects. For example, Zhang et al.21 found that there were significant individual differences between participants, ranging from a concentration of 7.07 ± 0.35/cm2 to 233.43 ± 0.00/cm2 (data was for a single participant), whereas others26 have found a mean fungiform papillae concentration to be 156.00 ± 5.86/cm2. Further, it has been found that papillae can appear significantly differently in structure between individuals, with variation in height, width, and shape,21 though limited evidence regarding the possible implications of these differences. Given previous findings linking papillae number with taste sensitivity, it is plausible that a similar relationship may also exist for oral fatty acid sensitivity, whereby those who are more orally sensitive to fatty acids may have a higher density of taste papillae and therefore a higher number of oral fatty acid receptors. While this association is yet to be established, it presents a novel area of research may help implicate the underlying mechanisms guiding the over consumption of fat.
The techniques described for determination of oral fatty acid thresholds, fatty food liking, and tongue papillae density have been validated and used in a number of published works in recent years and we suggest oral fatty acid threshold assessment, the fat ranking task and fatty food liking be performed in duplicate at each relevant time point in a study. There has been some discussion regarding the optimum method for assessing detection thresholds32. In particular, the composition of solutions used varies between laboratories, as does the methodology itself. Specifically, the fatty acid used in this protocol, C18:1, we believe is a generally representative and easy to use fatty acid, as opposed to other fatty acids, including linoleic acid (C18:2) and lauric acid (C12:0), which have been used previously9. C18:1 is commonly found in the food supply and unlike C12:0 is liquid at RT, and is more resistant to oxidation than C18:29. C18:1 has also been shown to provide reliable data across multiple testing sessions, and is highly correlated with C18:2 and C12:010. Furthermore, C18:1 has been examined extensively throughout relevant literature, and is thus more helpful for comparisons.
A major point of difference between the protocol outlined within the present paper and other procedures used in other laboratories are the vehicles used for presenting fatty acid stimuli and the systematic approach by which detection thresholds are determined. Two major fatty acid vehicles used within the literature are non-fat milk10,17 and water emulsions6. While both have demonstrated efficacy for fatty acid threshold determination, participants may be more likely to identify the taste of fat within milk, that is, it is unusual to taste fatty acids in water, which may result in lower levels of external validity for studies utilizing a water base. Non-fat milk provides a vehicle for fatty acid chemoreception, without compromising validity. Although these two methods are yet to be directly compared in the literature, it is known that fatty acids are poorly soluble in water33. As a result of fatty acid solubility in milk-based solutions, this emulsion could both be kept longer and be more homogenous than water-based solutions, though this is yet to be confirmed. When implementing this methodology, it is important to note free fatty acids may be naturally present in milk34 and consequently, the product should be used well within its expiry to prevent the increase of free fatty acids (which develop with age) and potential interference with taste threshold performance. Successful preparation of the solutions depends on numerous factors. Firstly, the order in which the 'ingredients' are added is imperative. Vehicle preparation steps should carefully follow those outlined earlier to ensure proper vehicle composition and a stable emulsion. Secondly, temperature must be controlled for. Each sample must be presented to participants at RT to ensure participants do not detect the 'odd sample' due to factors other than 'taste'. Finally, all samples must be correctly homogenized for the suggested period of time. While the emulsion of fatty acids and no-fat milk is more effective than if water were to be used, there is still a chance of emulsion separation within the sample.
The specific testing method used in oral fatty acid threshold determination must also be considered. Two sensory-based methods have been commonly described in the literature; one being the ascending forced choice triangle procedure and the alternate, the staircase method35. The ascending forced choice triangle methodology is an established method for taste threshold determination and can be considered useful for several reasons, including the fact that, unlike the staircase method, the ascending method begins with the lowest concentration of C18:1 (0.02 mM) and increases until the participant is able to detect the presence of fatty acid in solution9. Conversely, the staircase method involves increasing or decreasing the fatty acid concentration from a predetermined midpoint11. However, starting a threshold determination at a point above threshold may cause a desensitization of response impairing ones tasting ability. Further, the ascending method has a lower probability of random chance influencing results (3.7%) compared with the staircase method (11.1%)11. As such, we suggest the ascending forced choice triangle method, combined with non-fat milk as a vehicle for taste testing appears to be an effective means of accurately determining oral thresholds.
Food acceptance or liking testing is one of the more straightforward assessments performed within sensory research and as such there are few problems that tend to arise. However, the type of liking scale used is an important focus. In this case, a hedonic gLMS is the most effective, as it has good discriminatory power and is easy for participants to use36. The end points of the hedonic gLMS are labeled with the descriptors 'strongest imaginable dislike' and 'strongest imaginable like' and participants evaluate liking against all hedonic experiences, not solely foods30,31. This is effective in controlling for ceiling effects produced by standard 9-point scales, as all experiences are considered and compared. Further, the hedonic gLMS is more able to demonstrate greater individual variance, as the scale is broader36. Food acceptance testing itself may be limited by the foods presented, in that we only present two options per food type. Further research may include several more brands or types of each food, each with differing fat contents, or perhaps specifically made products where fat content can be controlled and is the only variable. It is important to note that the interpretation of all data must be done with caution. While a potential link between liking, preference and intake is plausible and intriguing, results are generated within a laboratory environment and there may be limits to the applicability of these findings to real-world situations.
Assessing papillae density through tongue photography is a more difficult process, with specific steps that must be taken in order to produce appropriate and applicable results. In particular, it is important to identify the correct papillae type. Three types of taste papillae are visible on the human tongue; fungiform, foliate and circumvallate4. Fungiform papillae can however be easily distinguished as mushroom-shaped structures26, and are generally the papillae that are recorded during sensitivity assessments. Fungiform papillae tend to range in concentration from 5-60 per 6-mm area37 (depending on sensitivity), though there have been studies indicating that some individuals may have upwards of 230 papillae the same area21. The type of camera used is fundamental to obtaining appropriate results and may account for this variability. Prior to the use of digital photography in this area, videomicroscopy was the gold standard for identifying and recording papillae density. However, it has been determined that the same level of identification is possible using an appropriate digital camera26. Further, digital photography takes only several minutes, where videomicroscopy may take up to an hour26. Not only this, but digital photography has the potential to be far less costly, and more portable, which may be helpful for use with various participant groups26. Finally, while we aim to measure fungiform papillae density for associations with oral fatty acid detection, we also suggest taste thresholds for the five prototypical tastes also be performed in parallel. Given previous linkage with papillae density and taste function, this could serve as an additional 'checking measure' which may add integrity to the data, especially given this is a new area of research.
The area of oral chemoreception research, particularly regarding fatty acids, is an emerging one, and as such it is important for all research to be performed to a high standard, preferably with the use of consistent protocols to allow for direct comparisons.
The authors have nothing to disclose.
The authors would like to acknowledge the support of the Australian National Health and Medical Research Council and Deakin University. The work performed at the Deakin University Sensory laboratory was supported by the National Health and Medical Research Council Grant (1043780)(RSJK) and Horticulture Australia Limited (BS12006)(RSJK).
Name of Material/ Equipment | Company | Catalog Number | Comments/Description |
Gum Arabic TIC Pretested PRE-HYDRATED FT Powder | Alchemy Agencies Ltd. NZ | CFR# 21 CFR 184.1330 | Food grade agrigum |
EDTA (Ethylenediaminetetraacetic acid) | Merck | 1.08418 0250 | Disodium salt dehydrate |
L4RT Homogenizer | Silverson Longmedow, MA | L4RT | |
Liquid Paraffin | Fauldings | No catalog number as liquid paraffin is a regular consumable product | |
Nikon AF-S VR Micro Nikkor 105mm f/2.8G IF-ED camera lens | Nikon | 2160 | |
SLIK Sprint Pro II tripod | Slik Corporation | 611-849 | |
Nikon D90 Digital Camera with LCD Protector | Nikon | BM-10 | |
Nitrogen | |||
Tanita Body Scan Composition Monitor Scales | Tanita, Cloverdale, WA, Australia | BC-551 | |
Seca Stadiometer | Medshop Australia, Fairfield, VIC, Australia | MED435 |