Children with otitis media may be predisposed to changes in taste, obesity

Shin I. Arch Otolaryngol Head Neck Surg. 2011;137:242-246.

Chronic otitis media with effusion has been associated with a change in taste, which may contribute to pediatric obesity, according to a study published online.

Il Ho Shin, MD, of the department of otolaryngology and head and neck surgery, School of Medicine, Kyung Hee University, Seoul, South Korea, and colleagues conducted a case-controlled study in which 42 children with chronic otitis media with effusion (COME) who had undergone a tympanostomy tube insertion in their inner ear were compared with 42 children who did not have COME. The researchers tested the children’s taste thresholds. Chemical taste tests were done using the four standard taste solutions: salt, sugar, citric acid and quinine hydrochloride.

Results demonstrated that children in the COME group had a significantly higher BMI than the children from the control group. The COME group also showed increased taste thresholds on the anterior part of the tongue compared with the control group. The sweet and salty taste thresholds were also elevated for children in the COME group.

The researchers concluded that because of the higher thresholds for salty and sweet foods, children with COME likely eat saltier and sweeter food to experience the same taste sensation as children who do not have COME. This could lead to increases in calorie intake, as well as increased fat deposition and fluid retention, which ultimately would result in obesity.

Disclosure: The researchers report no relevant financial disclosures.

Shin and colleagues studied changes in taste function and obesity in 42 South Korean children aged 3 to 7 years with chronic otitis media with effusion (COME) and a similar aged group of controls. The children with COME were defined as those who underwent placement of ventilating tubes because of 3 months of OME; controls were 4 to 7 years of age without history of OME who underwent tonsillectomy or adenoidectomy for snoring or other reasons unrelated to otitis media.

The results were of interest: BMI was significantly higher in the COME than in the control group; and electrogustometry showed that there were higher taste thresholds in the COME than in the control group. Inflammation is now recognized as a common pathway for many different disease states and physiologic changes. Is it possible that inflammation associated with a chronic respiratory conditions (eg, COME) may be associated with inflammation related to obesity? Is it possible that the chronic inflammation induced by COME is related to stimulation of the chorda tympani nerve, which controls taste? The authors refer to a prior publication in which they reported that BMI and serum total cholesterol concentrations were significantly higher in children with COME than in controls. These are areas of investigation that are new to me, and I suspect to most of my colleagues interested in otitis media, and suggest a need for corroboration in children of different racial and ethnic groups. Who knew that middle ear disease and obesity might have a common inflammatory pathway.

-Jerome Klein, MD

Infectious Diseases in Children Editorial Board member

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