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      Higher Body Mass Index Is Associated with Subjective Olfactory Dysfunction

      research-article
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      Behavioural Neurology
      Hindawi Publishing Corporation

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          Abstract

          Background. Morbidly obese patients demonstrate altered olfactory acuity. There has been no study directly assessing Body Mass Index (BMI) in patients with olfactory dysfunction. Our purpose was to compare BMI in a group of patients with subjective olfactory dysfunction to those without subjective olfactory complaints. Methods. Retrospective matched case-control study. Sixty patients who presented to a tertiary care otolaryngology center with subjective smell dysfunction over one year were identified. Neoplastic and obstructive etiologies were excluded. Demographics, BMI, and smoking status were reviewed. Sixty age, gender, and race matched control patients were selected for comparison. Chi-square testing was used. Results. 48 out of 60 patients (80%) in the olfactory dysfunction group fell into the overweight or obese categories, compared to 36 out of 60 patients (60%) in the control group. There was a statistically significant difference between the olfactory dysfunction and control groups for this stratified BMI ( p = 0.0168).   Conclusion. This study suggests high BMI is associated with olfactory dysfunction. Prospective clinical research should examine this further to determine if increasing BMI may be a risk factor in olfactory loss and to elucidate what role olfactory loss may play in diet and feeding habits of obese patients.

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          Most cited references21

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          A novel multigene family may encode odorant receptors: a molecular basis for odor recognition.

          The mammalian olfactory system can recognize and discriminate a large number of different odorant molecules. The detection of chemically distinct odorants presumably results from the association of odorous ligands with specific receptors on olfactory sensory neurons. To address the problem of olfactory perception at a molecular level, we have cloned and characterized 18 different members of an extremely large multigene family that encodes seven transmembrane domain proteins whose expression is restricted to the olfactory epithelium. The members of this novel gene family are likely to encode a diverse family of odorant receptors.
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            Physiological role of pleasure.

            M Cabanac (1971)
            A given stimulus can induce a pleasant or unpleasant sensation depending on the subject's internal state. The word alliesthesia is proposed to describe this phenomenon. It is, in itself, an adequate motivation for behavior such as food intake or thermoregulation. Therefore, negative regulatory feedback systems, based upon oropharingeal or cutaneous thermal signals are peripheral only in appearance, since the motivational component of the sensation is of internal origin. The internal signals seem to be complex and related to the set points of some regulated variables of the "milieu interieur," like set internal temperature in the case of thermal sensation (15). Alliesthesia can therefore explain the adaptation of these behaviors to their goals. Only three sensations have been studied- thermal, gustatory, and olfactory, but it is probable that alliesthesia also exists in such simple ways as in bringing a signal, usually ignored, to the subject's attention. For example, gastric contractions, not normally perceived, are felt in the state of hunger (16). Since alliesthesia relies on an internal input, it is possible that alliesthesia exists only with sensations related to some constants of the "milieu interieur" and therefore would not exist in visual or auditory sensations. As a matter of fact, luminous or auditory stimuli can be pleasing or displeasing in themselves, but there seems to be little variation of pleasure in these sensations, that is, no alliesthesia. There may be some esthetic value linked to these stimuli but it is a striking coincidence that they are in themselves rather neutral and that it is difficult to imagine a constant of the "milieu interieur" which could be possibly modified by a visual or an auditive stimulus-such as light of a certain wavelength or sound of a given frequency. In the light of this theory, it is possible to reconsider the nature of the whole conscious experience. The existence of alliesthesia implies the presence of internal signals modifying the concious sensations aroused from peripheral receptors. It is therefore necessary to question the existence of sensations aroused by direct stimulation of central receptors, such as hypothalamic temperature detectors, osmoreceptors, and others. Does their excitation arouse sensations of their own, or does the sensation have to pass through peripheral senses? Only human experimentation could answer this question. In the same way, it is possible that selfstimulation of the brain is pleasant, not by giving a sensation in itself, but because the electrical stimulus (17), renders peripheral stimuli pleasant.
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              Screening for and management of obesity in adults: U.S. Preventive Services Task Force recommendation statement.

              Update of the 2003 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for obesity and overweight in adults. The USPSTF reviewed new evidence on the benefits and harms of screening and primary care–feasible or referable nonsurgical weight-loss interventions. The USPSTF recommends screening all adults for obesity. Clinicians should offer or refer patients with a body mass index of 30 kg/m(2) or higher to intensive, multicomponent behavioral interventions (B recommendation).
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                Author and article information

                Journal
                Behav Neurol
                Behav Neurol
                BN
                Behavioural Neurology
                Hindawi Publishing Corporation
                0953-4180
                1875-8584
                2015
                25 June 2015
                : 2015
                : 675635
                Affiliations
                Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA 30308, USA
                Author notes

                Academic Editor: Luigi Ferini-Strambi

                Article
                10.1155/2015/675635
                4496469
                92e237e4-8276-4f5c-999e-27e44da121a0
                Copyright © 2015 Z. M. Patel et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 March 2015
                : 8 June 2015
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                Research Article

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