by Wilson, Bee
It is extremely rare to have, like Abi, anosmia from birth. What is far more common is to develop anosmia later in life, often after a head injury (though it may also be caused by sinusitis, nasal polyps, dementia, chemotherapy, stroke, liver disease, or sometimes for no clear reason at all). At a conference organized by the anosmia support group Fifth Sense in the spring of 2014, anosmia sufferers spoke of how doctors were often dismissive of their condition: “Be thankful you’re not deaf ” was a common refrain. But it’s hard to be thankful for a malady that separates you from the food memories that define so much of who you believe yourself to be. One woman at the conference, who had been in a cycling accident, talked about how her marriage had broken down after she became anosmic. Her relationship could not survive her inability to share her husband’s continuing pleasure in food. Before the accident, they had both loved throwing dinner parties, and her husband couldn’t understand that elaborate cooking now did nothing for her. Every meal was a cruel reminder of what she had lost. The predicament of those who are born with anosmia is that they can’t share the pleasurable food memories that the rest of us have. The predicament of those who develop anosmia later in life is that they have the memories, but no means to access them. They are cut off from their own past.
It was a bright spring day in San Francisco in 2011 when Marlena Spieler, a food writer with more than twenty cookbooks to her name, was knocked down by a car at a crossing. Both of her arms were broken and she suffered a concussion. As the initial excruciating pain gradually lessened, Marlena—a sunny optimist with Marilyn-platinum hair—noticed another injury, which to her was far worse than the broken limbs. The head trauma had damaged the nerve connecting to her olfactory bulb—the part of the brain that interprets flavor—and she could no longer enjoy food. Coffee had been one of Marlena’s great pleasures since she was very young. Now it was tasteless. “Cinnamon drops, a childhood favorite, were bitter, horrible,” she wrote in the New York Times. “Tamales were as bland as porridge. Bananas tasted like parsnips and smelled like nail polish remover.” As for chocolate, it was “like dirt.”
I got to know Marlena in 2002 on a press trip to Parma, Italy, organized by the consortium of producers of Prosciutto di Parma. For three days we ate ribbons of pink salty ham at every meal, and Marlena, with great California ebullience, talked about the foods she loved the most. These were long—very long—conversations. She spoke of artichokes and lemons, earthy dried mint and pungent truffles, bread and cheese, and how she would rather be in Italy than anywhere else in the world. She ate with a dainty slowness, as if trying to extract the essence from each bite.
After the accident, she could still perceive the heat of pungent spices such as mustard, Aleppo pepper, or cinnamon, because her trigeminal nerve, the part of the body that tingles when you eat hot food, was not damaged. But without the flavor to offset it, the tingling sensation was offensive. Her beloved cinnamon felt abrasive. Meanwhile, she developed new cravings—for intensely sweet desserts and for fish. When I first knew Marlena, she was indifferent to desserts and hostile to fish. Now, suddenly, she had yearnings for smoked mackerel and anchovies. She also developed a very sweet tooth. A scientist working on flavor and the brain told her that this might be because she could no longer detect the qualities in fish and sweets that had previously disgusted her. They only seemed desirable because she couldn’t recognize the ways they had once repelled her.
People sometimes speak of anosmia as “loss of taste,” but damage to the taste buds themselves is actually very rare. More than 90 percent of cases of taste-related disorders involve a weakening or loss of the sense of smell. The taste buds in our mouths only supply a fraction of the complex pleasures that we enjoy as “flavor.” The rest is perceived via our noses, through something called retronasal olfaction. We smell coffee by breathing in—is any scent better than a warm bag of freshly ground beans? But we taste a cup of coffee by smelling it backward, or retronasally. The hundreds of chemical compounds that go together to make up the flavor of a particular blend and roast of coffee travel to the backs of our mouths and sneak through the nasopharyngeal passage into the nasal cavity. As we sip and swallow, we are not conscious that the splendid flavors—the nuttiness of the roast, the notes of cherry and peach—are created in the nose, not the mouth. This spectrum of retronasal joy is lost to anosmia sufferers. All they have left is the harsh and basic tongue-notes of sweet, sour, bitter, and salty. Like Abi Millard enjoying a salty gammon steak, anosmia sufferers often seek out extremely salty or sweet foods to compensate for the loss of flavor.
Anosmia is a surprisingly common problem—as many as 2 million people in the United States have some form of smell or taste disorder. It is not a trivial disability. The ability to pick out the jasmine aroma in a cup of espresso, or to spot the difference between grapefruit and pomelo, might seem of little importance to anyone except food writers. But medicine and neuroscience are now starting to recognize that anosmia can be an extremely traumatic condition, and not just because of the danger in emergencies of not detecting the smell of smoke or gas. Sufferers often end up depressed and malnourished. Without flavor, the motivation to eat is lost. When nothing can be smelled, there is a yearning for familiar tastes that can never be satisfied. Christmas goes by without the background aroma of turkey or spice; summers are no longer marked by the perfume of strawberries and cut grass. Sufferers often describe it as a deep loss. Duncan Boak, the founder of Fifth Sense, who became anosmic after a head injury, said that he feels as if he were looking at life through a pane of glass.
Part of what is missing for the anosmia sufferer is the safe place of childhood, a place to which the rest of us can return whenever we eat the foods we have always loved. A couple of years after the accident, Marlena Spieler found that glimmers of her former responsiveness to flavor were returning. Depending on the level of damage to the brain, some anosmia sufferers do recover. Marlena slowly trained herself to love chocolate again, starting with the blandest milk chocolate and working up to 70 percent cocoa solid dark chocolate. Occasionally, her morning coffee gave her pleasure rather than just blankness. We met for lunch at an Italian restaurant and she seemed to be doing well, exclaiming over the blood-orange slices in our cocktails and nibbling on a deep-fried sage leaf. But even as her flavor perception was improving, she continued to feel unsettled. It wasn’t just that food tasted bad. It was that—she told me—she no longer felt quite “like Marlena.” As she explained to the BBC Radio 4 Food Programme, our sense of taste is something that anchors us to the person we have always known ourselves to be: “Your world has a certain taste. Your mother makes something a certain way. You’re used to certain flavours in your life and if you take that away, you start saying, ‘Who am I?’”
Memory is the single most powerful driving force in how we learn to eat; it shapes all of our yearnings. Sometimes the memories are very short-term ones—for instance, whether or not we’ve just eaten. In one study, when a profoundly amnesiac patient was offered another meal only minutes after he had completed the first, he willingly took it. Minutes after that one, he ate a third meal. Only when a fourth meal was offered did he refuse, telling the experimenters that his “stomach was a little tight.” This suggests that having a conscious memory of our last meal matters as much as hunger in determining how much we eat.
For most of us, though, the food memories that really matter go much further back. You may not be able to remember what you had for lunch last Tuesday, but I bet you can recall the habitual meals of childhood, the breakfast you were given for a weekend treat, and the way bread tasted in your house. These are the memories that still have emotional force years or even decades later.
Such memories, conscious or unconscious, are what drive us to seek out the old habitual foods—particularly packaged foods—even if, judged objectively, they do not really taste nice or do our bodies any good. Experiments have been done with rats and mice where the animals were given dopa
mine blockers, drugs that interfere with the part of the brain that governs reward. These drugs take away much of the chemical reward of eating food. Yet the dopamine blockers do not extinguish the rodents’ food-seeking behavior, at least not straightaway. At first, the animals continue to press the lever (or run through the alleyway, or whatever the task might be) and eat the pellets, even though the dopamine blocker means that the food no longer offers the same gratification. Next, they carry on pressing the lever to earn the pellets, but do not eat them. Finally they stop pressing the lever, indicating that at last their desire for the pellets has gone away. The interesting thing is that it takes so long for the desire to fade. As the neuroscientist Roy A. Wise has observed, it is only when “the memory of the reward is degraded through experience that the desire is lost.” The craving for the pellets is more a function of memory than of how they taste. Memory propels human food urges in much the same way. As we traverse the supermarket aisles in a trance-like state, we are like rats in an alleyway, steered to this or that food by memories of rewards long gone.
One of the reasons that we do not usually think of our tastes as learned is that most of the learning tends to happen in the very early years of life—and then it stops. For those of us who believe in personal development, it is depressing to learn that a person’s food “likes” at age two generally predict their tastes at twenty. In 2005, researchers in Turkey interviewed nearly seven hundred undergraduate students and their mothers. The mothers were asked about their children’s eating habits when they were two, and the students were asked about how they ate at the time of the experiment. There was a remarkable continuity between past and present. The students who were “picky eaters” as children still described themselves as picky eaters. The ones whose mothers recalled that they always ate too much still did so. And the three people in the study who “never” ate vegetables as children still had no vegetables in their diet. So much for putting aside childish things.
When we talk of memory and food, we generally assume that nostalgia is a phenomenon that occurs late in life—as when Marcel Proust was transported to his youth by a madeleine dipped in lime-blossom tea. But food-memory is there from the start. Even babies have nostalgia! It’s a large part of how we learn to eat. The foods parents give to babies provide them with powerful memories that trigger lasting responses to certain flavors. This process begins before birth. We are all born with echoes of our mother’s diet, which means that no one is a totally blank slate when it comes to flavor. We arrive predisposed to respond to certain foods by our experiences in utero.
It’s hard to know what newborns think about taste, since we can’t exactly ask them. Or rather, they can’t exactly answer. But in 1974, the Israeli doctor Jacob Steiner realized that babies’ reactions to the basic tastes of sweet, sour, salty, and bitter could be gauged by their facial expressions, which are vivid and mobile, even in the first week. Steiner took babies just a few hours old and offered them a range of tastes on a cotton swab, filming their facial expressions. When given salt, which you’d think might make them cry, the babies, surprisingly, showed little reaction, continuing to look expressionless (a liking for salt only emerges later, around four months). But all of the other basic mouth-tastes produced strong reactions. The sour swab made the babies pucker their lips. Bitterness provoked an expression of abject distress and an open mouth, as if trying to spit or vomit it out. As for the sweet swab, Steiner found that it produced a dreamy look of “relaxation” with an “eager licking of the upper lip” and even a “slight smile”—and this at an age when babies are not supposed to be capable of smiling. Such is the power of sugar.
The test has since been repeated many times, with similar results. What it confirms is that, as we have seen, all human babies, from Sweden to China, have a strong innate preference for sweetness and a dislike of bitterness and sourness. Basic tastes are not a question of memory—we are hardwired to think sweetness is wonderful and bitterness is scary. No one has to learn these simple tongue reactions. But flavor is another matter. Flavors—these memories generated backward through our nose—are all learned. What we think about flavor in all its myriad forms, from toasted cumin to sea bass, from parsley to spaghetti carbonara, is not fixed. Each of us will have a different bank of memories and feelings about these; and it exists from day one, if not before.
Taste buds appear at seven or eight weeks of gestation. Already, by thirteen to fifteen weeks, the taste buds are mature. A thirteen-week-old fetus weighs maybe an ounce, with no fat under the skin, no air in the lungs. Yet already he or she cannot only swallow but taste, and these sips of fluid leave memories.
In 2000, some French scientists did a remarkable experiment showing that newborns arrive in the world with a memory of how their particular amniotic fluid tasted. The mothers studied came from the Alsace region, where strong-tasting anise sweets are a local delicacy. Some of the women had eaten anise regularly during pregnancy, but some had not. The babies were tested straight after birth and again four days later, having tasted nothing outside the womb but milk. When an anise odor was wafted in front of them, the babies born to anise-eaters showed a marked and “stable” preference for anise. They turned their heads toward the anise smell, sticking their tongues out with a licking gesture. They remembered it, and apparently, it pleased them.
Further experiments have confirmed that other strong flavors, such as garlic, can also find their way into amniotic fluid. In one study, women agreed to swallow garlic capsules forty-five minutes before they were due for an amniocentesis; when it was tested, their amniotic fluid smelled garlicky. Babies born to voracious garlic eaters will have been floating in a sac of garlic water for nine months. It has been shown that babies exposed to garlic before birth are more likely to enjoy garlic in food later on. Likewise, mice whose mothers had been fed on artificial sweeteners when pregnant had an exaggerated taste for sweetness. Pregnant rats fed on junk-food chow—including savory snacks, sweetened cereals, and chocolate-hazelnut spread—had babies who also selected these foods over regular rodent pellets, though the babies’ preference for junk was lessened if the mothers switched to a healthier diet during lactation.
The flavors our mothers ingest most regularly can become like mother’s milk to us. Julie Mennella and Gary Beauchamp, biopsychologists working at the Monell Chemical Senses Center in Philadelphia, have done a series of experiments on how flavor in utero and in breast milk leaves children with lasting memories and preferences for certain foods. One of their most celebrated studies, from 2001, involved carrot juice. The babies of a group of mothers who drank carrot juice during the last trimester of pregnancy and again during the first two months of breastfeeding were predisposed to like the flavor of carrot. When the babies were weaned onto solid food, several months after the mothers stopped drinking the carrot juice, they showed a marked preference for cereal flavored with carrot juice over plain cereal flavored with water.
The early exposure of babies to flavor—both in utero and through milk—works as a kind of “imprinting,” as Gary Beauchamp puts it. We become emotionally attached to these early aromas. As we saw in Chapter 1 with the “flavor window,” younger babies are more open than older ones to new tastes. When it comes to weaning, this is an argument—as we saw in Chapter 1—for ignoring the advice on exclusive breastfeeding for six months and offering early, varied bites of vegetable purees between four and six months. When it comes to the pre-food stage, however, flavor may be one of the strongest arguments for mothers attempting to breastfeed, at least for the first few months, and eating as varied a diet as possible while doing so. Some psychologists suggest that instead of saying to mothers, “Breastfeed for the baby’s good,” health-care advisers should say, “Breastfeed for your own good,” because if you do, you are likely to have a baby who is less fussy to deal with in the early stages of eating. Then again, I’ve known children (not my own) who’ve gone from formula milk at four months to black olives and spina
ch tart at twelve months, so it doesn’t always follow.
It is curious that we talk so little about the flavor of formula, given that it is the main thing many babies taste during that crucial first year. Because any given brand of formula milk does not vary, it seems to have an even greater “imprinting” power than breast milk. Babies who cannot tolerate regular cow’s-milk formula are sometimes given a special “hydrolysate” formula, whose proteins have been broken down (hydrolyzed) to make them more digestible. To adult tastes, these formulas taste especially nasty, with a sour cheesy tang and a strange hay-like odor. Mennella and Beauchamp followed children who had been fed with two different hydrolysate formulas. Objectively, both of these milks tasted equally unpleasant. But to the infants, the particular formula they had been assigned—sour or not—taught them how food should taste. When the two brands were switched round, the infants drank less: they preferred their own bad-tasting formula to the other one. More strikingly still, children aged four and five who had been fed on these sour-tasting hydrolysates as babies showed more positive feelings about sour tastes and smells than children who had been fed on breast milk or regular formula. This is vivid proof that anything can start to taste good if you have enough positive memories of being fed it by a parent. The obvious implication is that formula-fed babies would benefit from having their milk flavored with vegetables.
Formula can never match the myriad benefits of breast milk, which range from lessening the risk of eczema and ear infections to reducing the likelihood of type 2 diabetes later in life to promoting healthy gut microbiota. But in the developed world, as we’ve seen, most mothers are unable or unwilling to breastfeed exclusively for the first six months. With each of my own babies, I gave it up for one reason or another (illness, work, bereavement, and a child with feeding difficulties) at three months. During the wait until one year, when they were old enough for regular whole cow’s milk, I’d have been glad to buy formula that was mildly scented with a range of green vegetables, just enough to give them a memory of spinach when the time came for them to try them for real.