ArticleFrontiers in nutrition2026
Pediatric oncology patients prefer cocoa over oral nutritional supplements in a double-blinded feeding-trial.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Background: Malnutrition is a common problem during the treatment of pediatric cancer. Therapy-induced taste alterations (dysgeusia) can further exacerbate this and may reduce the acceptance of oral nutritional supplements (ONS). There are no available data on the acceptability of commercially available ONS among children and adolescents in Germany. Methods: In a prospective, double-blind tasting trial, 36 pediatric oncology patients (6-20 years) evaluated commercially available ONS and a cocoa-based reference beverage. The primary outcome was overall liking (taste rating) on a 1-6 ordinal scale (1 = excellent; 6 = unacceptable). Additional assessments included ratings of appearance and temperature, perceived basic taste qualities, and free-text flavour descriptions. Using linear mixed models, beverage taste ratings were compared globally and pairwise (adjusted for multiple comparisons), and sensory characteristics associated with higher acceptance were explored. Results: Cocoa was rated best overall (mean taste rating 1.42 ± 0.7) and significantly outperformed all tested ONS in taste (Bonferroni-corrected Conclusion: Among patients in pediatric oncology, receiving chemotherapy, cocoa was consistently preferred over commercially available high-energy ONS. While cocoa served as a highly accepted reference beverage, the findings highlight the importance of flavour characteristics for acceptance. Strategies focusing on flavour optimization of nutritionally complete supplements may help improve oral intake during therapy. In addition to fruit-based beverages, cocoa-based formulations - particularly when combined with energy enrichment approaches - may represent a practical and cost-efficient strategy to support oral nutritional intake when acceptance of standard ONS is limited.
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