1. Introduction
Coffee and tea are the two most frequently consumed hot drinks in the world [
1]. Other widely consumed hot drinks include herbal infusions, hot chocolate, and mate. These drinks are obtained by solid–liquid extraction (coffee, tea, mate, etc.) or by dissolution using a solvent (example: hot chocolate and instant coffee). In any case, their preparation involves the use of a solvent that is heated to a very high temperature, most often water. For example, brewing coffee requires water with a temperature ideally between 85 and 95 °C [
2]. At the end of the preparation, the temperature of the drink is lower than that of the given solvent. However, the temperature remains very high. In the catering industry, the recommended temperature for keeping drinks warm is between 85 and 88 °C [
2]. According to Brown and Diller [
3], hot beverages such as tea, hot chocolate, and coffee are frequently served at temperatures between 71.1 and 85 °C. These results were corroborated by data from a lawsuit against a fast food restaurant chain in the United States that showed that coffee that caused burns was dispensed at a temperature between 75 and 88 °C [
4]. Furthermore, Verst et al. [
4] showed that the average serving temperature of coffee approximately two minutes after preparation varied between 66 and 77 °C depending on the given machine and the context (household or food service industry). Hot drinks are not always consumed directly after preparation. The time between the preparation and the introduction of hot drinks into the mouth allows for cooling. This drop in temperature depends on several factors such as the initial temperature of the drink, the time between preparation and its introduction into the mouth, the thermal properties of the container, the ambient temperature, and the amount of other added substances such as milk and cream. [
3]. When consumers deem the temperature satisfactory, the hot drinks are taken into the mouth and consumed. In practice, this consumption is sometimes preceded by a test phase intended to estimate the risk of burns. Several studies have made it possible to determine the temperature that is considered to be ideal by consumers. For coffee, which has been frequently studied, the ideal temperature seems to be between 60 and 70 °C [
2,
4,
5,
6]. For tea or mate, the preferred temperature seems to be close to 70 °C [
6]. However, the temperature that is considered ideal varies across consumers. In fact, in a cohort study involving more than 40,000 regular tea drinkers, Islami et al. [
7] showed that 39.0% of participants drank their tea at a temperature below 60 °C, 38.9% drank it between 60 and 64 °C, and 22.0% drank it at more than 65 °C.
The introduction of hot drinks into the mouth causes an increase in the temperature in the tissues of the tongue, the oral cavity, and then the esophagus. The temperature increase at the surface of the tissues primarily depends on the temperature of the liquid, contact time, and the thermal conductivity of the exposed surfaces. Lee et al. [
8] showed that coffee at a temperature of 60 °C could increase the surface area temperature of the tongue to 53 °C. This temperature is above the threshold for the emergence of pain on the tongue surface, which is approximately 46–48 °C [
6,
8]. The fact that the preferred temperature exceeds the threshold temperature for pain could be explained by the short residence time of the hot drink and by the phenomenon of habituation [
6,
8,
9]. To our knowledge, there have been no experimental studies concerning burns on the surface of the tongue caused by heat from liquids in the mouth. However, there are data on the epidermis from other parts of the body. According to Borchgrevink et al. [
2], 45 °C is the equilibrium point of the skin. Below this exposure temperature, there is no damage. Between 45 and 51 °C, the rate of cell destruction doubles for every degree of Celsius. Between 60 and 65 °C, the destruction rate is 10 million times higher than it would be at a temperature of 45 °C. Above 70 °C, the destruction of the cells is complete, even for contact times of less than 1 s [
6]. In addition, a mathematical model that accounted for the specific characteristics of the external tissues of the tongue (mucosa) was developed by Brown and Diller [
3] with the objective of simulating burns and quantifying the extent of thermal damage. When applied to drinking coffee, this model indicated that a temperature of 57.8 °C limits the risk of burns while maintaining consumer satisfaction.
The usual temperatures for serving and consuming hot drinks are therefore within a temperature range liable to cause cellular damage in the oral cavity, including on the tongue. After examining more than 1000 observational and experimental studies, a working group from the International Agency for Research on Cancer (IARC) came to the conclusion that drinking very hot beverages at temperatures above 65 °C is probably carcinogenic to humans [
1,
10]. It was also specified that it is the temperature of the liquid and not the nature of the liquid that is in question. Taken together, these findings indicate that very hot drinks can constitute, to some extent, a physical aggression on the cells of the oral cavity, including the tongue.
It is well-known that taste is fundamentally important for food selection. Thus, it appears essential that the taste buds function normally in order to properly perceive this characteristic of foods. Therefore, we thought it would be interesting to know whether hot drink consumption could have an impact on taste sensitivity. Surprisingly, no study has yet addressed this topic. Nevertheless, the papillae containing the taste buds are primarily expressed on the dorsal surface of the tongue [
11], especially on the anterior two-thirds of the tongue [
12]. This position makes the papillae particularly vulnerable since the tip of the tongue is, along with the lips, the first part of the body that is in direct contact with hot drinks. This part of the tongue is also the one that is most often involved in taste dysfunctions [
12]. The life span of human taste buds is approximately ten days, with a range of 3–30 days. Normally, taste buds appear to degenerate and regenerate at the same rate [
13]. However, we wonder if the aggression represented by regular exposure to very hot drinks could influence their renewal rate or more generally disrupt their normal functioning and simultaneously reduce the ability to perceive tastes. In this case, the taste capacities of consumers who were accustomed to drinking very hot beverages should be lower than that of consumers accustomed to lower temperatures.
Among the factors having an impact on taste sensitivity, apart from illnesses or medical treatment, are gender and age. The literature regarding differences in sensitivity between men and women has been contradictory. Some studies have shown a greater taste sensitivity for women [
12,
14,
15], while other studies have shown no significant difference [
16]. Additional data are needed on the subject. The effect of age is much clearer. Two comprehensive literature reviews clearly showed that taste abilities decline with age [
16,
17]. In any event, there is a clear consensus on the need to consider these factors when assessing taste sensitivity.
This article presents the results of a study conducted to assess the possible negative influence of consuming very hot drinks on the ability to perceive tastes. Our hypothesis was that subjects who drink very hot liquids would exhibit a lower taste sensitivity than subjects who drink liquids at lower temperatures. We also hypothesized that a high frequency of consumption would be an aggravating factor. The aim of the study was to evaluate the taste sensitivity of a group of 82 subjects and to characterize their hot drink consumption habits. We then studied the links between these two datasets. We focused our attention on the most frequently consumed drink. In fact, due to the high frequency of the consumption of this drink, it constitutes the bulk of the risk associated with high temperatures. We considered age and sex of participants in the analyses as factors of variation due to their recognized influence on taste sensitivity [
16,
17].
2. Materials and Methods
2.1. Subjects
The 82 subjects who participated in this study were all part of a larger panel recruited for a research project called Taste and Oral Microbiota (TOM). They were all normal-weight nonsmokers, did not follow any long-term drug treatment (lasting more than one month), had not taken antibiotics or antiseptic mouthwashes, and had received no dental care in the 30 days preceding the experiment. In addition, for the purposes of the present study, they all consumed at least one of the following hot drinks: coffee, tea, herbal infusions, or hot chocolate (at least 2 times/week). The panel was composed of 42 women and 40 men aged 18–65 (mean: 42; median: 43 years old). The sex ratios (number of men/number of women) for the 18–35, 36–50, and 51–65 age groups were 0.8, 1.0, and 1.1, respectively. All the subjects signed a consent form and were compensated with up to 30€ for their participation. A competent ethics committee approved the protocol for the taste sensitivity assessment (Comité de Protection des Personnes Ouest V, n ° 2016-A01954-47).
2.2. Study Design
Figure 1 shows the general design of the study. For each taste, three measurements were performed with a one-week interval, always between 10 and 11 a.m. During one session, all five tastes were tested. The order of evaluation for the different tastes varied according to Williams’ Latin square. The first and third taste sensitivity measurements took place in our laboratory in a room dedicated to the study of oral physiology. These sessions were individual and always performed by the same investigator. The stimulated saliva flow was measured during these two laboratory sessions. The second measure of taste sensitivity was performed at home, during the second week of the study, without the presence of the investigator. The material needed for the test (see
Section 2.3.1) was given to the subjects at the end of the first laboratory session. Responses to the sensitivity test were given via an internet questionnaire. The objective of this measurement performed at home was to assess the ability to perform such measures outside the laboratory without making people move in the future. Finally, the subjects completed an internet questionnaire on hot drink consumption habits after the end of the sensitivity measurements.
2.3. Taste Sensitivity Test
For the taste sensitivity evaluation, we chose to focus on the ability to perceive low concentrations close to the detection threshold. This type of measurement is very often used in clinical studies to detect taste dysfunctions [
18]. The sensitivity test used in this study made it possible to specifically stimulate the first third of the tongue (regional test). This type of test was suitable for our purpose because this part of the tongue is the first to come into contact with hot liquids when they are introduced into the mouth. In addition, this area is the most involved in taste dysfunction [
12].
We assessed the sensitivity for the five basic tastes. Fructose for sweet taste (CAS: 57-48-7, Cooper, France), sodium chloride for salty taste (NaCl, CAS: 7647-14-5, Cooper, France), citric acid for sour taste (CAS: 5949-29-1, Cooper, France), quinine hydrochloride for bitter taste (Quinine HCl, CAS: 6119-47-7, Merck KGaA, Germany), and monosodium glutamate for umami taste (MSG, CAS: 6106-04-3, Merck KGaA, Germany) were used as the prototypical taste compounds. These five molecules were all of food or pharmacopoeia qualities. We chose fructose for technical reasons (the viscosity of the solutions to be printed; see
Section 2.3.1).
2.3.1. Material
The sensitivity test used here, called T@sty, was in the form of several edible test sheets, each allowing for one sensitivity measurement to a given taste. Each test sheet consisted of six triplets of detachable precut discs to be placed in contact with the tongue (
Figure 2a). The triplets all consisted of one tasty disc and two neutral discs. The tastants, which were in a solution of deionized water, were printed on the surface of the discs (wafer paper) using a food-grade inkjet printer. The position of the tasty disc varied randomly depending on the triplets and the test sheets. The surface concentration of the tastant and the intensity of taste gradually increased from the first to the sixth triplets. Distilled water was printed in the same manner on the neutral discs to make them look the same as the tasty discs. Several pretests made it possible to determine the appropriate concentrations leading to a discriminating test. The pretests consisted of carrying out several preliminary studies involving 60–200 subjects and observing the distribution of the scores obtained. The concentrations were adjusted until a distribution close to a Gaussian distribution was obtained. The final surface concentrations were as follows: 2.1, 2.7, 4.1, 7.1, 16.1, and 35.4 µg/cm
2 (fructose); 4.9, 5.2, 5.6, 6.7, 8.8, and 12.6 µg/cm
2 (NaCl); 3.6, 4.1, 5.6, 9.5, 17.1, and 24.7 µg/cm
2 (citric acid); 2.9, 9.5, 19.2, 48.8, 98.3, and 133.5 ng/cm
2 (quinine HCl); and 1.1, 1.6, 3.79, 19.6, and 29.6 µg/cm
2 (MSG).
2.3.2. Test Principle
For each test sheet, and thus for each taste, the subjects had to successively evaluate the six triplets, starting with the triplet located at the top of the sheet and then moving downwards. The lowest concentration was used for the triplet numbered 1, and the highest concentration was used for the triplet numbered 6. For example, we used the following concentrations for the tasty disc for fructose triplets 1–6, respectively: 2.1, 2.7, 4.1, 7.1, 16.1, and 35.4 µg/cm
2. For each triplet, the subjects had to successively taste the three discs, from left to right, and then indicate the tasty disc (forced choice). The name of the tested taste was indicated on the support. The subjects therefore knew which taste was being tested. However, because some weakly concentrated tastants were known to sometimes have a different taste quality than expected at higher concentrations, the subjects were informed that if there was any doubt about the perceived sensation, they should find the disc that was different from the other two.
Figure 2b shows how to taste a disc. The evaluation took less than five minutes per taste sheet. Rinsing with water followed by a 3-min break (return to normal salivation) was imposed between the different test sheets dedicated to the different tastes. Training samples were used during the first session to familiarize the subjects with the procedure and the stimulus to be perceived (consisting of a reduced test sheet with a single triplet of discs). The maximum surface concentration of the range was used for the tasty disc of this triplet.
2.3.3. Sensitivity Score
Figure 3a schematizes the rule for determining the sensitivity scores. This approach was based on the best estimate threshold (BET) method described in standard E679-19 [
19], with the difference that the result of the test was not expressed as a concentration but as a sensitivity score ranging from 0 to 6. The higher the score was, the more the given subject exhibited a good ability to detect low concentrations of the given tastant. The average of the three replicates was used to determine the sensitivity of the subjects (
Figure 3b).
2.4. Questionnaire on Hot Drink Consumption Habits
The participants completed an internet questionnaire regarding their hot drink consumption habits. The objective of this questionnaire was to determine, for each subject, the most frequently consumed drink (named “favorite hot drink” in this document) and its usual temperature level at consumption.
The four hot drinks selected for this study (coffee, tea, herbal infusions, and hot chocolate) were the most frequently consumed in France during the winter (the period studied for the survey). For each drink, the subjects were asked to specify (i) the frequency of consumption (number of units/cups per day, week or month) and (ii) the usual temperature of consumption (lukewarm, medium hot, very hot, or boiling). The participants were informed that they had to answer all the questions by considering the last four months as a reference period (i.e., from December to March—the winter season). The questions were asked with the following phrasing: (i) During the last four months, how often did you drink each of the drinks below (coffee, tea, herbal infusions, and hot chocolate)? (ii) At what temperature do you prefer to consume the drinks below (coffee, tea, herbal infusions, and hot chocolate)?
2.5. Salivary Flow
Unstimulated whole saliva was collected by passive drooling into a pre-weighed tube [
20]. This measurement was performed before the taste sensitivity measurement during the two laboratory sessions. Salivary flow was measured as a possible confounder impacting on the primary outcome variable.
2.6. Data Analysis
The data were analyzed with the XLSTAT software (Addinsoft (2020), XLSTAT statistical and data analysis solution, Paris, France.
https://www.xlstat.com, 2021).
2.6.1. Validity of Sensitivity Measurements
The repeatability of the measurements was evaluated by calculating, for each taste, the Pearson correlation coefficients between the sensitivity scores obtained during the three replicates. A significant linear relationship was expected. In addition, for each taste, an ANOVA (type III) was performed to determine whether the scores obtained during the three measurements differed (model: sensitivity score = subject + replicate + error). Tukey’s post-hoc test (significance level set at 0.05) made it possible to identify which replicates differed. For each taste and subject, the average of the three replicates was used for the following analyses.
2.6.2. Interindividual Variability
For each taste, descriptive statistics linked to the distributions of the mean scores made it possible to comment on the interindividual variability.
2.6.3. Link between Sensitivity for the Five Tastes
The Pearson correlation coefficient was used to study the correlations between the scores obtained for the different tastes. A principal component analysis (PCA; biplot representation), which was performed on the correlation matrix, provided a multidimensional representation of the links between the scores obtained for the different tastes.
2.6.4. Hot Drink Consumption Habits
Descriptive statistics were used to comment on the global hot drink consumption patterns (the frequency of consumption and usual temperature level). The Chi2 test was used to compare the frequency of consumption for men and women and for the different age groups in the study.
2.6.5. Influence of Hot Drink Consumption, Age and Sex on Taste Sensitivity
For each taste, a covariance analysis (ANCOVA, type III) was performed with the objective of studying the influence of the consumption frequency (number of units per month) and usual temperature (medium hot or very hot) on taste sensitivity while accounting for participant gender (male/female) and age group (18–25, 26–50, or 51–65 years old). The model was as follows: sensitivity score = temperature level + age group + sex + consumption frequency + error). A 5% threshold was chosen to test the significance of the factors. We considered that p values between 0.05 and 0.01 reflected a trend. For each of the factors, Tukey’s post-hoc test (with the significance level set at 0.05) was used for multiple comparisons of the means. The normalized coefficient from the ANCOVA was used to clarify the direction of the relationship between the consumption frequencies and sensitivity scores.
2.6.6. Salivary Flow
For each subject, the values collected during the two replicates were averaged. The links between the mean flows and the sensitivity scores were investigated using the Pearson correlation coefficient. An ANOVA (type III) was performed to find whether there were significant differences in salivation between men and women on the one hand and between age groups on the other hand (model: flow = age group + sex + error).
5. Strengths and Limitations
To our knowledge, this is the first time that the link between the consumption of very hot drinks and the ability to perceive tastes has been studied. The hypothesis that the consumption of very hot drinks could have a deleterious effect on taste sensitivity was raised from the fact, both simple and strong, that hot drinks are sometimes taken into the mouth at temperatures likely to cause cell damage on the tongue.
For this study, which should be considered a first approach that was intended to give an initial insight into the strength of the studied factors, we chose to evaluate the temperature perceived during the consumption of hot drinks using a questionnaire (self-reported temperature level). The primary reason that guided this choice was the cumbersome nature of the protocols implemented to obtain a reliable objective/instrumental measurement of the consumption temperature [
2,
6,
8], which was accentuated by the number of drinks we targeted (four drinks) and the number of participants involved in our study (
n = 82). For a preliminary test, we preferred the subjective measurement presented in this document.
The risk associated with using self-reported temperature levels is that among subjects who reported drinking “very hot” there were likely many subjects who actually drink their hot drinks at very high temperatures. However, a few subjects who are used to drinking at lower temperatures may have responded “very hot” because they have a high temperature sensitivity or low tolerance to high temperatures. We could have the opposite reasoning for the subjects who declared drinking “medium hot.” However, we believe that this potential bias related to the subjective perception of temperature or tolerance for high temperature is likely to reduce the significance of the links observed between the consumption temperature and sensitivity for sweet and salty tastes—not exacerbate it. Indeed, if our hypothesis concerning the deleterious effect of high temperatures is correct, then the situation that would maximize the significance of this effect would correspond to the case where all the subjects who drink at high/low temperatures, respectively, answer “very hot”/“medium hot.” This is the reason that we are confident about the observed effects, even though we believe that further experimentation is necessary to fully verify these preliminary results.
Several other pieces of evidence suggest that a self-reported temperature level measurement makes sense, although it is not as accurate as an instrumental measurement. First, an IARC report specified that drinking temperature can be considered “hot” between 50 and 65 °C and “very hot” at temperatures above 65 °C [
1,
10]. This indicates that these two terms used in everyday language cover a physical reality. Second, the attribution of a term, for example “very hot,” to qualify the perceived temperature of a food results from a lesson partly based on collective experience, i.e., on the opinions expressed by other people about shared experiences. The use of these terms is therefore probably relatively homogeneous. Moreover, a study conducted by Dirler et al. [
6] showed that, on average, coffee was perceived as “too hot” for temperatures beyond 66 °C, with a standard deviation of 3 °C. This very small standard deviation suggests that the judgments made by the subjects regarding the temperature of their drinks are relatively homogeneous.
Despite these arguments, it would be interesting to extend this study into a similar work based on the instrumental evaluation on the temperatures of hot drinks. These measurements could relate to all the hot drinks consumed to account for a possible additional effect of occasionally consumed drinks. The study could even be extended to solid foods. Indeed, solid foods can also occasionally be vectors of high temperatures. For example, a study by Lachenmeier and Lachenmeier [
37] showed that a slice of 2.5-mm-thick boiled potato with a temperature of 70 °C could cause the tongue temperature to rise to almost 55 °C. Physiological measurements, in particular those intended to compare the state of the papillae and taste buds in consumers of very hot versus moderately hot foods, would provide a better understanding of the origin of the effects observed in this study. Finally, the influence of texture sensitivity on hot drink consumption habits (usual temperature) and the influence of thermal status on taste perception thresholds could be interesting factors to study in future work.