Food Liking and Craving: A Cross-cultural Approach

Abstract-The notion that eating chocolate would prevent or treat hypertension is appealing to many who produce and enjoy chocolate. Several studies have documented beneficial effects of dark chocolate on insulin action and endothelial function. However, the published studies on chocolate and blood pressure include a relatively small number of subjects, and results are conflicting. In addition, because of secrecy surrounding the production of chocolate and the unique sociocultural context of this popular food, research on efficacy and effectiveness is complex. 4 Prehypertension is associated with a 3.0-fold greater likelihood of progression to hypertension and 1.4-to 2.0-fold greater risk for cardiovascular events than normal blood pressure (BP) Ͻ120/Ͻ80 mm Hg. 5 Lifestyle changes are foundational management for all hypertensive patients and the only management option recommended for most prehypertensives. 4 Hypertension and prehypertension are associated with a cluster of risk factors, including abdominal obesity, hyperinsulinemia, insulin resistance, and vascular dysfunction. 6 -8 Although several lifestyle changes, for example, the Dietary Approaches to Stop Hypertension Eating Plan, 4 are efficacious for lowering BP and improving other risk factors, their effectiveness is limited. In fact, Americans are becoming progressively heavier and their diets less like the Dietary Approaches to Stop Hypertension diet over time. 9,10 Thus, simple and effective lifestyle changes, which would be adopted and maintained by a large proportion of prehypertensives, could reduce the burden of prehypertension and hypertension. Dark chocolate/cocoa may be an intervention that could be implemented and maintained by a large proportion of at-risk individuals. 11 A diverse evidence base suggests that cocoa lowers BP while improving insulin sensitivity, vascular function, and cardiovascular outcomes. 12,13 Cocoa, BP, and Cardiovascular Disease: An Ecological Perspective The Kuna Indians live on the San Blas Islands off Panama. They consume large quantities of cocoa, and, despite high sodium intake, have a low prevalence of hypertension. Their BP does not rise with age. 14 Kuna Indians who migrate to Panama manifest age-dependent increases of BP and a higher prevalence of hypertension than Kuna Islanders. Thus, Kuna are not genetically protected from hypertension. Kuna Islanders consume Ϸ10 times more cocoa than those in Panama and have Ϸ80% less cardiovascular disease. On the basis of this and other evidence, Corti et al 11 proposed that flavanols, especially epicatechin, in cocoa lower BP and improve vascular function and insulin sensitivity while reducing platelet reactivity. Chocolate Within a Sociocultural ContextCacao was first brewed as a beer in Mesoamerica Ͼ3000 years ago. 15 The Spanish brought cocoa to Europe where local tastes required adding sugar to and heating the cocoa drink. The development of cocoa powder by the Dutch, pralines by the Belgians, and conching to produce smoother chocolate by the Swiss all contributed t...

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“…Spaniards, for example, like white chocolate more than Americans. 17 Chocolate processing is also associated with national …”

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confidence: 99%

Does Dark Chocolate Have a Role in the Prevention and Management of Hypertension?

Egan

Laken²,

Donovan³

et al. 2010

Hypertension

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“…In both the United States and Spain, women crave sweet foods most frequently, whereas men crave mainly savory foods (543,623,823). This sex difference may be related to the sex difference in sweet hedonics discussed below.…”

Section: R1226 Sex Differences In the Physiology Of Eatingmentioning

confidence: 97%

Sex differences in the physiology of eating

Asarian

Geary²

2013

American Journal of Physiology-Regulatory, Integrative and Comp

414

349

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(HPG) axis function fundamentally affects the physiology of eating. We review sex differences in the physiological and pathophysiological controls of amounts eaten in rats, mice, monkeys, and humans. These controls result from interactions among genetic effects, organizational effects of reproductive hormones (i.e., permanent early developmental effects), and activational effects of these hormones (i.e., effects dependent on hormone levels). Male-female sex differences in the physiology of eating involve both organizational and activational effects of androgens and estrogens. An activational effect of estrogens decreases eating 1) during the periovulatory period of the ovarian cycle in rats, mice, monkeys, and women and 2) tonically between puberty and reproductive senescence or ovariectomy in rats and monkeys, sometimes in mice, and possibly in women. Estrogens acting on estrogen receptor-␣ (ER␣) in the caudal medial nucleus of the solitary tract appear to mediate these effects in rats. Androgens, prolactin, and other reproductive hormones also affect eating in rats. Sex differences in eating are mediated by alterations in orosensory capacity and hedonics, gastric mechanoreception, ghrelin, CCK, glucagon-like peptide-1 (GLP-1), glucagon, insulin, amylin, apolipoprotein A-IV, fatty-acid oxidation, and leptin. The control of eating by central neurochemical signaling via serotonin, MSH, neuropeptide Y, Agouti-related peptide (AgRP), melanin-concentrating hormone, and dopamine is modulated by HPG function. Finally, sex differences in the physiology of eating may contribute to human obesity, anorexia nervosa, and binge eating. The variety and physiological importance of what has been learned so far warrant intensifying basic, translational, and clinical research on sex differences in eating.neuroendocrinology; estrogens; testosterone; eating disorders; obesity SEX DIFFERENCES ARE PERVASIVE in physiology and medicine (51,64,73,109,110,466,797,826). The controls of eating and energy homeostasis are no exceptions. It was observed approximately 100 years ago that removal of the ovaries leads to marked accretion of adipose tissue in rats (697), that daily food intake expressed as kilocalories per gram body weight differs between male and female rats (778), and that food intake varies regularly through the ovarian cycle in intact female rats (674, 779). Sex differences in eating have been the subject of physiological research ever since. The clinical relevance of this work is increasingly evident. In the United States, women are approximately threefold more vulnerable than men to psychiatric eating disorders (346,351) and approximately twofold more vulnerable to severe and morbid obesity (BMI Ն 35 and 40 kg/m 2 , respectively, mass/height 2 ) (226). Women also appear to suffer more from these disorders in terms of physical and psychological functioning and quality of life (24,84,273,292,465,531,762). The increased obesity burden suffered by women is reflected in the fact that Ͼ80% of bariatric surgery patients in the U...

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“…In one study, chocolate accounted for 49% of all food cravings reported by a sample of 25 healthy women (101). Greater chocolate craving has been reported among women than among men (193,212,289) particularly during the perimenstrual period (27,212,288), and a significant but small decline in cravings may occur after menopause (108). However, this association may be at least partially explained by cultural factors, as suggested by the work of Zellner et al (288).…”

Section: A Chocolate Cravingmentioning

confidence: 98%

Cocoa and Chocolate in Human Health and Disease

Katz

Doughty

Ali

2011

Antioxidants & Redox Signaling

346

256

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Cocoa contains more phenolic antioxidants than most foods. Flavonoids, including catechin, epicatechin, and procyanidins predominate in antioxidant activity. The tricyclic structure of the flavonoids determines antioxidant effects that scavenge reactive oxygen species, chelate Fe2+ and Cu+, inhibit enzymes, and upregulate antioxidant defenses. The epicatechin content of cocoa is primarily responsible for its favorable impact on vascular endothelium via its effect on both acute and chronic upregulation of nitric oxide production. Other cardiovascular effects are mediated through anti-inflammatory effects of cocoa polyphenols, and modulated through the activity of NF-jB. Antioxidant effects of cocoa may directly influence insulin resistance and, in turn, reduce risk for diabetes. Further, cocoa consumption may stimulate changes in redox-sensitive signaling pathways involved in gene expression and the immune response. Cocoa can protect nerves from injury and inflammation, protect the skin from oxidative damage from UV radiation in topical preparations, and have beneficial effects on satiety, cognitive function, and mood. As cocoa is predominantly consumed as energy-dense chocolate, potential detrimental effects of overconsumption exist, including increased risk of weight gain. Overall, research to date suggests that the benefits of moderate cocoa or dark chocolate consumption likely outweigh the risks. Antioxid. Redox Signal. 15, 2779-2811.

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Food Liking and Craving: A Cross-cultural Approach

Cited by 131 publications

References 23 publications

Does Dark Chocolate Have a Role in the Prevention and Management of Hypertension?

Does Dark Chocolate Have a Role in the Prevention and Management of Hypertension?

Sex differences in the physiology of eating

Cocoa and Chocolate in Human Health and Disease

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