Chocolates and Dental Plaque

A comparison of different kinds of European
chocolates on human plaque pH
by
Verakaki E, Duggal MS.
Department of Paediatric Dentistry,
Leeds Dental Institute, Leeds, England.
Eur J Paediatr Dent. 2003 Dec;4(4):203-10

To investigate the acidogenic response of plaque with various European chocolates of varying cocoa contents. METHODS: 14 subjects participated in the study. On each test day plaque pH measurements were taken at baseline and at 2, 5, 10, 15, 20 and 30 minutes after challenge with the test chocolates or control foods. A plaque sample was removed from the buccal surfaces of posterior teeth representing all quadrants, within 30 seconds. The plaque pH was measured on an ISFET electrode connected to a Sentron 2001 pH system. The test chocolates were: Diet chocolate (DC), Plain European chocolate (PEC 70% cocoa), Plain English chocolate (PenC 34% cocoa), Milk English chocolate (MenC 20% cocoa), Milk European chocolate (MEC 30% cocoa), White chocolate (WC no cocoa), Milk chocolate with hazelnuts (MHC 20% cocoa). 15 g of each chocolate was consumed by the volunteers and 10 ml of 10% sucrose and sorbitol solutions were included as controls. RESULTS: The data were analysed for: minimum pH, area below baseline, area below "critical pH", time spent below "critical pH" and Acidogenic Potential Index (API). DC was found to be significantly different to sucrose and all the other test chocolates, and similar to sorbitol for all the parameters studied. The area below baseline plaque pH was also significantly smaller for PEC (p<0.006)>

Perimenstrual Chocolate

The role of low progesterone and tension as triggers of perimenstrual chocolate and sweets craving: some negative experimental evidence
by
Michener W, Rozin P, Freeman E, Gale L
University of Pennsylvania,
Department of Psychology,
Philadelphia 19104-6196, USA.
Physiol Behav 1999 Sep; 67(3):417-20

Approximately half of the 40-50% of North American women who crave chocolate or sweets do so principally in the perimenstrum, the part of the menstrual cycle surrounding the onset of menstruation. We test two hypotheses about the events that trigger these cravings: 1) the premenstrual drop in progesterone levels; or 2) dysphoria or tension in the perimenstruum. Chocolate craving, sweets craving, and other perimenstrual symptoms were rated daily for six menstrual cycles by a sample of women with severe premenstrual syndrome (PMS). Forty-four women satisfied criteria for cyclicity in chocolate craving, and 44 for sweet craving, determined during the first two cycles. Thirty-four subjects satisfied criteria for craving of both chocolate and sweets. After placebo treatments during the third cycle, subjects were randomly assigned, double blind, to administration of placebo, oral micronized progesterone, or alprazolam (a tranquillizer). Treatments were administered from the beginning of the third week to the second day postonset of menstruation during the fourth to sixth months of study. Neither progesterone nor alprazolam decreased chocolate or sweets craving.

Chocolate Headaches?

A double-blind provocative study
of chocolate as a trigger of headache
by
Marcus DA, Scharff L, Turk D, Gourley LM
University of Pittsburgh,
Pain Evaluation and Treatment Institute,
PA 15213, USA.
dawn@peti.sm.upmc.edu
Cephalalgia 1997 Dec; 17(8):855-62; discussion 800

A provocative double-blind study of headache was performed using chocolate as the active agent and carob as the placebo. The chocolate and carob samples were formulated to duplicate products used in an earlier study (1) in which strong differential effects between the ability of chocolate and carob to trigger headache in migraine were shown. Sixty-three women with chronic headache (50% migraine, 37.5% tension-type, 12.5% combined migraine and tension-type) participated in the study. After 2 weeks of following a diet that restricted vasoactive amine-rich foods, each subject underwent double-blinded provocative trials with two samples of chocolate and two of carob presented in random order. Diaries were maintained by the subjects throughout the study, monitoring diet and headache. The results demonstrated that chocolate was not more likely to provoke headache than was carob in any of the headache diagnostic groups (chi2(2)=0.36, p=0.83). Interestingly, these results were independent of subjects' beliefs regarding the role of chocolate in the instigation of headache (chi2(1)=0.73, p=0.39). Headache diagnosis and the concomitant use of additional vasoactive amine-containing foods were also not associated with chocolate acting as a headache trigger. Thus, contrary to the commonly held belief of patients and physicians, chocolate does not appear to play a significant role in triggering headaches in typical migraine, tension-type, or combined headache sufferers.

Chocolate : food or drug ?

by
Bruinsma K, Taren DL
Arizona Prevention Center,
University of Arizona,
College of Medicine,
Tucson 85719, USA.
J Am Diet Assoc 1999 Oct; 99(10):1249-56

Although addictive behavior is generally associated with drug and alcohol abuse or compulsive sexual activity, chocolate may evoke similar psychopharmacologic and behavioral reactions in susceptible persons. A review of the literature on chocolate cravings indicates that the hedonic appeal of chocolate (fat, sugar, texture, and aroma) is likely to be a predominant factor in such cravings. Other characteristics of chocolate, however, may be equally as important contributors to the phenomena of chocolate cravings. Chocolate may be used by some as a form of self-medication for dietary deficiencies (eg, magnesium) or to balance low levels of neurotransmitters involved in the regulation of mood, food intake, and compulsive behaviors (eg, serotonin and dopamine). Chocolate cravings are often episodic and fluctuate with hormonal changes just before and during the menses, which suggests a hormonal link and confirms the assumed gender-specific nature of chocolate cravings. Chocolate contains several biologically active constituents (methylxanthines, biogenic amines, and cannabinoid-like fatty acids), all of which potentially cause abnormal behaviors and psychological sensations that parallel those of other addictive substances. Most likely, a combination of chocolate's sensory characteristics, nutrient composition, and psychoactive ingredients, compounded with monthly hormonal fluctuations and mood swings among women, will ultimately form the model of chocolate cravings. Dietetics professionals must be aware that chocolate cravings are real. The psychopharmacologic and chemosensory effects of chocolate must be considered when formulating recommendations for overall healthful eating and for treatment of nutritionally related health issues.

Chocolate : the Pleasure and the Pain

Changes in brain activity related to eating
chocolate: from pleasure to aversion
by
Small DM, Zatorre RJ, Dagher A, Evans AC, Jones-Gotman M.
Neuropsychology/Cognitive Neuroscience Unit,
and Northwestern Cognitive Brain Mapping Group,
Northwestern University School of Medicine,
Chicago, IL 60611, USA.
d-small@northwestern.edu
Brain. 2001 Sep;124(Pt 9):1720-33.

We performed successive H(2)(15)O-PET scans on volunteers as they ate chocolate to beyond satiety. Thus, the sensory stimulus and act (eating) were held constant while the reward value of the chocolate and motivation of the subject to eat were manipulated by feeding. Non-specific effects of satiety (such as feelings of fullness and autonomic changes) were also present and probably contributed to the modulation of brain activity. After eating each piece of chocolate, subjects gave ratings of how pleasant/unpleasant the chocolate was and of how much they did or did not want another piece of chocolate. Regional cerebral blood flow was then regressed against subjects' ratings. Different groups of structures were recruited selectively depending on whether subjects were eating chocolate when they were highly motivated to eat and rated the chocolate as very pleasant [subcallosal region, caudomedial orbitofrontal cortex (OFC), insula/operculum, striatum and midbrain] or whether they ate chocolate despite being satiated (parahippocampal gyrus, caudolateral OFC and prefrontal regions). As predicted, modulation was observed in cortical chemosensory areas, including the insula and caudomedial and caudolateral OFC, suggesting that the reward value of food is represented here. Of particular interest, the medial and lateral caudal OFC showed opposite patterns of activity. This pattern of activity indicates that there may be a functional segregation of the neural representation of reward and punishment within this region. The only brain region that was active during both positive and negative compared with neutral conditions was the posterior cingulate cortex. Therefore, these results support the hypothesis that there are two separate motivational systems: one orchestrating approach and another avoidance behaviours.

Chocolate and Prevention of Cardiovascular Disease : A Systematic Review

by Ding EL, Hutfless SM, Ding X, Girotra S.
Nutr Metab (Lond). 2006 Jan 3;3(1):2

BACKGROUND: Consumption of chocolate has been often hypothesized to reduce the risk of cardiovascular disease (CVD) due to chocolate's high levels of stearic acid and antioxidant flavonoids. However, debate still lingers regarding the true long term beneficial cardiovascular effects of chocolate overall. METHOD: We reviewed English-language MEDLINE publications from 1966 through January 2005 for experimental, observational, and clinical studies of relations between cocoa, cacao, chocolate, stearic acid, flavonoids (including flavonols, flavanols, catechins, epicatechins, and procynadins) and the risk of cardiovascular disease (coronary heart disease (CHD), stroke). A total of 136 publications were selected based on relevance, and quality of design and methods. An updated meta-analysis of flavonoid intake and CHD mortality was also conducted. RESULTS: The body of short-term randomized feeding trials suggests cocoa and chocolate may exert beneficial effects on cardiovascular risk via effects on lowering blood pressure, anti-inflammation, anti-platelet function, higher HDL, decreased LDL oxidation. Additionally, a large body of trials of stearic acid suggests it is indeed cholesterol-neutral. However, epidemiologic studies of serum and dietary stearic acid are inconclusive due to many methodologic limitations. Meanwhile, the large body of prospective studies of flavonoids suggests the flavonoid content of chocolate may reduce risk of cardiovascular mortality. Our updated meta-analysis indicates that intake of flavonoids may lower risk of CHD mortality, RR=0.81 (95% CI: 0.71-0.92) comparing highest and lowest tertiles. CONCLUSIONS: Multiple lines of evidence from laboratory experiments and randomized trials suggest stearic acid may be neutral, while flavonoids are likely protective against CHD mortality. The highest priority now is to conduct larger randomized trials to definitively investigate the impact of chocolate consumption on long-term cardiovascular outcomes.

Cafeine, Chocolate, Calcium and Osteoporosis

Is caffeine associated with bone mineral
density in young adult women?
by
Conlisk AJ, Galuska DA.
Biological and Biomedical Sciences Division,
Nutrition and Health Sciences Program,
Emory University,
Atlanta, Georgia 30322, USA.
aconlis@emory.edu
Prev Med 2000 Nov;31(5):562-8

BACKGROUND: By increasing the urinary excretion of calcium, caffeine consumption may reduce bone mineral density (BMD) and subsequently increase the risk for osteoporotic fracture. Although negative associations between caffeine consumption and BMD have been reported for postmenopausal women, in particular for those who consume low amounts of dietary calcium, the relation between caffeine and BMD in younger women is unclear. Therefore, we evaluated the association between caffeine consumption and BMD in a cross-sectional study of 177 healthy white women, age 19-26 years, who attended a Midwestern university. METHODS: Average caffeine intake (milligrams per day) was calculated from self-reports of the consumption of coffee, decaffeinated coffee, tea, colas, chocolate products, and select medications during the previous 12 months (mean caffeine intake = 99. 9 mg/day). BMD (grams per square centimeter) at the femoral neck and the lumbar spine was measured by dual-energy X-ray absorptiometry. RESULTS: After adjusting in linear regression models for potential confounders, including height, body mass index, age at menarche, calcium intake, protein consumption, alcohol consumption, and tobacco use, caffeine consumption was not a significant predictor of BMD. For every 100 mg of caffeine consumed, femoral neck BMD decreased 0.0069 g/cm(2) (95% confidence in terval [CI] = -0.0215, 0. 0076) and lumbar spine BMD decreased 0.0119 g/cm(2) (95% CI = -0. 0271, 0.0033). No single source of caffeine was significantly associated with a decrease in BMD. Furthermore, the association between caffeine consumption and BMD at either site did not differ significantly between those who consumed low levels of calcium (< or ="836">836 mg/day). CONCLUSIONS: Caffeine intake in the range consumed by young adult women is not an important risk factor for low BMD.

Is Cacao a Psychotropic Drug ?

Is cacao a psychotropic drug? Psychopathologic study of a population of subjects self-identified as chocolate addicts
by
Dallard I, Cathebras P, Sauron C, Massoubre C.
Service de Medecine Interne,
Hopital Nord, CHU de Saint-Etienne,
42055 Saint-Etienne.
Encephale. 2001 Mar-Apr;27(2):181-6.

The aim of this work was to search for eating disorders, DSM III-R Axis I mental disorders, personality disorders, and addictive behavior, in self-labeled "chocolate addicts". Subjects were recruited through advertisements placed in a university and a hospital. Fifteen subjects were included, 3 men and 12 women aged between 18 and 49. Most of them were not overweight, although 7 thought they had a weight problem. They consumed an average of 50 g per day of pure cacao and, for 13 subjects, this consumption was lasting since childhood or adolescence. The psychological effects of chocolate, as indicated by the subjects, consisted in feelings of increased energy or increased concentration ability, and in an anxiolytic effect during stress. Seven subjects described minor withdrawal symptoms. None of the subjects reached the thresholds for eating disorders on the EAT and BULIT scales. The structured interview (MINI) identified an important ratio of subjects with a history of major depressive episode (13/15), and one woman was currently experiencing a major depressive episode. Four people suffered, or had suffered from anxiety disorders. Although only one subject satisfied all criteria for a personality disorder on the DIP-Q, seven displayed some pathological personality features. The self-labeled "chocoholics" do not seem to suffer from eating disorders, but may represent a population of psychologically vulnerable and depression--or anxiety--prone people. They seem to use chocolate as a light psychotropic drug able to relieve some of their distress. The amount of cacao consumed, although very chronically, remains moderate, and they rarely display other addictive behaviors.

Cocoa and Antioxidants

Cocoa has more phenolic phytochemicals and a higher
antioxidant capacity than teas and red wine
by
Lee KW, Kim YJ, Lee HJ, Lee CY.
Department of Food Science and Technology,
School of Agricultural Biotechnology,
Seoul National University,
Seoul 151-742, South Korea.
J Agric Food Chem. 2003 Dec 3;51(25):7292-5

Black tea, green tea, red wine, and cocoa are high in phenolic phytochemicals, among which theaflavin, epigallocatechin gallate, resveratrol, and procyanidin, respectively, have been extensively investigated due to their possible role as chemopreventive agents based on their antioxidant capacities. The present study compared the phenolic and flavonoid contents and total antioxidant capacities of cocoa, black tea, green tea, and red wine. Cocoa contained much higher levels of total phenolics (611 mg of gallic acid equivalents, GAE) and flavonoids (564 mg of epicatechin equivalents, ECE) per serving than black tea (124 mg of GAE and 34 mg of ECE, respectively), green tea (165 mg of GAE and 47 mg of ECE), and red wine (340 mg of GAE and 163 mg of ECE). Total antioxidant activities were measured using the 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assays and are expressed as vitamin C equivalent antioxidant capacities (VCEACs). Cocoa exhibited the highest antioxidant activity among the samples in ABTS and DPPH assays, with VCEACs of 1128 and 836 mg/serving, respectively. The relative total antioxidant capacities of the samples in both assays were as follows in decreasing order: cocoa > red wine > green tea > black tea. The total antioxidant capacities from ABTS and DPPH assays were highly correlated with phenolic content (r2 = 0.981 and 0.967, respectively) and flavonoid content (r2 = 0.949 and 0.915). These results suggest that cocoa is more beneficial to health than teas and red wine in terms of its higher antioxidant capacity.

Dark Chocolate and the Healthy Heart

Dark chocolate might reduce blood
pressure, study suggests

CHICAGO - A small study suggests that eating dark chocolate can lower your blood pressure - a delicious instance in which something that tastes good might, for a change, be good for you, too.The short study would need to be confirmed in larger, longer-term ones before doctors could recommend treatment with chocolate, researchers say.Yet if the results can be confirmed, "you can sin with perhaps a little less bad feeling," said Dr. Franz Messerli, a hypertension expert at Ochsner Clinic Foundation in New Orleans.The German study appears in Wednesday's Journal of the American Medical Association.

Thirteen adults with untreated mild hypertension got to eat 3-ounce chocolate bars every day for two weeks. Half of the patients got white chocolate, half got dark chocolate.
Dark chocolate contains plant substances called polyphenols - ingredients scientists think are responsible for the heart-healthy attributes of red wine. Polyphenols also have been shown to lower blood pressure in animals.

Blood pressure remained pretty much unchanged in the group that ate white chocolate, which does not contain polyphenols. But after two weeks, systolic blood pressure - the top number - had dropped an average of five points in the dark-chocolate group. The lower, or diastolic, reading fell an average of almost two points.
The participants had an average blood pressure reading of about 153 over 84.

While their blood pressure did not fall enough to be considered in the desirable range - below 120 over 80 - the results show dark chocolate "might serve as a promising approach to reduce systolic blood pressure," said lead author Dr. Dirk Taubert of the University of Cologne.
Taubert said participants ate the chocolate bars instead of the sweets they usually consumed, and thus did not gain weight during the study.
The study received no industry funding - the researchers bought the chocolate themselves from the supermarket.

Associated Press
Aug. 26, 2003

Antiaging Chocolate ?

Confectioner claims new chocolates
counter ageing process

Felice Chocolate: the key to eternal youth?

A German confectioner claims to have come up with the first anti-ageing chocolates.
Adolf Andersen from Hamburg developed the chocolates with Dr Michael Kentze, from the Munich-based Kentze Institute for Age-Prevention Medicine.

Made with dark chocolate, mango and soya milk, the creators believe the Felice chocolates not only make you happy, but keep you young.
Dr Kentze said: "Dark chocolate contains three times as much cacao as milk chocolate and so the concentration of phenylethylamine and polyphenol is high.

"The first substances increase the heartbeat and releases feelings of well-being. The distribution of serotonin, dopamine and noradrenaline are also increased, which makes you feel more cheerful. And polyphenol protects the cells from free radicals."
He added: "Soya milk not only reduces menstrual complaints in women, but tightens the skin and protects men from prostate problems.

"Mango contains enzymes, which activate the metabolism and act to reduce inflammation."
The pair admitted that the chocolates combined with an unhealthy lifestyle would not have a great effect, but recommended one or two pralines at the end of the day with a cup of tea.
A tester for the Felice chocolates said: "They don't fill you up but you immediately feel 15 years younger."

Source: Ananova
Date: 28th July 2003

Chocolate Addiction

by
Hetherington MM, MacDiarmid JI
Department of Psychology,
University of Dundee,
Scotland.
Appetite 1993 Dec; 21(3):233-46

Definitions of chocolate addiction and its potential relationship to dieting and problem eating were investigated in 50 individuals who identified themselves as "chocoholics". Respondents were interviewed and completed a battery of questionnaires on food cravings, eating, weight, dieting and depression. On average this sample consumed about 12 (60-g) bars of chocolate per week and craved chocolate about six times per week. Cravings and amount consumed were not significantly related but amount consumed was significantly correlated with disinhibition (r = 0.3). Most (76%) respondents had definitions of chocolate addiction that centred on a lack of control around chocolate and regarded the "addictive" factor in chocolate as orosensory (i.e. taste, smell, texture). Unlike most others, dieters and secret eaters experienced negative affect following consumption of chocolate. Consumers who preferred to eat in secret reported a higher degree of aberrant eating. The extent to which the behaviour of "chocolate addicts" resembles that of eating disordered individuals and other addictions remains to be clarified.