Author Archives: Nicole Bleecker

Confessions of a Chocoholic

Looking back on the past couple weeks, I can definitely confirm that this trip has been one of gustatory indulgence. Surrounded by dazzling array of markets and boulangeries, I quickly abandoned my gluten-free/organic/veggie-based diet in exchange for a month-long foray into the hedonistic world of carbohydrates and simple sugars. The biggest change, however, came in the form of massive increases in the amount of chocolate I consumed on a daily basis. For a self-acknowledged Chocoholic, Paris exists simultaneously as the “worst” (and best) place to live. Being vegan, I was ecstatic to discover a vast array of artisan, naturally dairy-free creations present at every Chocolatier I visited. From velvety ganache to decadent truffles, with every bite I fell deeper under a magical, cocoa-fueled spell.

chocolate

SO BEAUTIFUL.

However, even as “Viva la Chocolate” became my new mentality, I wondered how the habitual inclusion of this high-sugar, high-fat product would affect my short and long-term health. When I return stateside, should I include less chocolate in my diet…. or avoid it all together? How much is “too much” when it comes to such an addictive dessert?

To investigate these questions, I turned to a recent study by Kwok et al. that examined the association between chocolate intake and future cardiovascular events. Based on long term data collected in the EPIC-Norfolk population study from a total of 20,591 European men and women, the cumulative meta-results of the study actually suggest that a higher chocolate intake is associated with a lower risk of coronary heart disease, stroke, and cardiovascular disease. Wait…. what?! So my consumption of chocolate may actually be helping me, rather than hurting me? Not convinced, I looked to other research to confirm these results.

My FAVORITE place.

My FAVORITE place.

Immediately, I found a fascinating study by Massee et al. examining the short and long term effects of cocoa supplementation on mood and mental fatigue, cognitive performance and cardiovascular functioning in young adults. To make a key distinction, cacao is the raw seeds obtained from the Theobrama cacao tree, cocoa is the roasted, grounded product, and chocolate is the processed confectionary dessert with added sugars and fats (Latif, 2013). Cacao seeds have been used as medicine for centuries and are rich in with catechin and epicatechin antioxidants known as “flavanols” (Nehlig, 2013). Based on previous animal studies, the researchers’ hypothesized that cocoa flavanols may have the ability to act on the human brain and improve cognitive performance through direct enhancement of memory systems (Nehlig, 2013). Furthermore, cocoa flavanals could potentially improve cardiovascular health by regulating blood pressure and cerebral blood flow (Dinges,2006).

In the experiment, the researchers’ investigated the effects of cocoa supplementation in 40 healthy young adults using a placebo-controlled, double blind test over a four-week period. Participants were randomly assigned to receive either an active cocoa tablet containing 250mg cacao seed extract OR an identical placebo tablet containing only cellulose powder. The researchers’ examined both the baseline vs acute (before and 2 hours after the tablets were ingested) and baseline vs chronic effects (4 weeks of daily tablet ingestion). To assess cognitive performance, the participants completed eight computer-based tasks including reaction/decision time, inhibition, and recognition/spatial/contextual memory. To measure mood and mental fatigue, the participants completed the mentally fatiguing cognitive demand battery test (CBD) which requires completion of two serial subtraction tests, a rapid visual information processing task (RVIP) and a visual cognitive fatigue scale. To assess cardiovascular health, the researchers’ measured the participant’s blood pressure and cerebral blood flow. The participants completed a total of three testing sessions: baseline (before ingestion), acute (2-3.5 hours after tablet ingestion) and sub-chronic (4 weeks after initial testing).

Cocoa cocoa everywhere!

Cocoa cocoa everywhere!

At the acute time point, cocoa-supplemented participants reported feeling significantly less mentally fatigued prior to completing the cognitive demand battery test and showed improved performance on the subtraction component of the CDB compared to the placebo group. Therefore, the researchers’ concluded that 250 mg dose of cocoa flavanols was found to improve mental fatigue and minor aspects of cognitive performance acutely, but not sub-chronically (aka long term) during a highly demanding task.

However, in both the short and long term measures, the study failed to produce any evidence that cocoa increases performance in the SUCCAB tests or enhances cardiovascular function. These results could have been affected by the study’s small size, 30 day experiment course, or insufficient dosage. In the future, I would be interested to see if these same effects could be mirrored in older adults and with different amounts of cocoa used.

Though still a skeptic at heart, based on the findings from these two studies, perhaps my addiction to chocolate isn’t as bad as I initially thought. In fact, if consumed in moderation (working on that one), chocolate may actually benefit some aspects of my mental and physical health. With that in mind, I’ll feel a little less guilty every time I gobble down another praline I made in Choco Story. After all, it’s the smart thing to do right?

References:

Dinges DF (2006) Cocoa flavanols, cerebral blood flow, cognition, and health: going forward. J Cardiovasc Pharmacol. 47Suppl 2 ():S221-3.

Kwok CS, Boekholdt SM, Lentjes MA, Yoke YK, Ruben RN, Yeong JK, Wareham NJ, Myint PK, Khaw KT (2015) Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women. Heart. 2014-307050

Latif R (2013) Chocolate/cocoa and human health: a review. Neth J Med.71 (2):63-8.

Massee LA, Reid K, Pase M, Travica N, Yoganathan J, Scholey A, Macpherson H, Kennedy G, Sali A, Pipingas A (2015) The acute and sub-chronic effects of cocoa flavanols on mood, cognitive and cardiovascular health in young healthy adults: a randomized, controlled trial. Front Pharmacol. 6:93.

Nehlig A (2013) The neuroprotective effects of cocoa flavanol and its influence on cognitive performance.Br J Clin Pharmacol. 75(3):716-27

Young Oliver “Sponge Bob ‘Did You Say Chocolate.’” Online Video Clip. Youtube. Youtube 16 May 2010. Web. 20 June 2016.

Images:

www.agriculturewire.com

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Up In Smoke

In Paris, €5.90 will buy you one the following: conditioner, flip flops, a mozzarella sandwich or a single pack of Lucky Strike cigarettes. Beyond the opulent architecture and elegant skyline, smoke was the first thing I noticed as I wandered the picturesque streets of my new home. Cigarettes in the hands of teenagers, waiters, lawyers, mothers, and ironically, and even medical students with immunology textbooks tucked under their arms. When I asked a local friend about his general smoking habits, his response surprised me:

Well, I guess the first time I tried it was when I was 12 – all my friends were doing it after all. Now, I just need to smoke… if I don’t, I get anxious and irritated.

Twelve-years old and already smoking, how could that be possible? However, my Parisian friend is not alone. In fact, according to CDC studies, among daily smokers, 88% begin before the age of 18 (National Center, 2012). With such a large well-known body of evidence detailing the physiological and psychological consequences of tobacco and nicotine, why would a teenager reach for a cigarette in the first place?

(The National Center, 2012)

Age of Onset of Smoking

The “big picture” mechanisms of smoking seem pretty straight forward. Cigarettes contain tobacco, which in turn contains nicotine, which in turn triggers the addiction process. Addiction, or compulsive use of a substance in the face of negative consequences, is characterized by four distinct stages: introduction, sensitization, association/craving and dependence (Herman et al., 2014). However, the reasons behind why adolescents like the chain-smoking Parisian teens in particular are so vulnerable to nicotine are less understood.

One recent theory, published in Neuroscience by researchers Bang and Commons, examined the role of nicotine on the adolescent serotonin system. Serotonin (aka 5-HT) is a chemical released by neurons in the brain, and may contribute to starting and continuing addictive behavior. Based on previous research, Bang and Commons (2011) hypothesized that if they gave adolescent subjects nicotine, there would be changes in the activation of their serotonin neurons.

In the experiment, the researchers used eight groups of rats total – four with adolescents and four with adults. For both ages, three of the groups served as experimental (test) groups, and each group member received an injection of a specific dose (amount) of nicotine (0.2, 0.4, 0.8 mg/kg). The fourth group served a baseline/control group and received saline (salt water) instead of nicotine.

After humanely killing the animals, the researchers cut frontal slices each rat brain and used a process called immunohistochemistry to chemically mark the brain for specific proteins. The researchers specifically stained and measured the amount of Fos protein in brain areas important in the serotonin system (dorsal raphe and median raphe nuclei). The Fos protein corresponds to biochemical activity, so if nicotine changed or increased activity in the serotonin system, the researchers would observe increased Fos levels in comparison to the normal levels of the saline control group.

When comparing the adolescent and adult group, the researchers concluded that adolescents showed an increased, widespread activation of their brain serotonin system at the lowest (0.2mg/kg) and highest nicotine dosage (0.8mg/kg). On a larger scale, these results indicate that the adolescent serotonin system may be more sensitive to an initial exposure to nicotine. Though there needs to be more research defining the serotonin system’s role in addiction, this study helps elucidate the science behind adolescent nicotine vulnerability.

Arrows Indicate Fos Staining

Arrows Indicate Fos Staining

Somehow, (and for the sanctity of my lungs) we need to stop teens from trying cigarettes in the first place. Based on the failure of smoking bans in France and the amount of smokers I saw on a daily basis, this is easier said than done.  Research indicates that pervasiveness and social support of smoking in adolescent social networks is strongly associated with both susceptibility AND readiness to quit (Roberts et al., 2015). To relate to my own experience, none of my friends at home or on the trip smoke, so it was easy to turn down a cigarette when I was offered.

These are ALL Tobacco Shops

These are ALL Tobacco Shops in Paris

In the future, perhaps France should take after the example of the highly successful American “Truth” association, which uses the celebrity-endorsed #FINISHIT social media campaign to raise awareness about teen smoking. Until then, I’ll concede to duck around smoke clouds and spend my €5.90 on some much needed fabric Fabreze.

References:

Bang SJ, Commons KG (2011) Age-dependent effects of initial exposure to nicotine on serotonin neurons. Neuroscience 179:1-8.

Herman Al. DeVito EE, Jensen KP, Sofuoglo ME (2014) Pharmacogenetics of nicotine addiction: role of dopamine. Pharmacogenomics 15(2):221-34.

Khan, Maria. “France: First Outdoor Public Smoking Ban in Paris Playground.” International Business Times. 20 Oct. 2014. Web. 7 Jun. 2015.

National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2012. 3, The Epidemiology of Tobacco Use Among Young People in the United States and Worldwide.

Roberts ME, Nargiso JE, Gaitonde LB, Stanton CA, Colby SM (2015) Adolescent social networks: general and smoking specific characteristics associated with smoking. J Stud Alcohol Drugs 76(2):247-55

Truthorange. “Finshers 2014 | truth.” Online video clip. Youtube. Youtubem 10 Aug. 2014. Web. 7 Jun. 2015.