ArticleLiterature Review

Effects of chocolate on cognitive function and mood: A systematic review

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Abstract

A systematic review was conducted to evaluate whether chocolate or its constituents were capable of influencing cognitive function and/or mood. Studies investigating potentially psychoactive fractions of chocolate were also included. Eight studies (in six articles) met the inclusion criteria for assessment of chocolate or its components on mood, of which five showed either an improvement in mood state or an attenuation of negative mood. Regarding cognitive function, eight studies (in six articles) met the criteria for inclusion, of which three revealed clear evidence of cognitive enhancement (following cocoa flavanols and methylxanthine). Two studies failed to demonstrate behavioral benefits but did identify significant alterations in brain activation patterns. It is unclear whether the effects of chocolate on mood are due to the orosensory characteristics of chocolate or to the pharmacological actions of chocolate constituents. Two studies have reported acute cognitive effects of supplementation with cocoa polyphenols. Further exploration of the effect of chocolate on cognitive facilitation is recommended, along with substantiation of functional brain changes associated with the components of cocoa.

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... In 2013, Scholey and Owen [23] published a review in which they investigated if chocolate or its individual (groups of) constituents were capable of influencing mood or cognitive function. "Cognition" is not easy to define, as it involves attention, perception, memory, language, executive, and psychomotor functions; in addition, these factors can be influenced by others such as the arousal and energetic level and "mood" [24]. ...
... Therefore, these effects were attributed to the CF fraction rather than to the methylxanthines, and it was hypothesized that this might be related to well-established effects of CF on endothelial functionality and blood flow (see below). Some other "mood" studies reviewed by Scholey and Owen [23] examined whole chocolate without analytical characterization. Therefore, it was not possible to draw any conclusion about the contribution of different constituents or classes of compounds to the observed effects. ...
... With regard to the studies on cognitive and neurocognitive functions reviewed by Scholey and Owen [23], three of these have been discussed above [7,25,29]. In addition, Francis et al. compared a high-flavanol (172 mg CF) and a low-flavanol (13 mg CF) cocoa drink administered to young female subjects. ...
Article
Cocoa and chocolate, prepared from cocoa beans that originate from the fruits of the cocoa tree Theobroma cacao, have a long-standing reputation as healthy food, including mood-enhancing effects. In spite of many clinical trials with chocolate, cocoa, or its constituents, the mechanisms of action on mood and cognition remain unclear. More in particular, it is still controversial which constituents may contribute to the psychopharmacological activities, ranging from the major cacao flavanols and methylxanthines to the minor amines, amides, and alkaloids. In this review a critical appraisal is made of recent studies on mood and cognition, with a special emphasis on analytical characterization of the test samples. It is concluded that the mood and cognition-enhancing effects of cocoa and chocolate can be ranked from more general activities associated with flavanols and methylxanthines, to more specific activities related to minor constituents such as salsolinol, with on top the orosensory properties of chocolate. Therefore, the “mood pyramid” of cocoa and chocolate is proposed as a new concept. To understand the role and interactions of the different major and minor constituents of cocoa, it is recommended that all test samples used in future in vitro, in vivo, or human studies should be phytochemically characterized in much more detail than is common practice today.
... In human, cognitive function is studied through a variety of standardized tests that evaluate mental processes such as perception, attention, memory, decision making, and language comprehension [32,40,41]. Performance of mental processes changes during lifetime; executive and working memory reaches a peak between the 20s and 30s [42]. ...
... The intake of flavanols or flavan-3-ols in cocoa has been linked to benefits on cognitive processes such as memory, motor, executive function and IQ [32,40,64]. Although promising evidence is beginning to emerge, the heterogeneity of the study designs, dose, the timeframe of intervention, vehicles, methods for assessment, sample size and characteristics of participants difficulties the comparison between investigations and makes challenging to draw robust conclusions [31]. ...
... The age and health condition of the studied population is another relevant aspect for comparison across investigations since it has been previously suggested that these characteristics may have a significant impact on cognitive abilities [66]. Most studies have been conducted in aging or people suffering from some degree of mental impairment, where cocoa polyphenols seem to have more consistent effects [32,40]. However, the benefits of the consumption of cocoa polyphenols in young and middle age healthy people require further investigation, as well as a potential preventive effect on cognition decline. ...
Article
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The effects of cocoa-derived polyphenols on cognitive functions have been analyzed through numerous studies using different interventions (doses, vehicles, time frame, cognition tests, and characteristics of participants) which may hamper the interpretation and comparison of findings across investigations. Thus, a systematic review was conducted to analyze the effects of cocoa-derived polyphenols intake on human cognition and discuss the methodological aspects that may contribute to the heterogeneity of findings. Randomized clinical trials evaluating the effect of cocoa polyphenols on cognitive function in healthy subjects were selected according to selection criteria. Twelve studies were selected. Quality was assessed according to the Cochrane risk for bias tool. The most common risk for bias was the lack of information about the sequence generation process. Effects on cognitive function were observed after consumption of 50 mg/day of (-)-epicatechin and in studies using a component-matched placebo and cocoa as the polyphenol vehicle given to healthy adults (18-50 years). Memory (n = 5) and executive function (n = 4) showed the most significant effects with medium and large effect sizes after intake of intermediate doses of cocoa flavanols (500-750 mg/day). Overall, this set of studies suggest a positive effect of cocoa polyphenols on memory and executive function. However, the available evidence is very diverse and future studies may address the identified sources of variation to strengthen current evidence on this promising field.
... Previously, we found an epicatechin-rich grape polyphenol extract that was highly effective in protecting against the onset and/or progression of multiple, diverse neurological, psychological, and metabolic disorders in animal models, mainly due to its bioactivities in modulating synaptic function [22][23][24][25][26][27][28] . Published evidence suggests cocoa consumption (in the form of chocolate) may improve cognitive function 29 and reduce fatigue 30 . Clinical observation also revealed that cocoa may beneficially modulate mood 29 . ...
... Published evidence suggests cocoa consumption (in the form of chocolate) may improve cognitive function 29 and reduce fatigue 30 . Clinical observation also revealed that cocoa may beneficially modulate mood 29 . The biological activities/properties of cocoa are modulated by the bioavailability of its bioactive constituents which include polyphenols 20,21 . ...
... Natural products have a history of being the source for many of the active ingredients in medications, and almost half of the drugs approved since 1994 are derived or inspired from natural products 40,41 . In recent years, cocoa products, specifically cocoa polyphenols, have received growing interest due to epidemiological observation that people consuming cocoa products such as chocolate reported either improvement in mood or attenuation of negative mood 29 . The benefits of chocolate have been in part, attributed to cocoa flavanols 42,43 . ...
Article
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Major depressive disorder (MDD) is a leading cause of disability, and there is an urgent need for new therapeutics. Stress-mediated induction of pro-inflammation in the periphery contributes to depression-like behaviors both in humans and in experimental models. Inflammatory cytokine interleukin-6 (IL-6) has emerged as a potential therapeutic target. Our studies demonstrated that metabolism of flavanol rich cocoa preparation (FRP) led to the accumulation of select phenolic acids that may contribute to its anti-inflammatory activity. Using a repeated social defeat stress (RSDS) model of depression, we showed that oral administration of FRP attenuates susceptibility to RSDS-mediated depression, supporting the further development of FRP as a novel therapeutic for the treatment of stress disorders and anxiety in humans.
... People believe that dark chocolate elevates mood (Scholey and Owen, 2013). Macht and Dettmer (2006) demonstrated that eating dark chocolate elevates mood more than eating other types of food such as apples. ...
... However, some studies did not find any effect of dark chocolate on mood, possibly due to the brevity of the mood-enhancing effect of dark chocolate (Parker et al., 2006). Yet, the metaanalysis of Scholey and Owen (2013) concludes that dark chocolate has the potential to influence mood: five out of the eight included studies showed either an improvement in mood state or reduction in a negative mood. Recent studies confirm the positive effects from eating dark chocolate on mood (Tuenter et al., 2018), for example, Pandolfi and colleagues (2016) showed that even eating a small piece of dark chocolate (5 g) increased happiness directly after food intake and this effect was still present after 5 min. ...
... However, dark chocolate seems to have something extra over other types of food as it has a higher mood-enhancing effect. The academic literature is still in debate on why this is the case and which reasons are contributing the most to the moodenhancing effect of dark chocolate (Scholey and Owen, 2013;Tuenter et al., 2018), but generally, it is assumed that dark chocolate has a positive impact on mood. ...
Article
Purpose Past research suggests that small details during a service may have a big impact on the service experience. Drawing from this literature, this study aims to test the impact of offering dark chocolate during a service on service performance outcomes. Design/methodology/approach Three scenario-based studies and one field study tested the hypotheses. The scenario-based experiments varied in both service context (e.g. restaurant and mobile phone store) and service quality. Findings Eating dark chocolate positively impacts service performance outcomes. This effect is fully mediated through mood. However, this effect disappears in negative valenced service encounters. Originality/value This paper makes a unique contribution, by testing whether changing a small detail at the start of a service improves mood and, in turn, customers’ outcomes in different service quality contexts.
... These properties are in turn linked to the prevention of chronic diseases in humans. For instance, polyphenols-rich dark chocolate seems to have anti-diabetes properties, as it increases the sensitivity to insulin (Scholey and Owen 2013). Moreover, the daily consumption of cocoa derivatives seems to ameliorate some biochemical parameters linked to lipid, cholesterol, and glucose metabolism (Leyva-Soto et al. 2018). ...
... Moreover, the presence of these substances might explain the typical craving for chocolate (Bruinsma and Taren 1999). Of note, methylxanthines themselves (particularly caffeine) may play a role in the mood-altering effects of chocolate, by increasing alertness (Scholey and Owen 2013). However, it should be noted that theobromine is also capable of conferring negative mood effects, including reductions in self-reported calmness (Mumford et al. 1994). ...
... Moreover, some natural substances with antiinflammatory properties, like curcumin Ng et al. 2017) and saffron (Shafiee et al. 2018;Toth et al. 2019), were reported to significantly improve affective symptoms in psychiatric patients in combination with standard therapy. However, it is worth underlining that the effects of flavonoids on antioxidant capacity are likely to be observed only after a longer intake of cocoa (Scholey and Owen 2013). As our meta-analysis included mainly studies with acute or short-term administration of cocoa derivatives, we cannot attribute our positive findings solely to the antiinflammatory properties of polyphenols. ...
Article
In the popular imaginary, cocoa-derived products, like chocolate, represent a panacea for mood and affectivity. However, whether this is a myth or a fact has yet to be clarified. A systematic review and meta-analysis were conducted according to the PRISMA guidelines to investigate the effect of cocoa-derived food on depressive and anxiety symptoms, positive and negative affect. We searched Web of KnowledgeTM and PsycINFO up to April 3, 2020. After screening 761 records, we selected nine studies. Two trials evaluated the long-term effects of cocoa consumption (>1 week), two studies the short-term effects (3 days), while five studies were conducted in acute (single administration). Random-effects meta-analyses found an overall significant effect of cocoa-rich products on depressive (Hedge’s g = 0.42, 95% CI 0.67 to 0.17) and anxiety symptoms (Hedge’s g = 0.49, 95% CI 0.78 to 0.19). Moreover, both positive (Hedge’s g = 0.41, 95% CI 0.06 to 0.77) and negative affect (Hedge’s g = 0.47, 95% CI 0.91 to 0.03) significantly improved. In all meta-analyses, the effect size was medium, while heterogeneity was low. Our findings suggest that the consumption of cocoa-rich products may improve affect and mood in the short term. However, given the short duration of trials, our results cannot be generalized to long-term intake of cocoa-derived food. Cautious interpretation is also needed due to the low number of participants and studies included in the meta-analyses.
... Dark chocolate is also thought to have effects on gastrointestinal function and is traditionally used as a home remedy for diarrhoea (10) ; however, objective evidence for the impact of cocoa on the gastrointestinal time or symptoms is lacking. Similarly, although chocolate has hedonic appeal and a positive influence on mood (11,12) , the central mechanisms behind these effects remain uncertain. ...
... Methods were identical for both study arms. PET-CT was preferred to functional MRI because the relatively long acquisition time increases test sensitivity and is less subject to variation in the concentration of biologically active substances in cocoa in the blood stream over time (the optimal time for acquisition of brain imaging after ingestion of cocoa flavanols is uncertain) (12) . Subjects were seated in a relaxing chair and an intravenous line was placed. ...
... This is consistent with the prevailing view that the mood-enhancing effects of chocolate are not caused by naturally occurring psychoactive substances (e.g. anandamide, an agonist of endogenous cannabinoid receptors) but are more likely explained by properties shared by both dark and white chocolate such as satisfaction of hunger and pleasurable oro-sensory qualities including high palatability, sweetness and optimal mouthfeel (12) . ...
Article
Dark chocolate is claimed to have effects on gastrointestinal function and to improve well-being. This randomised controlled study tested the hypothesis that cocoa slows gastric emptying and intestinal transit. Functional brain imaging identified central effects of cocoa on cortical activity. Healthy volunteers (HV) ingested 100 g dark (72 % cocoa) or white (0 % cocoa) chocolate for 5 d, in randomised order. Participants recorded abdominal symptoms and stool consistency by the Bristol Stool Score (BSS). Gastric emptying (GE) and intestinal and colonic transit time were assessed by scintigraphy and marker studies, respectively. Combined positron emission tomography–computed tomography (PET–CT) imaging assessed regional brain activity. A total of sixteen HV (seven females and nine males) completed the studies (mean age 34 (21–58) years, BMI 22·8 (18·5–26·0) kg/m ² ). Dark chocolate had no effect on upper gastrointestinal function (GE half-time 82 (75–120) v. 83 (60–120) min; P =0·937); however, stool consistency was increased (BSS 3 (3–5) v. 4 (4–6); P =0·011) and there was a trend to slower colonic transit (17 (13–26) v. 21 (15–47) h; P =0·075). PET–CT imaging showed increased [ ¹⁸ F]fluorodeoxyglucose (FDG) in the visual cortex, with increased FDG uptake also in somatosensory, motor and pre-frontal cortices ( P <0·001). In conclusion, dark chocolate with a high cocoa content has effects on colonic and cerebral function in HV. Future research will assess its effects in patients with functional gastrointestinal diseases with disturbed bowel function and psychological complaints.
... Our findings relating to cognitive function parameters contradict a systematic review by Scholey (2013). In their review, the authors did not perform meta-analysis to quantitatively pool the results, although three out of the seven included studies showed positive cognitive function effects. ...
... In their review, the authors did not perform meta-analysis to quantitatively pool the results, although three out of the seven included studies showed positive cognitive function effects. It was suggested that further investigation was needed of acute cognitive effects of chocolate along with examination of functional brain changes associated with cocoa-flavanols [54]. Recent human trials have shown that dark chocolate (35 g) improved verbal memory in health young adults, which further supports exploration in this area [12]. ...
Article
Full-text available
Chocolate has a history of human consumption tracing back to 400 AD and is rich in polyphenols such as catechins, anthocyanidins, and pro anthocyanidins. As chocolate and cocoa product consumption, along with interest in them as functional foods, increases worldwide, there is a need to systematically and critically appraise the available clinical evidence on their health effects. A systematic search was conducted on electronic databases such as MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) using a search strategy and keywords. Among the many health effects assessed on several outcomes (including skin, cardiovascular, anthropometric, cognitive, and quality of life), we found that compared to controls, chocolate or cocoa product consumption significantly improved lipid profiles (triglycerides), while the effects of chocolate on all other outcome parameters were not significantly different. In conclusion, low-to-moderate-quality evidence with short duration of research (majority 4–6 weeks) showed no significant difference between the effects of chocolate and control groups on parameters related to skin, blood pressure, lipid profile, cognitive function, anthropometry, blood glucose, and quality of life regardless of form, dose, and duration among healthy individuals. It was generally well accepted by study subjects, with gastrointestinal disturbances and unpalatability being the most reported concerns.
... Only a small number of studies have analyzed associations between chocolate consumption and depressive symptoms, with mixed findings. A 2013 systematic review of experimental research on the effects of chocolate or its components on mood identified eight small studies (n ≤ 113), of which five reported either an improvement in mood state or attenuation of negative mood (Scholey & Owen, 2013). A recent umbrella review on chocolate consumption and all health outcomes concluded on the basis of existing evidence that chocolate consumption has no impact on depression (Veronese et al., 2019). ...
... The present results are in line with the majority of experimental studies, which have shown benefits of chocolate consumption for mood, at least in the short-term (Scholey & Owen, 2013). However, they are inconsistent with previous surveys that have found positive T A B L E 1 Sociodemographic characteristics of US adults aged 20-80 years in the NHANES (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) associations between chocolate consumption and depressive symptoms (Barkeling et al., 2002;Rose et al., 2010). ...
Article
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Objective: To examine associations between chocolate consumption and depressive symptoms in a large, representative sample of US adults. Methods: The data were from 13,626 adults (≥20 years) participating in the National Health and Nutrition Examination Survey between 2007-08 and 2013-14. Daily chocolate consumption was derived from two 24-hr dietary recalls. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9), with scores ≥10 indicating the presence of clinically relevant symptoms. We used multivariable logistic regression to test associations of chocolate consumption (no chocolate, non-dark chocolate, dark chocolate) and amount of chocolate consumption (grams/day, in quartiles) with clinically relevant depressive symptoms. Adults with diabetes were excluded and models controlled for relevant sociodemographic, lifestyle, health-related, and dietary covariates. Results: Overall, 11.1% of the population reported any chocolate consumption, with 1.4% reporting dark chocolate consumption. Although non-dark chocolate consumption was not significantly associated with clinically relevant depressive symptoms, significantly lower odds of clinically relevant depressive symptoms (OR = 0.30, 95%CI 0.21-0.72) were observed among those who reported consuming dark chocolate. Analyses stratified by the amount of chocolate consumption showed participants reporting chocolate consumption in the highest quartile (104-454 g/day) had 57% lower odds of depressive symptoms than those who reported no chocolate consumption (OR = 0.43, 95%CI 0.19-0.96) after adjusting for dark chocolate consumption. Conclusions: These results provide some evidence that consumption of chocolate, particularly dark chocolate, may be associated with reduced odds of clinically relevant depressive symptoms. Further research capturing long-term chocolate consumption and using a longitudinal design are required to confirm these findings and clarify the direction of causation.
... Increased feelings of well-being, euphoria, and physical and psychological feelings of excitement after chocolate consumption are consistent with chocolate's ability to modulate both the opioid and the dopamine neurotransmitter systems. Both human and animal research has demonstrated the reinforcing potential and comforting and mood-ameliorating effects of chocolate [2,3,[21][22][23]. Contrary to our hypothesis, we did not find an association between self-reported scores on the MBG subscale and chocolate consumption. ...
... Chocolate's ability to modulate both the opioidergic and the dopaminergic systems, evident by the significant increase in self-reported scores on the PEQ, is consistent with research demonstrating chocolate's reinforcing potential and comforting and mood-ameliorating effects [2,3,[21][22][23]. These results help explain chocolate's high reinforcing value, as foods that elevate feelings of euphoria, as indicated by an increase in the number of positive responses on the MBG subscales, have a greater reinforcing potential [17]. ...
Article
Full-text available
Chocolate elicits unique brain activity compared to other foods, activating similar brain regions and neurobiological substrates with potentially similar psychoactive effects as substances of abuse. We sought to determine the relationship between chocolate with varying combinations of its main constituents (sugar, cocoa, and fat) and its psychoactive effects. Participants consumed 5 g of a commercially available chocolate with increasing amounts of sugar (90% cocoa, 85% cocoa, 70% cocoa, and milk chocolates). After each chocolate sample, participants completed the Psychoactive Effects Questionnaire (PEQ). The PEQ consists of questions taken from the Morphine-Benzedrine Group (MBG), Morphine (M,) and Excitement (E) subscales of the Addiction Research Center Inventory. After all testing procedures, participants completed the Binge Eating Scale (BES) while left alone and allowed to eat as much as they wanted of each of the different chocolates. We found a measurable psychoactive dose–effect relationship with each incremental increase in the chocolate’s sugar content. The total number of positive responses and the number of positive responses on the E subscale began increasing after tasting the 90% cocoa chocolate, whereas the number of positive responses on the MBG and M subscales began increasing after tasting the 85% cocoa chocolate sample. We did not find a correlation between BES scores and the total amount of chocolate consumed or self-reported scores on the PEQ. These results suggest that each incremental increase in chocolate’s sugar content enhances its psychoactive effects. These results extend our understanding of chocolate’s appeal and unique ability to prompt an addictive-like eating response.
... Previous human clinical studies showed that cocoa flavanols (CF) have antioxidant and anti-inflammatory properties and improve vascular function (Andújar et al. 2012). Moreover, evidence exists that CFs have neuroprotective and neuromodulatory effects (Francis et al. 2006;Scholey et al. 2010;Scholey and Owen 2013). It was suggested that long-term CF intake enhances neuronal function by interacting with neuronal intracellular signalling pathways involved in neuronal survival and differentiation, memory and long-term potentiation (Spencer 2008). ...
... Increasing the provision of metabolic substrates by enhancing CBF can result in cognitive benefits (Scholey and Owen 2013). Although there is compelling evidence that acute CF intake increases the cerebrovascular response, the effect of CF on cognitive performance is still ambiguous . ...
Thesis
Sports performance depends on physical factors, but also on cognitive functioning. Nutritional supplements as potential ergogenic aids can impact muscle, but also the brain. Cocoa flavanols (CF) have antioxidant capacities, can stimulate vascular function, and potentially enhance cognitive function. CF intake might thus improve exercise performance and recovery by reducing oxidative stress, increasing NO availability and/or boosting cognitive function. It is the purpose of this PhD to identify the effects of CF on physical and cognitive performance in healthy athletes at sea level and altitude, as well as in patients with type 1 diabetes. Our systematic review showed that CF can reduce exercise-induced oxidative stress, but without improving exercise performance. Combining CF intake and exercise training improves cardiovascular risk factors and vascular function in healthy and overweight participants, but evidence on the synergistic effects of CF and exercise training on oxidative stress, inflammation and fat and glucose metabolism is lacking.In a randomized, placebo-controlled, double blind cross-over study, we showed that 900 mg CF intake increased prefrontal oxygenation in athletes, but without affecting executive function. BDNF was not affected by CF intake. The effects of high-intensity exercise largely overruled the effects of CF intake: large beneficial effects of exercise on prefrontal oxygenation and cognitive function were observed and CF supplementation did not enlarge these effects. In a 2nd study, the effect of acute CF intake (530 mg CF) on performance on a demanding cognitive test was assessed in normoxia and hypoxia (simulated altitude 4000 m). Electroencephalogram and fNIRS were used to analyse neuronal activity and hemodynamic changes. Acute CF intake improved the neurovascular response, but did not affect neuronal activity and cognitive performance in normoxia and hypoxia. Most cognitive functions, the cerebrovascular response and neuronal activity, were not altered in hypoxia in healthy subjects. In a 3rd study, we found that acute intake of 900 mg CF enhanced cognitive performance on the Flanker test in patients with type 1 diabetes, and their healthy matched controls. CF intake increased the BOLD response in brain areas activated during this specific task. While cognitive performance was not deteriorated in patients with type 1 diabetes, a different brain activation pattern during the cognitive task was observed, compared to healthy controls and this brain activation pattern was altered by CF intake. To conclude, acute CF intake improves prefrontal oxygenation and cerebrovascular responsiveness. This can be associated with better cognitive function in patients with type 1 diabetes, but does not result in improved executive function in healthy persons. Compared to exercise, the magnitude of the CF-induced neurovascular changes is small.Two studies were conducted examining the effects of CF on exercise-induced oxidative stress, NO availability and its implications for exercise performance, in well-trained cyclists. We found that acute CF (900 mg) improved the exercise-induced increase in total antioxidant capacity, but did not reduce the exercise-induced increase in lipid peroxidation. One week CF intake (530 mg CF) improved vascular function at rest, and prefrontal oxygenation at rest and during low-intensity exercise, but did not influence muscular oxygenation. One week CF intake partially restored the hypoxia-induced decline in prefrontal oxygenation during rest and low-intensity exercise, but not during high-intensity exercise. One week CF intake reduced exercise-induced lipid peroxidation, but did not alter total antioxidant capacity. Both acute and 1-week CF intake did not improve exercise performance and recovery and do not change NO production during exercise (in normoxia and hypoxia) in well-trained athletes.
... Chocolate is widely consumed, and there have been studies examining its effect on mood and performance. A systematic review [8] identified eight relevant studies. ...
... In contrast, caffeine in coffee had selective effects on mood and performance, with the outcomes depending on the type of task and the impulsivity of the participant. The absence of effects of chocolate agrees with some previous studies, [8] and it appears that cocoa and flavanols lead to greater effects than chocolate per se. Similarly, dark chocolate produces greater effects than dairy milk chocolate. ...
Article
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Background: There has been considerable research on the effects of
... Rafnsson et al 2013 [24] Systematic review III-3 Two dietary intake studies of 342 and 1640 elderly participants for 3 and 10 years assessing the effects of flavonoids on cognitive decline, found a lower rate of cognitive decline with increased intake and no association respectively. Scholey and Owen 2013 [26] Systematic review II One RCT of 101 participants, ≥ 60 years of age and 6 weeks duration found no difference in cognitive performance following consumption of a chocolate bar (397mg proanthocyanins) and cocoa drink (357mg proanthocyanins) compared to placebo. ...
... For cocoa there was no evidence from a 6-week study that suggested cocoa polyphenols were associated with cognitive benefits. While this outcome was also supported in a further systematic review [26], the authors suggested that the lack of positive findings may be attributed to study methodology. Limitations in study methodology included variations in the types of food frequency questionnaires and foods used to estimate polyphenol intake, in addition to differences in the methods used to calculate polyphenol intake. ...
Article
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Background: The relationship between nutrition and cognitive functioning is unclear, especially in elderly populations as many elderly people with cognitive impairment have low blood levels of some nutrients even in the absence of malnourishment. The objective of this review was to assess the evidence from systematic reviews of human studies on the effectiveness of dietary interventions as monotherapies in delaying the onset of cognitive decline in older adults.Scope and approach: Evidence-based methodologies were used to gather and assess the highest levels of evidence that evaluated the effects of administration of any dose of the individual dietary interventions as neuroprotective agents for any duration. The search strategy was designed to identify systematic reviews and meta-analyses published from 1990 to December 2015. There were no language restrictions as part of the inclusion criteria.Key Findings and Conclusions: This review provides the current state of knowledge from systematic reviews on the effects on cognition of acetyl-L-carnitine, alpha-lipoic acid, choline, inositol compounds, omega-3 polyunsaturated fatty acids, and polyphenols, which are all commonly studied nutrients for neurocognitive effects. A critical evaluation of the current evidence from systematic reviews indicated that there are no clinically-relevant effects from supplementation with these nutrients on delaying the onset of cognitive decline in older adults. Keywords: diet, cognition, Alzheimer’s disease, dementia, nutrient
... Previous human clinical studies showed that cocoa flavanols (CFs) have antioxidant and anti-inflammatory properties and improve vascular function (Andújar et al. 2012). Moreover, evidence exists that CFs have neuroprotective and neuromodulatory effects (Francis et al. 2006;Scholey et al. 2010;Nehlig 2013;Scholey and Owen 2013). It was suggested that long-term CF intake enhances neuronal function by interacting with neuronal intracellular signaling pathways involved in neuronal survival and differentiation, memory, and long-term potentiation (Spencer 2008), while it seems that cognitive enhancements observed upon acute CF supplementation are associated with its vasodilatory actions (Socci et al. 2017). ...
... Increasing the provision of metabolic substrates by enhancing CBF can result in cognitive benefits (Scholey and Owen 2013). Although there is compelling evidence that acute CF intake increases the cerebrovascular response, the effect of CF on cognitive performance is still ambiguous (Socci et al. 2017). ...
Article
Full-text available
Introduction: Acute cocoa flavanols (CF) intake has been suggested to modulate cognitive function and neurovascular coupling (NVC). Whether increased NVC is solely driven by improved vascular responsiveness or also by neuronal activity remains unknown. This study investigated the effects of acute CF intake on cognitive performance, NVC, and neuronal activity in healthy subjects in normoxia and hypoxia (4000 m simulated altitude; 12.7% O2). Methods: Twenty healthy subjects (age 23.2 ± 4.3 years) performed four trials. Participants performed a Stroop task and "cognition" battery 2 h after acute CF (530 mg CF, 100 mg epicatechin) or placebo intake, and 30 min after initial exposure to hypoxia or normoxia. Electroencephalogram and functional near-infrared spectroscopy were used to analyze hemodynamic changes and neuronal activity. Results: CF enhanced NVC in the right prefrontal cortex during several tasks (risk decision making, visual tracking, complex scanning, spatial orientation), while neuronal activity was not affected. CF improved abstract thinking in normoxia, but not in hypoxia and did not improve other cognitive performances. Hypoxia decreased accuracy on the Stroop task, but performance on other cognitive tasks was preserved. NVC and neuronal activity during cognitive tasks were similar in hypoxia vs. normoxia, with the exception of increased β activity in the primary motor cortex during abstract thinking. Conclusions: Acute CF intake improved NVC, but did not affect neuronal activity and cognitive performance in both normoxia and hypoxia. Most cognitive functions, as well as NVC and neuronal activity, did not decline by acute exposure to moderate hypoxia in healthy subjects.
... Where specific foods have been linked to mood change (e.g. chocolate Scholey and Owen, 2013), the mechanisms considered are tentative. A comprehensive review of bioactive food flavour chemicals did identify similarities between a number of compounds and the antidepressant valproic acid (Martinez-Mayorga et al., 2013). ...
Article
Background: The use of herbal extracts and supplements to enhance health and wellbeing is increasing in western society. Aims: This study investigated the impact of the acute ingestion of a commercially available water containing an extract and hydrolat of rosemary ( Rosmarinus officinalis L. syn. Salvia rosmarinus Schleid.). Aspects of cognitive functioning, mood and cerebrovascular response measured by near-infrared spectroscopy provided the dependent variables. Methods: Eighty healthy adults were randomly allocated to consume either 250 mL of rosemary water or plain mineral water. They then completed a series of computerised cognitive tasks, followed by subjective measures of alertness and fatigue. Near-infrared spectroscopy monitored levels of total, oxygenated and deoxygenated haemoglobin at baseline and throughout the cognitive testing procedure. Results: Analysis of the data revealed a number of statistically significant, small, beneficial effects of rosemary water on cognition, consistent with those found previously for the inhalation of the aroma of rosemary essential oil. Of particular interest here are the cerebrovascular effects noted for deoxygenated haemoglobin levels during cognitive task performance that were significantly higher in the rosemary water condition. This represents a novel finding in this area, and may indicate a facilitation of oxygen extraction at times of cognitive demand. Conclusion: Taken together the data suggest potential beneficial properties of acute consumption of rosemary water. The findings are discussed in terms of putative metabolic and cholinergic mechanisms.
... • Over 100 manuscripts can be found examining the healing properties of cacao from the 16th to 20th century. • Most researchers [1] agree that chocolate contains several ingredients that can potentially influence cognitive function. • A recent study [2] found a strong positive correlation between intake per capita and the number of Nobel laureates in various countries. ...
Poster
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HPCC Systems visualization bundle is an effective tool for visualizing data. Although there is a correlation between chocolate consumption, happiness, and life expectancy, this does not imply that these factors are the cause of one or the other. Many factors influence life expectancy and happiness and more tests have to be done to prove the influence of chocolate consumption.
... Dark chocolate contains a group of phytochemicals known as flavonoids, which naturally occur in many fruits and vegetables. The consumption of flavonoids and flavonoid-rich foods has been associated with numerous health benefits, and reviews of the literature indicate that cocoa flavonoids are associated with benefits to cardiovascular health [1] and cognitive function [2,3]. For example, chronic trials ranging from 8 weeks to three months show that daily consumption of flavonoid-rich cocoa is associated with positive effects on working memory and executive function in healthy older adults [4][5][6]. ...
Article
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There is good evidence that cocoa flavonoids can acutely improve cognitive function in humans, possibly via mechanisms such as increased cerebral blood flow. To date, much of the evidence is based on measures of executive function with extracts and cocoa-based interventions with a high flavonoid content. The aim of the present study was to explore whether benefits to episodic verbal memory and mood are observed two hours post consumption of a commercially available dark chocolate (DC) bar relative to a 35 g white chocolate bar (WC). Ninety-eight healthy young adults (n = 57 females) aged 18–24 years consumed either a 35 g DC bar or a calorie-matched low flavonoid WC bar. Verbal episodic memory and mood were assessed pre consumption and 2 h post consumption. An ANOVA analysis showed that the DC was associated with better verbal memory performance for several outcome measures of the Rey Auditory Verbal Learning Test relative to the WC, however, there were no effects on mood. These findings lend support to the notion that everyday available portions of dark chocolate can confer benefits to the brain in healthy consumers.
... Se han encontrado evidencias sobre el efecto beneficioso de un patrón de dieta saludable sobre el estado cognitivo (7,8). También hay evidencias del efecto beneficioso de ciertos nutrientes como la vitamina D y los flavonoides sobre el estado mental (9)(10)(11). El chocolate es un alimento con gran contenido en flavonoides y metilxantinas. ...
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Introduction: Introduction: currently, the elderly population is increasing and with it, the presence of diseases. Phenolic compounds are substances that have antioxidant properties which can impact on the prevention of oxidative damage, closely related to the onset of various diseases. Most phenolic compounds are bioaccessible and bioavailable through mechanical, enzymatic and chemical routes. However, during aging these factors are modified, affecting the absorption of these compounds. Objective: to know the recent information related to the consumption of phenolic compounds and implications for health in the elderly. Methods: a search was made in different academic bases and/or search engines (EBSCOHOST, PubMed and Science Direct) about total phenol consumption in older adults. This information was analyzed and subclassified considering chronic diseases. Results: older adults have an intake of phenolic compounds ranging from 280 ± 130 to 2,771 ± 1,552 mg/day and the amount that reflects a benefit against cardiovascular diseases, metabolic syndrome and diabetes in older adults ranges from 322 ± 153 to 2,861 mg/day. Conclusion: in some cases, the consumption of polyphenols in the elderly is not enough to generate a prevention against different diseases, so increasing their quantity is recommended. There are different situations that modify bioaccessibility and bioavailability, including the deficiency of polyphenol transporters, so the amount needed is modified to carry out its action in the body. There are few studies of this type in this population, so more research is recommended.
... Effects of long-term chocolate and cocoa consumption on neurocognition, including age-related cognitive decline, have been shown in animal models while few human observational and intervention studies seem to corroborate these findings. These potential effects are probably linked to the high content of polyphenols in chocolate and cocoa [147,148]. Green tea has also shown affect on cognition, mood and human brain function, while laboratory studies also reported antiamyloid effects of tea components [149,150]. Finally, findings regarding coffee consumption are not univocal, showing a J-shaped association between coffee consumption and occurrence of cognitive disorders with the lowest risk of incident cognitive disorders at a daily consumption level of 1-2 cups of coffee [151]. ...
Article
The decline in cognitive function is generally the result of the complex interaction of several factors. First of all, age, but also demographic, educational, genetic, socio-economic, and environmental determinants, including nutrition. Cognitive decline and dementia prevalence are increasing, and they are projected to continue increasing in the next decades due to aging of the world population. Currently, there are no effective pharmacological treatments for these devastating and disabling conditions, which emphasizes the key role of preventive strategies. There is compelling evidence of the role of diet and lifestyle on cognitive function. Therefore, dietary/nutritional approaches that contribute to prevent, or slow cognitive decline may have a remarkable public health impact. Numerous studies have explored the role of dietary components and patterns on age-associated cognitive decline, with accruing evidence that combinations of foods and nutrients can have synergistic effects beyond those attributable to individual foods or nutrients. Dietary patterns with the strongest evidence for slowing the development of cognitive decline, incident Alzheimer’s disease and other dementias include the Mediterranean diet, the Dietary Approaches to Stop Hypertension diet, and their combination (the MedDiet-DASH Intervention for Neurodegenerative Delay - MIND), among others with few positive results. There are also dietary patterns with no evidence of such effects. This review examines the evidence for the effects of some dietary patterns as neuroprotective, with potential to delay cognitive decline and the onset of dementia.
... reappraisal, distraction, expressive suppression) is that it leverages hedonic capacity, or positive affect, which appears to be limited among depressed and depression-prone individuals (for a review see Gilbert, 2012; for a metaanalysis see Bylsma, Morris, & Rottenberg, 2008). If it is the hedonic tone of PAM that poses a challenge to depression-prone individuals, one would also expect impaired performance in implementing other hedonic toned strategies, such as turning to up-beat entertainment, seeking out humorous material, or eating pleasurable foods such as chocolate (Parkinson & Totterdell, 1999;Scholey & Owen, 2013;Thayer, Newman, & McClain, 1994). While there is evidence, for example, that comedy can ameliorate the negative physiological consequences of distress (Fredrickson & Levenson, 1998) and that consuming chocolate can reduce subjects' negative mood (Macht & Mueller, 2007), research has focused mostly on PAM in spite of the fact that it is infrequently used to repair mood in naturalistic settings (Heiy & Cheavens, 2014). ...
Article
The aim of the present study was to examine whether offspring at high and low familial risk for depression differ in the immediate and more lasting behavioural and physiological effects of hedonically-based mood repair. Participants (9- to 22-year olds) included never-depressed offspring at high familial depression risk (high-risk, n = 64), offspring with similar familial background and personal depression histories (high-risk/DEP, n = 25), and never-depressed offspring at low familial risk (controls, n = 62). Offspring provided affect ratings at baseline, after sad mood induction, immediately following hedonically-based mood repair, and at subsequent, post-repair epochs. Physiological reactivity, indexed via respiratory sinus arrhythmia (RSA), was assessed during the protocol. Following mood induction and mood repair, high- and low-risk (control) offspring reported comparable changes in levels of sadness and RSA. However, sadness increased among high-risk offspring following the post-repair epoch, whereas low-risk offspring maintained mood repair benefits. High-risk/DEP offspring also reported higher levels of sadness following the post-repair epoch than did low-risk offspring. Change in RSA did not differ across the three offspring groups. Self-ratings confirm that one source of difficulty associated with depression risk is diminished ability to maintain hedonically-based mood repair gains, which were not apparent at the physiological level.
... Small RCTs have shown enhanced denate gyrus function in healthy 50-to 69-year-olds, measured by cognitive tests after a cocoa flavanol containing diet for 3 months; increased brain perfusion in subjects (age 50-65 years) after intake of 494 mg of cocoa flavanols; and increased blood flow velocity in the middle cerebral artery after 1 and 2 weeks of cocoa flavanol intake by healthy subjects (mean age 72 years; Dominguez & Barbagallo, 2018). Other RCTs also provide supportive data to conclude benefits of cocoa flavanols on cognitive functions, including in healthy young adults and in elderly people with MCI (Massee et al., 2015; Sokolov et al., 2013).However, not all studies have concluded such effects, with a flavonoid-rich diet (in placebo groups) suggested to explain the lack of efficacy in some RCTs(Scholey & Owen, 2013). Many studies (laboratory and clinically) investigating the effects of cocoa flavanols do not define the specific chemical profile or identities of the cocoa flavanols studied. ...
Article
Cognitive decline can occur with normal ageing and in age‐related brain disorders, such as mild cognitive impairment and dementia, including Alzheimer's disease, with limited pharmacological therapies available. Other approaches to reduce cognitive decline are urgently needed, and so the role of dietary interventions or nutraceuticals has received much attention in this respect. In this review, we examine the evidence for dietary plants and their chemical constituents as nutraceuticals, relevant to both cognitive decline in normal ageing and in dementia. Pharmacological (in vitro and in vivo), clinical and epidemiological evidence is assessed for both frequently consumed plants and their dietary forms, including tea, coffee, cocoa (chocolate), red wine, grapes, citrus and other fruits; in addition to plants used less frequently in certain diets, and that cross the blurred boundaries between foods, nutraceuticals and medicinal plants. For the latter, turmeric, saffron, sage, rosemary and lemon balm are examples of those discussed.
... Cocoa is another polyphenol-rich food studied for its effects on cognition (91)(92)(93). In a recent review (94) cognitive benefits were noted following acute treatment with cocoa flavanols, but conflicting results were seen in longer trials. ...
Article
The aging population is expanding, as is the prevalence of age-related cognitive decline (ARCD). Of the several risk factors that predict the onset and progression of ARCD, 2 important modifiable risk factors are diet and physical activity. Dietary patterns that emphasize plant foods can exert neuroprotective effects. In this comprehensive review, we examine studies in humans of plant-based dietary patterns and polyphenol-rich plant foods and their role in either preventing ARCD and/or improving cognitive function. As yet, there is no direct evidence to support the benefits of a vegetarian diet in preventing cognitive decline. However, there is emerging evidence for brain-health-promoting effects of several plant foods rich in polyphenols, anti-inflammatory dietary patterns, and plant-based dietary patterns such as the Mediterranean diet that include a variety of fruits, vegetables, legumes, nuts, and whole grains. The bioactive compounds present in these dietary patterns include antioxidant vitamins, polyphenols, other phytochemicals, and unsaturated fatty acids. In animal models these nutrients and non-nutrients have been shown to enhance neurogenesis, synaptic plasticity, and neuronal survival by reducing oxidative stress and neuroinflammation. In this review, we summarize the mounting evidence in favor of plant-centered dietary patterns, inclusive of polyphenol-rich foods for cognitive well-being. Randomized clinical trials support the role of plant foods (citrus fruits, grapes, berries, cocoa, nuts, green tea, and coffee) in improving specific domains of cognition, most notably frontal executive function. We also identify knowledge gaps and recommend future studies to identify whether plant-exclusive diets have an added cognitive advantage compared with plant-centered diets with fish and/or small amounts of animal foods.
... Consuming chocolate is identified to not only improve mood but also increase blood glucose level and therefore productivity [11,12]. Before the recruitment period started for each trial, all residents and senior surgeons received chocolate gifts with printed information about the trials. ...
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Background: The success of a clinical trial depends on its recruitment of eligible patients; therefore, the recruitment period requires special attention. We hypothesized that with a new approach focused on continuous information and gratification, resident motivation to participate in scientific work will increase and recruitment rates will improve. Methods: Our new recruitment approach was applied to the recruitment phase of two prospective randomized trials (registered at the German Clinical Trials Register). Randomization of these trials was performed first using blinded envelopes; later a soft drink machine was used as the delivery tool of randomization as a lighthearted motivation to join scientific work and to reward the resident with free soft drinks for each recruitment. Residents were informed about the trial via a lecture and by mail. To increase interest everyone received Swiss chocolate. With a multiple choice survey we investigated the success of our actions at 6 and 12 months. Recruitment rates of the trials were evaluated and associated with the motivational approaches. Results: Our residents rated their awareness of the trials with median 9 (IQR 7;9) during the first and 8 (IQR 5;9) during the second survey and their interest in scientific work with median 7 (IQR 4;8) and 6 (IQR 5;8). The percentage of residents feeling highly motivated improved from 58% to 70%. The recruitment rates stayed stably high over time with 73% and 72% in trial 1 and 90% and 85% in trial 2; 24% of residents stated their motivation could be increased by gratifications. Conclusions: After implementation of our new recruitment approach we found positively motivated residents and high recruitment rates in the corresponding trials. We propose this procedure may help to ensure the successful initiation of clinical trials. Larger studies testing this approach are warranted.
... Across the included studies was a total of 84 eligible original studies. [25][26][27][28][29][30][31][32][33][34] These systematic reviews and meta-analyses included 19 health outcomes ( Table 1). Ten of these outcomes were derived from meta-analyses including RCTs, and the other nine from observational studies, all from longitudinal cohort studies. ...
Article
Background & aims The literature regarding the potential health benefits of chocolate consumption are unclear and the epidemiological credibility has not been systematically scrutinized, while the strength of the evidence is undetermined. We therefore aimed to map and grade the diverse health outcomes associated with chocolate consumption using an umbrella review of systematic reviews. Methods Umbrella review of systematic reviews of observational and interventional studies (randomized placebo-controlled trials, RCTs). For each association, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect and evidence for excess significance bias. For significant outcomes of the RCTs, the GRADE assessment was furtherly used. Results From 240 articles returned, 10 systematic reviews were included (8 of which included a meta-analysis), including a total of 84 studies (36 prospective observational studies and 48 interventional). Nineteen different outcomes were included. Among observational studies, including a total of 1,061,637 participants, the best available evidence suggests that chocolate consumption is associated with reduced risk of cardiovascular disease (CVD) death (n=4 studies), acute myocardial infarction (n=6), stroke (n=5) and diabetes (n=6), although this was based on a weak evidence of credibility. Across meta-analyses of intervention studies, chocolate consumption was positively associated with flow-mediated dilatation at 90-150 minutes (n=3) and at 2-18 weeks (n=3), and insulin resistance markers (n=2). However, using the GRADE assessment, the evidence for these outcomes was low or very low. Data from two systematic reviews, reported that chocolate consumption was not associated with depressive mood or cognitive function. Conclusions There is weak evidence to suggest that chocolate consumption may be associated with favorable health outcomes.
... Se han encontrado evidencias sobre el efecto beneficioso de un patrón de dieta saludable sobre el estado cognitivo (7,8). También hay evidencias del efecto beneficioso de ciertos nutrientes como la vitamina D y los flavonoides sobre el estado mental (9)(10)(11). El chocolate es un alimento con gran contenido en flavonoides y metilxantinas. ...
... Chocolate is known to have mood-enhancing properties, mostly due to its orosensory properties, psychoactive ingredients, and the activation of neural reward pathways [55]. The consumption of chocolate may be associated with an improvement in the mood state, the attenuation of negative moods, or reduced odds of clinically relevant depressive symptoms [55,56]. ...
Article
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Migraine is a chronic disorder with episodic attacks, and patients with a migraine often report that certain factors can trigger their headache, with chocolate being the most popular type of food-based trigger. Many studies have suggested a link between chocolate and headaches; however, the underlying physiological mechanisms are unclear. As premonitory symptoms may herald migraine attacks, a question arises regarding whether eating chocolate before a headache is a consequence of a food craving or indeed a real trigger. Here, we aim to summarize the available evidence on the relationship between chocolate and migraines. All articles concerning this topic published up to January 2020 were retrieved by searching clinical databases, including EMBASE, MEDLINE, PubMed, and Google Scholar. All types of studies have been included. Here, we identify 25 studies investigating the prevalence of chocolate as a trigger factor in migraineurs. Three provocative studies have also evaluated if chocolate can trigger migraine attacks, comparing it to a placebo. Among them, in 23 studies, chocolate was found to be a migraine trigger in a small percentage of participants (ranging from 1.3 to 33), while all provocative studies have failed to find significant differences between migraine attacks induced by eating chocolate and a placebo. Overall, based on our review of the current literature, there is insufficient evidence that chocolate is a migraine trigger; thus, doctors should not make implicit recommendations to migraine patients to avoid it.
... 4). Moreover, it seems the beneficial effect of dark chocolate on cognition probably presents the role of high flavanol and epicatechin content with antioxidant properties on the improvement of brain functions (Lamport et al., 2020;Scholey and Owen, 2013). In this way, Lamport et al. ...
... For example, 5-hydroxytryptophan (5-HTP) is an important precursor to monitor during roasting as it can pass the blood-brain barrier and form serotonin in the brains after decarboxylation (Turner et al., 2006). The top level represents the unique orosensory properties of cocoa (level 4), since presumably the mood and cognition are not only a ected by pharmacological actions, but also through avor (Scholey & Owen, 2013). ...
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Roasting plays a critical role in the production process of cocoa liquor and chocolate. Besides desirable changes in color and moisture content, flavor development is one of the most important reasons to roast cocoa. By means of a convective and/or conductive heat transfer, cocoa and nutty flavors are generated within the roasted beans, while the bitter taste and astringent mouthfeel are reduced. Roasting via a convective and/or conductive heat transfer is easy applicable and therefore also commonly used. However, these roasting techniques are lately questioned due to the long roasting times needed to sufficiently heat the core of the beans. Therefore, a growing interest is encountered to search for optimal roasting conditions and/or alternative roasting techniques, with the development of a desirable flavor profile as primary criterion. Within this research a comparison was made between conventional and microwave-assisted roasting with the main focus on flavor. The impact of varying roasting conditions (i.e. time, temperature and power input) on the flavor profile of cocoa liquor and chocolate was investigated via both instrumental (i.e. HS-SPME-GC-MS, UPLC-HRMS) and sensory (i.e. trained panel, consumer panel) techniques. Results confirmed that microwave-assisted roasting has the potential to be used as alternative technique.
... It follows that a higher score means better quality. Note that criterion 8 has been modified from "Was the intervention at a therapeutic dose?" to "Was the amount administered documented?", as in Scholey and Owen (2013). ...
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A transient improvement in cognitive performance can be observed following the ingestion of a glucose drink, a phenomenon known as the ‘glucose facilitation effect’. The effect has been studied thoroughly in the last three decades, but its neural underpinnings remain a matter of speculation. A systematic review was conducted to evaluate the current evidence from studies applying neuroimaging or neurophysiological methods to investigate the glucose enhancement effect. Eleven studies met the inclusion criteria of using neuroimaging in conjunction with cognitive outcomes. Six studies employed electroencephalography (EEG), four used functional magnetic resonance imaging (fMRI) and one employed functional near-infrared spectroscopy (fNIRS). All but one study reported modulation of neurophysiology or neuroimaging markers following glucose, while only five studies reported significant changes in cognitive outcomes. The evidence suggests that glucose administration enhances neurocognitive markers of episodic memory and attentional processes underpinned by medial temporal and frontal activation, sometimes in the absence of measurable behavioural effects. Further exploration of glucose facilitation using neuroimaging measures with increased sample sizes is warranted to replicate these findings.
... From the health point of view, taking small-moderate amounts of chocolate may have a number of health benefits (Latif 2013). Some researchers stated that chocolate may potentially possess anti-depressant effects and prevent cognitive dysfunction (Walcutt 2009;Latif 2013) while others did not find the relevant evidence (Scholey and Owen 2013;Veronese et al. 2019). Further investigation manifested that the consumption of chocolate enhanced positive mood, especially when it was eaten mindfully (Meier et al. 2017). ...
Article
With the dramatic development of source and detector components, terahertz (THz) spectroscopy technology has recently shown a renaissance in various fields such as medical, material, biosensing and pharmaceutical industry. As a rapid and noninvasive technology, it has been extensively exploited to evaluate food quality and ensure food safety. In this review, the principles and processes of THz spectroscopy are first discussed. The current state-of-the-art applications of THz and imaging technologies focused on foodstuffs are then discussed. The advantages and challenges are also covered. This review offers detailed information for recent efforts dedicated to THz for monitoring the quality and safety of various food commodities and the feasibility of its widespread application. THz technology, as an emerging and unique method, is potentially applied for detecting food processing and maintaining quality and safety.
... Research suggests that emotion regulation can derive from some foods, which are often high in fat and sugar and may be understood as "comfort foods" (Macht and Mueller 2007), temporarily diminishing negative mood and evoking a state of pleasure (e.g. Scholey and Owen 2013;Wansink et al. 2003). For example, Macht and Dettmer (2006) found participants reported a positive mood after eating chocolate in comparison with those eating an apple or nothing. ...
Article
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Foods high in fat and sugar can often act as emotional regulators during negative emotional states, and regularly engaging in such behaviour can contribute towards weight gain. The present study investigated whether using mindful construal diaries (MCD) adapted with the element of self-distancing could improve state mindfulness, attenuate negative affect, and reduce chocolate intake. One hundred twenty participants were randomly assigned to one of three conditions, self-immersed, self-distanced, and control, and after evoking a negative state affect through a film excerpt, participants were served chocolate. The findings suggested there were no significant differences in improving state mindfulness or state negative affect across the three conditions. However, participants in the control condition did consume significantly more chocolate than those in the self-immersed and self-distanced conditions. Whilst there were no significant differences in chocolate intake between the two experimental conditions, those in the self-distanced condition did consume the least amount of chocolate. The concept of self-distancing may be beneficial in improving emotional eating behaviours further in mindful and attentive eating interventions. Limitations and recommendations for future research are discussed.
... Together with minor alkaloids, some other minor compounds present in cocoa, such as biogenic amines are reported to contribute to the mood-enhancing effect of cocoa. The top level represents the unique orosensory properties of cocoa (level 4), since presumably the mood and cognition are not only affected by pharmacological actions, but also through flavor (Scholey & Owen, 2013). The authors suggested that the role and interaction of the major and minor compounds affecting mood and cognition should be further investigated by a more detailed phytochemical analysis of cocoa and other cocoa samples. ...
Article
The mood pyramid of cocoa, which was previously proposed as a new concept, consists of four levels (flavan-3-ols, methylxanthines, minor compounds and orosensory properties). Roasting is a crucial process for flavor development in cocoa but is likely to have a negative impact on the phytochemicals. We investigated the effect of roasting time (10 – 50 min) and temperature (110 – 160 °C) on the potential mood-enhancing compounds corresponding to the distinct mood pyramid levels. Phytochemicals were analyzed using UPLC-HRMS, while the flavor was mapped via aroma (HS-SPME-GC-MS) and generic descriptive analysis (trained panel). Results revealed that roasting at 130 °C for 30 min did not significantly affect the levels of epicatechin, procyanidin B2 and theobromine, while salsolinol significantly increased. Moreover, bitterness and astringency were reduced and the desired cocoa flavor was developed. Thus, through selection of appropriate roasting time and temperature conditions phytochemicals of interest could be retained without comprising the flavor.
... Consumption of dietary antioxidants such as the polyphenols in green tea has shown a negative correlation with depression-like symptoms Huang et al., 2019;Knüppel et al., 2017). Likewise, chocolate or its components have been found to reduce negative mood or enhance mood, and also enhance or alter cognitive functions temporarily (Scholey and Owen, 2013). Alcohol consumption is prevalent amongst university students including those who report feelings of sadness and hopelessness (Htet et al., 2020). ...
Article
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Academic achievement and cognitive functions are influenced by sleep and mood/emotion. In addition, several other factors affect learning. A coherent overview of the resultant interrelationships is essential but has not been presented till date. This unique and interdisciplinary review sits at the interface of physiology, psychology, and education. It compiles and critically examines the effects of sleep and mood on cognition and academic performance while including relevant conflicting observations. Moreover, it discusses the impact of several regulatory factors on learning, namely, age, gender, diet, hydration level, obesity, sex hormones, daytime nap, circadian rhythm, and genetics. Core physiological mechanisms that mediate the effects of these factors are described briefly and simplistically. The bidirectional relationship between sleep and mood is addressed. Contextual pictorial models that hypothesise learning on an emotion scale and emotion on a learning scale have been proposed. Essentially, convoluted associations between physiological and psychological factors, including sleep and mood that determine academic performance are recognised and affirmed. The emerged picture reveals far more complexity than perceived. It questions the currently adopted ‘one-size fits all’ approach in education and urges to envisage formulating bespoke strategies to optimise teaching-learning approaches while retaining uniformity in education. The information presented here can help improvise education strategies and provide better academic and pastoral support to students during their academic journey.
... Sadness processing was examined during sad mood induction and subsequent mood repair either via watching a comic film clip (Ruch, 1993) or consuming chocolate (Macht & Mueller, 2007). Mood repair has been associated with both watching comedy (e.g., Fredrickson & Levenson, 1998) and indulging in "comfort" foods, including chocolate (see Scholey & Owen, 2013, for a review). Based on abovementioned findings of blunted SNS processing associated with depression-relevant traits (Bibbey et al., 2013), we predicted that relative to controls, youths at familial risk for depression would display blunted SNS reactivity to sadness induction. ...
Article
Youths at high risk for depression have been shown to have problems in repairing their own sad mood. Given that sympathetic arousal has been implicated both in the experience and regulation of affect, an atypical pattern of arousal may be one of the factors that contribute to mood repair problems. In the current study, we measured sympathetic arousal of never‐depressed youths at high (n = 56) and low (n = 67) familial risk for depression during sad mood induction and instructed mood repair. Sympathetic arousal was indexed by skin conductance level (SCL) and cardiac pre‐ejection period (PEP); mood repair outcome was indexed by self‐rated affect. High‐risk youths demonstrated increased SCL during sadness induction, which persisted during mood repair; low‐risk youths evidenced increased SCL only during mood repair. Shortened PEP was evident only among high‐risk youths and only during mood repair. Furthermore, shortened PEP during mood induction predicted less successful mood repair in the low‐risk but not in the high‐risk group. The findings suggest that: (a) depression‐prone youths differ from control peers in patterns of sympathetic responses to emotional stimuli, which may impair their ability to relieve sadness, and (b) activation patterns differ across subsystems (SCL vs. PEP) of sympathetic activity, in conjunction with depression risk status. Difficulties in attenuating sadness (i.e., mood repair deficits) appear to be risk factors for depression. It is, therefore, important to understand better how physiological processes facilitate or hinder successful mood repair. In the present study, never‐depressed youths at high familial risk for depression and low‐risk control youths differed in sympathetic activation during sadness processing; sympathetic activation may, therefore, play a role in mood repair deficits.
... Dark chocolate contain at least 15% cocoa liquor but may contain as much as 60%, rich in polyphenols such as monomer flavanols (epicatechin and catechin) as well as procyanidins, especially dimer procyanidin B2 and B1 which are abundant phytochemicals in cocoa [2]. Accumulating epidemiological evidences suggest that polyphenol plays an important role in the prevention of chronic disease such as cardiovascular disease (CVD), cancer, diabetes, obesity and neurodegenerative disease [3][4][5][6][7][8]. Different preventive mechanisms have been proposed due to its high antioxidant properties (free radical scavenging and metal chelating) of polyphenol although the regulatory mechanism involved still unknown. ...
Article
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There was variety of chocolate in the market nowadays. Chocolate constituents such as cocoa liquor, cocoa butter, types of sugar and other additional ingredients were determined its potential as healthy chocolate. Supporting with historically records and recent scientific data shown that cocoa the main ingredient of chocolate, is rich in polyphenols that have been shown potential antioxidant which contribute to improve health and prevent degenerative disease. The study was carried out to examine the effect of two formulations high antioxidant dark chocolate on serum glucose and cholesterol level in Sprague-Dawley rats. Forty rats were divided into four groups (n=10) and received: normal diets (group C); normal diets+control dark chocolate, normal diets+chocolate F1 (group F1) and normal diets+chocolate F2 (group F2) for four weeks. There is an increased of body weight in control diabetic rats, dark chocolate and high antioxidant F1 chocolate groups. Small decreasing pattern were showed in % normality of serum glucose level in rats given high antioxidant chocolate F1 and F2 compare to control diabetic rats and rats given dark chocolate. Almost no changes in % normality of serum cholesterol level in all groups of diabetic rats. As conclusion, existing high antioxidant dark chocolate is not suitable to be consume among diabetic people and new high antioxidant dark chocolate formulation must be developed for better diabetic people consumption.
... Assim, o chocolate pode ser uma alternativa saborosa e prática além de minimizar a falta de prazer na alimentaçãosaudável.Os benefícios da utilização do chocolate amargo para a saúde são largamente conhecidos, são boas fontes de flavonóides e seu consumo está associado com a diminuição do risco de morte por doenças cardiovasculares, diminuição da pressão arterial e inibição da agregação plaquetária(Djousséet al.,2011).Não obstante, o mercado de chocolates com esse perfil ainda é pequeno, as prateleiras ainda estão cheias de produtos com alto teor de gorduras, açúcares e baixa concentração de cacau e polifenóis(Titton, Schumacher & Dani, 2014).O cacau (Theobroma cacao) é um fruto abundantena região Sul da Bahia-Brasil, utilizado como base para o chocolate, tem grande importância cultural e econômica para a região.Além do cacau, outras plantas brasileiras possuem efeitos benéficos, destacando aqui a Mansoa hirsuta DC, uma planta do semi-árido do Brasil, rico em ácidos triterpênicos.Apesar de estar presente em inúmeras plantas, a obtenção desses dois ácidos geralmente é feita através do seu isolamento de cascas de maçã, um processo oneroso(Siani et al., 2014). No entanto, recentemente, esses mesmos compostos foram extraídos e isolados da Mansoa hirsuta DC, uma planta do semi-árido do Brasil, em um processo de extração e isolamento realizadossob depósito de patente nº BR 1020150081804, os quais serão utilizados nesse trabalho.Um chocolate com adição de novas substâncias, como os ácidos ursólico e oleanólico, poderia potencializar seus efeitos e traria grandes vantagens à população, visto que é um alimento popular, que apresenta inúmeros benefícios à saúde e consumido mundialmente(Scholey & Owen, 2013). Algumas pesquisas foram realizadas com o intuito de verificar os efeitos do consumo de chocolate na saúde dos indivíduos (Bohannon, Koch, Obtenção dos ácidos ursólico e oleanólico O ácido ursólico e seu isômero o ácido oleanólico, isolados e extraídos das folhas da planta Mansoa hirsuta DC, em um processo de extração e isolamentorealizadossob depósito de patente nº BR 1020150081804, foram fornecidos pelo Laboratório de Farmacognosia do curso de Farmácia da Universidade Estadual do Sudoeste da Bahia, com autorização do autor da patente.Foram desenvolvidas duas formulações de chocolate; uma contendo os ácidos triterpênicos para ser utilizada em ensaio clínico de grupo teste; outra não contendo ácidos triterpênicos, para ser utilizada em ensaio clinico em grupo placebo.Tamanho médio das partículas foi determinado por meio da utilização de um micrômetro digital, com escala de 0-25 μm, de acordo comSampaio (2011).Foi realizada análise qualitativa para verificar a presença dos ácidos nas amostras de chocolate, por meio da metodologia de cromatografia em camada delgada, utilizando para fins comparativos os padrões dos ácidos ursólico e oleanólico, nas seguintes condições: ...
... Some reviews tend towards the positive. For instance, Scholey and Owen [31] highlighted beneficial acute effects of CF on cognitive performance, and Socci et al. [32] mentioned that CF could increase cognitive functioning and generally enhance cognitive achievement. In a systematic review that came out this year, Barrera-Reyes et al. [33], indicated that CF has a medium to large effect on memory and executive function. ...
Article
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Background: Consumption of cocoa flavanols may have acute physiological effects on the brain due to their ability to activate nitric oxide synthesis. Nitric oxide mediates vasodilation, which increases cerebral blood flow, and can also act as a neurotransmitter. Objectives: This study aimed to examine whether cocoa flavanols have an acute influence on visual working memory (WM). Methods: Two separate randomised, double-blind, placebo-controlled, counterbalanced crossover experiments were conducted on normal healthy young adult volunteers (NExp1=48 and NExp2=32, gender-balanced). In these experiments, 415 mg of cocoa flavanols were administered to test their acute effects on visual working memory. In the first experiment, memory recall precision was measured in a task that required only passive maintenance of grating orientations in WM. In the second experiment, the recall was measured after active updating (mental rotation) of WM contents. Habitual daily flavanols intake, body mass index, and gender were also considered in the analysis. Results: The results suggested that neither passive maintenance in visual WM nor active updating of WM were acutely enhanced by consumption of cocoa flavanols. Exploratory analyses with covariates (body mass index and daily flavanols intake), and the between subjects factor of gender also showed no evidence for effects of cocoa flavanols, neither in terms of reaction time nor accuracy. Conclusions: Overall, cocoa flavanols did not improve visual working memory recall performance during maintenance, nor did it improve recall accuracy after memory updating.
... Finally, further research is needed, in which more factors, related with the chocolate choice should be included. This is because such factors as craving [43,44] or feeling depressed [45] can lead to changes of the chocolate choice. ...
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... Another example, frequently promoted in health claims, is that of flavonoid polyphenols derived from cocoa that are present in high amounts in dark chocolate. These PC exhibit high antioxidant and antiinflammatory properties [77], and have been shown to exert beneficial effects by preventing neurodegeneration and mood impairment [78]. Jackson et al. [79] analyzed the US National Health and Nutrition Examination Survey (NHANES) data of dietary intake during 2007-2008 and 2013-2014, observing that dark chocolate intake associated with reduced depressive symptoms. ...
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Cocoa flavanols (CF) positively influence physiological processes in ways that suggest their consumption may improve aspects of cognitive function. This study investigated the acute cognitive and subjective effects of CF consumption during sustained mental demand. In this randomized, controlled, double-blinded, balanced, three period crossover trial 30 healthy adults consumed drinks containing 520 mg, 994 mg CF and a matched control, with a three-day washout between drinks. Assessments included the state anxiety inventory and repeated 10-min cycles of a Cognitive Demand Battery comprising of two serial subtraction tasks (Serial Threes and Serial Sevens), a Rapid Visual Information Processing (RVIP) task and a 'mental fatigue' scale, over the course of 1 h. Consumption of both 520 mg and 994 mg CF significantly improved Serial Threes performance. The 994 mg CF beverage significantly speeded RVIP responses but also resulted in more errors during Serial Sevens. Increases in self-reported 'mental fatigue' were significantly attenuated by the consumption of the 520 mg CF beverage only. This is the first report of acute cognitive improvements following CF consumption in healthy adults. While the mechanisms underlying the effects are unknown they may be related to known effects of CF on endothelial function and blood flow.
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HOLTZMAN (1974, 1975) was the first to report that the pure opioid receptor antagonist, naloxone, significantly reduced food consumption in rats. At first these unexpected results were difficult to interpret. However, following the discovery of endogenous opioid peptides, these data could be explained in terms of the antagonism of endogenous opioid activity (SANGER 1981; MORLEY and LEVINE 1982; COOPER and SANGER 1984). The suppressant effects of naloxone and other opioid receptor antagonists on feeding behaviour were described initially using food-deprived rats and mice (e.g. HOLTZMAN 1974; ROGERS et al. 1978; MARGULES et al. 1978; BRANDS et al. 1979; BROWN and HOLTZMAN 1979). Naloxone also reduced free-feeding and drinking in rats (COOPER 1980), as well as eating induced by tail pinch (Lowy et al. 1980; MORLEY and LEVINE 1980), by 2-deoxY-D-glucose (SEWELL and JAWAHARLAL 1980), and by electrical stimulation of the brain (CARR and SIMON 1983).
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Despite the popular belief that chocolate adversely affects young children's behaviour, there have been no direct investigations into the behavioural response to chocolate consumption. This study investigated the effect of chocolate ingestion on the behaviour of 26 preschool children. Dried fruit was consumed in a separate condition to control for nonspecific factors, such as excitement and novelty, associated with the effects of receiving positive substances. Children were observed while they listened to a short story, immediately before and 30 minutes after they ate chocolate or fruit. The children's behaviours were videotaped and scored by two blind raters who coded their behaviours according to six objective and two subjective measures. There were no significant behavioural changes due to consumption of either chocolate or fruit on subjective and objective ratings. These findings raise questions about the popular perception that chocolate promotes poor attention and increased activity in preschool children.
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Although certain commonalities exist between eating and drug use (mood effects, external cue-control of appetites, reinforcement, etc.), it is argued that the vast majority of cases of (self-reported) food craving and food “addiction” should not be viewed as addictive behavior. An explanation is proposed that instead gives a prominent role to the psychological processes of ambivalence and attribution, operating together with normal mechanisms of appetite control, the hedonic effects of certain foods, and socially and culturally determined perceptions of appropriate intakes and uses of those foods. Ambivalence (e.g., “nice but naughty”) about foods such as chocolate arises from the attitude that it is highly palatable but should be eaten with restraint. Attempts to restrict intake, however, cause the desire for chocolate to become more salient, an experience that is then labelled as a craving. This, together with a need to provide a reason for why resisting eating chocolate is difficult and sometimes fails, can, in turn, lead the individual to an explanation in terms of addiction (e.g., “chocoholism”). Moreishness (“causing a desire for more”) occurs during, rather than preceding, an eating episode, and is experienced when the eater attempts to limit consumption before appetite for the food has been sated.
Article
Exercise studies have suggested that the presence of carbohydrate in the human mouth activates regions of the brain that can enhance exercise performance but direct evidence of such a mechanism is limited. The first aim of the present study was to observe how rinsing the mouth with solutions containing glucose and maltodextrin, disguised with artificial sweetener, would affect exercise performance. The second aim was to use functional magnetic resonance imaging (fMRI) to identify the brain regions activated by these substances. In Study 1A, eight endurance-trained cyclists ( 60.8 ± 4.1 ml kg−1 min−1) completed a cycle time trial (total work = 914 ± 29 kJ) significantly faster when rinsing their mouths with a 6.4% glucose solution compared with a placebo containing saccharin (60.4 ± 3.7 and 61.6 ± 3.8 min, respectively, P= 0.007). The corresponding fMRI study (Study 1B) revealed that oral exposure to glucose activated reward-related brain regions, including the anterior cingulate cortex and striatum, which were unresponsive to saccharin. In Study 2A, eight endurance-trained cyclists ( 57.8 ± 3.2 ml kg−1 min−1) tested the effect of rinsing with a 6.4% maltodextrin solution on exercise performance, showing it to significantly reduce the time to complete the cycle time trial (total work = 837 ± 68 kJ) compared to an artificially sweetened placebo (62.6 ± 4.7 and 64.6 ± 4.9 min, respectively, P= 0.012). The second neuroimaging study (Study 2B) compared the cortical response to oral maltodextrin and glucose, revealing a similar pattern of brain activation in response to the two carbohydrate solutions, including areas of the insula/frontal operculum, orbitofrontal cortex and striatum. The results suggest that the improvement in exercise performance that is observed when carbohydrate is present in the mouth may be due to the activation of brain regions believed to be involved in reward and motor control. The findings also suggest that there may be a class of so far unidentified oral receptors that respond to carbohydrate independently of those for sweetness.
Article
Patients with seasonal affective disorder (SAD) selectively eat more carbohydrates (CHO), particularly sweets but also starch-rich foods, during their depression in winter. The Dutch Eating Behaviour Questionnaire (DEBQ) was administered to female SAD patients, healthy female controls, and female medical students to determine their eating style, together with the modified Seasonal Pattern Assessment Questionnaire (SPAQ+). SAD patients showed higher values for “emotional” (EMOT) eating than the students, and these in turn had higher values than the controls. In comparison to controls, SAD patients and students had high values for the factor “external” (EXT) eating, but there was no difference between the groups with respect to “restraint” (REST) eating. This is in strong contrast to patients with bulimia and anorexia nervosa, who are high REST eaters, indicating that SAD patients do not have a similar eating disorder. Additional items showed that SAD patients selectively eat sweets under emotionally difficult conditions (when depressed, anxious, or lonely). Configural frequency analysis showed that seasonal body weight change (SBWC) is high in subjects with high EMOT and REST eating together with a high body mass index (BMI). This result is in accordance with the concept of disinhibition of dietary restraint in extreme emotional situations, e.g., the depressive state.
Article
Extensive research indicates a strong relationship between endogenous opioid peptides (EOPs) and food intake. In the present paper, we propose that food cravings act as an intervening variable in this opioid-ingestion link. Specifically, we argue that altered EOP activity may elicit food cravings which in turn may influence food consumption. Correlational support for this opioidergic theory of food cravings is provided by examining various clinical conditions (e.g. pregnancy, menstruation, bulimia, stress, depression) which are associated with altered EOP levels, intensified food cravings, and increased food intake.
Article
The pleasure response to palatable foods, notably those rich in sugar and fat, may be mediated through the endogenous opioid peptide system. In a recent study, infusions of the opioid antagonist naloxone were shown to reduce taste preferences for sugar-fat mixtures and to decrease the consumption of sweet and high-fat foods. The effects were more pronounced among women characterized as compulsive ‘binge-eaters’ than among control subjects. Cravings by obese or bulimic women for chocolate and other sweet, fat-rich desserts may be under opioid control.
Article
In a randomized, double-blind placebo controlled trial, 63 middle-aged volunteers aged between 40 and 65 years were administered a daily chocolate drink containing 250 mg or 500 mg cocoa flavanols versus a low cocoa flavanol (placebo) drink over a 30-day period. Participants were tested at baseline as well as at the end of the treatment period on a test of Spatial Working Memory. Steady State Probe Topography (SST) was used to assess neurocognitive changes associated with cocoa flavanol supplementation during the completion of the Spatial Working Memory task. SST is an electrophysiological technique which utilizes a 13 Hz diffuse visual flicker in order to generate a steady state visually evoked potential (SSVEP). Changes in the amplitude and phase of the SSVEP response after 30 days were compared between treatment groups. Behavioral measures of accuracy and reaction time were not found to be significantly different between treatment groups, while average SSVEP amplitude and phase differences at a number of posterior parietal and centro-frontal sites were found to be significantly different between groups during memory encoding, the working memory hold period and retrieval. In the absence of significant behavioral effects, these differences in brain activation can be interpreted as evidence of increased neural efficiency in spatial working memory function associated with chronic cocoa flavanol consumption.
Article
In concert with growing public interest in complementary and alternative medicine (CAM), these therapies and products have been increasingly studied over the past two decades for the treatment of sleep disorders. While systematic reviews have been conducted on acupuncture and valerian in the treatment of insomnia, to date no comprehensive review has been conducted on all major CAM treatments. We sought to address this via a rigorous systematic review of hypnotic CAM interventions, including herbal and nutritional medicine, acupuncture, acupressure, yoga, tai chi, massage, aromatherapy and homoeopathy. The electronic databases MEDLINE (PubMed), CINAHL, PsycINFO, and The Cochrane Library were accessed during late 2009 for CAM randomized controlled trials (RCTs) in the treatment of chronic insomnia. Sixty-four RCTs were identified, of which 20 studies involving eight CAM interventions met final inclusion criteria. Effect size calculations (where possible) and a quality control analysis using a modified Jadad scale were undertaken. Many RCTs lacked methodological rigor, and were commonly excluded due to small sample size or an inadequate control condition. Among the studies that met inclusion criteria, there was evidentiary support in the treatment of chronic insomnia for acupressure (d=1.42-2.12), tai chi (d=0.22-2.15), yoga (d=0.66-1.20), mixed evidence for acupuncture and L-tryptophan, and weak and unsupportive evidence for herbal medicines such as valerian. Surprisingly, studies involving several mainstream CAM therapies (e.g., homoeopathy, massage, or aromatherapy) were not located or did not meet basic inclusion criteria. If CAM interventions are to be considered as viable stand-alone or adjuvant treatments for sleep disorders, future researchers are urged to use acceptable methodology, including appropriate sample sizes and adequate controls. RCTs evaluating other untested CAM therapies such as massage, homoeopathy, or osteopathy are encouraged, as is the exploration of using CAM therapies adjuvantly with conventional therapies.
Article
While type 2 diabetes is well-known to be associated with poorer cognitive performance, few studies have reported on the association of metabolic syndrome (MetS) and contributing factors, such as insulin-resistance (HOMA-IR), low adiponectin-, and high C-reactive protein (CRP)-levels. We studied whether these factors are related to cognitive function and which of the MetS components are independently associated. The study was embedded in an ongoing family-based cohort study in a Dutch population. All participants underwent physical examinations, biomedical measurements, and neuropsychological testing. Linear regression models were used to determine the association between MetS, HOMA-IR, adiponectin levels, CRP, and cognitive test scores. Cross-sectional analyses were performed in 1,898 subjects (mean age 48 years, 43% men). People with MetS had significantly higher HOMA-IR scores, lower adiponectin levels, and higher CRP levels. MetS and high HOMA-IR were associated with poorer executive function in women (P = 0.03 and P = 0.009). MetS and HOMA-IR are associated with poorer executive function in women.
Article
Cognitive decline and dementia both place a heavy burden on patients and their relatives, and any means of preventing such age-related changes are worthy of consideration. Those who have the metabolic syndrome with or without diabetes suffer more often from dysexecutive problems and slower psychomotor speed than do other patients. In epidemiological studies, diabetes has appeared to be a risk factor for all types of dementia, including vascular dementia, although the role of the metabolic syndrome in the risk of Alzheimer's disease is still a matter of debate. The possible mechanisms of cognitive alterations are multiple, and may differ according to age group and duration of diabetes or the metabolic syndrome. Drug interventional trials addressing the prevention of cognitive decline through action on the metabolic syndrome are disappointing-albeit scarce at this time. Lifestyle interventions in middle-aged or younger-elderly subjects should also be implemented in the general population.
Article
During the 1990s, both the European chocolate industry and the cocoa butter industry have become increasingly centralised. Today only a handful of companies in each segment control the production of intermediate goods and massmarketed brands. The cocoa sectors of the major producing countries in West Africa have at the same time been liberalised and privatised due to the dismantling of state marketing boards. This paper examines the relationship between the new raw material requirements (both in qualitative and quantitative terms) of the processing industry in Europe and restructuring processes in the cocoa sectors of major African producer countries.
Article
Dietary preferences influence basal human metabolism and gut microbiome activity that in turn may have long-term health consequences. The present study reports the metabolic responses of free living subjects to a daily consumption of 40 g of dark chocolate for up to 14 days. A clinical trial was performed on a population of 30 human subjects, who were classified in low and high anxiety traits using validated psychological questionnaires. Biological fluids (urine and blood plasma) were collected during 3 test days at the beginning, midtime and at the end of a 2 week study. NMR and MS-based metabonomics were employed to study global changes in metabolism due to the chocolate consumption. Human subjects with higher anxiety trait showed a distinct metabolic profile indicative of a different energy homeostasis (lactate, citrate, succinate, trans-aconitate, urea, proline), hormonal metabolism (adrenaline, DOPA, 3-methoxy-tyrosine) and gut microbial activity (methylamines, p-cresol sulfate, hippurate). Dark chocolate reduced the urinary excretion of the stress hormone cortisol and catecholamines and partially normalized stress-related differences in energy metabolism (glycine, citrate, trans-aconitate, proline, beta-alanine) and gut microbial activities (hippurate and p-cresol sulfate). The study provides strong evidence that a daily consumption of 40 g of dark chocolate during a period of 2 weeks is sufficient to modify the metabolism of free living and healthy human subjects, as per variation of both host and gut microbial metabolism.
Article
The purpose was to test the hypothesis that a multifaceted 11 weeks randomized controlled intervention would have a significant influence of functional abilities in old nursing home residents. Participants were 121 old (>65 years) residents in seven Danish nursing homes. The intervention consisted of nutrition (chocolate, homemade oral supplements), group exercise (moderate intensity) and oral care. Measurements taken were weight, body mass index (BMI), energy and protein intake, and functional abilities (activities of daily living=ADL, cognitive performance, and social engagement). The results showed that the nutrition and exercise were well accepted. After 11 weeks the change in % weight (1.3 vs. -0.6%, p=0.005), % BMI (0.4 vs. -0.2%, p=0.003), energy intake (0.7 vs. -0.3 MJ/day, p=0.084) and protein intake (5 vs. -2g/day, p=0.012) was higher in the intervention group than in the control group. Also, after 11 weeks, social and physical function had decreased in the control group but was unchanged in the intervention group. The difference between groups was significant in relation to social engagement (p=0.009). After the end of the intervention both groups had lost weight and physical function. Cognitive performance did not change, at any time. In conclusion, it seems possible to maintain social (and physical) functional abilities in old nursing home residents by means of a multifaceted intervention.
Article
In this paper we argue that compulsive overeating has compelling similarities to conventional drug addiction. Our case is based on their comparable clinical features, the biological mechanisms they have in common, and on evidence that the two disorders have a shared diathesis. In making the argument for overeating as an addictive behaviour, it is clearly not appropriate to include all cases of excessive food consumption in this taxon. Nor are we claiming that obesity and addiction are one and the same. However, it is proposed that Binge Eating Disorder (BED) is a phenotype particularly well-suited to such a conceptualization, and that sound clinical and scientific evidence exists to support this viewpoint. We have provided some recommendations for treatment modifications that recognize the similarities between treating drug dependence and compulsive overeating.