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FFS 21 Jan 2005 1 The Case for Pleasure Georges M. Halpern, MD, PhD Distinguished Professor of Pharmaceutical Sciences Hong Kong Polytechnic University.

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Presentation on theme: "FFS 21 Jan 2005 1 The Case for Pleasure Georges M. Halpern, MD, PhD Distinguished Professor of Pharmaceutical Sciences Hong Kong Polytechnic University."— Presentation transcript:

1 FFS 21 Jan The Case for Pleasure Georges M. Halpern, MD, PhD Distinguished Professor of Pharmaceutical Sciences Hong Kong Polytechnic University

2 FFS 21 Jan References Petr Skrabanek. The Death of Humane Medicine. The Social Affairs Unit, UK vol. 212p Dale Atrens. The Power of Pleasure. Duffy & Snellgrove, Potts Point, NSW vol. 240p Pleasure and Quality of Life. Eds: David M. Warburton & Neil Sherwood. John Wiley & Sons, Chichester (UK) vol. 313p Hoebel BG, Rada PV, Mark GP, Pothos EN. Neural systems for reinforcement and inhibition of behavior: relevance to eating, addiction and depression. In: D. Kahneman, E. Diener, N. Schwartz (Eds) Well-being: Foundations of Hedonic Psychology. New York: Russell Sage Foundation, 1999, pp

3 FFS 21 Jan Le Pain Poilâne 30% épeautre wheat, 15% bran Rich in Selenium & Magnesium Leaven: better taste & digestibility, source of vitamins Salt of Guérande: Iodine, Magnesium Supported by sustainable farming: no nitrates, no pesticides Hand made Poilâne wood-heated oven [XIXth century]

4 FFS 21 Jan ∆ Central Nervous System Endocrine SystemImmune System

5 FFS 21 Jan Yogurt and γ-IFN Live active culture (LAC) yogurt consumption is associated with a five-fold increased production of γ-IFN by PBMC. Halpern GM et al. Int J Immunoth 1991;7:

6 FFS 21 Jan Yogurt and Nasal Allergies The influence of chronic yogurt consumption on nasal allergies, over the course of one year, in a healthy college-aged population. Each quarter represent a 3-month period of time. The scale is: “Total days affected” Trapp CL, Chang CC, Halpern GM et al. Int J Immunoth 1993; 9:53-64

7 FFS 21 Jan Yogurt and Immunomodulation The “best” responders, i.e. the highest levels of γ- IFN, in the LAC yogurt groups, were the most creative for delicious recipes of smoothies and yogurt shakes.

8 FFS 21 Jan Diet after surgical operation Apfelbaum M Presse Med 1971;79: Seminal study demonstrating that artsy and tasting food shortens hospital stay of surgical patients by an average of 3 days. All constituents/calories were identical in both diets.

9 FFS 21 Jan Good Food Makes People Happy, and Healthy Melchior JC, Rigaud D, Chayvialle JA et al. Palatability of a meal influences release of beta- endorphin, and of potential regulators of food intake in healthy human subjects. Appetite 1994;22: The effect of the palatability of a meal was tested on the post- prandial release of several gut hormones or neuropeptides that are known to effect intake and satiety. Hormonal response was measured in plasma for 3 h after a highly palatable and energy-rich meal, or after the same meal served cold in a poorly acceptable form, as well as fasting. The early post-prandial pancreatic polypeptide and neurotensin response was significantly higher after the highly palatable meal than after the cold one.

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12 FFS 21 Jan Good digestion vs. cancer Gastrointestinal peptides play a role in the regulation of cellular toxicity against tumor cells. Van Tol EA, Verspaget HW, Pena AS et al. Immunol Invest 1991;20:

13 FFS 21 Jan Intensification of Sensory Properties of Foods for the Elderly Schiffman SS. J Nutr 2000;130:927S-930S Taste and smell losses in the elderly can reduce appetite and lead to inadequate dietary intake. One method for “treatment” of chemosensory losses involves sensory enhancement of foods with flavors and MSG. Amplification of flavor and taste can improve food palatability and acceptance, increase hunger and appetite while preventing weight loss, increase salivary flow and immunity, and reduce oral complaints in both sick and healthy elderly.

14 FFS 21 Jan Taste, Smell, Appetite & Immunity Schiffman SS, Graham BG. Taste and smell perception affect appetite and immunity in the elderly. Eur J Clin Nutr 2000;54:S54-S63. Many medical conditions and medications alter taste and/or smell (elderly), with dire consequences. Amplification of the flavor level of foods results in: increased total number of T & B lymphocytes; increased salivary S-IgA; correction of malnutrition; reduction of Na intake.

15 FFS 21 Jan Nutrition Influences Immunity Lesourd B. Nutrition: a major factor influencing immunity in the elderly. J Nutr Health Aging 2004;8: Normal Aging: ↓T CD3+ ↑T CD2+CD3- ↑memory T CD45RO+ ↓T CD8+ =B, innate Worse if PEM &/or chronic inflammation Changes are related to health status. Important in undernourished & micronutrient deficient. Nutrition influences long-lasting inflammation in stressed patients.

16 FFS 21 Jan Appetite Depends on Senses in Elders deJong N, Mulder I, de Graaf C, van Staveren WA. Impaired sensory functioning in elders; the relation with its potential determinants and nutritional intake. J Gerontol/Biol Sci 1999;54A:B324-B331 Age and functionality (independent living elders n=89 vs. institutionalized n=67) are determinants in smell identification and taste perception (5.7 vs.3.5; p<.0001). Poor performance is related to poor appetite.age-related factors and smoking are impairing sensory functioning.

17 FFS 21 Jan Nursing Home Residents Can Get Better with Flavor Enhancers Mathey MFAM, Siebelink E, deGraaf C, Van Staveren WA. Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents. J Gerontol/Med Sci 2000;56A:M200-M w parallel intervention; sprinkling flavor enhancers (n=4) over cooked meals (F; n=36) vs. control (C; n=31). Body weight of F↑ (+1.1kg; p<.05). Intake of cooked meals of F↑ (133kJ; p<.05), as well as hunger feelings. Flavor enhancers improve dietary intake & body wt in elderly nursing home residents.

18 FFS 21 Jan Blueberries vs. Aging of Brain Mazza G, Kay CD, Cottrell T, Holub BJ. Absorption of anthocyanins from blueberries and serum antioxidant status in human subjects. J Agric Food Chem 2002;50: Joseph JA, Shukitt- Hale B, Desinova NA et al. Reversals of age-related declines in neuronal signal transduction, cognitive and motor behavioral deficits with blueberry, spinach, or strawberry dietary supplementation. J Neurosci 1999;19: Consumption of blueberries (BB) is associated with a diet-induced increase in ex vivo serum anti- oxidant status. BB intake can retard and even reverse age- related declines in brain function, cognitive and motor performance, as well as inflammation and oxidative stress in quadriceps muscle.

19 FFS 21 Jan Sweetening the Pain Mercer ME, Holder MD. Antinociceptive effects of palatable sweet ingesta on human responsitivity to pressure pain. Physiol Behav 1997;52: Palatable sweet ingestion produces a morphine-like analgesia in infants. Canadian women who consumed a soft drink reported increased pain tolerance. Women who consumed chocolate-chip cookies demonstrated the palatability-induced anti- nociception.

20 FFS 21 Jan Oral Sucrose Relieves Pain in Babies Mitchell A, Waltman PA. Oral sucrose and pain relief for preterm infants. Pain Manag Nurs 2003;4:62-69 Sucrose is effective in relieving pain in term and preterm infants during heelsticks and venipunctures; it is combined with nonnutritive sucking for better analgesia. Oral sucrose is now recommended as analgesic in the NICU

21 FFS 21 Jan Chocolate beats Prozac® Bruinsma K, Taren DL. Chocolate: food or drug? J Am Diet Assoc 1999;99: Chocolate is the food with the greatest impact on mood. Besides its hedonic appeal –fat, sugar, texture, aroma-, it is used as self-medication for dietary deficiencies (Mg), or to balance low levels of mood-neurotransmitters (serotonin, dopamine). Chocolate contains appetite regulators, and cannabinoid- like fatty acids.

22 FFS 21 Jan Dark Chocolate in CV Disease Innes AJ, Kennedy G, McLaren M, et al. Dark chocolate inhibits platelet aggregation in healthy volunteers. Platelets 2003;14: Dark chocolate (but not white or milk) inhibited collagen-induced platelet aggregation in platelet rich plasma; it may have a role in prevention of cardiovascular and thromboembolic disease.

23 FFS 21 Jan Cocoa Inhibits Platelet Function Murphy KJ, Chronopoulos AK, Singh I, et al. Dietary flavonols and procyanidin oligomers from cocoa (Theobroma cacao) inhibit platelet function. Am J Clin Nutr 2003;77: Cocoa flavonol and procyanidin supplementation for 28d significantly increased plasma epicatechin and catechin concentrations and significantly decreased platelet function.

24 FFS 21 Jan Dark Chocolate Provides Antioxidants Serafini M, Buglianesi R, Maiani G, et al. Plasma antioxidants from chocolate. Nature 2003;424: healthy volunteers who consumed, in a double-blind experiment 100 g of dark chocolate had a 20% increase in blood antioxidants after 1, 2 and 4h (but not with milk chocolate, or milk with chocolate).

25 FFS 21 Jan Chocolate/Brain: From Pleasure to Aversion Small DM, Zatorre RJ, Dagher A, et al. Changes in brain activity related to eating chocolate: from pleasure to aversion. Brain 2001;124: H(2)(15)O-PET scans were performed on volunteers eating chocolate to beyond satiety. Senses & act (eating) were constant while reward value & motivation were manipulated. Areas of brain when highly motivated & rating pleasant, and when eating despite satiation were different. Medial and lateral caudal OFC showed opposite patterns of activity. There are 2 separate motivational systems!

26 FFS 21 Jan Wine Renaud S, Gueguen R. The French paradox and wine drinking. Novartis Food Sympos 1998;216: Wine has been part of human culture for >6,000 years, serving dietary and socio-religious functions. It contains a range of polyphenols that have desirable biological properties; these are 5 times higher in wine than in fresh grapes; fermentation dissolves them into wine. Catechin and epicatechin peak at about 2 hours, and half-life is about 4 hours, suggesting that regular ingestion, with food, is good. Indeed, wine may confer protection against adverse effects of some foods.

27 FFS 21 Jan Wine beats Valium® Paladini AC et al. Flavonoids and the CNS: from forgotten factor to potent anxiolytic compounds. J Pharm Pharmacol 1999:51; Some natural occurring wine flavonoids, e.g. chrysin and apigenin, selectively bind with high affinity to the central benzodiazepine receptor, and exert powerful anxiolytic effects.

28 FFS 21 Jan Enjoy in the Right Shape of Glass Huttenbrink KB, Schmidt C, Delwiche JP, Hummel T. The enjoyment of red wine is influenced by the shape of the wine glass. Laryngorhinootologie 2001;80: Egg-shaped glasses, compared to “tulip” or “beaker” glasses, appear to produce higher intensity and higher complexity of wine odors.

29 FFS 21 Jan Guilt Makes You Sick Lowe G et al. Pleasure, guilt and secretory IgA. Psychol Rep 1999;85: English subjects listed their pleasurable activities and rated them in terms of pleasure and guilt before producing saliva for S-IgA: levels of sIgA were higher in those subjects with high ratios of pleasure-guilt scores.

30 FFS 21 Jan Pleasure Makes Conscious Decisions Cabanac M, Guillaume J, Balasko M, Fleury A. Pleasure in decision-making situations. BMC Psychiatry 2002; 2:7-28 From a complex set of experiments and questionnaires it was concluded that pleasure is the key to decision making in theoretical situations. Subjects tend to choose ethical/unethical responses corresponding to their highest pleasure. In mathematical challenges, again, subjects chose correct or incorrect responses corresponding to their highest hedonic ratings. Decisions are made in the hedonic dimension of conscious experience.

31 FFS 21 Jan The Bliss Point McBride RL. The Bliss Point and Pleasure. In: Warburton DM, Sherwood N (Eds.) Pleasure and Quality of Life. John Wiley & Sons: Chichester pp The bliss point (or ideal point) curve is a trademark of hedonic research. There is almost always an optimum level for a sensation, whether this sensation be overall intensity, or e.g. sweetness. The characteristic shape of the bliss point curve is a trademark of research on food acceptance Intensity

32 FFS 21 Jan Orbitofrontal Cortex Correlates with Pleasantness Kringelbach ML. Food for thought: hedonic experience beyond homeostasis in the human brain. Neuroscience 2004;126:

33 FFS 21 Jan The Dark Side Everything I like is either illegal, immoral, or fattening Oscar Wilde

34 FFS 21 Jan The Commercial Exploitation & Abuse of Pleasure The only natural thing in a diet cola is the water The active ingredient is phosphoric acid (pH: 2.8). It will dissolve a nail in <4 days. It washes calcium away from bones To carry the concentrate, trucks must place the HAZARDOUS material card. Distributors use it to clean their trucks engines.

35 FFS 21 Jan The Commercial Exploitation & Abuse of Pleasure Drewnowski A et al. Taste responses and preferences for sweet high-fat foods. Physiol Behav 1992;51: Preferences and cravings for sweet high-fat foods observed among obese and bulimic patients involve the endogenous opioid system. [Ketchup at McDonalds is much sweeter (corn syrup). Only soft drinks are served. Vegetable oils “boils” the fries. Potatoes have a glycemic index >sucrose]

36 FFS 21 Jan The Commercial Exploitation & Abuse of Pleasure Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001;357: For each additional serving of sugar- sweetened drink consumed, both body mass index and frequency of obesity increased after adjustment for anthropometric, demographic, dietary, and lifestyle variables.

37 FFS 21 Jan The Commercial Exploitation & Abuse of Pleasure Melchior JC et al. Immunoreactive beta-endorphin increases after an aspartame chocolate drink in healthy human subjects. Physiol Behav 1991;50: Plasma beta-endorphin concentrations were more elevated after the aspartame drink than after sucrose or fasting. Insulin increased after drinking as much with aspartame as with sucrose.

38 FFS 21 Jan Resting the Case for Pleasure Vincent JD. Biology of pleasure. Presse Med 1994;23: Cabanac M. Preferring the pleasure. Am J Clin Nutr 1985;42: Pleasure is not an “extra”, or bonus bringing a little more soul to certain of our acts; it is a fundamental part of our animal life. It is just as difficult to define as spirit, but nonetheless humans are very conscious of it. Pleasure is a potent drive, inducing forms of behavior adapted to physiological needs, e.g. temperature regulation and food-and-fluid intake; sensory pleasure is an incentive to useful behavior, and maximization of pleasure the answer to physiological conflicts [a.k.a. stress].

39 FFS 21 Jan 干杯 Cheers!Salud! Santé! Salute!


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