The Case for Pleasure

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The Case for Pleasure

• Georges M. Halpern, MD, PhD
• Distinguished Professor of Pharmaceutical
  Sciences
• Hong Kong Polytechnic University

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References

• Petr Skrabanek. The Death of Humane Medicine. The
  Social Affairs Unit, UK. 1994. 1 vol. 212p
• Dale Atrens. The Power of Pleasure. Duffy
  Snellgrove, Potts Point, NSW. 2000. 1 vol. 240p
• Pleasure and Quality of Life. Eds David M.
  Warburton Neil Sherwood. John Wiley Sons,
  Chichester (UK). 1996. 1 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 558-572

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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

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?
Central Nervous System
Endocrine System
Immune System
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Yogurt and ?-IFN

• Live active culture (LAC) yogurt consumption is
  associated with a five-fold increased production
  of ?-IFN by PBMC.
• Halpern GM et al. Int J Immunoth 19917205-210

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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 953-64

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Yogurt and Immunomodulation

• The best responders, i.e. the highest levels of
  ?-IFN, in the LAC yogurt groups, were the most
  creative for delicious recipes of smoothies and
  yogurt shakes.

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Diet after surgical operationApfelbaum M Presse
Med 1971792027-2032

• 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.

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Good Food Makes People Happy, and
HealthyMelchior 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
199422233-244

• 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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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 199120257-267

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Intensification of Sensory Properties of Foods
for the ElderlySchiffman SS. J Nutr
2000130927S-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.

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Taste, Smell, Appetite ImmunitySchiffman SS,
Graham BG. Taste and smell perception affect
appetite and immunity in the elderly. Eur J Clin
Nutr 200054S54-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.

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Nutrition Influences ImmunityLesourd B.
Nutrition a major factor influencing immunity in
the elderly. J Nutr Health Aging 2004828-37.

• Changes are related to health status. Important
  in undernourished micronutrient deficient.
  Nutrition influences long-lasting inflammation in
  stressed patients.

• Normal Aging
• ?T CD3 ?T CD2CD3-
• ?memory T CD45RO
• ?T CD8 B, innate
• Worse if PEM /or chronic inflammation

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Appetite Depends on Senses in EldersdeJong 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 199954AB324-B331

• Age and functionality (independent living elders
  n89 vs. institutionalized n67) are determinants
  in smell identification and taste perception (5.7
  vs.3.5 plt.0001). Poor performance is related to
  poor appetite.age-related factors and smoking are
  impairing sensory functioning.

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Nursing Home Residents Can Get Better with Flavor
EnhancersMathey 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 200056AM200-M205.

• 16-w parallel intervention sprinkling flavor
  enhancers (n4) over cooked meals (F n36) vs.
  control (C n31). Body weight of F? (1.1kg
  plt.05). Intake of cooked meals of F? (133kJ
  plt.05), as well as hunger feelings. Flavor
  enhancers improve dietary intake body wt in
  elderly nursing home residents.

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Blueberries vs. Aging of BrainMazza G, Kay CD,
Cottrell T, Holub BJ. Absorption of anthocyanins
from blueberries and serum antioxidant status in
human subjects. J Agric Food Chem 2002507731-7.
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
1999198114-21.

• 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.

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Sweetening the PainMercer ME, Holder MD.
Antinociceptive effects of palatable sweet
ingesta on human responsitivity to pressure pain.
Physiol Behav 199752219-225

• 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.

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Oral Sucrose Relieves Pain in BabiesMitchell A,
Waltman PA. Oral sucrose and pain relief for
preterm infants. Pain Manag Nurs 2003462-69

• 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

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Chocolate beats ProzacBruinsma K, Taren DL.
Chocolate food or drug? J Am Diet Assoc
1999991249-1256

• 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.

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Dark Chocolate in CV DiseaseInnes AJ, Kennedy G,
McLaren M, et al. Dark chocolate inhibits
platelet aggregation in healthy volunteers.
Platelets 200314325-327.

• 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.

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Cocoa Inhibits Platelet FunctionMurphy KJ,
Chronopoulos AK, Singh I, et al. Dietary
flavonols and procyanidin oligomers from cocoa
(Theobroma cacao) inhibit platelet function. Am J
Clin Nutr 2003771466-73.

• Cocoa flavonol and procyanidin supplementation
  for 28d significantly increased plasma
  epicatechin and catechin concentrations and
  significantly decreased platelet function.

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Dark Chocolate Provides AntioxidantsSerafini M,
Buglianesi R, Maiani G, et al. Plasma
antioxidants from chocolate. Nature
20034241013.

• 12 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).

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Chocolate/Brain From Pleasure to AversionSmall
DM, Zatorre RJ, Dagher A, et al. Changes in brain
activity related to eating chocolate from
pleasure to aversion. Brain 20011241720-1733

• 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!

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WineRenaud S, Gueguen R. The French paradox and
wine drinking. Novartis Food Sympos
1998216217-218

• Wine has been part of human culture for gt6,000
  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.

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Wine beats ValiumPaladini AC et al. Flavonoids
and the CNS from forgotten factor to potent
anxiolytic compounds. J Pharm Pharmacol
199951519-526

• 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.

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Enjoy in the Right Shape of GlassHuttenbrink KB,
Schmidt C, Delwiche JP, Hummel T. The enjoyment
of red wine is influenced by the shape of the
wine glass. Laryngorhinootologie 20018096-100.

• Egg-shaped glasses, compared to tulip or
  beaker glasses, appear to produce higher
  intensity and higher complexity of wine odors.

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Guilt Makes You SickLowe G et al. Pleasure,
guilt and secretory IgA. Psychol Rep
199985339-340

• 30 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.

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Pleasure Makes Conscious DecisionsCabanac M,
Guillaume J, Balasko M, Fleury A. Pleasure in
decision-making situations. BMC Psychiatry 2002
27-28

• 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.

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The Bliss PointMcBride RL. The Bliss Point and
Pleasure. In Warburton DM, Sherwood N (Eds.)
Pleasure and Quality of Life. John Wiley Sons
Chichester. 1996. pp 147-154

• 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
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Orbitofrontal Cortex Correlates with
PleasantnessKringelbach ML. Food for thought
hedonic experience beyond homeostasis in the
human brain. Neuroscience 2004126807-819
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The Dark Side

• Everything I like is either illegal, immoral, or
  fattening
• Oscar Wilde

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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 lt4 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.

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The Commercial Exploitation Abuse of
PleasureDrewnowski A et al. Taste responses and
preferences for sweet high-fat foods. Physiol
Behav 199251371-379

• 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 gtsucrose

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The Commercial Exploitation Abuse of
PleasureLudwig DS, Peterson KE, Gortmaker SL.
Relation between consumption of sugar-sweetened
drinks and childhood obesity a prospective,
observational analysis. Lancet 2001357505-508

• 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.

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The Commercial Exploitation Abuse of
PleasureMelchior JC et al. Immunoreactive
beta-endorphin increases after an aspartame
chocolate drink in healthy human subjects.
Physiol Behav 199150941-944

• 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.

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Resting the Case for PleasureVincent JD. Biology
of pleasure. Presse Med 1994231871-1873Cabanac
M. Preferring the pleasure. Am J Clin Nutr
1985421151-1155

• 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.

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• Cheers!
• Salud!
• Santé!
• Salute!