We only eat what we like – Part 1
A few months ago, my friend Michel Oliver, great chef, superb winemaker and successful author of cooking books for children (and adults), told me a story:
“A few years ago, on a sand beach with big surf, a little boy was flying his kite. He was running with the wind on the sand. He noticed, far away on the beach, a silhouette; he ran closer. Then he saw, on the wet sand, miraculously beautiful portraits, plants, fortresses, women dancing, a huge gallery of dreams as art. The little boy was transfixed, mesmerized; his jaw was falling; his eyes filled with tears of joy. This was his epiphany.
He walked along these marvels –one more strikingly beautiful than the other- and saw that the genius who had drawn those in the sand was an old man. He wanted to tell him…and then a huge wave erased everything. The man stood up, and left; he was Pablo Picasso”.
Chinese historian and philosopher Tu Weiming states  that “the distinctiveness of being human lies in continuity with, rather than rupture from Heaven, Earth, and the myriad things”. He then says: “The body so conceived is an attainment. We do not own our bodies. We become our bodies; as we learn to sit, stand, walk, run, and talk, we are empowered to express ourselves through our bodies. Although ontologically we are our bodies, in an existential sense, we must learn to become our bodies. The Confucian idea of the living body as the primary datum and an irreducible reality is diametrically opposed to the Cartesian view that the body, contrasted with the thinking mind, is not essential for self-identity. For the Confucians, the body is the proper home for the heart-and-mind. Furthermore, the heart-and-mind manifests itself through the lived body and expresses its true nature by the experiences and feelings of the body. This is the reason that Mencius asserted that only the sage could bring the bodily form to fruition: ‘Our body and complexion are given to us by Heaven. Only a sage can give his body complete fulfillment.’”
This, I suggest, is commensurability
“We are what we eat”…and drink. What patients eat, drink, consume will either help or worsen their condition. Food is medicine, and many medicines were (are) foods, as we know from the Asian traditions. But the single one major variable that never appears in any medical study is the role of pleasure.
One of the major foods consumed in Western (and other) societies is bread; it is a basic, tradition-filled, and inexpensive food item. And since it is part of our daily intake, the industry has for decades focused on its quality to make it whiter, sweeter, softer, toast-able, never-to-rot, and –above all- bland. Bread is more and more an anonymous, cardboard-tasting support for “no-cholesterol” artificially colored spread-able concoctions. But traditional bread does exist: it is crusty, tasty, flavorful, quite rich in fiber and magnesium, wholesome, and basic: wheat flour, leaven, water, salt –and the loving art of the baker. The best baker in the world –so declared Smithsonian magazine- was my friend Lionel Poilâne. His bread is “rich in selenium [Halpern et al.1992; Olin et al. 1994] and magnesium; its salt is harvested in Guérande, tastes like violet, and provides iodine and magnesium; the natural leaven (starter of sourdough) results in better taste and digestibility, and is a precious source of vitamins. Poilâne supports sustainable farming: no nitrates, no pesticides, and his bread is hand made. The loaves are baked in Poilâne wood-heated oven (XIXth century) [www.poilane.com]. But this description does NOT bring back the flavor, the crustiness, the texture, the taste, the pleasure you experienced when you bate into this large toasted tartine of Poilâne’s bread… Medical articles miss the emotional, rewarding dimension.
Stress vs. pleasure:
The notion that stress makes you sick and belief makes you well has been part of the popular culture for thousands of years. These ideas are universal throughout the cultures. In Western culture this notion held away from before the time of Hippocrates, when the Greeks built temples to Asclepios, the god of healing, all the way through the modern times when Norman Cousins and Norman Vincent Peale have espoused the idea that laughter and positive thinking heals [Steinberg 2000]. But recent studies [Leonard 2000] cast doubts on previous assumptions pointing to hypercortisolemia causing immune suppression. It is now apparent that adaptive changes result from chronic stress and depression that lead to a hypoactivity of the glucocorticoid receptors on immune cells and in limbic regions of the brain. Depression and anhedonia are associated with hypersecretion of proinflammatory cytokines and hyperactivity of the hypothalamic-pituitary-adrenal axis. Moreover stress impacts health by modulating the rate of cellular aging [Epel et al. 2004]. There is now evidence that psychological stress –both perceived stress and chronicity of stress- is significantly associated with higher oxidative stress, lower telomerase activity, and shorter telomere length, which are known determinants of cell senescence and longevity, in healthy premenopausal women. Women with the highest level of perceived stress have telomeres shorter on average by the equivalent of at least one decade (9-17y) of additional aging compared to low stress women! The observation of people aging suddenly after major psychological stress, e.g. bombing of Dresden on February 13, 1945, has now a biological confirmation.
The brain talks directly to the immune system, sending commands that control the body’s inflammatory response to infection and autoimmune diseases; Kevin J. Stacey has demonstrated that stimulation of the vagus nerve (through the release of acetylcholine) could block a rogue inflammatory response and treat a number of diseases, including life-threatening sepsis, inflammatory bowel disease, rheumatoid arthritis, type 2 diabetes, and other conditions of excessive cytokine release. It also enables consideration of the neurological basis of complementary and alternative medical therapies, such as meditation and acupuncture. He calls this network “the inflammatory reflex” [Oke et al. 2007].
Pleasantness is the principal perceptual aspectof olfaction; it is the primary perceptual aspect humansuse to discriminate odorants or combine them into groups. Pleasant and unpleasant odorants are evaluatedat different speeds and by dissociableneural substrates, as evidenced in both electrophysiologicalrecordings and functional neuroimaging studies. Studies with newbornssuggest that at least some aspects of olfactory pleasantnessmay be innate. Itis clearly the hedonic meaning of odor that dominates odor perception. When one orders aset of odorants based on the variance in their physicochemicalproperties alone, they end up roughly ordered by perceptualpleasantness as well. This phenomenon allows to predict(r = 0.5; p < 0.004) odorant pleasantness of >50 moleculesthat one did not smell previously and that were tested in >80 subjectsspanning three cultures. The olfactory system is known for plasticity at multiplelevels, which reflects an advantageousevolutionary mechanism. To automatically reject food that smellsfermented is generally a safe bet. However, if through experienceone learns that exceptions exist, and for example fermentedfish can be both tasty and healthy, than its pleasantness representationmay shift. This is what allows Swedes to enjoy their SurströmmingHerring (a dish not for the faint of heart), although even theywill not say they like the odor per se. Finally in this respect,it is notable that although the predictive power for pleasantnessis significant (p < 0.004), this explains only a portionof the variance. This leaves open the possibility that individualdifferences and plasticity in olfactory hedonics make importantcontributions to olfactory perception [Khan et al. 2007].
And the pleasure of eating is associated with well-being: Individuals who were both high on pleasure associated with eating and high on restraint showed the lowest self-clarity and the highest neuroticism scores, while the opposite pattern was found for those high on pleasure but low on restraint. Restrained eating affects well-being [Remick et al. 2009]. Conversely –and apparently paradoxically- morbid thoughts whet appetite: consumers who wrote about their own deaths wanted to buy more and ate more than those who wrote about a painful medical procedure (control group). Consumers, especially those with a lower self esteem, might be more susceptible to over-consumption when faced with images of death during the news or their favorite crime-scene investigation shows [Mandel et al. 2008].
Never underestimate pleasure:
In 1991, I published a study demonstrating that live active culture (LAC) yogurt consumption is associated with a five-fold increased production of gamma-interferon (γ-IFN) by PBMC [Halpern et al. 1991].Then, in 1993, we demonstrated that regular consumption of LAC yogurt –but not “heat-killed” yogurt- over the course of one year resulted in a significant reduction of the number of days during which the subjects suffered on symptoms of allergic (pollen) rhinitis [Trapp et al. 1993]. But in 1997 I went back to the subjects’ files and redid some calculations, and conducted interviews; I found that
our “best” responders, i.e. subjects who demonstrated the highest levels of γ-IFN, in the LAC yogurt groups, were the most creative for delicious recipes of smoothies and yogurt shakes.
“The pleasures of the table are for every man, of every land, and no matter of what place in history or society; they can be a part of all other pleasures and they last the longest, to console us when we have outlived the rest” [Brillat-Savarin 1825].
Food is (much) more than nutrition. The value of food intake on social patterns, self-esteem, pleasure and enjoyment impacts quality of life. While nutrition can provide the basic need for nutrients, the loss of the eating function is a distressing experience, especially given the cultural focus on social gatherings and meals [Winkler 2007].
The Pleasure of/with Meals:
“The primary requisite for writing well about food is a good appetite. Without this, it is impossible to accumulate within the allotted span, enough experience of eating to have anything worth setting down. Each day brings only two opportunities for field work, and they are not to be wasted minimizing the intake of cholesterol” [Liebling 1959].
Food intake is an essential human activity regulated by homeostatic and hedonic systems in the brain that has mostly been ignored by the cognitive neurosciences. It was probably too trivial, too banal, or even sinful. Yet the study of food intake integrates fundamental cognitive and emotional processes in the human brain, and can provide evidence on the neural correlates of the hedonic experience central to guiding behavior. This hedonic experience is related to qualia, which has been described as “the hard problem of consciousness” [Chalmers 1995]. Fortunately, recently neuroimaging [Kingelbach 2004] has identified the medial anterior part of the orbitofrontal cortex as the strongest candidate for linking food to hedonic experience [De Araujo et al. 2003]. Pleasant, but not unpleasant odors were found to activate a medial region of the rostral orbitofrontal cortex [Rolls et al. 2003]; other candidate brain regions such as the anterior cingulated, the insular cortex and ventral striatum could be part of hedonic networks in the human brain.
But what about patients subjected to hospital fare after surgery? In a seminal study, Marian Apfelbaum  demonstrated that artsy and tasting food shortens hospital stay of surgical patients by an average of 3 days. All constituents/calories were identical in both the abject diet provided by the central hospital kitchen, and the elaborate dishes shining on china produced by a dietician-turned-chef.
Why is that? The group of Apfelbaum [Melchior et al. 1994] tested the effect of the palatability of a meal on the post-prandial release of several gut hormones or neuropeptides that are known to have an effect on intake and satiety. Hormonal response was determined in plasma during the 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 while fasting. The early post-prandial pancreatic polypeptide and neurotensin response was significantly higher after the highly palatable meal than after the cold one. Post-prandial levels of beta-endorphin were elevated only after the cold meal and were associated with an elevated response of ACTH, a marker of stress. J.C. Melchior et al. suggest that beta-endorphin might be secreted in response to an aversion towards the non-palatable cold meal. This could, subsequently, inhibit the cephalic phase of pancreatic polypeptide response and the early post-prandial response of neurotensin by a central anticholinergic effect. That study evidenced an effect of palatability on the modulation of the digestive hormonal response after a meal.
Food intake is a regulated system. Afferent signals provide information to the central nervous system, which is the center for the control of satiety or food seeking. Such signals can begin even before food is ingested through visual, auditory and olfactory stimuli. One of the recent interesting findings is the demonstration that there are selective fatty acid taste receptors on the tongue. CCK inhibits food intake in human subjects. Enterostatin, the pentapeptide produced when pancreatic colipase is cleaved in the gut, has been shown to reduce food intake. This peptide differs in its action from CCK by selectively reducing fat intake. Enterostatin reduces hunger ratings in human subjects. Bombesin and its human analogue, gastrin inhibitory peptide (also gastrin-insulin peptide), reduce food intake in obese and lean subjects. Circulating glucose concentrations show a dip before the onset of most meals in human subjects. When the glucose dip is prevented, the next meal is delayed. The dip in glucose is preceded by a rise in insulin, and stimulating insulin release will decrease circulating glucose and lead to food intake. Leptin released from fat cells is an important peripheral signal from fat stores that modulates food intake. Leptin deficiency or leptin receptor defects produce massive obesity. This peptide signals a variety of central mechanisms by acting on receptors in the arcuate nucleus and hypothalamus. Pancreatic hormones including glucagon, amylin and pancreatic polypeptide reduce food intake. Four pituitary peptides also modify food intake. Vasopressin decreases feeding. In contrast, injections of desacetyl melanocyte-stimulating hormone, growth hormone and prolactin are associated with increased food intake. Finally, there are a group of miscellaneous peptides that modulate feeding. Beta-casomorphin, a heptapeptide produced during the hydrolysis of casein, stimulates food intake in experimental animals. In contrast, the other peptides in this group, including calcitonin, apolipoprotein A-IV, the cyclized form of histidyl-proline, several cytokines and thyrotropin-releasing hormone, all decrease food intake. Many of these peptides act on gastrointestinal or hepatic receptors that relay messages to the brain via the afferent vagus nerve [Bray 2000].
Preferences and Prejudices about Food:
On these days of mega mergers among the manufacturers and carriers of information –and education-, the tendency to “unify”, i.e. make monotony the gold standard, is an Orwellian reality. And it can grow on fertile ground: two studies explored Americans’ tendency to simplify nutrition information [Rozin et al. 1996]. Substantial minorities of separate samples of college students, physical plant workers, and a national sample considered a variety of substances, including some essential nutrients [salt and fat], to be harmful at trace levels. Almost half the respondents believed that high-calorie foods in small amounts contained more calories than low-calorie foods in much larger amounts. Many subjects classified foods according to a good/bad dichotomy, and almost all subjects confounded nutritional completeness with long-term healthfulness of foods. To account for these results, the authors suggest the following heuristics and biases: dose insensitivity, categorical perception, a “monotonic mind” belief (if something is harmful at high levels it is harmful at low levels), and the magical principle of contagion.
But what about other human beings for whom food is a critical contributor to physical well being, a major source of pleasure, worry and stress, a major occupant of waking time, and, across the world, the single greatest category of expenditures? Paul Rozin published in 1999 [Rozin et al. 1999] the first study on the way food functions in the minds and lives of people from four cultures. Adults and college students from Flemish Belgium, France, U.S.A. and Japan were surveyed with questions dealing with beliefs about the diet-health link, worry about food, the degree of consumption of foods modified to be “healthier” (e.g. reduced in salt or fat), the importance of food as a positive force in life, the tendency to associate foods with nutritional vs. culinary contexts, and satisfaction with the healthiness of one’s own diet. In all domains except beliefs about the importance of diet for health, there are substantial country (and usually gender) differences. Generally the group associating food most with health and least with pleasure is the Americans, and the group most food-pleasure-oriented and least food-health-oriented is the French. In all four countries, females, as opposed to males, show a pattern of attitudes that is more like the American pattern, and less like the French pattern. In either gender, French and Belgians tend to occupy the pleasure extreme, Americans the health extreme, with the Japanese in between. Ironically, the Americans, who do the most to alter their diet in the service of health, are the least likely to classify themselves as healthy eaters. These differences may influence health and may partially account for differences in rates of cardiovascular diseases, a.k.a. the “French paradox”.
But why do we like fat [Drewnowski 1997]? Dietary choices are strongly influenced by the taste and texture of foods. Fats are responsible for the sensory properties of many foods and greatly contribute to eating pleasure. Although diets rich in fats tend to be more flavorful and varied, they also are high in energy. Because excessive fat consumption has been associated with higher rates of obesity and coronary heart disease, nutrition education efforts have focused on replacing dietary fats with grains, vegetables, and fruit. However, preference for high-fat foods appears to be a universal human trait, and in the absence of efficient physiologic mechanisms regulating fat intake, fat consumption appears to be determined simply by the amount of fat available in the food supply. Fat consumption at national levels is determined largely by economic variables such as urbanization or income. The question is whether appropriate nutrition education and intervention programs can surmount these barriers; but facing the humungous ever-present incitation of the fat-laden food industry we should remain skeptical about the success rate of such programs.
PBMC Peripheral blood mononucleated (or mononuclear) cells
ACTH Adrenal corticotrophin hormone
LDL Low Density Lipoprotein
NMR Nuclear Magnetic Resonance
MS Mass Spectrometry
HIV Human Immunodeficiency Virus
NK Natural Killer Cell
HDL High Density Lipoprotein
IgA Immunoglobulin A
sIgA Secretory IgA
TNF Tumor Necrosis Factor
HGH Human Growth Hormone
DOPAC Dihydroxyphenylacetic Acid
SEB Staphylococcal Enterotoxin B
Hs-CRP High sensitivity C-Reactive Protein
GNP Gross National Product
CDC Centers for Disease Control
SUNY State University New York
Apfelbaum M. Diet after surgical operation. Presse Médicale. 1971;79:2027-32
Avena NM, Hoebel BG. A diet promoting sugar dependency causes behavioral cross-sensitization to a low dose of amphetamine. Neuroscience 2003;122:17-20
Baum M, Liesen H. Sports and the immune system. 1997;Orthopade 26:976-80
Baum M, Muller-Steinhardt M, Liesen H, Kirchner H. Moderate and exhaustive endurance exercise influences the interferon-gamma levels in whole-blood culture supernatants. Eur J Appl Physiol Occupat Physiol 1997;76:165-9
Benziger DP, Edelson J. Absorption from the vagina. Drug Metabol Rev 1983;14:137-168
Berk LS, Tan S. Laughter remains good medicine. 122nd Annual Meeting American Physiological Society, New Orleans, LA. 2009;April 18-22.
Bewernick BH, Hurlemann R, Matusch A et al. Nucleus accumbens deep brain stimulation decreases ratings of depression and anxiety in treatment-resistant depression. Biol Psychiatry 2010;67:110-116
Blood AJ, Zatorre RJ. Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proc Nat Acad Sci 2001;98:11818-23
Bray GA. Afferent signals regulating food intake. Proc Nutr Soc 2000;59:373-84
Brillat-Savarin JA. Physiologie du Goût ou Méditations de Gastronomie Transcendante Dédié aux Gastronomes parisiens par un Professeur. 1825. Paris:A. Sautelet. 128p
Bruinsma K, Taren DL. Chocolate: food or drug? J Am Diet Assoc 1999;99:1249-56
Butt DS. The sexual response as exercise. A brief review and theoretical proposal. Sports Med 1990;9:330-43
Cabanac M. Emotion and phylogeny. Jap J Physiol 1999;49:1-10
Cabanac M. Preferring for pleasure. American Journal Clinical Nutrition 1985;42:1151-5
Carey B. What makes people happy? TV, study says. NY Times Dec 3, 2004
Chalmers D. Facing up to the problem of consciousness. J Conscious Studies 1995;2:200-219
Charnetski CJ, Brennan FX Jr, Harrison JF. Effect of music and auditory stimuli on secretory immunoglobulin A (IgA). Percept Mot Skills 1998;87:1163-70
Charnetski CJ, Brennan FX Jr.. The effect of sexual behavior on immune system function. East Psychol Assoc Providence, RI. 1999, April 17
De Araujo IET, Rolls ET, Kringelbach ML, McGlone F, Phillips N. Taste-olfactory convergence and the representation of the pleasantness of flavour, in the human brain. Eur J Neurosci 2003;18:2059-2068
Drewnowski A, Krahn DD, Demitrack MA, Nairn K, Gosnell BA. Taste responses and preferences for sweet high-fat foods: evidence for opioid involvement. Physiol Behav 1992;51:371-9
Drewnowski A. Energy intake and sensory properties of food. Am J Clin Nutr 1995;62:1081S-1085S
Drewnowski A. Why do we like fat? J Am Diet Assoc 1997;97:S58-62
Epel ES, Blackburn EH, Lin J, Dhabbar FS, Adler NE, Morrow JD, Cawthon RM. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA. 10.1073/pnas.0407162101 [Dec 1, 2004]
Fitch-Hilgenberg M. Science Daily/U Arkansas Fayetteville 2007, Oct 27
Gallup Jr GG, Burch RL, Platek SM. Does semen have antidepressant properties? Arch Sexual Behav 2002;31:289-293
Gani F, Passalacqua G, Senna G, Mosca Frezet M. Sport, immune system and respiratory infections. Allerg Immunol (Paris) 2003;35:41-6
Gardner EL, Vorel SR. Cannabinoid transmission and reward-related events. Neurobiol Dis 1998;5:502-33
Goodkin K, Blaney NT, Feaster D, Fletcher MA, Baum MK, Mantero-Atienza E, Klimas NG, Millon C, Szapocznik J, Eisdorfer C. Active coping style is associated with natural killer cell cytotoxicity in asymptomatic HIV-1 seropositive homosexual men. J Psychosom Res 1992;36:635-50
Guerrero-Romero F, Rodriguez-Morán M, Evangelina R. Consumption of soft drinks with phosphoric acid as a risk factor for the development of hypocalcemia in postmenopausal women. J Clin Epidemiol 1999;52:1007-1010.
Halpern GM, Vruwink KG, Van de Water J, Keen CL, Gershwin ME. Influence of long-term yoghurt consumption in young adults. Int J Immunother. 1991;7:205-210
Halpern GM, Davis PA, Gershwin ME, Poilâne L. Etude comparative de la composition en acides gras de farines, produits de meunerie et boulangerie; broyage à la meule ou au cylindre. Médecine Hygiène. 1992;50:1006-1010
Halpern GM. Multiple orgasms are associated with increased γ-IFN production. Unpublished 1996
Hartling L, Shaik MS, Tjosvold L et al Music for medical indications in the neonatal period: a systematic review of randomised controlled trials Arch Dis Childh Fetal Neonatal 2009;94:F349-354
Hjern A, Hedberg A, Haglund B, Rosen M . Does tobacco smoke prevent atopic disorders? A study of two generations of Swedish residents. Clin Exper Allergy 2001;31:908-14
Hucklebridge F, Lambert S, Clow A, Warburton DM, Evans PD, Sherwood N. Modulation of secretory immunoglobulin A in saliva; response to manipulation of mood. Biol Psychol 2000;53:25-35
Huttenbrink KB, Schmidt C, Delwiche JF, Hummel T. The enjoyment of red wine is influenced by the shape of the wine glass. Laryngootorhinologie 2001;80:96-100
James J, Thomas P, Cavan D, Kerr D. Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomized controlled trial. BMJ 2004;328:1236-1243
Jang HJ, Kokrashvili Z, Theodorakis MJ, Carlson OD et al. Gut-expressed gustducin and taste receptors regulate secretion of glucagon-like peptide-1. PNAS 2007;104:15069-15074
Kahneman D, Krueger AB, Schkade DA, Schwarz N, Stone AA. A survey method for characterizing daily life experience: the day reconstruction method. Science 2004;306:1776-1780
Khan RM, Luk CH, Flinker A et al. Predicting odor pleasantness from odorant structure: pleasantness as a reflection of the physical world. J Neurosci 2007;27:10015-10023
King NA, Hopkins M, Caudwell P et al. Beneficial effects of exercise: shifting the focus from body weight to other markers of health. Br J Sports Med 2009;43:924-927.
Komisaruk BR, Whipple B. Love as sensory stimulation: physiological consequences of its deprivation and expression. Psychoneuroendocrinol 1998;23:927-44
Koskimäki J, Shiri R, Tammela T, Häkkinen J, Hakama M, Auvinen A. Regular intercourse protects against erectile dysfunction: Tampere aging male urologic study. Am J Med 2008;121:592-596
Kringelbach ML. Food for thought: hedonic experience beyond homeostasis in the human brain. Neuroscience 2004;126:807-819
Krondl M, Coleman P. Social and biocultural determinants of food selection. Progr Food Nutr Sci 1986;10:179-203
Langewiesche W. The million-dollar nose. The Atlantic2000;286:42-70
Leonard B. Stress, depression and the activation of the immune system. World J Biol Psychiatry 2000;1:17-25
Lesourd B. Nutrition: a major factor influencing immunity in the elderly. J Nutr Health Aging 2004;8:28-37
Liebling AJ. Between Meals. An Appetite for Paris. 1959.The Modern Library, NY. 182p
Lowe G, Greenman J, Lowe G. Pleasure, guilt and secretory immunoglobulin A. Psychol Rep 1999;85:339-40
Lowe MR, Butryn ML. Hedonic hunger: a new dimension of appetite? Physiol Behav 2007;91:432-439
Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001;357:505-8
Mandel D, Lubetzky R. Mozart therapy: a sonata a day keeps the doctor away. Tel Aviv U Med School http://sciencedaily.com/releases/2010/01/100107132551.htm
Mandel NI, Smeesters D et al. The sweet escape: Effects of mortality salience on consumption quantities for high- and low-self-esteem consumers. J Consumer Res 2008;08051417203817 DOI:10.1086/587626
Martin FP, Rezzi S, Peré-Trepat E et al. Metabolic effects of dark chocolate consumption on energy, gut microbiota, and stress-related metabolism in free-living subjects. J Proteome Res 2009;8:4799-4809
Mathey MFAM, Siebelink E, de Graaf C, Van Staveren WA. Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents. J Gerontol 2001;56A:M300-M305
Matthews T. The ABC’s of Wine Tasting. www.winespectator.com/Wines/Archives/Show-Article
Mazariegos-Ramos E, Geurrero-Romero F, Rodriguez-Morán M et al. Consumption of soft drinks with phosphoric acid as a risk factor for the development of hypocalcemia in children: a case-control study. J Pediatr 1995;126:940-942
Melchior JC, Rigaud D, Colas-Linhart N, Petiet A, Girard A, Apfelbaum M. Immunoreactive beta-endorphin increases after an aspartame chocolate drink in healthy human subjects. Physiol Behav 1991;50:941-4
Melchior JC, Rigaud D, Chayvialle
JA, Colas-Linhart N, Laforest MD, Petiet A, Comoy E, Apfelbaum M. Palatability of a meal influences release of beta-endorphin, and of potential regulators of food intake in healthy human subjects. Appetite 1994;22:233-44
Mercer ME, Holder MD. Antinociceptive effects of palatable sweet ingesta on human responsivity to pressure pain. Physiol Behav 1997;61:311-8
Mondaini N, Cai, T, Gontero P, Gavazzi A et al. Regular moderate intake of red wine is linked to a better women’s sexual health. J Sex Med 2009;6:2772-2777
Ney PG. The intravaginal absorption of male generated hormones and their positive effect on female behavior. Med Hypotheses 1986;20:221-231
Nicoli RM, Nicoli JM. Biochemistry of Eros. Contracept Fertil Sexual 1995;23:137-44
Oke SL, Tracey Kj. The inflammatory reflex and complementary and alternative medicine. Ann NY Acad Sci 2007 Sep 28 Epub 0:13930131
Olin KL, Simonoff M, Simonoff G, Halpern GM, Poilâne L. Evaluation of selenium content of French wheat flour and bread with PIXE technique. Trace Elem Electrol. 1994;11:121-124
Paladini AC, Marder M, Viola H, Wolfman C, Wasowski C, Medina JH. Flavonoids and the central nervous system: from forgotten factors to potent anxiolytic compounds. J Pharm Pharmacol 1999;51:519-26
Parker RM Jr. Introduction. Parker’s Wine Buying Guide. 5th Ed. 2003;Monkton, MD: Wine Advocate. 1703p
Pedersen BK, Toft AD. Effects of exercise on lymphocytes and cytokines. Br J Sports Med 2000;34:246-51
Remick AK, Pliner P, McLean KC. The relationship between restrained eating, pleasure associated with eating, and well-being re-visited. Eat Behav 2009;10:42-44
Renaud S, Gueguen R. The French paradox and wine drinking. Novartis Found Symp 1998;216:208-17; discussion 217-22, 152-8
Rezzi S, Ramadan Z, Martin FPJ, Fay LB et al. Human metabolic phenotypes link directly to specific dietary preferences in health individuals. J Proteome Res 2007;6:4469-4477
Rolls ET, Kringelbach ML, de Araujo IET. Different representations of pleasant and unpleasant odours in the human brain. Eur J Neurosci 2003;18:695-703
Rozin P, Ashmore M, Markwith M. Lay American conceptions of nutrition: dose insensitivity, categorical thinking, contagion, and the monotonic mind. Health Psychol 1996;15:438-447
Rozin P, Fischler C, Imada S, Sarubin A, Wrzeniewski A. Attitudes to food and the role of food in life in the U.S.A., Japan, Flemish Belgium and France: possible implications for the diet-health debate. Appetite1999;33:163-180
Schiffman SS. Intensification of sensory properties of foods for the elderly. J Nutr 2000;130:927S-30S
Schwartz GJ, Astarita G, Li X, Gaetani S, Campolongo P, Cuomo V, Piomelli D. The lipid messenger OEA links dietary fat intake to satiety. Cell Metab 2008;4:281-288
Soto D, Funes MJ, Guzman-Garcia A, Warbrick T, Humphreys GW. Pleasant music overcomes the loss of awareness in patients with visual neglect. PNAS 2009;DOI:10.1073/pnas.0811681106
Sternberg EM. Does stress make you sick and belief make you well? The science connecting body and mind. Ann N Y Acad Sci. 2000;917:1-3
Stuber M, Dunay Hilber S, Libman Mintzer L, Castaneda M, Glover D, Zeltzer L. Laughter, humor and pain perception in children: A pilot study. eCAM 2009;6:271-276
Tapsell LC, Hemphil T, Cobiac L et al. Health benefits of herbs and spices: the past, the present, the future. Med J Austr 2006;185(4 Suppl):S4-24.
Trapp CL, Chang CC, Halpern GM, Keen CL, Gershwin ME. The influence of chronic yogurt consumption in populations of young and elderly adults. Int J Immunother. 1993;9:53-64
Tu WM. Centrality and Commonality: An Essay on Confucian Religiousness. State University of New York Press, 1989
Tucker KL, Morita K, Qiao N et al. Colas, but no other carbonated beverages, are associated with low bone mineral density in older women. The Framingham Osteoporosis Study. Am J Clin Nutr 2006;84:936-942
van Tol EA, Verspaget HW, Pena AS, Jansen JB, Aparicio-Pages MN, Lamers CB. Modulatory effects of VIP and related peptides from the gastrointestinal tract on cell mediated cytotoxicity against tumour cells in vitro. Immunol Investig 1991;20:257-67
Vincent JD. Biology of pleasure. Presse Médicale 1994;23:1871-6
Wester RC, Noonan PK, Maibach H. Variations in percutaneous absorption of testosterone in the rhesus monkey due to anatomic site of application and frequency of application. Arch Dermatol Res 1980;267:229-235
Whipple B, Komisaruk BR. Elevation of pain threshold by vaginal stimulation in women. Pain 1985;21:357-67
Winkler MF. American Society of Parenteral and Enteral Nutrition Presidential Address: food for thought: it’s more than nutrition. JPEN 2007;31:334-340
Wyshak G, Frisch RE, Albright TE et al. Nonalcoholic carbonated beverage consumption and bone fractures among women former college athletes. J Orthop Res 1989;7:91-99.
Wyshak G, Frisch RE. Carbonated beverages, dietary calcium, the dietary calcium/phosphorus ratio, and bone fractures in girls and boys. J Adolesc Health 1994;15:210-215
Yoshida R, Ohkuri T, Jyotaki M et al. Endocannabinoids selectivelyenhance sweet taste. PNAS 2010;107:935-939.
Georges M. Halpern, MD, PhD
Distinguished Professor of Medicinal Sciences
The Hong Kong Polytechnic University
E-mail: [email protected]