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The Case for PleasureThe Case for Pleasure

Georges M. Halpern, MD, PhDGeorges M. Halpern, MD, PhDDistinguished Professor of Pharmaceutical SciencesDistinguished Professor of Pharmaceutical Sciences

Hong Kong Polytechnic UniversityHong Kong Polytechnic University

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ReferencesReferences

Petr Skrabanek. The Death of Humane Medicine. The Social Petr Skrabanek. The Death of Humane Medicine. The Social Affairs Unit, UK. 1994. 1 vol. 212pAffairs Unit, UK. 1994. 1 vol. 212p

Dale Atrens. The Power of Pleasure. Duffy & Snellgrove, Potts Dale Atrens. The Power of Pleasure. Duffy & Snellgrove, Potts Point, NSW. 2000. 1 vol. 240pPoint, NSW. 2000. 1 vol. 240p

Pleasure and Quality of Life. Eds: David M. Warburton & Neil Pleasure and Quality of Life. Eds: David M. Warburton & Neil Sherwood. John Wiley & Sons, Chichester (UK). 1996. 1 vol. Sherwood. John Wiley & Sons, Chichester (UK). 1996. 1 vol. 313p313p

Hoebel BG, Rada PV, Mark GP, Pothos EN. Neural systems for Hoebel BG, Rada PV, Mark GP, Pothos EN. Neural systems for reinforcement and inhibition of behavior: relevance to eating, reinforcement and inhibition of behavior: relevance to eating, addiction and depression. In: D. Kahneman, E. Diener, N. addiction and depression. In: D. Kahneman, E. Diener, N. Schwartz (Eds) Well-being: Foundations of Hedonic Schwartz (Eds) Well-being: Foundations of Hedonic Psychology. New York: Russell Sage Foundation, 1999, pp Psychology. New York: Russell Sage Foundation, 1999, pp 558-572558-572

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Le Pain PoilLe Pain Poilâânene

30% 30% éépeautre wheat, 15% branpeautre wheat, 15% branRich in Selenium & MagnesiumRich in Selenium & MagnesiumLeaven: better taste & Leaven: better taste &

digestibility, source of digestibility, source of vitaminsvitamins

Salt of GuSalt of Guéérande: Iodine, rande: Iodine, MagnesiumMagnesium

Supported by sustainable Supported by sustainable farming: no nitrates, no farming: no nitrates, no pesticidespesticides

Hand madeHand madePoilPoilââne wood-heated oven ne wood-heated oven

[XIXth century][XIXth century]

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∆∆Central Nervous System

Endocrine System Immune System

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Yogurt and Yogurt and γ-IFNγ-IFN

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Live active culture Live active culture (LAC) yogurt (LAC) yogurt consumption is consumption is associated with a associated with a five-fold increased five-fold increased production of production of γ-IFN γ-IFN by PBMC.by PBMC.

Halpern GM et al. Halpern GM et al. Int J Immunoth Int J Immunoth 1991;7:205-2101991;7:205-210

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Yogurt and Nasal AllergiesYogurt and Nasal Allergies

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The influence of chronic The influence of chronic yogurt consumption on yogurt consumption on nasal allergies, over the nasal allergies, over the course of one year, in a course of one year, in a healthy college-aged healthy college-aged population. Each quarter population. Each quarter represent a 3-month represent a 3-month period of time. The scale period of time. The scale is: “Total days affected”is: “Total days affected”

Trapp CL, Chang CC, Halpern GM et al. Trapp CL, Chang CC, Halpern GM et al. Int J Int J Immunoth 1993; 9:53-64Immunoth 1993; 9:53-64

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Yogurt and ImmunomodulationYogurt and Immunomodulation

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

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Diet after surgical operationDiet after surgical operationApfelbaum M Presse Med 1971;79:2027-2032Apfelbaum M Presse Med 1971;79:2027-2032

Seminal study Seminal study demonstrating that artsy demonstrating that artsy and tasting food and tasting food shortens hospital stay of shortens hospital stay of surgical patients by an surgical patients by an average of 3 days. All average of 3 days. All constituents/calories constituents/calories were identical in both were identical in both diets.diets.

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Good Food Makes People Happy, and HealthyGood Food Makes People Happy, and HealthyMelchior JC, Rigaud D, Chayvialle JA et al. Palatability of a meal influences release of beta-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. endorphin, and of potential regulators of food intake in healthy human subjects. AppetiteAppetite 1994;22:233-2441994;22:233-244

The effect of the palatability of a The effect of the palatability of a meal was tested on the post-meal was tested on the post-prandial release of several gut prandial release of several gut hormones or neuropeptides that hormones or neuropeptides that are known to effect intake and are known to effect intake and satiety. Hormonal response was satiety. Hormonal response was measured in plasma for 3 h after a measured in plasma for 3 h after a highly palatable and energy-rich highly palatable and energy-rich meal, or after the same meal meal, or after the same meal served cold in a poorly acceptable served cold in a poorly acceptable form, as well as fasting. The early form, as well as fasting. The early post-prandial pancreatic post-prandial pancreatic polypeptide and neurotensin polypeptide and neurotensin response was significantly higher response was significantly higher after the highly palatable meal after the highly palatable meal than after the cold one.than after the cold one.

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Mood improved during the palatable meal

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Pancreatic Polypeptide level was higher in the palatable meal than in the cold meal (p<0.03)

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Good digestion vs. cancerGood digestion vs. cancer

Gastrointestinal peptides Gastrointestinal peptides play a role in the play a role in the regulation of cellular regulation of cellular toxicity against tumor toxicity against tumor cells.cells.

Van Tol EA, Verspaget HW, Pena Van Tol EA, Verspaget HW, Pena AS et al. AS et al. Immunol Invest Immunol Invest

1991;20:257-2671991;20:257-267

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Intensification of Sensory Properties of Intensification of Sensory Properties of Foods for the ElderlyFoods for the Elderly

Schiffman SS. Schiffman SS. J NutrJ Nutr 2000;130:927S-930S 2000;130:927S-930S

Taste and smell losses in the elderly can reduce Taste and smell losses in the elderly can reduce appetite and lead to inadequate dietary intake. appetite and lead to inadequate dietary intake. One method for “treatment” of chemosensory One method for “treatment” of chemosensory losses involves sensory enhancement of foods losses involves sensory enhancement of foods with flavors and MSG. Amplification of flavor with flavors and MSG. Amplification of flavor and taste can improve food palatability and and taste can improve food palatability and acceptance, increase hunger and appetite while acceptance, increase hunger and appetite while preventing weight loss, increase salivary flow preventing weight loss, increase salivary flow and immunity, and reduce oral complaints in and immunity, and reduce oral complaints in both sick and healthy elderly.both sick and healthy elderly.

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Taste, Smell, Appetite & ImmunityTaste, Smell, Appetite & ImmunitySchiffman SS, Graham BG. Taste and smell perception affect appetite Schiffman SS, Graham BG. Taste and smell perception affect appetite

and immunity in the elderly. and immunity in the elderly. Eur J Clin NutrEur J Clin Nutr 2000;54:S54-S63. 2000;54:S54-S63.

Many medical conditions and Many medical conditions and medications alter taste medications alter taste and/or smell (elderly), with and/or smell (elderly), with dire consequences. dire consequences. Amplification of the flavor Amplification of the flavor level of foods results in: level of foods results in: increased total number of T increased total number of T & B lymphocytes; & B lymphocytes; increased salivary S-IgA; increased salivary S-IgA; correction of malnutrition; correction of malnutrition; reduction of Na intake.reduction of Na intake.

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Nutrition Influences ImmunityNutrition Influences ImmunityLesourd B. Nutrition: a major factor influencing immunity in the elderly.Lesourd B. Nutrition: a major factor influencing immunity in the elderly.

J Nutr Health Aging J Nutr Health Aging 2004;8:28-37.2004;8:28-37.

Normal Aging:Normal Aging:

↓↓T CD3+ ↑T CD2+CD3-T CD3+ ↑T CD2+CD3-

↑↑memory T CD45RO+memory T CD45RO+

↓↓T CD8+ =B, innateT CD8+ =B, innate

Worse if PEM &/or Worse if PEM &/or chronic inflammationchronic inflammation

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

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Appetite Depends on Senses in EldersAppetite Depends on Senses in EldersdeJong N, Mulder I, de Graaf C, van Staveren WA. Impaired sensory functioning 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. the relation with its potential determinants and nutritional intake. J Gerontol/Biol SciJ Gerontol/Biol Sci 1999;54A:B324-B331 1999;54A:B324-B331

Age and functionality Age and functionality (independent living elders (independent living elders n=89 vs. institutionalized n=89 vs. institutionalized n=67) are determinants in n=67) are determinants in smell identification and smell identification and taste perception (5.7 taste perception (5.7 vs.3.5; p<.0001). Poor vs.3.5; p<.0001). Poor performance is related to performance is related to poor appetite.age-related poor appetite.age-related factors and smoking are factors and smoking are impairing sensory impairing sensory functioning.functioning.

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Nursing Home Residents Can Nursing Home Residents Can Get Better with Flavor EnhancersGet Better with Flavor Enhancers

Mathey MFAM, Siebelink E, deGraaf C, Van Staveren WA. Flavor enhancement of food Mathey MFAM, Siebelink E, deGraaf C, Van Staveren WA. Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents.improves dietary intake and nutritional status of elderly nursing home residents.

J Gerontol/Med SciJ Gerontol/Med Sci 2000;56A:M200-M205. 2000;56A:M200-M205.

16-w parallel intervention; 16-w parallel intervention; sprinkling flavor enhancers sprinkling flavor enhancers (n=4) over cooked meals (F; (n=4) over cooked meals (F; n=36) vs. control (C; n=31). n=36) vs. control (C; n=31). Body weight of FBody weight of F↑ (+1.1kg; ↑ (+1.1kg; p<.05). Intake of cooked meals p<.05). Intake of cooked meals of F↑ (133kJ; p<.05), as well of F↑ (133kJ; p<.05), as well as hunger feelings. Flavor as hunger feelings. Flavor enhancers improve dietary enhancers improve dietary intake & body wt in elderly intake & body wt in elderly nursing home residents.nursing home residents.

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Blueberries vs. Aging of BrainBlueberries vs. Aging of BrainMazza G, Kay CD, Cottrell T, Holub BJ. Absorption of anthocyanins from blueberries and serum Mazza G, Kay CD, Cottrell T, Holub BJ. Absorption of anthocyanins from blueberries and serum

antioxidant status in human subjects. antioxidant status in human subjects. J Agric Food Chem J Agric Food Chem 2002;50:7731-7. Joseph JA, Shukitt-2002;50:7731-7. Joseph JA, Shukitt-Hale B, Desinova NA et al. Reversals of age-related declines in neuronal signal transduction, Hale B, Desinova NA et al. Reversals of age-related declines in neuronal signal transduction,

cognitive and motor behavioral deficits with blueberry, spinach,cognitive and motor behavioral deficits with blueberry, spinach, or strawberry dietary supplementation. or strawberry dietary supplementation. J Neurosci J Neurosci 1999;19:8114-21.1999;19:8114-21.

Consumption of blueberries (BB) Consumption of blueberries (BB) is associated with a diet-induced is associated with a diet-induced increase in increase in ex vivo ex vivo serum anti-serum anti-oxidant status. BB intake can oxidant status. BB intake can retard and even reverse age-retard and even reverse age-related declines in brain related declines in brain function, cognitive and motor function, cognitive and motor performance, as well as performance, as well as inflammation and oxidative inflammation and oxidative stress in quadriceps muscle.stress in quadriceps muscle.

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Sweetening the PainSweetening the PainMercer ME, Holder MD. Antinociceptive effects of palatable sweet ingesta on human responsitivity to Mercer ME, Holder MD. Antinociceptive effects of palatable sweet ingesta on human responsitivity to

pressure pain. pressure pain. Physiol BehavPhysiol Behav 1997;52:219-225 1997;52:219-225 Palatable sweet ingestion Palatable sweet ingestion

produces a morphine-like produces a morphine-like analgesia in infants.analgesia in infants.

Canadian women who Canadian women who consumed a soft drink consumed a soft drink reported increased pain reported increased pain tolerance. Women who tolerance. Women who consumed chocolate-chip consumed chocolate-chip cookies demonstrated the cookies demonstrated the palatability-induced anti-palatability-induced anti-nociception.nociception.

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Oral Sucrose Relieves Pain in BabiesOral Sucrose Relieves Pain in BabiesMitchell A, Waltman PA. Oral sucrose and pain relief for preterm infants. Mitchell A, Waltman PA. Oral sucrose and pain relief for preterm infants. Pain Manag NursPain Manag Nurs

2003;4:62-692003;4:62-69

Sucrose is effective in Sucrose is effective in relieving pain in term relieving pain in term and preterm infants and preterm infants during heelsticks and during heelsticks and venipunctures; it is venipunctures; it is combined with combined with nonnutritive sucking for nonnutritive sucking for better analgesia. Oral better analgesia. Oral sucrose is now sucrose is now recommended as recommended as analgesic in the NICUanalgesic in the NICU

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Chocolate beats ProzacChocolate beats Prozac®®Bruinsma K, Taren DL. Chocolate: food or drug? Bruinsma K, Taren DL. Chocolate: food or drug? J Am Diet AssocJ Am Diet Assoc 1999;99:1249-1256 1999;99:1249-1256

Chocolate is the food with the Chocolate is the food with the greatest impact on mood.greatest impact on mood.

Besides its hedonic appeal –fat, Besides its hedonic appeal –fat, sugar, texture, aroma-, it is sugar, texture, aroma-, it is used as self-medication for used as self-medication for dietary deficiencies (Mg), or dietary deficiencies (Mg), or to balance low levels of to balance low levels of mood-neurotransmitters mood-neurotransmitters (serotonin, dopamine). (serotonin, dopamine). Chocolate contains appetite Chocolate contains appetite regulators, and cannabinoid-regulators, and cannabinoid-like fatty acids.like fatty acids.

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Dark Chocolate in CV DiseaseDark Chocolate in CV DiseaseInnes AJ, Kennedy G, McLaren M, et al. Dark chocolate inhibits platelet aggregation in healthy Innes AJ, Kennedy G, McLaren M, et al. Dark chocolate inhibits platelet aggregation in healthy

volunteers. volunteers. PlateletsPlatelets 2003;14:325-327. 2003;14:325-327.

Dark chocolate (but not Dark chocolate (but not white or milk) inhibited white or milk) inhibited collagen-induced collagen-induced platelet aggregation in platelet aggregation in platelet rich plasma; it platelet rich plasma; it may have a role in may have a role in prevention of prevention of cardiovascular and cardiovascular and thromboembolic thromboembolic disease.disease.

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Cocoa Inhibits Platelet FunctionCocoa Inhibits Platelet FunctionMurphy KJ, Chronopoulos AK, Singh I, et al. Dietary flavonols and procyanidin oligomers from Murphy KJ, Chronopoulos AK, Singh I, et al. Dietary flavonols and procyanidin oligomers from

cocoa (cocoa (Theobroma cacaoTheobroma cacao) inhibit platelet function. ) inhibit platelet function. Am J Clin NutrAm J Clin Nutr 2003;77:1466-73. 2003;77:1466-73.

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

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

Nature Nature 2003;424:1013.2003;424:1013.

12 healthy volunteers 12 healthy volunteers who consumed, in a who consumed, in a double-blind double-blind experiment 100 g of experiment 100 g of dark chocolate had a dark chocolate had a 20% increase in blood 20% increase in blood antioxidants after 1, 2 antioxidants after 1, 2 and 4h (but not with and 4h (but not with milk chocolate, or milk chocolate, or milk with chocolate). milk with chocolate).

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Chocolate/Brain: From Pleasure to AversionChocolate/Brain: From Pleasure to AversionSmall DM, Zatorre RJ, Dagher A, et al. Changes in brain activity related to eating chocolate:Small DM, Zatorre RJ, Dagher A, et al. Changes in brain activity related to eating chocolate:

from pleasure to aversion. from pleasure to aversion. BrainBrain 2001;124:1720-1733 2001;124:1720-1733

H(2)(15)O-PET scans were H(2)(15)O-PET scans were performed on volunteers eating performed on volunteers eating chocolate to beyond satiety. chocolate to beyond satiety. Senses & act (eating) were Senses & act (eating) were constant while reward value & constant while reward value & motivation were manipulated. motivation were manipulated. Areas of brain when highly Areas of brain when highly motivated & rating pleasant, motivated & rating pleasant, and when eating despite and when eating despite satiation were different. Medial satiation were different. Medial and lateral caudal OFC showed and lateral caudal OFC showed opposite patterns of activity. opposite patterns of activity. There are 2 separate There are 2 separate motivational systems!motivational systems!

                                              

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WineWineRenaud S, Gueguen R. The French paradox and wine drinking. Renaud S, Gueguen R. The French paradox and wine drinking. Novartis Food Sympos Novartis Food Sympos

1998;216:217-2181998;216:217-218

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

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Wine beats ValiumWine beats Valium®®Paladini AC et al. Flavonoids and the CNS: from forgotten factor to potent anxiolytic compounds. Paladini AC et al. Flavonoids and the CNS: from forgotten factor to potent anxiolytic compounds.

J Pharm Pharmacol J Pharm Pharmacol 1999:51;519-5261999:51;519-526

Some natural occurring Some natural occurring wine flavonoids, e.g. wine flavonoids, e.g. chrysin and apigenin, chrysin and apigenin, selectively bind with selectively bind with high affinity to the high affinity to the central benzodiazepine central benzodiazepine receptor, and exert receptor, and exert powerful anxiolytic powerful anxiolytic effects.effects.

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Enjoy in the Right Shape of GlassEnjoy in the Right Shape of GlassHuttenbrink KB, Schmidt C, Delwiche JP, Hummel T. The enjoyment of red wine is influencedHuttenbrink KB, Schmidt C, Delwiche JP, Hummel T. The enjoyment of red wine is influenced

by the shape of the wine glass. by the shape of the wine glass. Laryngorhinootologie Laryngorhinootologie 2001;80:96-100.2001;80:96-100.

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

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Guilt Makes You SickGuilt Makes You SickLowe G et al. Pleasure, guilt and secretory IgA. Lowe G et al. Pleasure, guilt and secretory IgA. Psychol Rep Psychol Rep 1999;85:339-3401999;85:339-340

30 English subjects listed 30 English subjects listed their pleasurable their pleasurable activities and rated them activities and rated them in terms of pleasure and in terms of pleasure and guilt before producing guilt before producing saliva for S-IgA: levels saliva for S-IgA: levels of sIgA were higher in of sIgA were higher in those subjects with high those subjects with high ratios of pleasure-guilt ratios of pleasure-guilt scores.scores.

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Pleasure Makes Conscious DecisionsPleasure Makes Conscious DecisionsCabanac M, Guillaume J, Balasko M, Fleury A. Pleasure in decision-making situations.Cabanac M, Guillaume J, Balasko M, Fleury A. Pleasure in decision-making situations.

BMC PsychiatryBMC Psychiatry 2002; 2:7-28 2002; 2:7-28

From a complex set of experiments and From a complex set of experiments and questionnaires it was concluded that pleasure is questionnaires it was concluded that pleasure is the key to decision making in theoretical the key to decision making in theoretical situations. Subjects tend to choose situations. Subjects tend to choose ethical/unethical responses corresponding to ethical/unethical responses corresponding to their highest pleasure. In mathematical their highest pleasure. In mathematical challenges, again, subjects chose correct or challenges, again, subjects chose correct or incorrect responses corresponding to their incorrect responses corresponding to their highest hedonic ratings. Decisions are made in highest hedonic ratings. Decisions are made in the hedonic dimension of conscious experience.the hedonic dimension of conscious experience.

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The Bliss PointThe Bliss PointMcBride RL. The Bliss Point and Pleasure. In: Warburton DM, Sherwood N (Eds.) Pleasure and McBride RL. The Bliss Point and Pleasure. In: Warburton DM, Sherwood N (Eds.) Pleasure and

Quality of Life. John Wiley & Sons: Chichester. 1996. pp 147-154Quality of Life. John Wiley & Sons: Chichester. 1996. pp 147-154

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The bliss point (or ideal point) The bliss point (or ideal point) curve is a trademark of curve is a trademark of hedonic research. There is hedonic research. There is almost always an optimum almost always an optimum level for a sensation, whether level for a sensation, whether this sensation be overall this sensation be overall intensity, or e.g. sweetness. intensity, or e.g. sweetness. The characteristic shape of the The characteristic shape of the bliss point curve is a trademark bliss point curve is a trademark of research on food acceptance 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 2004;126:807-819

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The Dark SideThe Dark Side

Everything I like Everything I like is either illegal, is either illegal, immoral, or immoral, or fatteningfattening

Oscar WildeOscar Wilde

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The Commercial Exploitation & Abuse of PleasureThe Commercial Exploitation & Abuse of Pleasure

The only natural thing The only natural thing in a diet cola is the in a diet cola is the

waterwaterThe active ingredient is phosphoric The active ingredient is phosphoric

acid (pH: 2.8). It will dissolve a acid (pH: 2.8). It will dissolve a nail in <4 days. It washes calcium nail in <4 days. It washes calcium away from bonesaway from bones

To carry the concentrate, trucks must To carry the concentrate, trucks must place the place the HAZARDOUS HAZARDOUS material material card.card.

Distributors use it to clean their Distributors use it to clean their trucks engines.trucks engines.

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The Commercial Exploitation & Abuse of PleasureThe Commercial Exploitation & Abuse of PleasureDrewnowski A et al. Taste responses and preferences for sweet high-fat foods. Drewnowski A et al. Taste responses and preferences for sweet high-fat foods.

Physiol Behav Physiol Behav 1992;51:371-3791992;51:371-379

Preferences and cravings for Preferences and cravings for sweet high-fat foods sweet high-fat foods observed among obese and observed among obese and bulimic patients involve the bulimic patients involve the endogenous opioid system.endogenous opioid system.

[Ketchup at McDonalds is much [Ketchup at McDonalds is much sweeter (corn syrup). Only soft sweeter (corn syrup). Only soft drinks are served. Vegetable oils drinks are served. Vegetable oils “boils” the fries. Potatoes have a “boils” the fries. Potatoes have a glycemic index >sucrose]glycemic index >sucrose]

           

  

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The Commercial Exploitation & Abuse of PleasureThe Commercial Exploitation & Abuse of PleasureLudwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. drinks and childhood obesity: a prospective, observational analysis. LancetLancet 2001;357:505-508 2001;357:505-508

For each additional serving For each additional serving of sugar-sweetened drink of sugar-sweetened drink consumed, both body consumed, both body mass index and mass index and frequency of obesity frequency of obesity increased after increased after adjustment for adjustment for anthropometric, anthropometric, demographic , dietary, demographic , dietary, and lifestyle variables.and lifestyle variables.

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The Commercial Exploitation & Abuse of PleasureThe Commercial Exploitation & Abuse of PleasureMelchior JC et al. Immunoreactive beta-endorphin increases after an aspartame chocolate drink in Melchior JC et al. Immunoreactive beta-endorphin increases after an aspartame chocolate drink in

healthy human subjects. healthy human subjects. Physiol Behav Physiol Behav 1991;50:941-9441991;50:941-944

Plasma beta-endorphin Plasma beta-endorphin concentrations were concentrations were more elevated after the more elevated after the aspartame drink than aspartame drink than after sucrose or fasting. after sucrose or fasting. Insulin increased after Insulin increased after drinking as much with drinking as much with aspartame as with aspartame as with sucrose.sucrose.

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Resting the Case for PleasureResting the Case for PleasureVincent JD. Biology of pleasure. Vincent JD. Biology of pleasure. Presse MedPresse Med 1994;23:1871-1873 1994;23:1871-1873

Cabanac M. Preferring the pleasure. Cabanac M. Preferring the pleasure. Am J Clin NutrAm J Clin Nutr 1985;42:1151-1155 1985;42:1151-1155

Pleasure is not an “extra”, or bonus bringing a little Pleasure is not an “extra”, or bonus bringing a little more soul to certain of our acts; it is a fundamental more soul to certain of our acts; it is a fundamental part of our animal life. It is just as difficult to define part of our animal life. It is just as difficult to define as spirit, but nonetheless humans are very conscious as spirit, but nonetheless humans are very conscious of it.of it.

Pleasure is a potent drive, inducing forms of behavior Pleasure is a potent drive, inducing forms of behavior adapted to physiological needs, e.g. temperature adapted to physiological needs, e.g. temperature regulation and food-and-fluid intake; sensory regulation and food-and-fluid intake; sensory pleasure is an incentive to useful behavior, and pleasure is an incentive to useful behavior, and maximization of pleasure the answer to physiological maximization of pleasure the answer to physiological conflicts [a.k.a. stress].conflicts [a.k.a. stress].

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干杯干杯Cheers!Cheers!

Salud!Salud!

SantSanté!é!

Salute!Salute!