Chocolate cravings in American and Spanish individuals: biological and cultural influences

This study investigated relationships of culture and physiology with chocolate cravings. Gender differences in chocolate cravings in Spaniards and Americans were examined using parallel Spanish- and English-version questionnaires administered to 259 undergraduate students at one university in Spain and 306 at one university in the US. Responses were examined separately for men and women in American and Spanish samples using multivariate analyses to control for variables like chocolate availability and cultural involvement (which was described by country of birth, years spent in that country, media use, and cultural identification). Chocolate was the most craved food among all Spanish students, but only female American students. A total of 91% of American women and 59% of American men reported chocolate cravings, and this significant difference persisted when controlling for American cultural involvement. In contrast, 90% of Spanish women versus 78% of Spanish men reported chocolate cravings, but the gender difference was no longer significant when controlling for Spanish cultural involvement. These results do not reject a role of physiology in chocolate cravings, but suggest that American culture encourages disproportionately more chocolate cravings among females than males, and that globalization may have led to a similar craving pattern among Spaniards, although gender differences in cravings are less clear-cut than they are in the US.     

Food liking and craving: A cross-cultural approach.

Spanish and American participants rated how much they liked three common sweets and three common beverages listed on a questionnaire. They also named the food or drink for which they had the strongest craving. Cross-cultural comparisons in liking were almost always consistent with cross-cultural comparisons in rates of exposure. In both cultures, among subjects whose cravings could be so classified more females (about 5/8) craved sweet foods than savories and more males (about 5/8) craved savories than sweets. Among sweet cravers, chocolate craving was much more frequent for American females (44.6%) than for American males (17.4%), but no such gender difference occurred for the Spaniards (28.6 and 22.2%). The results argue for a possible physiological basis for the gender differences in sweet/savory craving but against a physiological basis for chocolate craving.     

Perimenstrual chocolate craving. What happens after menopause?

About half of American women crave chocolate, and approximately half of the cravers crave it specifically around the onset of menstruation. This study examines whether the primary cause of this “perimenstrual” craving is a direct effect of hormonal changes around the perimenstrum, or rather if the craving is a general response in some individuals to stress or other notable events. Insofar as there is a direct hormonal effect, one would predict a substantial decrease of 38% in total chocolate craving in women post-menopause, corresponding to the proportion of women pre-menopause who report craving chocolate exclusively perimenstrually. Based on a survey of pre- and post-menopausal alumnae of the same University, we report a significant but small decrease in prevalence of chocolate cravings post-menopause. The decrease is only 13.4% and thereby much smaller than a 38% drop predicted by a purely hormonal explanation, suggesting that female reproductive hormones are not the principal cause of perimenstrual chocolate craving.     

Sex differences in young adults' snack food intake after food commercial exposure

Exposure to food commercials on television is considered to be related to elevated snack food intake in front of the television. However, this assumed relation has as yet not been fully established. The present study, therefore examined the direct effects of watching television food commercials on concurrent non-advertised snack food intake in young adults. In addition, possible sex differences were investigated. Participants (N=82, 50% male) watched a movie interrupted by two commercial breaks that contained either food commercials or neutral commercials. While watching, they could freely eat crisps and chocolate coated peanuts. Afterwards, participants filled out questionnaires and were weighed and measured. Regression analyses showed that men and women were differently affected by the food commercials. Food intake in women was higher when they watched the food commercials than when they watched the neutral commercials, whereas food intake in men was lower when they watched the food commercials than when they watched the neutral commercials. The results suggest that especially women are vulnerable for eating more snack food when exposed to food commercials.     

Food cravings in relation to body mass index, restraint and estradiol levels: a repeated measures study in healthy women.

The study considered the nature and extent of cravings in 108 healthy women between the ages of 20 and 37 who were tested at four time points over a 2-year period. There was substantial consistency over the four widely separated time points (3 months-1 year) in the types of foods craved, with chocolate and ice cream highest on the list, followed by fatty and spicy foods, and sweets. Women with a higher body mass index reported more consistent cravings for salty foods, especially those with high flavor intensity. There were no significant relationships between dietary restraint and the number, frequency or types of cravings. There were also no strong relationships between estradiol levels and the number, frequency or types of cravings women reported in the whole sample. The data suggest that women have a stable core of foods for which they experience cravings, relatively independent of estradiol levels, BMI or degree of dietary restraint.     

"Chocolate Addiction": a Preliminary Study of its Description and its Relationship to Problem Eating

Definitions of chocolate addiction and its potential relationship to dieting and problem eating were investigated in 50 individuals who identified themselves as "chocoholics". Respondent were interviewed and completed a battery of questionnaires on food cravings, eating, weight, dieting and depression. On average this sample consumed about 12 (60-g) bars of chocolate per week and craved chocolate about six times per week. Cravings and amount consumed were not significantly related but amount consumed was significantly correlated with disinhibition (r=0·3). Most (76%) respondents had definition of chocolate addiction that centred on a lack of control around chocolate and regarded the "addictive" factor in chocolate as orosensory (i.e. taste, smell, texture). Unlike most others, dieters and secret eaters experienced negative affect following consumption of chocolate. Consumers who preferred to eat in secret reported a higher degree of aberrant eating. The extent to which the behaviour of "chocolate addicts" resembles that of eating disordered individuals and other addictions remains to be clarified.     

Adaptation of the food-craving questionnaire trait for the assessment of chocolate cravings: validation across British and Spanish women

English and Spanish versions of the FCQ-T [Cepeda-Benito, A., Gleaves, D. H., Williams, T. L., & Erath, S. A. (2000). The development and validation of the state and trait food-cravings questionnaires. Behavior Therapy, 31, 151-173] were adapted to create the food chocolate-craving questionnaire trait (FCCQ-T). Female college students from England (N=293), and Spain (N=373) completed the FCCQ-T. Good and similar measurement fits for the English and Spanish versions were found. In concordance with the higher consumption of chocolate in Britain, British women reported greater chocolate cravings than Spanish women. Overall, the FCCQ-T appears a well-suited instrument to investigate chocolate cravings in English- and Spanish-speaking populations.     

The effect of deprivation on food cravings and eating behavior in restrained and unrestrained eaters

OBJECTIVE: The relation between being deprived of a food and intake and craving for that food was investigated in restrained and unrestrained eaters. METHOD: For 1 week, 103 female undergraduate students were assigned to be chocolate deprived, vanilla deprived, or nondeprived. Only chocolate deprivation was expected to elicit cravings, as chocolate is not easily substituted, whereas vanilla is. RESULTS: The main effect of chocolate deprivation on consumption was qualified by an interaction with restraint. Chocolate-deprived restrained eaters consumed more chocolate food than did any other group. Restrained eaters experienced more food cravings than did unrestrained eaters and were more likely to eat the craved food. Moreover, restrained eaters deprived of chocolate spent the least time doing an anagram task before a "taste-rating task" in which they expected that chocolate foods might be available. CONCLUSION: Converging measures of craving indicate that deprivation causes craving and overeating, but primarily in restrained eaters.     

Reported pica behavior in a sample of incident dialysis patients

In a prospective study, pica behavior was investigated during baseline interviews with a cohort of incident patients (n=226) who began chronic dialysis therapy in metropolitan Atlanta, GA, during 1996 to 1997. Pica, defined as current pica behavior and/or reported history of pica behavior, was reported by 16% of the sample. Patients reporting pica were significantly more likely to be African American women and were significantly younger than the remainder of the sample. Approximately two thirds of patients who reported pica behaviors craved and excessively consumed ice; the remainder craved and consumed starch, dirt, flour, or aspirin. Among patients reporting pica, average serum albumin values were low and average phosphorus was increased. The average hematocrit of patients reporting ice pica was low. Over half of the hemodialysis patients reporting pica behavior had excessive usual interdialytic weight gain. Potential symptoms/problems affecting quality of life among patients practicing pica, eg, cramps, are shown in a case report. The data indicate the need for targeted education and support for dietitians' increased interaction with dialysis patients involved in pica behaviors.     

Migrant fathers and their attitudes to potential male hormonal contraceptives

Irregular menstrual bleeding associated with use of hormonal contraceptives is a leading cause of contraception discontinuation. If bleeding disrupts sexual activity, this could contribute to contraceptive discontinuation. The impact of bleeding on sexual activities other than intercourse is unknown.A self-administered questionnaire in Spanish or English was used to collect information on demographics and the practice of various sexual behaviors during times of vaginal bleeding or spotting. The questionnaire was offered consecutively to 86 men and 75 women attending urban family-planning and young men's clinics. The men and women were approached individually, not as couples.Women reported a mean age of 25 years, a wide range of educational attainment, described themselves as mostly Hispanic (89%), and most chose the Spanish version of the questionnaire (67%). Men also described themselves as mostly Hispanic (80%), and reported a similar range of educational attainment, but were younger (mean age of 21, p < 0.001), and were less likely to choose the Spanish version of the questionnaire (23%, p < 0.001).Kissing, breast touching, and receiving non-genital touching did not change during bleeding or spotting. Forty-five percent of women reported usually receiving genital touching, which declined to 6% during bleeding and to 10% during spotting (p < 0.001). Similar proportions of women reported usually giving genital touching to their partner (50%) during bleeding (41%) or spotting (44%). Men also reported usually giving less genital touching to their partner, but no change in receiving genital touching during bleeding or spotting. Forty percent of women reported usually receiving oral sex, which declined to 4% during spotting or to 0% bleeding (p < 0.001). Forty-two percent of women reported usually giving oral sex, which declined to 23% during bleeding and to 35% during spotting (p = 0.06). Fifty percent of women and 68% of men reported engaging in vaginal intercourse. Among women, reported intercourse declined to 7% during bleeding and to 26% during spotting (p < 0.001). Among men, reported intercourse declined to 19% during bleeding and to 23% during spotting (p < 0.001).The presence of vaginal bleeding or spotting is associated with decreases in genital sexual behaviors among urban, Hispanic women and men. Such disruptions in sexual behavior could contribute to contraceptive discontinuation.     

Prevalence of dementia in three ethnic groups: the South Florida program on aging and health

To determine the prevalence of cognitive impairment and dementia in a multi-ethnic community, we examined a population sample of 2,759 elderly (65 years of age and older) African American, Hispanic-Cuban and white non-Hispanic men and women of Dade County, Florida. The Short Portable Mental Status Questionnaire (SPMSQ) was used as a screening test. The prevalence of cognitive impairment for African American men was 17.0% and women 16.7%; Cuban men 9.4% and women 11.4%; and white non-Hispanic men 9.0% and women 8.5%. Participants with cognitive impairment were referred to two Memory Disorder Clinics for diagnosis of dementia/Alzheimer's disease (AD). SPMSQ cutpoints took account of race and education. The prevalence of dementia/AD was adjusted for sensitivity and specificity of the SPMSQ in each sex/ethnic group. The prevalence of dementia among African American men (20.9%) was twice that among white non-Hispanic men (11.6%). White non-Hispanic and Cuban women had a similar prevalence of dementia (12.1% vs. 12.9%). Low SPMSQ specificity for Cuban men and African American women gave unstable dementia prevalence estimates. More than two thirds of all dementia cases had AD, and among white non-Hispanics, women had double the prevalence of AD among men (10.9% vs. 5.4%). The prevalence of AD among African American men was more than two and a half times greater than the prevalence among white non-Hispanic men (14.4% vs. 5.4%). Age (p = 0.001), family history of AD (p = 0.02) and African American (p = 0.0001) or Cuban (p = 0.006) ethnic group were directly and independently associated with the prevalence of AD.     

Gender differences related to heterosexual condom use: the influence of negotiation styles.

The present study had three primary goals. The first was to identify gender differences related to negotiation styles associated with condom use. We hypothesized that women would report engaging in more negotiation behaviors associated with condom use than men. The second goal was to determine whether the relationships between intentions to use condoms and past condom use for women and men were moderated by negotiation behaviors. The third goal was to examine gender differences in responses to an open-ended question inquiring why participants did not use condoms. Male and female college students (N = 219) anonymously completed a series of measures. The results indicated that women and men have unique roles in the negotiation process; women play a more active role in negotiation of condom use, while men play a more reactive role. The relationship between intentions to use condoms and past condom use increased for men when their partners were more active in the process of deciding whether to use condoms. Responses to the open-ended item revealed that women identified perceptions of low risk as the most common reason for not using condoms, while men identified the inconvenience or unavailability of condoms as the most common reason. The implications of these results are discussed as they relate to health efforts to increase condom use.     

Comparative microhematocrit values of Spanish Americans and whites attending Los Angeles County youth clinics.

Determinations were made of the microhematocrit levels of 50 male and 50 female Spanish Americans and 50 male and 50 female white persons selected at random at two Los Angeles County youth clinics. One clinic served primarily a Spanish American population and the other, primarily a white population. Among both men and women the mean level for whites was significantly less than that for the Spanish Americans. If microhematocrit levels below 36 percent are considered below normal for women and those below 42 percent below normal for men, the prevalence of below-normal microhematocrit levels among whites was 18 percent of the women and 28 percent of the men in contrast to a prevalence of 10 percent of the women and 14 percent of the men among the Spanish Americans. The findings are contrary to those which may have been anticipated on the basis of the "Ten State Nutrition Survey, 1968-1970."     

Chocolate craving and liking.

Liking and craving for chocolate and related substances were surveyed in a sample of University of Pennsylvania undergraduates (n = 249) and their parents (n = 319). Chocolate was highly liked in all groups, with a stronger liking by females. Chocolate is the most craved food among females, and is craved by almost half of the female sample (in both age groups). Although this craving is related to a sweet craving, it cannot be accounted for as a craving for sweets. About half of the female cravers show a very well defined craving peak for chocolate in the perimenstrual period, beginning from a few days before the onset of menses and extending into the first few days of menses. There is not a significant relation in chocolate craving or liking between parents and their children. The current motivation for chocolate preference seems to be primarily, if not entirely, sensory. Liking for chocolate correlates significantly with liking for sweets and white chocolate. The liking for the sensory properties could originate in innate or acquired liking based on the sweetness, texture and aroma of chocolate, or it could be based in part on interactions between the postingestional effects of chocolate and a person's state (e.g., mood, hormone levels). Based on correlational data, we find little evidence for a relation between addiction to chocolate or the pharmacological (e.g., xanthine-based) effects of chocolate and the liking for chocolate.     

Incidence of urinary bladder cancer in an industrialized area of Spain

AIM: To identify all incident cases of bladder cancer in the county of Vallès Occidental (Spain), describe their histopathological characteristics, and make comparisons with other Spanish and European areas. METHOD: The study was carried out from the Corporació Parc Taulí (Sabadell). All new cases of bladder cancer in residents of the county Vallès Occidental, a highly industrialised area of Catalonia (Spain), were included between 1992 and 1994. Incidence rates of bladder cancer were adjusted and were compared with adjusted incidence rates reported by registries in other Spanish and European countries. RESULTS: 485 new cases were identified. Transitional cell carcinomas predominated (95.5%). The majority of tumours were diagnosed in their initial stages, 75.9% being superficial and 62.6% well to moderately differentiated. Bladder cancer was more common in men than in women, but women presented tumours of worse prognosis. The mean age at diagnosis was also higher in women than men (71 vs. 66 years, p = 0.03). The adjusted incidence rate in men (52.2 cases/100,000) was among the highest of the observed areas, whereas for women (5.4 cases/100,000) was relatively low. CONCLUSIONS: The incidence of bladder cancer among men in Vallès Occidental is among the highest in Europe, and intermediate for women. The high male/female ratio seen in all Spanish areas could be attributed to the fact that women in Spain have been less exposed than men to the risk factors, or their exposure occurred more recently.     

Chocolate, well-being and health among elderly men

OBJECTIVE: We hypothesized that chocolate preference would be related to health and psychological well-being in old men. DESIGN, SETTING AND PARTICIPANTS: We have followed up a socio-economically homogenous group of men, born in 1919-1934, since the 1960s. In 2002-2003, a mailed questionnaire was used to assess the health and well-being (including questions related to positive life orientation, visual analogue scales and the Zung depression score) of survivors. In addition, candy preference was inquired. Those men who reported no candy consumption (n=108) were excluded from the analyses. OUTCOME MEASURES: Psychological well-being in old age. RESULTS: The response rate was 69% (1367 of 1991). Of the respondents, 860 and 399 preferred chocolate and other type of candy, respectively. The average age in both candy groups was 76 years. Of the respondents, 99% were home-dwelling, 96% were retired and 87% were presently married, without differences between the candy groups. Men preferring chocolate had lower body mass index and waist circumference, and they also reported more exercise and better subjective health (P=0.008) than other candy consumers. Variables related to psychological well-being were consistently better in those preferring chocolate. The differences were statistically significant in feeling of loneliness (P=0.01), feeling of happiness (P=0.01), having plans for the future (P=0.0002) and the Zung depression score (P=0.02). CONCLUSIONS: In this socioeconomically homogenous male cohort, chocolate preference in old age was associated with better health, optimism and better psychological well-being. SPONSORSHIP: The Academy of Finland, the P?ivikki and Sakari Sohlberg Foundation, the Helsinki University Central Hospital and the Finnish Foundation for Cardiovascular Research.     

Maternal Nutrition: An overview and adaptation to the hispanic client

White American, Hispanic, and African American women were surveyed in public health and low‐income clinics in Los Angeles, California, and Seattle, Washington, to determine if they delayed seeking prenatal care because of battering during their pregnancies. Nursing staff in the clinics attempted to enroll in the study all pregnant women from these groups who presented themselves for care; no other criteria were used, other than the ability to read either English or Spanish. Results were obtained from 162 White Americans, 208 Hispanics, and 132 African Americans. Although the incidence of abuse was not significantly different among the ethnic groups, battered women sought prenatal care 6.5 weeks later than the nonabused sample, with a similar delay in each ethnic group. Twenty‐one percent of the women reported physical harm during the pregnancy, and 13.7% stated that they had delayed care because of injuries.     

Effect of satiety on brain activation during chocolate tasting in men and women

BACKGROUND: The brain plays a crucial role in the decision to eat, integrating multiple hormonal and neural signals. A key factor controlling food intake is selective satiety, ie, the phenomenon that the motivation to eat more of a food decreases more than does the motivation to eat foods not eaten. OBJECTIVE: We investigated the effect of satiation with chocolate on the brain activation associated with chocolate taste in men and women. DESIGN: Twelve men and 12 women participated. Subjects fasted overnight and were scanned by use of functional magnetic resonance imaging while tasting chocolate milk, before and after eating chocolate until they were satiated. RESULTS: In men, chocolate satiation was associated with increased taste activation in the ventral striatum, insula, and orbitofrontal and medial orbitofrontal cortex and with decreased taste activation in somatosensory areas. Women showed increased taste activation in the precentral gyrus, superior temporal gyrus, and putamen and decreased taste activation in the hypothalamus and amygdala. Sex differences in the effect of chocolate satiation were found in the hypothalamus, ventral striatum, and medial prefrontal cortex (all P < 0.005). CONCLUSIONS: Our results indicate that men and women differ in their response to satiation and suggest that the regulation of food intake by the brain may vary between the sexes. Therefore, sex differences are a covariate of interest in studies of the brain's responses to food.     

Pattern of health services use by immigrants from different regions of the world residing in Spain

Objective

To determine immigrants?? frequency of use of four health services by place of origin and compare it with that of the Spanish population.

Methods

Based on the 2006 National Health Survey in Spain, we estimated the frequency of use of four health services in men and women from: Spain, Western countries, Eastern Europe, Latin America, North Africa, Sub Saharan Africa and Asia/Oceania. These results were compared with the Spanish population by calculating odds ratios adjusted for age, socioeconomic position, health status, and type of health coverage.

Results

Immigrant men generally use health services less frequently than Spanish nationals. The main exceptions are Latin American men, who more often use emergency services (OR 1.68, 95% CI 1.41?C1.99) and Sub-Saharan men, who use specialists more frequently (OR 2.93, 1.70?C5.05). Immigrant women use health services about as frequently as Spanish women. The main exceptions are North African women, who less frequently use specialists (OR 0.39, 0.22?C0.71) and Sub-Saharan women who more frequently use GPs (OR 4.06, 2.21?C7.44), specialists (OR 2.29, 1.06?C4.95) and emergency services (OR 2.92, 1.49?C5.72).

Conclusions

Health services use by the immigrant population in Spain differs by gender and place of origin.