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- Robert Emanuel (13 January 1999)
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Sweets improve your mood
- Andreas F P Temmel, Josef Toth, Christian Quint (23 January 1999)
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Re: Sweets improve your mood, but so does moderate alcohol consumption
- David Gurwitz (26 January 1999)
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Should we begin a war against sweets in Latinoamerican countries?
- Emilio Polo Ledezma (20 May 1999)
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Robert Emanuel
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Editor-I read the article "Life is sweet: candy consumption and longevity"1, with some concern. The article concludes with a very narrow message that the presence of antioxidants in chocolate may be beneficial in protecting against heart disease and cancer. There is also a vast amount of evidence that shows increased consumption of sugar leads to dental caries2. The morbidity from toothache secondary to dental caries is high with many people suffering from extreme episodes of pain, and let us not forget the problem of treating dental caries in young children with multiple extractions under potentially risky general anaesthetic. Undoubtedly dietary factors may have an influence on the development of chronic disease, but surely a more holistic view, or at least one which at least considers the issue of dental disease, would be to suggest a healthy diet where a good supply of antioxidants would be provided by eating fruit and vegetables, rather than "candy" or chocolate. Robert Emanuel Senior Dental Officer in Special Needs Central Clinic Stoke Abbott Road Worthing BN11 1HE. 1 I-Min Lee, Ralph S Paffenbrger Jr. Life is sweet: candy consumption and longevity. BMJ 1998;317:1683-4 (19-26 December) 2 Health Education Authority. Sugars in the Diet. Based on the report of the panel on dietary sugars, committee on medical aspects of food policy, "Dietary Sugars and Human Disease". DOH 1990, HMSO, London. |
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Andreas F P Temmel, Senior Registrar University of Vienna, Dept. of ENT, Josef Toth, Christian Quint
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The authors describe that moderate consumption of candy was associated with longevity, but they failed to explain their findings nor did they describe the quality of life of the participants. As mood, appetite and quality of life may be closely related we want to point out the results of research in hysteroid dysphoria, a form of atypical depression, characterized by repeated episodes of depressed mood in response to feeling rejected, together with a craving for sweets and chocolate (1). Central serotonin pathways appear to participate in the regulation of mood and behavioural impulsivity, and modulate eating patterns qualitatively and quantitatively. Ingestion of carbohydrates increases the plasma ratio of tryptophan to other large neutral amino acids in man and animal, and the serotonin synthesis in the rat brain. Based on these findings it has been suggested that the excessive carbohydrate intake by patients with depression reflects a self-medication that temporarily relieves the vegetative symptoms via an increased central serotonergic activity (2). One explanation for the association between longevity and candy consumption may be that one who consumes sweets and chocolate regularly but moderately may be permanently in a better mood by increasing serotonin levels and therefore increaseing the quality of life and consecutively reduce mortality. Reference: (1) Schuman-M; Gitlin-MJ; Fairbanks-L Sweets, chocolate, and atypical depressive traits. J-Nerv-Ment-Dis. 1987 Aug; 175(8): 491-5 (2) Moller-SE. Serotonin, carbohydrates, and atypical depression. Pharmacol-Toxicol. 1992; 71 Suppl 1: 61-71 |
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David Gurwitz, Lab Director, National Laboratory for the Genetics of Israeli Populations Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, ISRAEL
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The authors note that mortality was lowest among subjects consuming sweets moderately (1-3 times a month) rather than three or more times weekly, and conclude that 'as with most things in life, moderation seems to be paramount' (1). This wise notion appears to embrace also alcohol consumption by members of the same study group: Table 1 documents reduced mean alcohol intake among candy consumers (76 gr alcohol/week) compared with the non-consumers (104 gr alcohol/week), a highly significant observation (p<0.001). Thus, an alternative explanation could be that rather than recording a protective effect of candy (or chocolate) consumption, the study rather documented a protective effect of moderate alcohol consumption (apparently associated with moderate candy consumption) which is widely documented to lower risks of stroke and cardiovascular diseases (2-4). References (1) I-Min Lee, Ralph S Paffenbrger Jr. Life is sweet: candy consumption and longevity. BMJ 1998;317:1683-4 (19-26 December) (2) Sacco RL, Elkind M, Boden-Albala B, Lin IF, Kargman DE, Hauser WA, Shea S, Paik MC. The protective effect of moderate alcohol consumption on ischemic stroke. JAMA. 1999 Jan 6;281(1):53-60. (3) Kannel WB, Ellison RC. Alcohol and coronary heart disease: the evidence for a protective effect. Clin Chim Acta. 1996 Mar 15;246(1-2):59-76. (4) Allebeck P, Rydberg U. Risks and protective effects of alcohol on the individual. Alcohol Clin Exp Res. 1998 Oct;22(7 Suppl):269S. |
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Emilio Polo Ledezma
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I want to thank to you for your attention in reading my letters and for excuse to me because of my writing and linguistic mistakes. A week before we receive the B.M.J. 19-26 December 1998 issue and yesterday I discussed with my students the very interesting paper "Life is sweet: Candy consumption and Longevity" written by I-Min Lee, and Ralph S Paffenbarger Jr. In relation with this paper I would like to bring your attention about the sweet life in Latinoamerican countries mainly in Colombia. In my dailies biochemistry's lectures I do always emphasis about the dangerous relation between the excessive ingestion of foods, which are richs in combustible biomolecules and the poor quality of the life in the majority of people who live in our country and every day invite to our future physicians to begin a big campaign in order to change the daily eating customs of our people. Our society always, and specially now, as product of the actual economical crisis (In our Financial State the people every day pay the interests of the interests of the interests...) eat rice, plane tree fruits in several eating forms, kidney beans of all colours, sweets, yucca and gaseouses, during the breakfast, at lunch, and during the evening, at dinner. After the 1970s the sweets have become an important part of the typical colombien meal, because they are cheap and easy to get. Our children consume all kind of candies, chocolates, and gaseouses, from the early age in "industrial quantities"(much more than 7 Kg. per person annually). Where they stay: at home, at school, on the street, around the park, playing soccer or in front the play station. Today, in Colombia, we can say, that people become an easily exploitable source of sweet and gaseouses companies and shop labour, with obvious detrimental effects on health The colombien cities and their automotive park have grown a lot and the people prefer to eat street rambler foods in places which are without a good control of the drugs and foods administration centers. Places of sale, where offer mainly pizza, snacks with different flavors, sweet sauces, hamburgers, hot dogs, chocolates, pie desserts, candies and gaseouses among other foods. This includes an umbalanced diet with many carbohydrates, and little highest biological value proteins. In my lectures I call these sites "degradants" instead restaurants, because they don't help to restore the body structure and by the contrary, they bring it to the destruction. May be in relation with this in any colombien cities some children call, in popular terms, to old men - "rejectable men". The excessive amount of sugar and grease present in this kind of foods increase later the level of compounds related with the pathogenesis of chronic illnesses such as artherial hypertension, atherosclerosis, obesity and other cardiovascular diseases. If we want to ameliorate the quality of life in Colombia, and in all Latinoamerican countries, it's urgent and necessary to begin a " war against sweets" in order to decrease significantly the excessive consumption of all sweets, which play a key role and predispose individuals to cardiovascular diseases. There are two strategies that might win the war against the daily increasing of the incidence of cardiovascular diseases in Colombia, and the two are not mutually exclusive. The first approach actually is in practice: the therapeutic intervention, and the greatest percentage of cardiovascolar money is currently spent on therapy. The major types of therapy include surgery, pharmacotherapy, and alternative therapies. What has been the benefit-cost relationship of these therapies until now? Vast amount of money, drugs and human resources is spent annually in direct health-care costs related to cardiovascular diseases. We have received a little benefit from these expenditures and the problem is increasing every day and the morbidity related to cardiovascular diseases is greater as the doctors prolong life in some of these patients. A much more satisfying approach to solving the cardiovascular diseases problem in Latinoamerican countries would be to prevent people from ever developing these illnesses. This is the strategy of prevention. Thus, stopping excessive candy and chocolate consumption and changing diet and life style in Latinoamerica should play a major role in preventing cardiovascular diseases and in securing and maintaining human health. Very respectfully yours Emilio Polo Ledezma Biochemist |
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