Understanding Chocoholism

Among chocolate consumers there is a self-acclaimed group who call themselves chocoholics – or an individual who is addicted to chocolate.  This particular group of people generally claim they 1. Love chocolate to a substantially higher degree than other people.  2.  Declare that they cannot go a day without chocolate.  3. Their consumption exceeds that of a normal individual.  However, it is difficult to observe to what extent these so-called chocoholics are truly affected by addiction or if they are simply confusing and overstating their love for chocolate as addiction.  Addiction is an extremely complex topic and its definition changes depending on if it is defined via a biological model, or a psychological model.  By exploring how chocoholism relates to the DSM-V model of substance abuse/addiction (psychological), the effect on the mesolimbic dopamine system (biological) can be examined and it will illuminate the validity of the claim that chocolate is an addictive substance.  Furthermore, the evolution of chocolate and the cultural implications can be evaluated as well.

In general, drug addiction is defined as a chronic relapsing disorder of excessive and harmful drug use characterized to take and seek the drug, loss of control in limiting intake, and emergence of a negative emotional state when access to the drug is prevented.

Figure 1: Loose Definition of Drug Addiction with Pictures.

1. Seeking the “substance”
2. Loss of Control in Limiting Intake

3. Emergence of Negative Emotional State when access to “substance” is prevented.
Image Source: http://kako.co.nz/wp-content/uploads/LOOKING-OVER-CHOCOLATE-COMPRESSED-300×195.jpg , http://i.imgur.com/4cE6YeV.jpg , https://www.youtube.com/watch?v=1NDkVx9AzSY)

The DSM-V expounds on this general definition and establishes a formal name for “addiction” to be substance use disorder. Substance use disorder is defined as a maladaptive pattern of substance use leading to 3 or more of the following in the same 12 month period: tolerance, withdrawal, substance taken over longer sustained period/larger amounts than intended (bingeing), persistent desire to cut down or stop, great deal of time/resources spent to obtain, use, or recover from substance’s effects, important life activities abandoned in favor of substance use, and/or continued substance use despite knowledge of persistent or psychological problems with substance use. In addition, the DSM-V model addresses the severity of the criteria. For example, caffeine is clinically shown to have addictive properties (tolerance, and withdrawal) but it needs to be identified whether or not it is a “clinically significant disorder” so it is under review by the American Psychiatric Association. As such, if a person is truly experiencing a problem with addiction, their symptoms must be significant enough to negatively impact their life otherwise it is technically classified as an “addiction” but not a very serious one. As such, the claims of a chocoholic being addicted to chocolate can be true but the only question is to what extent? Although psychologically a chocoholic can be addicted to chocolate, measures of addiction are subjective because it is difficult to address subjective opinion – one person may say they are experiencing stronger withdrawal symptoms than they are actually feeling, underplay their symptoms, etc. A biological model can offer insight as to the processes that affect tolerance, withdrawal, and bingeing while also offering specific measures that can be compared to drug addiction.

Figure 2: Mesolimbic Dopamine Pathway. Illustrates the Dopamine start and end points of the mesolimbic system which is often associated as being the center for addiction. Image Source:http://upload.wikimedia.org/wikipedia/en/8/88/Dopamineseratonin.png

In general, when talking about addiction in a biological perspective one must examine a substance’s effect on the mesolimbic dopamine system (or mesolimbic pathway for short) as it is known that it plays a key role in the neurobiology of addiction. Generally speaking, dopamine (a neurotransmitter that sends signal in the brain and is associated with reward-motivated behavior) is created in the Ventral Tegmental Area (VTA), dopamine then travels to the Nucleus Accumbens (NAc) – plays a “critical role in the valuation of rewards and the establishment of reward-associated memories,” which then travels the prefrontal cortex (PFC) – “critical for the cognitive control; that permits goal-directed behaviors to proceed to a successful conclusion” (Hyman et al., 571). Overall, this process a biological representation of how a human feels/seeks reward, pleasure, and compulsion (this is a slight overgeneralization as this system is also responsible for mood, memory processing, cognition, sleep, motor functions, and many other functions). The mesolimbic system is a natural process that is vital in survival as it allows humans to understand the “circumstances under which they can obtain food and other resources for bodily needs and find opportunities for mating” (Hyman et al., 570). This system is reliant on the right amount of dopamine given within a very specific time period.

Figure 3: Dopamine Release in the VTA for normal rewards – typically food is not high enough to be classified as addictive relative to illicit drugs like cocaine, nicotine, morphine, or amphetamines.  Click to Magnify. (Source : Di Chiara et al., Neuroscience, 1999., Fiorino and Phillips, J. Neuroscience, 1997 and Di Chiara and Imperato, PNAS, 1988, Personal Communication 2013)
Figure 3: Dopamine Release in the VTA for normal rewards – typically food is not high enough to be classified as addictive relative to illicit drugs like cocaine, nicotine, morphine, or amphetamines. (Source : Di Chiara et al., Neuroscience, 1999., Fiorino and Phillips, J. Neuroscience, 1997 and Di Chiara and Imperato, PNAS, 1988, Personal Communication 2013)

As figure 3 illustrates, food naturally operates on the mesolimbic dopamine system and the percent of dopamine release is about 150% of normal dopamine release whereas drugs such as cocaine can be as high as 400% and Amphetamines being up to 1000% of normal. The higher dopamine response can be associated to learning and liking and is an innate process of human survival. For example, when a person tries a new food and they find it nutritious and delicious, the brain will associate that memory as a positive memory so the person can be reminded to seek the same food again if given the opportunity. Addiction typically exacerbates this effect to a point where the brain can no longer function normally. Tolerance, withdrawal, and bingeing are a direct consequence of this drastic imbalance. Technically, chocolate is considered a food and therefore should not be significant enough to be classified as an addictive substance in a biological sense. However, the modern chocolate bar no longer really resembles food.

One of the most popular chocolate brands in the United States is Hershey’s. By examining the composition of a standard 1.55 ounce Hershey’s milk chocolate bar, it shows how chocolate is primarily composed of sugar and fat. According to the Hershey’s website, the nutritional value of a 1.55 ounce Hershey’s milk chocolate bar is approximately 220 kcal total, 110 kcal fat, 13g of fat (9g saturated fat), sugar 24g, and 64mg of theobromine (one of the primary components of cacao). Doing some conversions from sugar to weight, assuming 1g = .03524 ounces, 24g of sugar amounts to approximate .847 ounces, 13g of fat amounts to approximately .458 ounces, and .002 ounces of theobromine. The grand total of the major components of chocolate is about 1.305 ounces of sugar and fat out of 1.55 ounces of “chocolate.” Theobromine is so small that it barely accounts for .1% of the chocolate bar while fat and sugar account for 84% of the chocolate bar. Furthermore, 1.5 ounces of Dutch pressed cocoa powder is the equivalent of 1107 mg of theobromine (nutritiondata.self.com, 2015). Therefore, it can be inferred that only about .0867 ounces of cocoa powder (1.5 ounces cacao * 64/1107) is used in every Hershey’s milk chocolate bar. Therefore, it’s more accurate to say that chocoholics who are addicted to modern day chocolate are addicted to a chocolate flavored fat and sugar bar. If a chocoholic claims to be addicted to chocolate and only eats chocolate created by big companies like Hershey’s, Nestle, Ferrero and Cadbury, then it is much more accurate assertion that they are addicted to the fat and sugar as opposed to chocolate in the traditional sense. Of course this is only analyzing milk chocolate bars and numbers will vary for different types of chocolate with different cacao content but fat and sugar content of a Hershey’s milk chocolate bar is astounding. Given that cacao/chocolate is not very prevalent in modern day chocolate, how addicting is the major components, or fat and sugar, of modern chocolate bars?

The addictive nature of fat can be examined in Valdivia et al.’s “Acute High Fat Diet Consumption Activates the Mesolimbic Circuit and Requires Orexin Signaling in a Mouse Model.” The study consisted of adult mice and they were split into three groups. First group was given regular chow, second group was given a high fat diet ad lib (HFD, ad lib – “at one’s pleasure”), and the final group was given HFD pair fed (limited intake to match the same as control). Among many other measurements, intake was observed to be substantially higher in the HFD ad lib. The implication is that they “provided[ed] evidence that acute HFD consumption recruits centers of the mesolimbic pathway including neurons of the VTA, NAc” (Valdivia et al., 8). In other words, it is observed that high fat foods were consumed substantially more than normal controls and HFD pair fed subjects and that this effect was monitored in the VTA. Furthermore, the dopamine release for both HFD groups was high in the VTA which is the start of the mesolimbic system. Although it is already established that eating activates the mesolimbic system, the interesting observed effect is the HFD ad lib group binged uncontrollable toward the high fat foods which can possibly imply substantially higher activation in dopamine. Although more research needs to be done in order to prove that fat is an addictive substance, if it is, there are serious implications to nations where fat is easily accessible. Looking at the United States in particular which is renowned for being an obese and sedentary nation, addiction to energy dense foods may not only exacerbate current problems but prime future generations to become more dependent on fats. However, fat is only a part of the problem. Sugar can be much more addictive.

Figure 4:  Study of fat food consumption over controls and controlled fat food consumption. Valdivia et al. 2
Figure 4: Study of fat food consumption over controls and controlled fat food consumption. Valdivia et al. 2

In Nicole M. Avena’s study “Sugar-dependent rats show enhanced responding for sugar after abstinence: Evidence of a sugar deprivation effect,” Avena analyzes rats trained to work an operant conditioning lab. Rats were either exposed to 12 hours a day worth of glucose (note that this is sugar but not sucrose – table sugar) or 30 minutes a day worth of glucose. Rats that were exposed to 12 hours a day worth of glucose demonstrated enhanced intake after an abstinence period of five days. This implies that continued consumption of sugar over a long period of time promotes dependency. Furthermore, it can be implied that the mouse binges on sugar in order to compensate for the lost time which may imply a tolerance effect, loss of self-control, or withdrawal (overcompensates sugar consumption in order to cope with negative effects of withdrawal). Any of the implications are consistent with the substance use disorder criteria. In this particular study, glucose is used and glucose is used as energy for most bodily processes. It is processed in such a way that gives the longest sustaining energy than other types of sugar. With chocolate however, sugar is often made with refined sucrose which can rapidly increase blood sugar levels. Consuming too much sugar with sustained use will lead to irregular blood sugar levels and may result in diabetes. Both fat and sugar are incredibly pleasurable and when consumed together the effect is loss of control or bingeing to an extreme. Furthermore, fat and sugar are extremely accessible, more so than in the past. Humans may find themselves to be predisposed to obesity and diabetes and this will likely become more and more prevalent in future generations unless a change to diet is made.

Figure 5: Image of what an operant chamber looks like and how the Nicole M. Avena study was conducted. Image source: http://iws2.collin.edu/lipscomb/16_week_course/images/Skinner_Box.jpg

Although sugar and fat are the main ingredients in most big chocolate companies, chocolate historically has been a very popular food among Mayans and Aztecs. Cacao was often referred to being the “food of the gods.” Considering that most chocolate at the time consisted of crushed cacao beans added with water, spices, and grains to make a frothy and cold concoction, why were the Mayans and Aztecs so in love with this food? Aztecs in particular loved chocolate for its stimulant and filling effects. This can be attributed to the psychopharmacological effects of theobromine and caffeine which is prevalent in cacao. In Hendrik J. Smit and Rachel J. Blackburn’s study “Reinforcing effects of caffeine and theobromine as found in chocolate,” Smit et al. performed a study where they analyzed 64 participants and separated them into two groups. One group which had a drink containing 19 mg of caffeine and 250 mg of theobromine and the other group had a placebo drink (drink is a combination of apple juice, lemon and raspberry flavoring). The end results showed that participants that drank the caffeine and theobromine mixture enjoyed and rated the drink higher than its placebo counterpart which illustrates the appealing effect of cacao (Smit et al., 101). Furthermore, theobromine and caffeine are stimulants – theobromine technically less effective than caffeine but is observed to amplify the stimulant effects of caffeine (whether it is additive or synergistic is still a question). This implies that people like stimulant drinks for the psychoactive effects. Even though caffeine content in the study is quite low relative to coffee and cacao (study – 19mg, cacao – 198mg, Starbucks medium roast coffee –330mg: Source: Starbucks menu and nutritiondata.self.com), 19 mg of caffeine along with 250 mg of theobromine will still produce powerful enough psychopharmacological effects that causes people to love the drink substantially more than a placebo. However, by the DSM-V definition of substance abuse, caffeine is not technically an oppressively addictive substance and would be labeled as a minor addiction in extreme cases (because its dependence does not typically impede on an individual’s life and does not ruin chemical imbalances in the brain). It is unclear whether or not the Mayans and Aztecs were addicted to the substance due to its psychoactive effects or if it was the best food choice available which resulted in the brain causing them to seek it out more. What is known for sure is that Mayans and Aztecs loved and consumed the substance in abundance.

By understanding the definition of addiction in both the psychological and biological context, the constituents of chocolate responsible for addiction can be examined. It can be inferred that if Mayans and Aztecs were addicted to chocolate, it was due to cacao and its chemical components of theobromine and caffeine. Most modern chocoholics and chocolate enthusiasts are likely addicted to fat and sugar due to its pleasurable effects and for causing the brain to lose self-control. Chocolate can be expressed and created in many forms, either as a cold drink or fat sugary bar. It is important not to overgeneralize chocolate as a source of addiction but rather to closely examine its components. Regardless, chocolate has been consumed for many generations and it likely will continue on as it has played a major part in modern culture. From trick-or-treaters on Halloween, to expressing love to another individual, chocolate is rooted in human culture. Even if humans are not addicted to it, they love it, which to some is practically the same thing.

Figure 5: “All you really need is love but a little chocolate now and then doesn’t hurt!” – Lucy Van Pelt in Peanuts by Charles M. Schulz. Img Source: https://s-media-cache-ak0.pinimg.com/736x/96/92/22/969222d2599cf0a19815428e8d9206b8.jpg

Works Cited:

Avena, N., Long, K., & Hoebel, B. (n.d.). Sugar-dependent rats show enhanced responding for sugar after abstinence: Evidence of a sugar deprivation effect. Physiology & Behavior, 359-362.

Di Chiara et al., Neuroscience, 1999., Fiorino and Phillips, J. Neuroscience, 1997

Di Chiara and Imperato, PNAS, 1988

Smit, H., & Blackburn, R. (n.d.). Reinforcing effects of caffeine and theobromine as found in chocolate. Psychopharmacology, 101-106.

Valdivia, S., Patrone, A., Reynaldo, M., Perello, M., & Chowen, J. (2014). Acute High Fat Diet Consumption Activates the Mesolimbic Circuit and Requires Orexin Signaling in a Mouse Model. PLoS ONE, E87478-E87478.

Special Thanks: A lot of information used and “Personal Communications” were from Neurobiology of Drug Addiction, Abnormal Psychology, The Science of Physical Activity Applied to Health and Well-being, and of course, Chocolate, Culture, and the Politics of Food, all taught at the Harvard Extension School.

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