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Chocolate, Depression and PMS

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A research team from San Diego reported recently that people who are depressed eat more chocolate than non-depressed individuals. Although this news might surprise men, any woman who has experienced premenstrual syndrome takes this for granted. PMS and chocolate cravings go together like peanut butter and jelly or fireworks and the 4th of July.

An editor of a woman's magazine told me years ago that she always knew when she was premenstrual because she was unable to walk by a gourmet chocolate shop next to her office without going in and buying a large chocolate bar. "The crankiness, fatigue, confusion and depression come later on," she told me. "The craving for chocolate is always there first. I remember once longing for a chocolate ice cream while sitting through a formal three-course dinner and after-dinner speaker. The food served at the meal did not tempt me at all but as soon as I could leave, I headed for the nearest ice cream shop. Sure enough, I was premenstrual."

The association between chocolate craving and premenstrual syndrome has been known for decades and theories promoted to explain this relationship tended toward the fanciful or bizarre: hysterical personality, malfunction of the reproductive organs or water on the brain. Moreover, because doctors noted that the women eating the chocolate were bad-tempered, depressed or confused, they concluded that the chocolate was making them that way. As recently as 10 to 15 years ago, chocolate-craving premenstrual women were told that eating chocolate, and indeed any sweet food, would make their moods worse and to eat only fruits, vegetables and lean protein. This advice can still be found in some women's health and fitness magazines. Not only is it wrong but any premenstrual women who follow it will gnash her teeth over being denied her chocolate.

There is a good reason why women with PMS go out in a blizzard to get chocolate or eat a dinner of melted chocolate on a chocolate brownie sitting on chocolate ice cream. The chocolate was making them feel better, not worse.

The improvement in mood is due to chocolate's substantial sugar content and, to a small extent, the caffeine-like ingredient is also contains. Because chocolate has a creamy texture, we are unaware of how much sugar it contains. But anybody who has accidentally mistaken baking chocolate for the eating kind knows the difference; baking chocolate is incredibly bitter. Sugar is a simple carbohydrate and when sugar of any carbohydrate, except that found in fruit, is eaten without protein, the body responds by making new serotonin in the brain. To be sure the flavor and mouth-feel of chocolate starts the eater on the road to a good mood. But the immediate sensations on the taste buds quickly disappear, whereas the relief from irritation, agitation and fatigue may last for a couple of hours.

Several years ago at the MIT clinical research center, we carried out some extremely complicated studies with premenstrual women to show scientifically that eating a brownie or even a bowl of starchy carbohydrate like cornflakes relieves the mood and eating disturbances of PMS. To begin with, we found that normal weight women may increase their calorie intake by more than 1100 calories a day when they are premenstrual compared to when they are in the first half of their menstrual cycle. And to no one's surprise, these calories came from sweet and starchy snacks and starchy meal food, and not from chicken, fish or cottage cheese. We also found the anger, confusion, depression, anxiety and cravings of PMS became more tolerable after women consumed a beverage containing a mixture of carbohydrates. When they drank a beverage containing protein, there was no improvement in how they felt. They did not know what they were drinking and the two beverages tasted exactly the same.

For reasons we still don't understand, hormonal changes associated with the menstrual cycle affect serotonin activity. This also may be true for women who are pre-menopausal. When our premenstrual volunteers ate carbohydrates, their brain cells made more serotonin and this chemical messenger brought the women back to feeling normal. An extra bonus was that they lost their intense cravings for carbohydrate so those who were trying to lose weight felt their appetite was under control.

Just to be sure that serotonin was the main actor in all this, we also carried out more studies with one of the antidepressant drugs that activated serotonin. We found that a short bout of treatment with the drug improved the moods of women who had severe PMS and this actually led to drug companies using some antidepressants for the extreme form of this disorder.

Obviously someone on a diet, or even not on a diet, cannot live on a meal plan consisting of chocolate Cheerios for breakfast, a chocolate bar between two slices of bread for dinner (they do eat this in Switzerland) and a bowl of hot fudge sauce for dinner when she has PMS.

But as long as portion control is monitored, fat is decreased as much as possible (for example, fat-free fudge sauce) and a vitamin pill is taken, no real nutritional harm will come from a once-a-month indulgence in this wonderful mood food. However, all carbohydrates except fructose (fruit sugar) will produce the same beneficial effect on premenstrual mood. If you find that your mood is bearable in the early part of the day but intolerable by afternoon eat your protein, vegetables and dairy products for breakfast and lunch and switch to carbohydrates from 3 pm on. This way your nutritional and emotional needs will be met. Rather than dreading PMS, think about chocolate and look forward to it.

Copyright 2010 Judith J. Wurtman, PhD, co-author of The Serotonin Power Diet: Eat Carbs -- Nature's Own Appetite Suppressant -- to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain