Dr K K Aggarwal: Valentine’s Day

Wednesday, February 13, 2019

Are chocolates the right gift for Valentine’s Day?

Dr KK Aggarwal

Chocolates have been forever associated with love and romance. Come Valentine’s Day, chocolates are much in demand. Beautifully packaged, they are a popular Valentine’s Day gift.

So, why are chocolates gifted as an expression of love?

To understand the reason for this is to know the chemistry of love because the neurochemistry of eating chocolates is the same as that occurs when a person falls in love.

Any relationship undergoes four major phases: Euphoria, reaction, adjustment and liking.

When two persons are attracted to each other, a virtual explosion of adrenaline-like neurochemicals occurs. Phenylethylamine, a naturally occurring amphetamine, speeds up the flow of information between nerve cells. Also, involved in chemistry are dopamine and norepinephrine, chemical cousins of amphetamines. Dopamine makes one feel good and norepinephrine stimulates the production of adrenaline, which makes the heart race. Together these three chemicals combine to produce “infatuation” the first stage of love, the feeling of euphoria and floating on air.

Phenylethylamine mediates feelings of attraction, excitement, giddiness, apprehension and euphoria associated with falling in love. Hence, it is also called the “love chemical”. Chocolate contains phenylethylamine and this is one reason it is often used by persons embarking on a new relationship.

The caffeine and theobromine in chocolate are both stimulants and may at least partly be the reason as to why chocolate is so addictive.

Chocolate triggers the release of endorphins, the feel-good hormones, which bring on a feeling of well-being. They can also bring about feelings of euphoria. Serotonin is also released when chocolate is eaten, which makes a person more calm and happier. Chocolate contains tryptophan, which produces serotonin.

Chocolate also contains anandamide, an endogenous cannabinoid in the brain, which helps to stimulate and open synapses in the brain and facilitates easy transmission of the “feel good” waves. Anandamide was discovered in 1992 and has been named after “ananda”, the Sanskrit word, which means joy, bliss and so has been called the “bliss molecule”.

Remember, most chocolates are high in calories, fat and free sugars; dark chocolate contains 48 g sugar, white chocolate 59 g, Hershey’ Milk Chocolate Bar 43 g, Snickers Bar 57 g, Dairy milk 56 g, Munch 27.5 g, Gems 60 g (all per 100 g). Therefore, moderation is the key.

Dark chocolates have been shown to prevent cancer, improve heart health and cognition, lower blood pressure. These beneficial effects are attributed to polyphenols and flavonoids (antioxidants) in cocoa. Dark chocolate mainly contains cocoa (more than 60%) and cocoa butter, sugar and does not contain milk or milk.

But, those who have heartburn should avoid chocolates as they can worsen the heartburn (dyspepsia), a symptom of gastroesophageal reflux disease (GERD) or acid reflux. The American College of Gastroenterology (Am J Gastroenterol. 2005;100:190-200) has listed chocolate as one of the foods that may trigger GERD symptoms by decreasing the lower esophageal sphincter pressure.

Cocoa in chocolate is acidic; caffeine and theobromine in the chocolate relax the lower esophageal sphincter causing acid reflux and aggravating the symptoms.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

Tuesday, February 12, 2019

14th Feb is Valentine’s Day: Beware of date rape drugs

We often hear of cases of alleged rapes. The girl was given some drink following which she had no recall of what happened. Once caught, often the defense of the accused is that the girl was a party to the sexual act. Such cases are the result of date rape drugs, used to spike soft drinks or alcoholic drinks. Their use is common.

Although alcohol, marijuana, ecstasy, over-the-counter sleeping pills and anti-histamines, even cold medications can be used, the term “date rape drug” classically applies to any of the three drugs: GHB (gamma hydroxybutyric acid), Rohypnol (flunitrazepam), popularly called “Roofies” and ketamine (ketamine hydrochloride). Rohypnol is legal in Europe and Mexico, but is banned in the US and India.

In 2013, ketamine hydrochloride was shifted from Schedule H to Schedule X of the Drugs & Cosmetics Rules to prevent its easy availability and misuse. It has been listed as psychotropic substance under the Narcotic Drugs and Psychotropic Substances (NDPS) Act

Several factors make these drugs desirable to sexual predators. They often have no color, smell or taste and so can be easily slipped into drinks and food without the victim’s knowledge. They are very fast acting; as all traces of the drugs leave the body within 72 hours of intake, they are not found in any routine toxicology screen or blood test.

The victim is rendered unconscious but responsive with little or no memory of what happens while the drug is active in their system. The drugs also make the person act without inhibition. They are incapable of thinking clearly or of making appropriate decision. This makes for a very passive victim; one who is still able to play a role in what is happening but is unable to refuse and will have no clear memory of what happened, the assailant, or the events surrounding the assault. Without any memory of events, the victim is often unaware that they have even been raped, and if they are aware or have suspicions they make very poor witnesses.

Here are a few tips to protect from date rape.

1. Don’t accept any drinks from other people, except trusted friends.

2. Open containers yourself.

3. Keep your drink with you at all times, even when you go to the bathroom.

4. Don’t share drinks

5. Don’t drink from punch bowls or other large, common, open containers. They may already have drugs in them

6. Don’t drink anything that tastes or smells strange. Sometimes, GHB tastes salty.

7. Have a non-drinking friend with you to make sure nothing happens (if you are consuming alcohol).

8. If you think that you have been drugged and raped: Go to the police station or hospital right away. Get a urine test as soon as possible. The drugs leave your system quickly. Rohypnol leaves your body 72 hours after you take it. GHB leaves the body in 12 hours. Don’t urinate before getting help. Don’t douche, bathe, or change clothes before getting help. These things may give evidence of the rape.