9. Perimenstrual chocolate craving: from pharmacology and physiology to cognition and culture

In: Handbook of diet and nutrition in the menstrual cycle, periconception and fertility
J.M. Hormes
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Chocolate craving is a common phenomenon, but only in some cultures. Americans are much more likely to report chocolate craving than individuals in other cultures that have been surveyed. Furthermore, in the United States, women are about twice as likely to experience chocolate craving, compared to men. In about half of female US chocolate cravers, craving fluctuates cyclically with a well-defined peak in frequency and intensity beginning approximately four days prior to and lasting until about four days after the onset of menstruation. Though the phenomenon of cyclically fluctuating chocolate craving has been called ‘premenstrual’, it is thus more appropriately termed perimenstrual craving. The pattern of cyclically occurring chocolate cravings has raised questions about a possible causal role of the menstrual cycle in eliciting cravings. This chapter reviews existing accounts of mechanisms underlying perimenstrual chocolate craving, including pharmacological, physiological, cognitive, and socio-cultural explanations. Evidence generally does not support a causal role of the active ingredients in chocolate in either the etiology or the satisfaction of craving. Cyclic fluctuations in hormones do not appear to directly elicit chocolate craving. The interplay of several cognitive factors, including ambivalent attitudes to chocolate, dietary restraint, and thought elaboration, on the other hand, may play a role in the etiology of craving in general, and perimenstrual chocolate craving in particular. A growing body of literature also suggests that perimenstrual chocolate craving is a culture-bound syndrome, limited to North America. Based on these findings it is hypothesized that perimenstrual chocolate craving arises as the result of women’s efforts to restrict consumption of a highly ambivalent food, along with a culturally-driven view of the perimenstrum as a cue signalling permission to engage in an otherwise prohibited indulgence.

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