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The science behind global chocolate
obsession

Dark, milk, white, flavored with orange, mint, strawberry and the growing favorite — salted caramel —approximately 7.5 million tons of chocolate are consumed annually. But there are reasons chocolate, celebrated around the world on Sept. 13, International Chocolate Day, is so beloved and it’s not just that it tastes so good.

How did it get so delicious? That is a tale of innovation.

The Swiss have been perfecting chocolate since the early 19th century. Francois-Louis Cailler, took the granular texture of the cocoa bean to a smooth chocolate bar. Then world-renowned chocolatier Rudolph Lindt perfected that recipe by adding cocoa butter with a machine he invented called a conche.

But why does the vast majority of the world love it so much?

It’s a chemical thing. The ingredients and chemicals in chocolate have positive effects on our brains and bodies. It’s not necessarily the individual amounts, but the chemicals combined that result in the desired effect.

First on the chocolate inventory list is phenylethylamine, the catalyst in the release of endorphins and an increase in serotonin and dopamine — offering feelings of happiness and contentment. Phenylethylamine is also the chemical released by the brain when you are in love. So it’s with good reason we give in to the impulse buy stack of chocolate at the grocery check-out.

Additionally, the stimulant theobromine offers chocolate eaters a bit of a boost. This ingredient causes a similar energy lift as caffeine, but the effects of theobromine will last longer. Chocolate also contains the real caffeine deal with nearly 25 percent of the caffeine in the average 8-ounce cup of coffee.

So far, we’re happy, content and feeling wide awake and energetic. What’s next?

IMAGE: Freepik

L-tryptophan is an amino acid that makes essential proteins and is not produced naturally by the body, so we get it from the foods we consume. And yes, chocolate has this too. Combined with the sugar carbohydrates in chocolate, this magic chemical, like serotonin, offers us a little chill-out vibe.

And one of the big winners is polyphenol — a valuable antioxidant found in various foods that protects the brain. It is often used as a supplement for those struggling with psychiatric or cognitive challenges as it has less harmful side effects than medications.

So now we know why chocolate makes us feel good, but there are health benefits to a moderate relationship with chocolate — most commonly dark chocolate.

According to Johns Hopkins Medicine, some chocolate has a positive effect on heart health. So, if you’re reaching for a fix and hoping to feel good about your choice, come over to the dark side.

It’s those magic antioxidants again.

The most impactful is flavonol — a phytochemical compound called epicatechin found in dark chocolate that offers a number of health benefits.

Epicatechin lowers the risk of heart disease and stroke by reducing blood pressure and increasing healthy blood flow to the heart. It offers immune-system stability, preventing an overactivity linked to some diseases. It also helps the body use insulin properly, combatting diabetes.

Those are the health benefits of the things epicatechin reduces in our bodies, but what are the gains?

Well, it offers some welcome gifts to our brains. These include a memory boost, increased response time and better visual acuity. In addition, epicatechin reduces the amount of oxygen required by athletes, increasing the volume of nitric oxide in the bloodstream so they can perform longer.

There is a long list of reasons dark chocolate should be a welcomed addition to our diets but it is also important to maintain a healthy and moderate relationship with the delicious treat. Sugar content and high carbohydrates are things to watch for.

Too much can counter all of the good it can do for us in moderation. According to Health Digest, “A diet high in sugar-rich chocolate can be a factor in the development of insulin resistance, which can lead to Type 2 diabetes.”

And Type 2 diabetes can lead to blindness, heart disease, stroke, nerve damage and kidney disease.

So, as you reach for your chocolatey favorite this International Chocolate Day, remember—chocolate is your friend, but consider it a fair-weather one.

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The placebo problem

Leigh Frame, Ph.D., Master of Health Science, likes vitamin D. Executive director of the Office of Integrative Medicine and Health at George Washington School of Medicine and Health Sciences, she is especially interested in the role of vitamin D as an immune modulatory hormone.

She was starting a pilot study to determine the effectiveness of vitamin D supplementation via patch delivery (through the skin) versus pill delivery (via the gut) when the pandemic hit.

Vitamin D is a fat-soluble nutrient that also functions as a steroid hormone. Many of the body’s organs and tissues have receptors for vitamin D, which suggest important roles beyond what we currently know about its role in bone health.

Principles of research ethics

Respect for persons: Treat participants as autonomous; protect participants with decreased autonomy. Read more›››

Beneficence: First, do no harm; maximize benefits to participants; minimize risks to participants.

Justice: Fair recruitment of participants; participants asked to bear the risk should benefit from the research.

From “Ethical Concerns in Placebo-Controlled Supplementation Studies: How to Design a Rigorous Randomized Controlled Trial.” Permission from Leigh Frame.‹‹‹ Read less

“We had planned to bring 30 healthy subjects to the medical campus, who would otherwise not have needed to visit the campus,” Frame says. “Now, each visit would represent an added risk to them, which raises concerns in terms of the principles of beneficence and justice. Given that the benefit to these subjects is minimal as this study is not looking at potential therapeutic benefits, the risk of contracting COVID-19 through being on campus greatly outweighs the potential benefit to society. It would not have been ethical to proceed with this trial during the COVID-19 pandemic.”

 A SUDDEN HALT

The sudden emergence of COVID-19 meant clinical research was halted — or even terminated — in deference to the immediate needs of caring for patients and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Once social distancing had been introduced by governments as a public health measure to prevent or slow the spread of disease, trial sponsors and investigators were required to determine whether ongoing trials should proceed. Several factors determined the fate of these trials, including trial location, the indication for the trial, the urgency of continuation, the safety of participants and staff, and risks to trial integrity.

The main question: Would it be ethical to continue?

“The field of research ethics has developed in response to research conducted without proper consideration for ethical issues or with blatant disregard for ethical concerns,” Frame wrote in a 2020 publication on ethical concerns in placebo-controlled supplementation studies. “The design of most research studies today involves more nuanced issues of research ethics relating to the Principles of Research Ethics.”

While Frame’s trial was put on hold, numerous studies were conducted on the potential of vitamin D to reduce risk of infection with COVID-19. Frame’s study looked at the efficacy of different supplementation methods: we already know that vitamin D supplementation can be beneficial, so investigating how this is best achieved fell short of the principle of beneficence. Using vitamin D as a preventative and potential adjunct treatment in COVID-19, however, was an unknown and potentially important in the fight against COVID-19.

“If you do a PubMed search for ‘vitamin D’ and ‘COVID,’ 936 results are returned from 2020 to 2021, plus 273 in 2022 as of June,” Frame says. “Those are substantial numbers, however if you restrict those results to clinical trials only, 30 results ranging from study protocols to completed results are returned from 2020 to Jun 2022. That is actually a very large number considering the extremely tight timeline from the emergence of COVID-19. Many of these studies, however, are observational in nature, meaning they are looking at vitamin D status in relation to COVID-19 infection and its progression and outcomes.”

ADDRESSING THE RISK

Observational studies are very low risk for the subjects, introducing very little additional risk to participants but offering potential benefit to society, though not the individual, Frame stresses. “Prioritizing this type of study during a pandemic makes sense ethically, not just due to the low risk, but because we have some evidence to inform a potential intervention that may prove beneficial. Vitamin D has known actions in viral infections and in the immune system more broadly. Therefore, it could be reasoned that vitamin D supplementation for prevention or as a potential adjunct therapy would be beneficial with minimal potential for harm.”

In these studies, the risk/benefit ratio is in favor of continuing. Keeping in mind the principles of beneficence and justice, it would be ethical to proceed.

“In fact, you could argue it would be unethical not to proceed,” Frame says. “Given the potential benefit to society, especially in a global pandemic, coupled with the potential benefit to the individual and the minimal risk they’d face. As this research would be done in those mostly likely to be affected by Covid-19, this bolsters the ethical nature of such studies. Plus, conducting research in those of greatest risk to morbidity and mortality from Covid-19 would further strengthen the justice component and could be used to improve health equity.”

Many of these studies found the same thing: insufficient blood levels of vitamin D were associated with increased risk of COVID-19 susceptibility, severity, and mortality.

Further research is still needed to determine the precise role and efficacy of vitamin D as a preventative or therapeutic measure in cases of COVID-19, but since vitamin D deficiency is common around the world, any link to its possibly helping surely justifies investigation.

Frame, and the principles of ethics in trial design, have concerns: One major concern with such studies is their use — or not — of placebo. Using a true placebo, an inert substance that participants believe is the therapeutic, has small positive effects in most cases, known as the placebo effect. However, this is likely smaller than an active control, in this case, a low dose vitamin D supplement.

Research is revealing that vitamin D has much broader effects than previously assumed, as it is an immune-modulating hormone. Vitamin D deficiency may lead to health issues involving infection, autoimmunity, cancer, chronic diseases such as cardiovascular disease, and even mental illness. Withholding vitamin D in clinical trials, therefore, may see harm done.

“As demonstrated in the Tuskegee Study of Untreated Syphilis, it is unethical to withhold treatment when there is a known, effective therapy,” Frame writes in Ethical Concerns in Placebo-Controlled Supplementation Studies. “This becomes less clear when talking about nutrition.”

COULD IT CAUSE HARM?

An individual may be found to have suboptimal or deficient stores of the nutrient in question. If they receive the therapy during the trial, their nutritional status should improve at least, even if the dose is insufficient to bring their levels to those required for the effect in question. If they are unfortunate enough to be placed in the control group, their nutritional status will not improve and may even worsen over the course of their treatment. This is the crux of the ethical issue, Frame says.

“Are we doing harm to these participants? That answer depends on many factors, but to be ethical we must maximize the benefits to participants and minimize the harm. I recommend using the current Recommended Dietary Allowance (RDA) as the active control in nutrition studies, which is the minimum amount most people need each day to avoid disease, but not to optimize health. A low dose of vitamin D would minimize risk, improving the risk/benefit ratio. However, this may make detecting differences between the groups more difficult by reducing the difference in effect sizes between the groups, requiring a larger sample size and increasing the cost of the study.”

As demonstrated in the Tuskegee Study of Untreated Syphilis, it is unethical to withhold treatment when there is a known, effective therapy.

– Leigh Frame

Above all, Frame advocates for weighing the risk/benefit ratio for each individual study during the study design process to optimize the potential for meaningful results from the study while protecting those participating:

“As a member of the research study team, it is your duty to protect your study participants and to ensure that your research is conducted ethically.”

Frame’s supplementation technique trial is still on hold. “We are hoping to start it very soon, as the risk of both contracting COVID-19 and the consequences of such infection have greatly decreased.”

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Tech conceived during the pandemic
aims to calm a post-COVID world

A face mask developed during the pandemic to reduce stress and anxiety is evolving into a digital tool that can continue to serve its original purpose in a post-mask environment.

One of the winning teams of the 2022 Women to Impact venture of King Abdullah University of Science and Technology (KAUST) created a face mask called takeAbreath that monitors the wearer’s stress and anxiety levels. It then uses gaming technology to recommend breathing exercises to reduce any anxiety and stress identified.

The team – Anna-Maria Pappa, Sofia Dias and Leontios Hadjileontiadis of Khalifa University and Sahika Inal of KAUST – conceived the product during the height of the pandemic and are adapting the technology to offer relief for those who struggle with stress and anxiety.

Next generation
of face masks

People around the world wore masks in their daily lives during the pandemic to help prevent infection. Now, a new kind of mask might help diagnose illness. Read more›››

Engineers from MIT and Harvard say their new prototype can produce a COVID-19 test result in 90 minutes. The wearer breathes normally into the mask, and droplets produced by exhaling and coughing collect on a pad. The wearer then presses a button to activate the test. A small bit of water is released, flowing through the pad and rehydrating freeze-dried cells that react to the presence of coronavirus markers.After about 90 minutes, a colored line indicates whether the result is positive or negative. It looks like a pregnancy test. The team used a typical N95 mask and the results were published in Nature Biotechnology.This technology had been developed to detect other viruses such as Ebola. The MIT and Harvard teams have further plans for the technology. “We’ve demonstrated that we can freeze-dry a broad range of synthetic biology sensors to detect viral or bacterial nucleic acids, as well as toxic chemicals, including nerve toxins. We envision that this platform could enable next-generation wearable biosensors for first responders, health-care personnel and military personnel,” MIT researcher James Collins tells MIT news.Meanwhile, researchers at Khalifa University have been working on the NavaMASK, a sustainable and environmentally friendly mask made with a bio-based polymer that can be composted and integrated back into the ecosystem. “The NavaMASK not only addresses the pressing issue of mask waste but also highlights the importance of using renewable resources and minimizing environmental impact,” Shadi Hasan, director of KU’s Center for Membranes & Advanced Water Technology, tells KUST Review.‹‹‹ Read less

“In the end we do this to help people,” Pappa, who in 2019 was one of MIT Technology Review’s Innovators Under 35, tells KUST Review.

And now the team is adapting the technology into an app that, in its initial phase, begins with a simple breath into a phone and will eventually operate concurrently with wearable biosensors.

Users breathe into smartphone microphones, which capture the breath rate. The wearable biosensors read the wearers’ biological responses to stress. After the data is analyzed, the app recommends personalized breathing games to calm the heart rate and the wearer’s stress.

Breathing correctly, the team members say, is a skill people have to learn. They compare it to an athlete building endurance.

“Breathing in for seven seconds is not easy,” Dias says.

The team is working through some challenges around the many different brands of mobile devices and hopes to have a marketable product soon.

“Clearly, many development stages are on the horizon, yet we are hoping in one year to have the conceptualized idea transformed to a product. This will only happen with the intensive research efforts that we are currently undertaking, the support from Khalifa University and potential angel/venture funders,” Hadjileontiadis tells KUST Review.

The ultimate goal is for every breath to be a tool to “unlock our mindset toward stressless living,” Hadjileontiadis says.

According to the World Health Organization, stress and depression increased by 25 percent in the first year of the pandemic alone. It was so prevalent that it prompted 90 percent of countries surveyed to include mental health and psychosocial support in their COVID-19 response plans.

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Polluted oceans:
Let the trash take itself out

Up to 12.7 million tons of waste makes its way into the world’s oceans each year, forming massive “plastic islands” in oceanic gyres and devastating birds and marine life in the process.

Cleanup, in which plastics are currently collected at sea, stored and shipped to shore for disposal, is estimated to take from 50 to 130 years with annual costs expected by some at nearly US $37 million. In the meantime, the trash is degrading faster than it can be gathered, disintegrating into harmful and even more difficult to mitigate microscopic forms.

Listen to the Deep Dive

Now a team of researchers from Massachusetts in the United States is suggesting a new approach: self-powered cleanup vessels that turn the trash they harvest from the seas into the fuel they use for the job.

RELATED: Microplastics: The invisible threat

The “blue diesel”-powered ships could reduce the amount of fuel and roundtrips needed to remove ocean waste, the researchers write in a paper published in the Proceedings of the National Academy of Sciences of the United States of America.

The researchers, representing Harvard University, the Woods Hole Oceanographic Institution and the Worcester Polytechnic Institute, suggest using high temperatures and high pressure in a process called hydrothermal liquefaction to depolymerize the plastics into a harnessable energy, creating self-powered cleanup that eliminates the need to refuel or unload plastic waste and potentially reduces total cleanup times.

Of course, it isn’t enough to clean up the oceans faster and with less fuel waste. The world needs to address the amount of garbage that makes it into the oceans in the first place, the researchers write. “Reducing or eliminating the amount of plastic waste generated is critically important, especially when the current loading may persist for years to even decades,” they say.

 COVID’s toll on the oceans 

Meanwhile, researchers from China’s School of Atmospheric Sciences at Nanjing University and the Scripps Institute of Oceanography at the University of California-San Diego say the COVID-19 pandemic is making an already bad situation in the oceans even worse.

Also writing in the Proceedings of the National Academy of Sciences of the United States of America, the scientists say that of the 8 million tons of plastic waste generated until recently in the fight against the virus, about 25,000 tons of medical waste, mostly from hospitals, has entered the world’s oceans. And more is expected to come, not only damaging marine species but potentially spreading contaminants including the COVID-19 virus.

The hospital trash, they say, dwarfs the amount of waste from discarded personal-protective equipment (PPEs) and plastic packaging produced by a surge of online shopping in the wake of the pandemic. For a little perspective, the authors cite another study estimating that 1.56 million face masks made it to the oceans in 2020.

Plastics that wash into the oceans are endangering wildlife. IMAGE: Shutterstock

Five of the top six rivers associated with medical-waste discharge are in Asia (Shatt al Arab, Indus, Yangtze,Ganges Brahmaputra and Amur). The other, the Danube, is in Europe.

The authors call for increased public awareness of plastics’ environmental impacts; better collection, treatment and recycling of plastic waste; and improved waste-management practices at pandemic epicenters, particularly in developing countries.

 Microbots to the rescue? 

A solution to microplastics in water might come in an equally small package: microbots.

The bacterium-size bots when added to water with a little hydrogen peroxide attach to microscopic bits of plastic and begin to break them down. The research was recently published in ACS Applied Materials & Interfaces.

“They can sweep a much larger area than you would be able to touch with stationary technology,” says study co-author Martin Pumera, a researcher at the University of Chemistry and Technology, Prague.

Pumera envisions setting the microbots loose in the oceans to collect microplastics, but Win Cowger, an expert in plastic pollution at the University of California, Riverside, who was not involved with the study, tells Scientific American that closed systems such as those for drinking-water or wastewater treatment would probably be better potential targets.

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Civil planning in the age of pandemics

COVID-19 was not the first pandemic to force changes in how we live: Communicable diseases have transformed urban planning before.

The Black Death outbreak in 14th century Europe saw narrow public squares transformed into larger public spaces better integrated with nature. The cholera outbreak in 19th century London prompted improvements to water-management infrastructure. And during the Spanish flu, residents eschewed cramped public transport in favor of walking in uncrowded streets.

Many of the practices in architectural and urban design prevalent now have evolved from similar measures taken throughout history to safeguard the health, hygiene and comfort of city dwellers. Now, researchers are turning their attention to suburbia.

Cities have to learn how to balance the competing demands of social distancing, preserving the economy and promoting people’s well-being.

– Khaled Alawadi

The team from Khalifa University says accessibility and walkability are crucial aspects for pandemic-proofing neighborhoods. The findings, published in Sustainable Cities and Society, suggest suburbs can provide better pedestrian accessibility with the right combination of structure and design.

Future pandemics may bring more lockdowns, says Khaled Alawadi, associate professor in the KU Department of Civil Infrastructure and Environmental Engineering, and open spaces will be vital.

“Cities have to learn how to balance the competing demands of social distancing, preserving the economy and promoting people’s well-being. … We argue that suburban design in the post-pandemic era should facilitate a balanced density level that is higher than the suburban norm but lower than that of traditional compact cities.”

A heavy Western influence

Despite the vast majority of the population continuing to reside in suburbs, retrofitting efforts to promote walkability and transit-oriented development are mostly limited to city centers. In GCC countries and the UAE in particular, suburbanization is the dominant development trend: suburbs occupy more than 50 percent of Abu Dhabi’s urbanized land and 40 percent of Dubai’s urban area.

Because suburbs are likely to continue to be the primary features of urban development, the researchers argue that suburban design should be rethought, instead of vilified, discarded or ignored. Their work integrates morphological mapping, urban-network analysis and forgotten urban-form elements such as alleys into designing future suburban areas. They focused on neighborhoods in Abu Dhabi and Dubai, examining the structural and physical layouts of both cities that resemble neighborhood typologies common in Western cities.

The grids and fragmented layouts that comprise the diverse set of neighborhoods in Abu Dhabi and Dubai are the same applied in city planning around the world.

– Khaled Alawadi

“Both cities have a history of inviting and hiring consulting firms and foreign architects who were all trained in Western countries,” Alawadi says. “The grids and fragmented layouts that comprise the diverse set of neighborhoods in Abu Dhabi and Dubai are the same applied in city planning around the world.”

The need to rethink suburban design stemmed from the need to confront climate change, long before the emergence of the novel coronavirus. Suburbs have been harshly criticized for their social, economic and environmental impact, and in terms of physical planning ideals, one of the key criticisms is low pedestrian accessibility.

Detached, single-family housing — the primary form of the suburban landscape all over the world — has either been glorified as the icon of the American dream of vilified as a deplorable built environment, but the KU team argues suburbia should not be visualized as sprawling low-density settlements only.

“The potential to design suburbs in various forms and levels of density cannot be overlooked,” Alawadi says. “For example, new suburbs can be designed to feature interconnected street systems rather than fragmented and broken street networks. Accessibility plays a vital role in good urban form. Residents are more likely to walk or cycle when their local area is more accessible and the distance between origins and destinations is shorter.”

Increasing accessibility

Accessibility and mobility go hand in hand: Mobility can be defined simply as how far you can go in a given amount of time, whereas accessibility is how easily one can get there. Research shows that, at neighborhood scale, accessibility has a significant influence on urban living, spatial equity, public health and walkability.

Comparing Abu Dhabi with Dubai, the researchers found that Dubai is more accessible overall but particularly when its network of alleys is considered. This suggests that better accessibility can be achieved by linking street networks with alleys between buildings.

“Walking within neighborhoods for recreational, fitness and utilitarian purposes is indispensable in a post-pandemic world,” Alawadi says. “The COVID-19 pandemic revived old debates in urban planning but there is an almost unanimous consensus regarding the need for walkable neighborhoods in post-pandemic cities. People want easy access to outdoor spaces, public parks and other destinations to meet their daily needs. Redesigned suburbs with more suitable infrastructure for local accessibility have the potential to serve as a viable housing option for the post-pandemic world.”