INCREASING COCOA CONSUMPTION-MEETING CHANGING LIFESTYLES

I read your piece last week, “Cocoa Consumption-Beyond the National Chocolate Day”. I think with all the benefits of cocoa you espoused in the piece, cocoa should be visible at all our missions across the world. The missions should be well informed about the health benefits of cocoa. It should form a key aspect of the message we give to persons trying to visit Ghana. Ghana is not the only country that grows cocoa but from all indications, Ghana’s cocoa is said to be of the highest quality. It should be possible to engage the airlines flying into and out of Ghana to incorporate cocoa product into either the main menu or the appetizers on flight.

I could not agree more with the reader. The other area I see another need for regular consumption of cocoa is the air crew (pilots, air hostesses, etc). This also applies to regular flyers. I would even stretch it to cover anyone planning to fly. Again my interest in the gut microbiota and good health provides reasons for cocoa consumption.  There are ten times the numbers of microbial cells in the human gut than in the whole human body, totalling roughly 100 trillion microbes and weighing about 2kg. The gut microbiota is now referred to as the new organ system of the body.

Human metabolism is adapted to a circadian rhythm of the 24 h that is synchronized to the Earth’s 24 h light/dark cycle (Shanthi et al.Potential Role for the Gut Microbiota in ModulatingHost Circadian Rhythms and Metabolic Health. Microorganisms 2019, 7, 41; doi: 10.3390/microorganisms7020041). This rhythm is orchestrated by the brain’s central clock in the hypothalamic suprachiasmaticnucleus, which in turn synchronizes peripheral clocks in the rest of the body. This molecular clock mechanism plays an important role in regulating the rhythmic expression of clock-controlled genes, which in turn regulate the synthesis, storage, and expenditure of energy. The light/dark cycle is the most potent Zeitgeber (an external or environmental cue that entrains the endogenous clock rhythms) for the central clock.

Peripheral clocks may also be entrained by behavioural cues such as feeding and exercise.

The 24/7 lifestyles of shift work, early morning starts, delayed bedtimes, jet lag, and late night eating may cause circadian disruption, as our internal clocks may fail to keep pace with the conflicting information of the external light/dark cycle and our behaviour in an optimal way. This misalignment of the rhythms that control our energy metabolism increases the risks of weight gain and metabolic syndrome, including type 2 diabetes mellitus. Interestingly, an imbalance in our intestinal microbiota is also associated with obesity and diabetes. The intestine affects our energy status by controlling physiological functions such as digestion and absorption of food, and gastric emptying—activities that are also regulated by clock genes.

Life on Earth is dictated by circadian fluctuations of light causedby the planet’s rotation around its own axis. Biological clocksare oscillators that enable the anticipation of diurnal variationsin environmental conditions and thereby couple physiologicalprocesses to geophysical time. In humans, disruption of the circadian clock is a commonhallmark of the modern alteration in lifestyle. This is especiallyevident in individuals engaged in chronic shift work or frequentlyflying across time zones and experiencing the ‘‘jet lag’’ phenomenon.

This new set of disruptive conditions to human physiologyis associated with an increased tendency for a wide range of diseases,including obesity, diabetes, cancer, cardiovascular disease,and susceptibility to infection. The microbiota plays a pivotalrole in the regulation of many physiological processes, includingdigestion of food components, host metabolism, the maturationand function of the immune system, and even host behaviour andcognitive functionall of whichshow features of circadian control. Recently, rhythmic microbial

sensing by intestinal epithelial cells was found to be essential forepithelial homeostasis

The gut microbiota itself followsdiurnal oscillations in composition and function whose regulationis governed by host feeding rhythms. Furthermore,the body’s circadian misalignmentresults in microbial dysbiosis, which drives metabolicimbalances. This is attributed to a close interaction of the body with the gut microbes in diurnal rhythmsin modern human disease (Thaiss et al. Transkingdom Controlof Microbiota Diurnal OscillationsPromotes Metabolic Homeostasis. Cell 159, 514–529, October 23, 2014).

I saw an interesting commentary on this research by Michael Ash in Clinical Education. If you have ever travelled across time zones you will be familiar with the adverse effects on your physical function such as loss of clarity and productivity. The organisms present in your gut, share the same trip and to some extent the same consequences. Organisms ranging from bacteria to humans have circadian clocks to help them synchronise their biological activities to the time of day. The gut microbes in humans have circadian rhythms that are controlled by the biological clock of the host in which they reside. Disruption of the circadian clock in the host alters the rhythms and composition of the microbial community, potentially leading to obesity and metabolic problems. These findings provide an explanation for a long-standing observation, that people with chronically disturbed day-night cycles due to repetitive jet lag or shift work have a tendency to develop obesity and other metabolic complications.

Disruption of the circadian clock in humans is a hallmark of relatively recent lifestyle changes involving chronic shift work or frequent flights across time zones. These widespread behavioural patterns have been linked to a wide range of diseases, including obesity, diabetes, cancer, and cardiovascular disease. The gut microbes thrive on high fiber diet and polyphenol-rich diets. Cocoa has high fiber content. Cocoa is also the richest food source of polyphenols on weight basis. Dear reader, I believe you can appreciate my drive for increased consumption of polyphenol-rich cocoa at all fronts.

DR. EDWARD O. AMPORFUL

CHIEF PHARMACIST

COCOA CLINIC