Does culture create craving? Evidence from the case of menstrual chocolate craving

PLOS ONE, Dec 2019

Craving is considered a key characteristic of diverse pathologies, but evidence suggests it may be a culture-bound construct. Almost 50% of American women crave chocolate specifically around the onset of menstruation. Research does not support popular accounts implicating physiological factors in menstrual chocolate craving etiology. We tested the novel hypothesis that greater menstrual craving prevalence in the U.S. is the product of internalized cultural norms. Women of diverse backgrounds (n = 275) reported on craving frequency and triggers and completed validated measures of acculturation. Foreign-born women were significantly less likely to endorse menstrual chocolate craving (17.3%), compared to women born to U.S.-born parents (32.7%, p = .03) and second generation immigrants (40.9%, p = .001). Second generation immigrant and foreign-born women endorsing menstrual chocolate craving reported significantly greater U.S. acculturation and lower identification with their native culture than non-menstrual cravers (all p < .001). Findings inform our understanding of food cravings, with important implications for the study of cravings in other domains.

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Does culture create craving? Evidence from the case of menstrual chocolate craving

July Does culture create craving? Evidence from the case of menstrual chocolate craving Julia M. Hormes 0 Martha A. Niemiec 0 Andrea S. Wiley, Indiana University Bloomington, UNITED STATES 0 University at Albany, State University of New York , Albany, New York , United States of America Craving is considered a key characteristic of diverse pathologies, but evidence suggests it may be a culture-bound construct. Almost 50% of American women crave chocolate specifically around the onset of menstruation. Research does not support popular accounts implicating physiological factors in menstrual chocolate craving etiology. We tested the novel hypothesis that greater menstrual craving prevalence in the U.S. is the product of internalized cultural norms. Women of diverse backgrounds (n = 275) reported on craving frequency and triggers and completed validated measures of acculturation. Foreign-born women were significantly less likely to endorse menstrual chocolate craving (17.3%), compared to women born to U.S.-born parents (32.7%, p = .03) and second generation immigrants (40.9%, p = .001). Second generation immigrant and foreign-born women endorsing menstrual chocolate craving reported significantly greater U.S. acculturation and lower identification with their native culture than non-menstrual cravers (all p < .001). Findings inform our understanding of food cravings, with important implications for the study of cravings in other domains. Introduction Craving is now widely considered a key characteristic of diverse pathologies, including weight and eating disorders, substance and non-substance addictions, impulse control and obsessive compulsive disorders, and paraphilias [1±6]. The role of craving in relapse into addictive behaviors has been widely documented [7±10]. Craving is also thought to play a role in food addiction [ 11 ], and to act as a powerful trigger in the onset of binge eating episodes in patients with bulimia nervosa and binge eating disorder, and a barrier to the successful achievement and maintenance of weight loss [ 4,12,13 ]. The role of internal factors such as stress or negative affect in the onset of craving episodes is generally recognized [ 14 ]. Research has also increasingly acknowledged the importance of external context and situational cues in craving etiology [ 15 ]. This study sought to expand upon our understanding of the importance of contextual factors in the emergence of craving by examining the role of culture in a specific and well-documented instance of craving, namely cyclically occurring craving for chocolate. Chocolate cravings are endorsed by over 90% of U.S. women [ 16 ]. In about half of these female cravers, chocolate craving frequency and intensity markedly increase specifically around the onset of menstruation [ 17 ]. This striking temporal pattern is the subject of ongoing speculation. Popular accounts regarding menstrual chocolate craving etiology implicate cyclically fluctuating hormones or ingredients in chocolate thought to either alleviate premenstrual nutritional deficits or remedy premenstrual symptoms via their pharmacological effects. Remarkably, in spite of continuing resistance against abandoning a largely biomedical view of menstrual craving, empirical evidence has consistently failed to support these hypotheses [ 18,19 ]. While general and menstrual chocolate cravings are common in the U.S., they are exceedingly rare in other parts of the world. For example, a mere 6% of Egyptian women endorse craving chocolate [ 20 ]. Only 28% of Spanish women experience menstrual cravings [ 16 ]. These geographic differences hint at a possible causal role of internalized cultural norms: in a society that emphasizes the ªthin idealº of female beauty, women may view menstruation as a socially sanctioned excuse to indulge in an otherwise ªtabooº food, resulting in cyclic increases in reported craving frequency [ 16 ]. This study sought to test the surprising, yet increasingly compelling hypothesis that culture is causally implicated in menstrual chocolate craving etiology by assessing 1. chocolate craving prevalence in women of diverse cultural backgrounds and 2. associations between menstrual craving and U.S. acculturation. Materials and methods The Institutional Review Board at the University at Albany reviewed and approved all methods. Participants were informed of the nature and purpose of the research and consented prior to completion of questionnaires. Procedures and participants Data were collected as part of a larger survey study examining types and frequency of food cravings in individuals from diverse cultural backgrounds. Participants included in the present analyses were undergraduate women (n = 275) who received research participation credit in exchange for time spent in the laboratory. Recruitment materials specifically targeted individuals (a) born outside the U.S., (b) with parent(s) or primary guardian(s) born outside the (...truncated)


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Julia M. Hormes, Martha A. Niemiec. Does culture create craving? Evidence from the case of menstrual chocolate craving, PLOS ONE, 2017, Volume 12, Issue 7, DOI: 10.1371/journal.pone.0181445