1  

 

 

DIPLOME  D’UNIVERSITE  DU  GOUT,  DE  LA  GASTRONOMIE  ET  DES  ARTS  DE  LA  TABLE  

DUGGAT  

                                                                           

MÉMOIRE  DE  FIN  D’ÉTUDE  

 

JUIN    2009  

 

 

 

 

 

 

 

 

Maria  Isabel  Toulson  Davisson  Correia  

 

A  journey  into  the  world  of  taste:  medicine,  

nutrition  and  gastronomy  side  by  side  in  health,  disease  and  

hedonism    

2  

AKNOWLEDGMENTS

- To all that have been part of this project, this is to say, the group of Hautes

Études du Goût 2008: organizers, teachers and classmates who were so

much fun, great company, and above all great friends throughout the two

intense weeks spent together in Paris and Reims. You will be forever part of

my life!

- To my three men, Mário, Marco Túlio and Gustavo, who so patiently live

through all my adventures and endeavors, always figuring out what it is going

to come next…….you never know!

- To my parents for the blessing of my existence!

- To God, Buddha, Allah and all divinities for life…. so good and so intense!

“True religion is real living; living with all one's soul, with all one's goodness and

righteousness.”

Albert Einstein, 1879 - 1955

3  

SUMMARY

LIST OF FIGURES..........................................................................................4

ABSTRACT .....................................................................................................5

1. REVIEW OF THE LITERATURE ................................................................6

1.1. TASTE ..................................................................................................7

1.2. MEDICINE ..........................................................................................12

1.2.1. Art .................................................................................................12

1.2.2. Science.........................................................................................13

1.3. NUTRITION ........................................................................................16

1.3.1 Essential to life .............................................................................16

1.3.2. Science.........................................................................................17

1.4. GASTRONOMY.................................................................................20

1.4.1 Science.........................................................................................20

1.4.2. Art .................................................................................................31

1.5. HEALTH AND DISEASE....................................................................34

1.5.1. Eating habits................................................................................36

1.5.2. Commensality..............................................................................38

1.5.3. Learning attitudes ........................................................................41

1.5.4. Disease........................................................................................43

1.5.5. Molecular gastronomy .................................................................48

2. CONCLUSION ....................................................................................54

3. FUTURE PERSPECTIVES .................................................................56

4. REFERENCES....................................................................................58

4  

LIST OF FIGURES

Figure 1. Anatomy of the tongue (papillae and nerves) …………………..…08

 

Figure 2. Montages of a tongue tip of a non-taster versus a taster ……..….11

Figure 3. Hippocrates oath .........................................................................16

Figure 4. Portrait of Yvan Mei .....................................................................23

Figure 5. Carême’s drawing of the hermitage russe ...……………..………..32

Figure 6. Feeding the sick ………………………………………………………34

Figure 7. The map of hunger …………………………………………………...38

Figure 8. Enhancing recovery after surgery …………………………………..45

Figure 9. Food chain in the hospital setting …………………………………..47

Figure 10. Forbidden to forbid ………………………………………………….48

Figure 11. Be healthy ………………………………...………………………….52

5    

ABSTRACT  

Every time something is placed in somebody’s mouth one or a combination

of tastes alerts to vital information about that matter. This might justify why

Romantic gastronomers, self proclaimed professors of taste, considered the

profoundly physical pleasures of the palate to be the pinnacle of aesthetic

appreciation. No wonder why food, as approached by gastronomy, was

elevated during the nineteenth century to the status of fine arts. However,

food should also be seen as science because it has, throughout the

centuries, been the subject of many studies which have assessed its role in

the prevention and treatment of several disease states, not to talk of its social

role. In this sense, Medicine, directly associated with the existence of human

kind, should similarly be regarded as art and science, where food, taste and

pleasure are intertwined both in health and disease. To support the relevant

association of all these arts and sciences, more recently chemistry in the

form of molecular gastronomy has been added to the roll, presenting its

fascinating approach on food phenomena and as an alternative to be offered

to certain disease states and culinary experiences. It is thus the purpose of

the current review to invite people to delve into the wonderful journey of

taste, medicine, nutrition and gastronomy placed side by side in health,

disease and hedonism.

 

Key-Words: taste, medicine, nutrition, diet, gastronomy, molecular

gastronomy, health, disease.

6    

1. REVIEW OF THE LITERATURE “When we no longer have good cooking in the world, we will have no literature, nor high and

sharp intelligence, nor friendly gathering, nor social harmony.”

Antonin Caréme, 1766 - 1823

7    

1.1. TASTE

“The senses are the organs by which man places himself in connection with exterior

objects.”

Brillat Savarin, 1755 - 1826

Every time something is placed in somebody’s mouth one or a

combination of tastes alerts to vital information about that matter. If it's sweet,

maybe it's got the nutrients the body needs to keep running for another few

hours. If it's salty, perhaps it is necessary to replace some of those vital

minerals just excreted through sweat or urine. If it's sour, there's a chance it's

not ripe and will cause a bad bellyache. If it's bitter, watch out….. it could be

poison and the next swallow will be the last. Thus, eating is associated to

neurophyscological inherited and acquired phenomena. Deciding what

tastes "good" is anything but simple.

A food's flavor doesn't usually depend on data from a single sense1.

Rather, smell, touch, sight and even hearing often come into play, and the

best methods of pleasurably exciting those senses, during a meal or snack,

occupies the days of thousands of chefs, brewers, marketing flaks, and

scientists around the world.

Senses depend on an intricate cross talk between the different

sensitive areas enervated by peripheral nerve branches and the remaining

nervous system, medulla and brain1, 2. This is a complex system yet not fully

known which has demanded scientists to delve deeply into its mechanisms2.

In terms of taste, until very recently, a concept that has guided much

taste research is the existence of only four (or possibly five) independent

taste qualities. These four so-called basic” or “primary” tastes are sweet,

sour, salty, and bitter; a fifth quality, the taste of glutamate salts called

“umami,” has also been described1-3. All other tastes are presumed to be

combinations of these basic tastes mixed in various proportions. The idea

that taste was, as the other senses, just a mechanical action in which

8    

nervous fibers played the conductors to reach the brain has also been

rejected. A new concept has emerged showing that aside from the receptor,

this has to interact with a chemical signal or “a tastant”4.

Tastants are chemicals that stimulate receptors and ion channels in

taste receptor cells found in taste buds ( garlic clove-like structures). The

latter are contained within papillae on the tongue’s surface in the soft palate,

pharynx, larynx, and epiglottis.. Papillae types vary according to the region in

the tongue. For example, in the anterior area of the tongue fungiform

papillae predominate, foliate papillae are located in the posterior lateral sides

of the tongue and circumvallate (rearward facing chevron across the back of

the tongue) papillae (Figure 1 ).

Figure 1 - Anatomy of the tongue (papillae and nerves) 1

Taste buds contain between 50 and 150 cells that form a discrete

ovoid structure2. These cells are divided into basal cells (from which new

taste cells originate) as well as elongated cells, some of which have microvilli

that extend through a taste pore into the oral environment. Tastants dissolve

in saliva and cross a mucus layer to reach microvilli and taste receptors.

Diminished salivary production can impair taste perception and this explains

why elderly people who, in general, have less saliva present with taste

9    

disorders, as well as those individuals who have undergone chemo or

radiotherapy. The tastants then activate either ion channels (sour, salty) or G

protein (gustucin) coupled receptors (sweet, bitter, umami), depolarizing

these cells. These, in turn, set up impulses in the taste nerves. It is

interesting to note that the pleasure response to sweetness and disgust from

bitterness is present at birth and not learned. Response to saltiness develops

during the first year of life2, 3.

Branches of three cranial nerves innervate taste buds, transmitting the

electrical impulses to the medulla: the chorda tympani nerve innervates

fungiform and anterior foliate papillae and the lingual nerve innervates the

posterior foliate and circumvallate papillae. Taste buds on the soft palate are

innervated by the superficial petrosal nerve, while those on the epiglottis are

innervated by the superior branch of the vagus nerve. Each nerve has fibers

that respond best to a specific taste quality1. However, the tongue map – the

idea that certain areas respond only to certain taste qualities – is wrong; all

areas of the tongue respond to all qualities3.

From the medulla, the taste impulses reach the brain, more precisely

the primary taste cortex in the rostal insula and adjoining frontal operculum

and the orbitofrontal cortex that contains the secondary taste cortex, in which

the reward value of taste is represented. The latter area also contains the

secondary and tertiary olfactory cortical areas, in which information about the

identity and also about the reward value of odors is represented. The

orbitofrontal cortex also receives information about the sight of objects from

the temporal lobe cortical visual areas, and neurons in it learn and reverse

the visual stimulus to which they respond when the association of the visual

stimulus with a primary reinforcing stimulus (such as taste) is reversed.

Foods and beverages stimulate multiple fibers in the trigeminal nerve

(CN V): tactile sensations such as particle size, texture and creaminess

stimulate mechanoreceptors while temperature triggers thermoreceptors and,

irritants and pungent foods stimulate nociceptors. Somatosensory input is

tightly integrated with, but separate from, smell and taste input.

10    

Hedonic responses to odorants are learned through positive (e.g.

pairing odors with energy, repetitive exposure) and negative (i.e. flavor

aversions) conditioning. Odors reach the olfactory epithelium via the nares

passively through breathing and actively through sniffing and via the mouth

and nasopharynx actively through chewing and swallowing. Retronasal

olfaction is as important as oral sensation, however they play different roles5.

For example, cheese that is aversive when sniffed is enjoyed when eaten.

Within the mouth, amino acids and salt stimulate the taste system and fat

stimulates somatosensation. Chewing warms the cheese and releases

volatiles. When swallowed, the latter creates a pressure differential that

pumps cheese volatiles through the oropharynx and nasopharynx to the

olfactory epithelium.

The way a person eats impacts on his/her taste perception and an

example is slowing the rate which allows time to savor the flavor. The

blending of taste, somatosensory and retronasal experiences promotes

satiation6. All these sensations are transmitted to the brain where the odor

message is compared with a template of past experiences and is enjoyed or

not according to them. Thus, the integration of peripheral inputs occurs

centrally.

Elderly and sick people lack some of these capacities and genetics

definitely interfere in each person’s individual capacity of taste. This explains

why some people become experts in chocolate or coffee tasting etc1, 3, 4, 6.

Compared with nontasters, supertasters taste sweet, sour, salty and bitter

compounds more intensely, as well as perceive more chemesthetic

sensations from chili peppers, black pepper, ginger, carbonation, and

alcohol. Supertasters also experience heightened tactile sensations from

high-fat milk products, salad dressings and greater intensities from

retronasal stimuli1. (Fig 2).

 

11    

Food preferences and dietary behaviors seem to be related to

variation in taste, smell and oral somatosensation. These, on the other hand,

depend on complex genetic-environmental interactions. All of them are

extremely important to man’s perception of food and a link between physical

and psychological approaches.

In common parlance, moral transgressions “leave a bad taste in the

mouth.” This metaphor implies a link between moral disgust and more

primitive forms of disgust related to toxicity and disease. Some authors have

tested directly the primitive oral origins of moral disgust by searching for

similarity in the facial motor activity evoked by gustatory distaste (elicited by

unpleasant tastes), basic disgust (elicited by photographs of contaminants),

and moral disgust (elicited by unfair treatment in an economic game). They

found that all three states evoked activation of the levator labii muscle region

of the face, characteristic of an oralnasal rejection response. These results

suggest that immorality elicits the same disgust as disease vectors and bad

tastes7.

Taste is directly related to nutrition and diets. It impacts brain function

across the lifespan. The importance of specific nutrients for brain function,

cognitive and mental health, and susceptibility and resistance to brain

dysfunction, as well as many other health and disease states is just

beginning to be explored. Also taste has a direct role in hedonic behavior.

Romantic gastronomers, self proclaimed professors of taste,

considered the profoundly physical pleasures of the palate to be the pinnacle

of aesthetic appreciation. Food was elevated during the nineteenth century

to the status of fine arts, adopting the same juridical language and concern

with philosophical principles that defined the eighteenth century discourse of

aesthetics8. Nonetheless, taste has always been ranked low on the

philosophical hierarchy of the senses as a means to ingress to the mind.

Whereas sight and hearing allow for a proper representative distance from

the object of contemplation, taste like its closest cousin smell, is bound up

with the chemical physiology of the body. While the exertion of the higher

senses theoretically leads to more mind, the exercise of the lower senses of

taste and smell can result in too much body and its various forms of

 

12    

sensuousness: to indulge the most basic human appetites is to risk becoming

a glutton, a drunkard or a voluptuary.

Thus, a journey into the world of taste justifies why medicine, nutrition

and gastronomy are side by side in health, disease and hedonism.

1.2. MEDICINE

“The practice of medicine is an art, not a trade; a calling, not a business; a calling in which

your heart will be exercised equally with your head. Often the best part of your work will have

nothing to do with potions and powders, but with the exercise of an influence of the strong

upon the weak, of the righteous upon the wicked, of the wise upon the foolish.”

William Osler, 1849 - 1919

1.2.1. Art

Art is the subtle or imaginative ability in inventing, devising, or

executing something9. And what does Medicine have to do with art? First,

they share a common goal: to complete what nature has not. Second, they

have a common substrate, the physical, visible world of matter. More

significant, however, are the similar qualities of mind, body, and spirit

demanded of the practitioners of each, artist and physician. Chief among

them is an eye: the ability not only to observe, but to observe keenly -- to

ferret out the tiny detail from the jumble of facts, lines, colors -- the tiny detail

that unlocks a painting or a patient's predicament. Observation demands

attention, and this is the key to both art and medicine. Attention is nothing

more than a state of receptiveness toward its object, the artist to nature, the

viewer to the work of art, the physician to the patient. It is no accident, I

believe, that clinicians -- or treating physicians, as they are often called -- are

referred to as "attending physicians." "Attention" and "attend" are both

derived from the same Latin root meaning "to stretch toward." Many more

"affinities" exist between medicine and the visual arts, but I will close with just

one: Medicine is itself an art. It is an art of doing, and if that is so, it must

employ the finest tools available -- not just the finest in science and

13    

technology, but the finest in the knowledge, skills, and character of the

physician. Truly, medicine, like art, is a calling10.

1.2.2. Science

Medicine has also to be science because its role has been beyond

comforting and curing the sick ones. More recently, a key aspect of

Medicine has been to prevent the outbreak of diseases. In order to perform

such, it has been fundamental do investigate hypothesis, to develop theories,

to spend times in the laboratories and search for better diagnosing tools and

treatments, plus creating vaccines.

Even before there were humans on earth, there was disease. Studies

of animal fossils have shown that prehistoric creatures were subject to

manifold diseases and injuries. Fossil teeth with erosions, abscess and

pyorrhea, as well as cavities were identified. Investigations of human

remnants from different historic periods have uncovered many disease

entities such as tuberculosis, bone fractures and parasitic infections.

The mummies in Egypt show characteristics of tubercular disease of

the spine, pneumonia, stones, parasites, urinary infections and even

arteriosclerosis. Ancient bones in the Americas have shown that pre-

Columbian syphilis or a different spirochetal disease was a reality. Bone

wasting (osteomalacia) has been interpreted as a sign of poor nutrition in

ancient times, although rickets was rare, maybe due to great light exposition.

The healing process has also been part of man’s instinct maybe much

similar to how sick animals treat themselves. In the first century of Christian

Era, Pliny repeated the tall tale about the hippopotamus which when ill would

plunge its knee into a sharp reed to let out blood and heal itself11. The

principle of bloodletting so much adopted in human Medicine not until long

ago. Also, animals when hurt apply mud to their wounds and plunge into cold

water to relieve discomfort. Men on the other hand rub wounds using thus

heat to ameliorate inflammation and apply cold to deaden pain, principles

much identical to the ones used by animals.

14    

Apparently primitive societies were subject to many of the same

diseases which still afflict humans today if we were to judge by the multiplicity

of ailments under the care of specializes shamans. These included stomach

upsets, diarrheal diseases, respiratory illnesses, rheumatic ailments and

menstrual disorders. However, with the evolution of times, other diseases

were added to this list and obesity is nowadays the biggest epidemic

worldwide.

Disease has affected men and women differently. All throughout

times, men seemed to have lived longer than women, the common

assumption being that pregnancy and childbirth were responsible for the

difference. However, even if this were true it would only justify life expectancy

for the younger ones and not the overall community. Nutrition, on the other

hand, maybe the explanation for this phenomenon, since chronic

malnutrition, starting in infancy and continuing through childhood and

adulthood made women less resistant to illness. According to this theory,

men and boys, as leaders, hunters and warriors, were considerably better fed

than women and girls who were the home laborers, crop cultivators and child

bearers.

No matter which diseases have afflicted humankind, food has always

been linked to many of them, be either related to deficiencies such as

malnutrition or excess as obesity12. Many medical bases for food prohibitions

have had their principles not only on religious principles but also on social

and anthropological reasoning.

In Nei Ching, or The emperor's book of internal medicine, written by

the Yellow Emperor, sometime in 3.000BC, there are three kinds of

medicines: the lowest is poisonous, the middle is a little poisonous and the

highest is not poisonous. The lowest cures six out of every 10 diseases and

leaves poison in the body. The middle cures seven of every 10 diseases and

leaves a little poison in the body. Even the highest cures only nine to ten of

every 10 diseases. Diseases that cannot be cured with Medicine, can be

cured only with food13.

15    

Medicine, as practiced nowadays, owes much to Hippocrates, the first

world known, reputed physician and teacher at the famous medical school

on the Mediterranean island of Cos. Hippocrates is generally credited with

turning away from divine notions of Medicine and using observation of the

body as a basis for medical knowledge. Prayers and sacrifices to the gods

did not hold a central place in his theories, but changes in diet, beneficial

drugs, and keeping the body "in balance" were the key. Central to his

physiology and ideas on illness was the humoral theory of health, whereby

the four bodily fluids, or humors, of blood, phlegm, yellow bile, and black bile

needed to be kept in balance. Illness was caused when these fluids became

out of balance, sometimes requiring the reduction in the body of a humor

through bloodletting or purging. The Hippocratic Corpus, or the collected

writings attributed to Hippocrates, contains about sixty works on a variety of

medical topics, including diagnosis, epidemics, obstetrics, pediatrics, surgery

and nutrition.

In his writings, Hippocrates introduced ethical concepts (Hippocrates

Oath – fig. 3 ) which prevail till nowadays, by pointing to the importance of

curing sometimes, treating frequently and comforting always. He

acknowledged the importance of giving each individual just the right quantity

of nutrition and exercise, not too little, not too much, but just enough to lead

to healthy living habits. His famous quote “Let food be thy medicine and

medicine be thy food" has certainly confirmed that health and disease are

linked by one basic and essential determinant: Nutrition.

16    

Figure 3 – Hippocrates Oath, available at http://wwwihm.nlm.nih.gov/ihm/images/A/24/222.jpg

1.3. NUTRITION

“Our food should be our medicine and our medicine should be our food."

Hippocrates, 460 BC – 370 BC

1.3.1 Essential to life

Nutrition is essential to the survival of any living being. It plays a key

role in man’s life by covering body requirements but also supporting social

roles. Although some have tried to prove that life is possible without eating14,

by just looking at the sun, evidences from hunger strikers have shown that

among those who had lost 38% of the usual body weight , 33% died15.

Healthy individuals when undergoing a fasting state presented with loss of

20% of total body proteins which equaled 15% of usual body weight loss.

This led to muscle mass weakness and decreased respiratory function. Ten

to twenty percent of these impairments were immediately recovered after five

days of nutrition supplementation16.

17    

Disease and nutritional status interact. The former might lead to

disease while the latter worsens the disease per se and the patient’s overall

clinical condition.

Past pope John Paul II 17(1920- 1985) stated at the inaugural

conference of the International Conference of Nutrition, in Rome, 1992 that

“Hunger and malnutrition are unacceptable in a world that has both the

knowledge and the resources to end this human catastrophe”. He also

pointed that “The Universal Declaration of Human Rights had already

asserted the right to sufficient food. What we must now do is ensure that this

right is applied and that everyone has access to food, food security, a healthy

diet and nutrition education. In short, all people must be able to enjoy

personal and community living conditions that allow them to realize their full

human potential, at every point in their lives.” He finalized his speech by

saying “This is why the Pope asks you, participants at the International

Conference on Nutrition, to work for a world in which no one is denied his or

her daily bread or health care.”

1.3.2. Science

Nutrition sciences have long played a key role in humanity

development both in community and hospital settings. Famines which have

marked distinct eras throughout time, leading to the death of millions of

people, have only been diminished due to strong efforts of various scientists.

In the same line, hospital malnutrition to which many hospital complications

and deaths have been attributed has been the focuses of several studies

wordwide18-22.

Cicely Williams first described kwashiorkor malnutrition in what is now

Ghana in 193323. Her excellent publication was overlooked until J. Brock

(World Health Organization; WHO) and M. Autret (FAO) toured Africa and

reported to the second FAO/WHO Expert Committee in 1951 that the disease

described by Williams was widespread throughout Africa. This was

recognized as a condition common in Central America, also, where

Scrimshaw 24 began to study intensively both kwashiorkor and marasmus

18    

using one cot and one crib for six children on an overcrowded pediatric ward

in the general hospital. With a nutritionist to supervise their food intake, the

kwashiorkor children rapidly lost edema, skin lesions, anorexia, and apathy.

However, they failed to gain weight for many more weeks. After, these

children were later individually kept in a unit of six individual cubicles in a

private pediatric hospital, never again there was a stationary period in the

treatment of kwashiorkor. It was then realized that it was the adverse

nutritional impact of multiple cross-infections in an open ward that prevented

these children from gaining weight. Based on their recently found reports, this

author together with a group of investigators developed the concept and

patent of Incaparina a free use indigenous protein supplement to be freely

used in any developing country24.

Hospital malnutrition was assessed by the Brazilian National Survey

on Hospital Nutritional Assessment (IBRANUTRI). This was a study

designed to provide missing information regarding the nutrition status of

hospitalized patients covered by the Brazilian public health care system

(SUS). Specifically, the prevalence of malnutrition, awareness of nutrition

status in hospitalized patients, and the use of nutrition therapy were

assessed20. This study showed that almost 50% of hospitalized patients were

malnourished. In a larger study in Latin America similar results were found18.

Hospital malnutrition was significantly associated with complications,

mortality, length of hospital stay and costs19.

Eating habits and poor diets have also been linked to most major

nutrition epidemics of the current world. Of these, obesity plays a key issue

by increasing overall complications and death rates. The World Health

Organization estimates that more than two billion people are overweight and

this number has been plunging year after year25.

Although, many people are convinced of the importance of food in both

causing and relieving diseases, many doctors' knowledge of nutrition is still

rudimentary. Most feel much more comfortable with drugs than foods, and

the "food as medicine" philosophy of Hippocrates has been largely neglected.

That may be about to change! Concern about obesity, as previously

19    

mentioned, is rocketing up political agendas, and a growing interest in the

science of foods is opening up many therapeutic possibilities.

One example of this could be attributed to Lucy Wills, 1931, who

described how yeast extract could be effective in preventing tropical

macrocytic anaemia of late pregnancy26. Folate was shown to be the crucial

factor. In the 1980s a series of studies showed how periconceptional folate

could prevent spina bifida. Then, later meta-analysis studies have

established that high homocysteine concentrations were a risk factor for

atherosclerosis27. Dietary folate reduces homocysteine, raising the possibility

that a vitamin might prevent vascular disease. Next, several nucleotide

polymorphisms were found to be related to folate, meaning that folate levels

might influence the chance of developing cancer264.

These discoveries are not surprising as folate metabolism is involved

in many of the fundamental processes of life. It is important for nucleotide

biosynthesis. Thymidylate synthase, an enzyme that helps synthesize DNA,

depends on a folate derivative. Low levels of folate may thus lead to breaks in

DNA, predisposing to cancer. There are many other ways in which folate can

affect gene function, and so folate is central to nutrigenomics—the study of

the links between nutrition and gene function26.

Folate may thus be a leading contender for panacea of the 21st

century. Addition of folate to foods might reduce birth defects, vascular

disease, and heart disease—and the Americans favour fortifying bread with

folate. But folate being involved in so many of life's fundamental processes

not only leads to its possibilities as a panacea but also to the prospect that

"messing around with folate" could do extensive harm. The folate used in

food fortification is not a natural co-enzyme, and nobody knows the long term

effects of exposing whole populations to the unnatural folate. There is thus

great potential for good, some possibility of harm, and much uncertainty. The

question of fortifying foods inevitably becomes highly political, and the politics

of nutrition are just as complex as the science. The current prediction is that

we will be hearing much more about the science, medicine, and politics of

food. Hippocrates would be pleased. Therefore, it’s extremely important to

20    

stimulate and finance more research into this intricate field in order to halt

such situations, of which the above mentioned ones are just few examples.

Much more could be discussed on the role of food either preventing, treating

or even causing disease.

1.4. GASTRONOMY

“Gastronomy, has been the joy of all peoples through the ages. It produces beauty and

wit and goes hand in hand with goodness of heart and a consideration of others."

Charles Pierre Monselet, 1825-88

1.4.1Science

The history of food in its most basic sense needs no justification. The

idea that a society’s soul is revealed by its cooking has, in fact, been used

since earlier times. According to Greek classical and also Chinese tradition,

barbarians ate raw and crudely cooking, and this was the essential aspect of

their barbarism. The Huns, and eight hundred years later the Mongols, were

reputed to cook slabs of meat by placing them between the thigh of the horse

rider and his mount28. As these and in many other cases, the identification of

a populace by its cuisine is the preoccupation of outside observers and their

stereotypic ideas more than an activity of self-reflection.

The Greeks played an important role in such science, binding food and

eating habits with Medicine and Nutrition in principles still validated

nowadays. Theorion, in the 5th. century BC who invented bread ovens and

bakeries, plus Mitahecus and Sarambus, the later a wine maker, were

considered by Plato the three men who were “best at caring for men’s

bodies”. The belief that whole wheat bread is more laxative and healthful

promoter than the wheat itself comes from these Greek times, although they

themselves preferred the white bread. Furthermore, Dionysius advised that

wine drinking was to be practiced in such mode: one to health; one to love

and pleasure; and the 3rd to sleep28. It was very common to Greeks to add

wine to water at a concentration of 3% to 5%. The other Greek contribution to

human diet was olive oil, this sponsored by the Goddess Athena who planted

the first olive tree. Refinement in Greek cuisine appears to have been

21    

stimulated by both eastern (Lydia and Persian) and western influences (Sicily

and South Italy). Eastern influence was marked by the best bread and cake

makers, complex dishes and perfumes. The western influence was played by

the highly sophisticated professional cooks and cookery book writers

imported from Italy. The basic difference between Greeks and Romans

seems to be that the first shared their meals usually amongst men while the

latter shared them with their wives. According to Popei “the one I do not dine

with is a barbarian for me”28.

European cuisine was born with the ingenuity of the Sicilian cooks.

Their rich cuisine of many ingredients, elaborate sauces and seductive

honey-cakes was enjoyed and admired. The Romans were eager to learn

from others, especially from the Easterns and maybe due to this, ended up

using much spices and exotic sauces in their cuisine. Garum or liquamen

was a sauce made of salting the fish and having it fermented with enzymatic

and not bacterial action. This sauce was very much similar to the South

Asian fish sauces used today. Upon this, it’s almost impossible to dismiss the

claim that the Romans had a preference for the taste of rotting food. Garum

was produced in factories all over the Roman Empire and it varied in quality,

taste, color, and of course, in price. However, it may come as a surprise that

all the foods that are considered today as characteristic of the area, such as

tomatoes, green peppers, aubergines, oranges and macaroni were not

available yet at that time. The Romans essentially ate grains, meat, fish,

venison, boar, hare and dormice (all parts of these animals were fully

consumed, nothing was wasted). They also ate different kinds of birds and

aquatic animals such as oysters, crayfish and prawns. These were available

especially in coastal areas. Everything was eaten with different sauces made

of a huge variety herbs (parsley, celery leaf, catmint), spices (pepper, cumin,

savory, marjoram), liquefiers (garum, fruit juice, wine, vinegar, mustard) and

thickeners (egg whites or egg yolks, wheat starch). In addition to the varied

and fine cuisine, Romans had the peculiar habit of selling food on the streets

and even around the baths, besides in the taverns. Mostly, they liked the

plebeian convivium. The Romans succeed in building an empire that

22    

survived and resisted internal and external crises for over thousands of

years.

Meanwhile in the far east Asia, China also played an extremely

important role in the world of culinary and its association with health status

issues 29. “Have you eaten? “….this is the most common daily greetings in

China and attests to the central position occupied in Chinese lives by food.

The most fundamental principle underlying Chinese cuisine is its most

distinctive characteristic of fan-cai principle. This divides all foods in two

categories: fan denotes rice but it encompasses all grains and such other

carbohydrates as bread and noodles; cai denotes the dishes made to flavor

the fan, and it is of secondary importance. The Chinese also praised the yin

and yang principle of balance into their cuisine. These were not regarded as

diametrical opposites but as complementary poles on either end of a

spectrum on which any item of food would be. Foods were divided into

cooling and heating types according to their effect on the body, this is to say

not the temperature they were served, but rather their properties. Chicken

soup, for example, was ranked as a heating food while crabs were cooling

food. These ideas were further reinforced with the latter introduction of the

humoral system. According to this theory, the human body was affected by

heat and cold, and to a lesser extent by wetness and dryness, and balance

was essential to wellbeing. The humoral system might have reached China

from the West as a consequence of Buddhism spread. The Chinese divided

the cosmos into five successive phases generated by yin and yang namely,

wood, fire, earth, metal and water. Each one had a counterpart in every other

group. The most connected to food was the five flavors, that is, acidic or

sour, as in vinegar; bitter as in bitter melon and apricot kernels; sweet as in

honey and later sugar; pungent as in ginger and garlic and finally; salty as in

salt and later soy sauce. Also the Chinese paid much attention to health and

hygiene and it explains why freshness and cleanliness has always played a

central role in Chinese cuisine. The influence of Chinese cuisine on health

issues dates way back from Confucius who very much praised what he ate.

His principles were: “do not eat rice which has been damaged by heat or

damp and turned sour, nor fish or flesh which has gone bed. Do not eat what

23    

is discolored or what is in bad flavor, nor anything which is ill-cooked or not in

season”29. The Chinese might also have been the ones who started the idea

of dining out. Restaurants, or better say, establishments with the same

principle of these were a reality in that country ever since the Song Dynasty

in Hangzhou (960–1279 AD).

In the late Ming dynasty (1368-1644), Chinese cuisine and thus taste

was marked by a burgeoning consumer culture that bestowed enormous

prestige upon possession and enjoyment of material things, encouraging a

new market in luxuries. This definitely prompted a full interest in

gastronomy. Three late Ming authors gave some sense of the epicurean life

of this period, both in terms of food itself and in terms of pleasure. Gao Lian,

one of these authors, advocated that for elegant living one must share

lengthy discourses on food and drinking. He also devoted his energies to

questions of health and longevity. In harmony with a general trend towards

articulating standards of good taste, Gao’s book “Eight discourses on the art

of living from the studio where elegance is valued” was a work of

connoisseurship suggesting ways in which one might perfect both one’s

material surroundings and one’s metaphysical existence. Out of his eight

sections, one was fully devoted to ways of prolonging life and avoiding

illness, one to medicine and one to food and drink. So, once again, taste,

medicine, nutrition and gastronomy had its destiny connected in the history of

these arts. This was later stressed by Yuan Mei29 (figure 4) a famous writer

and intellectual who was compared to the French intellectual Brillat-Savarin,

for his strong opinions about cooking and because of his insistence on the

importance of gourmet knowledge.

Figure 4 – Yuan Mei available at http://www.poetry-chaikhana.com/M/MeiYuan/index.htm

24    

He stressed that cooks should only and solely use the best-quality

ingredients, rejecting anything not absolutely fresh. According to him, cooks

should thrive to achieve balance in seasoning and respect the natural flavor

of an ingredient; they should also pay attention to hygiene, use separate

pans for different flavors and pour water onto tea-leaves only when it reaches

boiling point.

In summary, Chinese imperial gastronomy consisted of two main

branches, procuring and savoring the best and rarest foods and writing about

them. This was intertwined to the uncanny resemblance to the fan-cai

principle that ordered gastronomy itself to concern for flavor, health and good

taste.

In the middle East, Islamic cuisine was marked by haram (evil –

forbidden) and haial (good - permitted) principles. Muslims similar to Jewish

were not allowed to eat certain foods such as pork, blood and improperly

slaughter animals. For Jewish much of these prohibitions were presumably

made on medical basis, considering that many of these animals lived under

dirty conditions. However, there were also other explanations such as the

pigs competed with humans for water and grain (scarce commodities in a

barren land) in contrast to cattle and sheep which consume relatively little

water and graze on forage inedible to man. Since tapeworm and other

parasitic infections were also transmitted by sheep and cows, thus singling

out pigs would not be wholly logical30. On the other hand, Muslims were

enjoined by Allah in to “eat of the good things wherewith We have provided

you”.

Since the second half of the 8th century there were culinary books in

the Arab world. They were written by important people as the brother of Calif

Haroum al-Rashid, famous for having invented the eponymous ibrahymyia, a

sour meat stew made with verjuice or vinegar31. For Medieval Muslims the

most important genres of Arabic culinary literature were the poems of the

table, elaborate poetic paeans to food and dining that were recited at dinner

parties. Dining was an elaborate lavish matter, something unheard since the

25    

Roman times, which direly contrasted to Muhammad’s principles of eating

only the necessary. The caliphs would boast of the fact that no less than 300

different dishes might be presented in a single sitting and by doing so they

expressed their wealth and power. However, in the same period, dissidents

of such principle of life or the so called cult of the stomach, doctors depicted

their concepts in dietary treatises which were much similar to the Greek

theories. One of such books, the book of Foods (Kitãb al-aghdbiya) written by

doctor Ishaq B. Sulayman al-Isra’ili was even translated into Latin and was

worth of consultation by many European physicians. The principle was to

object to the conspicuous consumption of so much food based on moral

grounds since excessive devotion to the stomach prevented true

enlightenment. This philosophy was spread to Europe by Ziryab31, a freed

slave and musician from Baghdad who found a position in Spain. Although

hired as a musician, he became one of the greatest arbiters of taste the world

has ever seen. He set the standards for matters of etiquette, fashion and

dining. He taught chefs new dishes from the east and introduced some

delicacies such as asparagus. Some of these specialties are still in use in

current Spain, such as the ziriabi, a dish of roasted and salted broad beans.

He also introduced the practice of dining in courses in which soup should be

followed by fish, and then fowl or meat, then desserts, ending with a small

bowl of pistachios or almonds. In other words, a meal from soup to nuts, a

style of dining that has persisted till nowadays.

Muslim food was much characterized by intense and diverse flavors

always with a touch of rose water to be sprinkled in the very last minute.

Interestingly, rice was not all that much prized until mid 16th century when

was then elaborated in different pilafs. On the other hand, bread was

tremendously prized and the more there was served, the better judged was

the host. To complement such specialties, Muslim cuisine was very rich in

candies. There were all different kinds which were exported to countries

invaded by them, including India. Furthermore, it was a Muslim custom to

wipe the sides of the pans with a clean cloth, for no reason other than it

would enhance its presentation, characterizing not only the art of cooking but

also the art of serving.

26    

Meanwhile, in Europe, with the fall of the Roman empire, Christianity

played an important role in food habits. This was represented by a swing

away from luxury life where gluttony prevailed to a more monastic self-

mortification model32. The principle that the human body depended on four

related humors seems to have been influenced by eastern philosophies.

These were: choler or yellow bile; phlegmon; black bile and; blood. Medieval

food matched the individual to foods with the optimum characteristics to

achieve a temperate state – warm and moist. Cooking changed a food’s

nature: heat dried food; boiling would moisten it. Digestion was a form of

cooking to be conducted in a measured way to translate the food into blood

or other humor. Over-indulgence at the meal might produce imbalance of

humors. So, once again food regains its importance in health and disease.

Late medieval medical theory considered that there were eight flavors: sweet,

greasy, bitter, salty, sharp, harsh, salty like the sea and vinegary. The eight

tastes were linked to humoral analysis and may underlie some of the working

of medieval cookery books. Physicians in great households were expected

to make this connection. An example of this is present in the history of Duke

of Burgundy who when at the table had his physician surveying the foods

served to him and advising which would be most profitable to him33. The

preserving of meat was developed and fruits were widely consumed as they

were indicated as a therapy to invalids.

Medieval cookery also revolved around the use of spices under the

influence of Muslims. More than 300 spices were described by Florentine

Francesco Pegalotti and these were used not only in cookery but also in

medicine and beauty products33. Spices played such an important role and

were considered the “oil” of the middle ages32. Some authors even

advocated that the world of crusades was no quest for Christianity but rather

a need to guarantee the supply of these ingredients to an Europe deprived of

them due to two great barriers: one political and other geographical. The

Ottoman empire would not allow anyone to travel through their domains to

look for spices. So, there was no possibility of making the journey that the

Polos had made earlier. The other barrier was geographical as no one knew

how far south the African continent stretched. The Arabs were at that time

27    

the best geographers but they had little desire to escape from the Ptolemaic

conception of the world as it was known to the ancient Greeks and they were

not prepared to speculate about possible routes to unknown continents.

Furthermore, they had a horror of the western ocean beyond Europe and

Africa which they referred as the “Green Sea of Darkness”32. Henry the

Navigator, the Portuguese infant (1394-1460) was a member of the

crusading expedition sent to Ceuta, in North Africa in 1415, with the goal to

interrogate the Arabs of the extent of the great trans-Saharan salt trade. Salt

was also a very important condiment known by the Arabs who traded it

across the Sahara, usually returning from those far sides with leather, goat

skins and ivory.

The information provided by the prisoners of Ceuta enabled Henry to

build up a mental map of the great continent. Surrounded by Jewish and

Arab cartographers, he created the beginning of the ocean discovery era of

the far sided continents. Henry not was only interested on the spice trading

but also on inflicting a decisive defeat on the Muslims, from whom Portugal

had only recently freed itself. After Henry, not only Europe was for sure

different but also, a world globalization was rocketed. New food ingredients

were brought into Europe from the colonies but also new food techniques

had to be developed to attend the demands of long months in the seas. The

first nutrition deficiencies were reported and ascribed to fresh food deficient

intake, such as vitamin C deficiency leading to scurvy. This inflicted so many

deaths on sailors.

European cuisine was much influenced by the Arabs and it’s possible

that the creation of sherbets and ice creams, in Italy, were under the

influence of them. Sugar, originally from India, was probably one of the most

important new ingredients that changed European habits. Sugar was also

recommended by doctors to their patients on account of it health-giving

qualities. According to Platina “nothing given us to eat is so flavorless that

sugar does not season it”34. It’s interesting to note that the English used less

spices than the French but on the other hand ate more sugar. As for the

French, spices such as grain of paradise were used in two out of three

recipes. One plausible explanation could be the idea brought about with the

28    

thought of heaven. Corn, potatoes, chocolate, turkeys were all new

ingredients brought to Europe together with a variety of new fruits. Some of

these food were changed by European habits.

Chocolate was a cold delicacy, not liquid, but frothed to a thick

consistency like that o honey, so that it had to be eaten with a spoon, h was

taken by the Aztecs as an aphrodisiac beverage. This was brought to Europe

by Cortez, a Spanish, who introduced it to the court of Spain. Chocolate

continued to be later regarded as aphrodisiac by English and French people,

also. Casonova, the famous French playboy was reputed for given his lovers

chocolate and guaranteeing his status of a true delicate and honorable lover.

Other drinks as coffee and tea were also important at European tables where

water, on the other hand, was seldom present, maybe due to the conditions

under which it was kept.

Coffee and tea, as well as an afternoon snack meal when chocolate

was drunk were habits incorporated into the European world. The reputation

of coffee as drink that enabled students to burn the midnight oil helped

promote the sale of the new exotic beverage. But soon this was questioned

by physicians who warned their patients that coffee drinking was the road to

ruin32. When towards the end of the seventeenth century a coffee house

opened in Marseilles, the town physician held a public meeting to explain to

the townspeople just how pernicious a drink coffee was. According to him,

the brew was a hot dry substance, which deprived the body of its natural

juices, plaguing the drinker with eternal wakefulness, exhaustion and, worse,

impotence.

The new world agriculture and habits impacted on social ideas and

issues. Slavery was a consequence of this new era. Twenty million black

men, women and children were carried overseas to plantations in the West

Indies, Brazil or America32 and there, they lived under the worst ruthless

conditions ever. This raised humanist attitudes in the old continent and the

first food boycott ever in history was held by abolitionists who started

sweetening their coffee with cream instead of sugar, and asking for French

brandy in place of rum.

29    

The development of the printing era certainly influenced the world of

taste, medicine and gastronomy (not yet used as such). Many books were

out on the subject. The first modern cookery book by Maestro Martino de

Como (1450) was an asset of gastronomy and medieval commentaries on

the philosophy of taste34. Martino’s book was a practical manual for courtly

cooks and was later adopted by the humanist writer Bartolomeeo Sacchi

(pseudonym Platina) as a reference in his treatise on the science and the art

of eating. The Bonessa Voluptate was the first book to be published in three

different idioms34. The highlights of this book were moderation and frugality,

galenic medical principles that in fact had not really fully disappeared

throughout all of those years when gluttony and extravaganza were mostly

defended by powerful ruling people.

Dietetic concerns ruled out certain foods as dangerous to consume.

Platina noted that the properties of mushrooms, for example, were cold and

damp and for this reason have the force to poison. In general, meat and fish

were considered to be more nourishing and healthier than fruit and

vegetables. He also oriented that vegetables should not be eaten after

consuming fruit because digestion is hampered by eating so many cool and

damp items. According to the galenic dietetic principles every person’s body

has its own complex set of humors and properties which must be balanced

by various different combinations. One can assume that this was potential

the first attempt to individualize nutrition treatments.

The table also became a place to show and share social manners.

Erasmus in his “De civilitate moreum puerillium”34 advised that “it’s neither

polite nor safe to drink or speak with ones mouth full”. Continuous eating

should be interrupted now and again with stories.” He also offered his

readers practical advice such as “It is boorish to plunge your hands into

sauced dishes. You should taste what you want with a knife or a fork; nor

should you select from entire dish as epicures do but should take whatever

portion is in front of you”. The fork was at that time a rather rare utensil. The

first record of a fork comes from Italy, sometime around the XIVth century, but

it only became of use around the sixteenth or seventeenth century. Catherine

de Medici35 was responsible for its introduction into the French court.

30    

Despite the efforts of humanist food writers to emphasize the

importance of good taste and good society at the tables, it’s is clear that the

princes of the time valued magnificence and ostentatious display at their

meals, so Platina’s book was a lonely cry in the wider intellectual culture of

the Renaissance humanism and cooking, although important and related to

health, did not achieve at that time such a high status as painting and

sculpturing.

Renaissance involved, at least in its earlier stages, a closing rather

than an opening of the mind. The veneration of antiquity became more

slavish, authority staked fresh claims against experience. So, the art and

science of eating was not as valued as those pieces of art that would call

attention to the eyes or to the other senses and to hedonism. It took about

two centuries for this to be changed! But things did start moving on when the

new science of the seventeenth century, a consequence of the overseas new

lands, encouraged an interest in novel foods and drinks. This was based

exactly on the previously above mentioned new products brought in from the

new world. Many scientists became curious and thus interested in studying

the commodities of tobacco, chocolate, tea and coffee. Their familiarity with

the Galenic medical model offered them a language they could explain the

health benefits of the new exotic products. Coffee, for example, was

remarked with the cure of small pox, as well as sugar was prescribed for

many disease states. Sweetness was thus transforming the European diet!

The birth of a new cuisine was paved by the moto “savory and sweet”.

These were the basics for the beginning of the French haute cuisine and the

introduction of dessert as the closing of a meal. Till then, most cookery books

focused solely on medical and dietetic advice but offered very little practical

orientation on how to prepare food. This was to be changed by the book “Le

cuisinier Francois” authored by Francois Pierre35 whose pen name was La

Varenne. It was the first book which provided recipes to prepare food and not

anymore a dietetic manual, despite its still conservative introduction on the

importance of good eating habits and, food impact on health and disease. He

definitely paved the way to modern gastronomy and introduced important

recipes still famous nowadays such as the fricassee and the ragout. Cooking

31    

was now a competition and an area of serious debate. It’s perhaps the

beginning of a new era: cooking as an art and not solely science anymore!

1.4.2. Art

“The discovery of a new dish does much for the happiness of mankind as the

discovery of a new star….tell me what to eat and I will tell you what you are. “

(Brillat Savarin – 1755 – 826)

Gastronomy is then the link between taste, medicine and nutrition in

the scientific arena of the sustaining principles of life maintenance: eating

the basic element of human life! Eating, a hugely complex activity, involves

innate biochemical processes and cultural phenomena. Thus, gastronomy

plays a lot more when it is also linked with the cultural and artistic side of the

three other sciences. Thus no better words to describe it: “art of arts”.

The word gastronomy per se only appeared around the year of 1800 in

the title of a poem by Joseph de Berchoux (1775- 1838). The noun

gastronome dates from 1803 and in the Manuel des amphytryons (1808),

gastronomy was a means of legitimizing the new social hierarchy that had

emerged from the French Revolution36.

Antonin Caréme, the first celebrity chef37, chef of the kings and king of

chefs, was the landmark of such new phase of this art. Author of many

books of which “Le Pâtissier Royal Parisien” was the first, he advised that

food should be served on hot plates and insisted in strict hygiene. He also

began to form theories about the marriage of wine and food. He also

suggested the liberal use of champagne wit food within recipes. Caréme was

a master in sculpturing his food assets, mainly desserts and he himself would

spend hours in libraries reading and later drawing his future masterpieces

(figure 5)

32    

.

His cooking was tempting and once the Prince Regent teased him by

saying that “his cooking would be the death of him”. Caréme replied “Your

highness, my concern is to tempt your appetite; yours is to curb it.” Caréme

praised very much quality and quantity and was firm saying that “the man

who calls himself a gourmand but eats like a glutton is not a gourmand. He is

a glutton”. His genius was to deploy methods that brought out the natural

flavors of food, for example, vegetables should be cooked a little firm. It was

his goal to create a gourmand’s paradise while at the same time producing a

feast which could, visually live up to the most opulent settings. His influence

was all over Europe as he served in England, Russia and Austria. He was

able to impact on Russian sauces, by introducing cream instead of only

vinegar to make them and supposedly for successfully ridding Russian cooks

of their over-reliance on pickling. To western Europe, he brought back the

Russian style use of flowers where porcelain and fruit had dominated table

decoration. He also imported to France the borsch and koulibiac (a pie with

either fish or chicken, boiled eggs and rice). He also endorsed of service à la

russe which is the predominant way of serving till nowadays.

By the Russian style each course is served to each guest individually.

French service was generally used up until then. Under this method, the

usually large menu (as many as 32 courses) was brought to the table in two

or three parts, and all of the dishes of each part would be placed on the table

at once. Guests would help themselves to each dish, most often in a

confused and combative manner, those with the longest arms getting their

Figure 5 - Carême's drawing of the Hermitage Russe which

Jacobin constructs for the Prince Regent's dinner

in honor of the Russian Ambassador

Available at

http://www.mirandaneville.com/antonin_careme.php#cherries

33    

favorites first. Frequently by the time you got too much of the food, it was no

longer hot. Then all of the dishes from that part of the service would be

cleared from the table and next part or 'service' would be placed on the table

in the same manner. Caréme somehow mingled the two systems.

The chef’s hat was also introduced by Caréme, and this seems to

have happened throughout his Austrian times. By then, Caréme was working

for the Ambassador of England, lord Stewart. Every morning, both would

meet to discuss the day’s menu in the kitchen, Caréme’s domain. It was

when Stewart first noticed his chef different appearance. Antonin had taken

to wearing a raised hat, a sort of toque, in contrast to white nightcaps usually

worn in kitchens those days. When Stewart asked why, Caréme promptly

replied he felt a chef should not dress as for a sickbed. This habit was

followed by other chefs in Vienna, then in Paris and then everywhere.

The French sauces were revolutionized by Caréme who had on them

the basis of its cuisine: velouté, béchamel, espagnol and allemande were all

his creations. Furthermore, Caréme had his finger on the role which

marketing and later the media would have on the world of gastronomy.

People were eager to be with Caréme, to share his company and eat his food

and this was mostly used by the French aristocracy to call attention to their

society. The Rothschilds were Caréme’s supporters in this new venture,

when inviting Lady Morgan to dine and later to write about the chef’s

qualities. According to lady Morgan, the once abandon urchin of Rue du Bac

had a Paris townhouse, his own coach and his own box at the Paris Opera37.

The era where the chef, not the writer or the critic, becomes a celebrity

is a culture where food, too is in revolution. This was mostly proven by Brillat

Savarin, the French intellectual who wrote the Physiology of Taste38. Savarin

discoursed not only on the qualities of food but also on the perceptions and

sensations it would bring altogether. He set principles on taste, senses,

appetite, food in germs, thirst, drinks, pleasures at the table, impact on sleep

and many other topics, including philosophical history of kitchens and even

death. Once again, the link between taste, medicine, nutrition and

gastronomy was stressed!

34    

According to Brillat Savarin, the sensation of taste is a chemical

operation produced by humidity. That is to say, the savorous particles must

be dissolved in some fluid, so as to be subsequently absorbed by the

nervous tubes, feelers, or tendrils, which cover the interior gustatory

apparatus38. He was also persuaded that without the interposition of the

organs of smell, there would be no complete degustation, and that the taste

and the sense of smell form but one sense, of which the mouth is the

laboratory and the nose the chimney; or to speak more exactly, that one

tastes tactile substances, and the other exhalations. Most of his thoughts

have been backed by recent discoveries in the science of taste.

Savarin defended that gastronomical knowledge is necessary to all

men, for it tends to augment the sum of happiness and gastronomy itself is a

scientific definition of all that relates to a man as a feeding animal. For him,

the most indispensable quality of a good cook is promptness.

1.5. HEALTH AND DISEASE

“Every human being is the author

of his own health or disease.”

Buddha, 565 B.C.

Science validates what our grandmothers and ancestors knew. Rich

homemade chicken broths have been used to cure colds.

Figure 6 – Feeding the sick. Available at http://wwwihm.nlm.nih.gov/ihm/images/A/21/484.jpg

35    

Stock contains minerals in a form the body can absorb easily—not just

calcium but also magnesium, phosphorus, silicon, sulphur and trace

minerals. It contains the broken down material from cartilage and tendons—

stuff like chondroitin sulphates and glucosamine, now sold as expensive

supplements for arthritis and joint pain, which not necessarily function as sold

out for. Of course that the intake of such substances, in a short period of

time, does not impact on disease, but sure enough plays a placebo role in

the treatment of the sick and guarantees a fairly well good intake of nutrients

to the anorexic sick patient.

Fish stock, according to traditional lore, helps boys grow up into strong

men, makes childbirth easy and cures fatigue. “Fish broth will cure anything,”

is another South American proverb. Broth and soup made with fish heads

and carcasses provide iodine and thyroid strengthening substances. When

broth is cooled, it congeals due to the presence of gelatin. The use of gelatin

as a therapeutic agent goes back to the ancient Chinese. Gelatin was

probably the first functional food, dating from the invention of the “digestor”

by the Frenchman Papin, in 1682. Papin’s digestor consisted of an apparatus

for cooking bones or meat with steam to extract the gelatin.

Gelatin held a position in the forefront of food research some 200

years ago, just as vitamins and other nutrients (for example, omega-3 fatty

acids) occupy the center of the stage in nutritional investigations today. At

that time, gelatin was universally acclaimed as a most nutritious foodstuff

particularly by the French, who were seeking ways to feed their armies and

vast numbers of homeless in Paris and other cities. Although gelatin is not a

complete protein, containing only the amino acids arginine and glycine in

large amounts, it may act as a protein sparer. During the siege of Paris, when

vegetables and meat were scarce, a doctor named Guerard put his patients

on gelatin bouillon with some added fat and they survived in good health.

The French were the leaders in gelatin research, which continued up

to the 1950s. Gelatin was found to be useful in the treatment of a long list of

diseases including peptic ulcers, tuberculosis, diabetes, muscle diseases,

infectious diseases, jaundice and cancer. Babies had fewer digestive

problems when gelatin was added to their milk. However, nowadays, no one

36    

would keep patients solely on gelatin for any kind of treatment and as it has

happened with many other such food supplements used to treat everything

and anything, it is now an out fashion topic in the literature.

Nonetheless, the nourishing properties of soups have been advocated

by many people. Even the epicures recognized that broth-based soup did

more than please the taste buds. Jean Anthelme Brillat-Savarin said, “Soup

is a healthy, light, nourishing food, good for all of humanity; it pleases the

stomach, stimulates the appetite and prepares the digestion.” Escoffier said :

“Indeed, stock is everything in cooking. Without it, nothing can be done.”

A cure-all in traditional households and the magic ingredient in classic

gourmet cuisine, stock or broth made from bones of chicken, fish and beef

builds strong bones, assuages sore throats, nurtures the sick, puts vigor in

the step and sparkles in love life—so say grandmothers, midwives and

healers. For chefs, stock is the magic elixir for making soul-warming soups

and matchless sauces. Meat and fish stocks play a role in ill traditional

cuisines worldwide—French, Italian, Chinese, Japanese, African, South

American, Middle Eastern and Russian.

1.5.1. Eating habits

Eating habits have been influenced by the history of evolution of man.

Man probably felt compelled to get up on his hind legs, so as to have to use

the two hands to carry out some eating process. Later on, by abandoning his

original food gathering for a hunting diet man left instinct behind him and he

had now to work out everything for himself. So, he began to acquire shaper

intelligence and a larger brain39 to cope with the new problems forced on him

by a change of diet32. Larger brains are energetically expensive, and humans

spend a larger proportion of their energy budget on brain metabolism. The

high costs of large humans brains (we have the largest compared to total

body surface) are supported by our energy and nutrient rich diets. Consistent

with an adaptation to a high quality diet, humans have relatively small

gastrointestinal tracts39. In addition humans are relatively under muscled and

over fat compared to other animals, features that help us offset the high

energy demands of our brains.

37    

The change to a meat diet undoubtedly made man more productive

and probably altered his whole physique for the better. However, a meat diet

presented with drawbacks and salt dependency was one of them. Salt is

present in meat in great quantity. Also cannibalism is thought to have been a

consequence of protein shortage. It’s true that cannibals also devoured their

victims with the hope they would inherit the mama 32 or magical power that

they attributed to some of their victims.

The discovery of fire rocketed food variety and also the idea of

commensality. Cooking also increased the nutritional quality of tubers by

making more of the carbohydrate energy available for biological processes.

According to Carleton Cook32, fire may have been a decisive factor in leading

man from primarily animal existence into one that was more fully human. In

summary although dietary change may not have been the prime force

responsible for the evolution of large human brain size, improvements in

dietary quality appear to have been a necessary condition for promoting

encephalization in the human lineage. Therefore, whatever man inherited

from his ancestrals, he has carried out till nowadays into his basic eating

habits.

Socio-economical aspects have also played a role on eating habits.

This has been much seen throughout the centuries but currently is still a

huge problem worldwide, when poor countries in Africa, Asia and also Latin

America present with higher rates of malnutrition due to lack of food. The

map of hunger (figure 6) is an uncontested proof of how underdeveloped

nations are plunged by lack of food resources.

38    

Figure 7 – The map of hunger available at http: //www.cdc.gov/

Subjective variables such as genetic and learning aspects are also

related to eating habits. Innate predisposition towards tastes, such as sweet

tastes, measured by observation of facial expressions present in neonates,

as well as aversion to sour or bitter tastes seem to be related to adaptive

human evolution40. Sweetness indicates the presence of sugars and

valuable calories, whereas bitterness or sourness may signal the presence of

harmful toxins or bacteria. Whilst not present at birth, preference for salty

tastes appears at around four months of age.

1.5.2. Commensality

Commensality is eating with other people, and commensal eating

patterns reflect the social relationships of individuals. When man started

gathering around fire, this new concept was born. The invention of fire which

was important in every sense, specially because the climate was becoming

much colder, brought man together around it to warm himself up and to cook

food. Eating hot food raises a well-being which might be rooted in a strong

recollection feeling, perhaps of mother’s milk.

39    

The first reports of banquets date back from Sumeria, in ancient Near

East. Sumerians shared public and private banquets for both political and

social reasons. To eat and drink together was a way of strengthening

relationships and doing good business. This has raised the idea of

ceremony, which according to the dictionary is a formal act or series of acts

prescribed by ritual, protocol or convention. Ceremony refers to activities

that take place on special occasions and that are consciously designed to

produce beneficial effects41.

Food-related ceremonies have marked humanity in a way that they

have been the center of joyful moments as well as of sad ones. Birth is

celebrated with food and death also. In many ancient and yet current cultures

the dead are buried with food offers next to them. Food has always been in

the center of man’s festivities, no matter what. Certainly due to this, man’s life

has been marked by food not only for its basic life sustaining role but also

for man’s well being. These ceremonies can be passed down as family

traditions or religious practices and can range from something as simple as

saying a blessing before eating to elaborate processes surrounding the

hunting, gathering, preparation, and eating of food.

There is a growing body of evidence that the consumption of food as

part of a functional ceremony has distinct health benefits. Even as early as

the year 1180, Moses Maimonides, a noted physician and rabbi, remarked

that one “should not gorge himself, but leave the table before his appetite is

fully appeased, using one fourth less food that what would completely gratify

him”41. Medieval theologian Thomas Aquinas said of gluttony: “gluttony

denotes, not only desire of eating and drinking, but an inordinate

desire….leaving the order of reason, wherein the good of moral virtue

consists”41.

Several more recent studies have depicted how important the role of

commensality is on a society’s development and on individual life style

patterns and health issues. In a recent study, meal partners in commensal

units and frequency of eating with others in commensal circles among 663

adults was assessed. Meal partner data revealed that most respondents ate

alone at breakfast, alone or with co-workers at lunch and with family

40    

members at dinner. Commensal frequency data revealed some eating at the

homes of other family members, little eating at friends' homes, and almost no

eating at neighbors' homes. Few demographic variations existed in

commensal eating, except that unmarried individuals more often ate

breakfast and dinner alone and more often ate with friends. These finding

suggest that contemporary work-oriented society may lead people to eat

alone during the day but share evening meals with family, and that people

maintain commensal relationships primarily with family members rather than

friends or neighbors. Peoples' social worlds appear to be focused on the

nuclear family, and family members are also the people they usually eat

with42.

Family bounds play an important role on the upbringing and eating

habits of tomorrow’s adults. A recent study43 showed that girls who ate three

to four family meals per week were at approximately one third the risk for

extreme weight control practices, and girls who ate five family meals per

week were at approximately one fourth the risk for extreme weight control

practices. It also revealed that boys also benefit from family meals, but the

association was not as strong as it is for girls. In another study44, in which

approximately one quarter (26.8%) of respondents ate seven or more family

meals in the past week, and approximately one quarter (23.1%) ate family

meals two times or less, the frequency of family meals was inversely

associated with tobacco, alcohol, and marijuana use; low grade-point

average; depressive symptoms; and suicide involvement after controlling for

family connectedness. These findings suggested that eating family meals

may enhance the health and wellbeing of adolescents.

The National Center on Addiction and Substance Abuse at Columbia

University’s (CASA) Family Day survey showed that of 1,987 teens ages 12

to 17 years, the number of teens who have regular family dinners drops by

50% as their substance abuse risk increases sevenfold. The survey

demonstrates the importance of regular family dinners, finding that,

compared with teens who have family dinners twice a week or less, teens

who have dinner with their families five or more nights in a week are 32%

likelier never to have tried cigarettes (86% vs 65%, respectively), 45% likelier

41    

never to have tried alcohol (68% vs 47%, respectively), and 24% likelier

never to have smoked pot (88% vs 71%, respectively)45.

From historical, cultural, and scientific perspectives, the gathering,

preparation, and consumption of food seems inextricably linked to religious

and ceremonial beliefs and practices. The growing body of evidence

supporting the health benefits of family meals is compelling and should point

us toward integrating ceremonial approaches to current and future

educational nutritional programs.

1.5.3. Learning attitudes

Poor nutrition is a leading lifestyle factor related to the development of

several noncommunicable diseases. One strategy for eliminating health

disparities and promoting long-term health is to get children to eat and like

healthful foods (eg, fruits and vegetables) from an early age. This (learning

attitudes) has been proven to be the factor mostly related to adequate eating

habits. Children are influenced by their mother’s eating and drinking patterns

while still in their mother’s wombs. More than one glass of beer, wine or

spirits per week during the pregnancy can be detected at birth. Alcohol in

early pregnancy--just when many mothers are unaware they are pregnant

can produce significant physical malformation, especially in the face.

Prenatal exposure to alcohol has significant effects on the intelligence and

behavior of the child. Many of these children are very restless46. Thus, the

impact on food preferences has also been attributed to mothers’ eating

patterns and habits.

Prenatal developmental events appear to influence infant and child

preferences for salty tastes47. Some studies suggest that severe maternal

emesis can have an enduring influence on response of offspring to salty

taste. Similarly, several behavioral measures related to salty taste preference

were inversely related to birth weight over the first four years of life. In

contrast to flavor compounds detected by the sense of taste, preferences for

flavor compounds detected by the sense of smell are generally more highly

42    

influenced with learning early in life, even in the uterus, being particularly

salient.

The sensory environment, in which the fetus lives, the amniotic sac,

changes as a function of the food choices of the mother as dietary flavors are

transmitted and flavor amniotic fluid. Experiences with such flavors lead to

heightened preferences for these flavors shortly at birth and at weaning.

Specifically, prenatal experiences with food flavors, which are transmitted

from the mother’s diet to amniotic fluid, lead to greater acceptance and

enjoyment of these foods during weaning. In an experimental study, infants

whose mothers were randomly assigned to drink carrot juice during the last

trimester of pregnancy enjoyed carrot-flavored cereals more than infants

whose mothers did not drink carrot juice or eat carrots48.

The best predictor of how much fruits and vegetables children eat is

whether they like the taste of these foods. The most salient feature of the

foods and beverages we consume is flavor. We define flavor as the

perceptual combination of three anatomically distinct chemical senses: taste,

smell, and chemosensory irritation, as previously depicted in this review.

Health organizations worldwide recommend five to 13 servings of

fruits and vegetables per day, depending on one's caloric requirement

Despite such recommendations, adults are not eating enough fruits and

vegetables and neither are children. The 2004 Feeding Infant and Toddlers

Study49, designed to update knowledge on the feeding patterns of American

children, alarmingly revealed that toddlers ate more fruits than vegetables

and one in four did not even consume one vegetable on a given day. Instead,

they were more likely to be eating fatty foods and sweet-tasting snacks and

beverages and less likely to be eating vegetables. None of the top five

vegetables consumed by toddlers was a dark green vegetable, those that are

usually most bitter.

As a consequence, scientific evidence has placed community nutrition

among the front line strategies in health promotion. Traditional food habits

have progressively changed in the last few decades. The combination of

43    

changes in food patterns and sedentary lifestyles has contributed to a

significant increase in the prevalence of overweight and obesity. Efforts in

community nutrition should now focus on three key aspects: nutrition

education in schools and in the community, food safety and enhanced

culinary skills in all age groups.

School meals and other catering services provided at work or

community sites should be consistent with the educational message.

Catering services should ensure adequate nutritional supply, foster healthy

eating practices and encourage participation in gastronomic culture and

social learning. Food safety includes the procurement of a safe adequate

food supply in sufficient amounts to cover the nutritional requirements of all

individuals. It has become a priority for Public Health.

Social changes along new scientific developments will introduce new

demands into community nutrition and request a more important role for

individually tailored advice. In order to face these challenges, community

nutrition professionals need to be highly qualified and skilled.

1.5.4. Disease

Every disease represents a stressful situation, thus an imbalance

milieu. Stress is a term applied to the fields of physiology and

neuroendocrinology to refer to those forces or factors that cause

disequilibrium to an organism and therefore threaten homeostasis50. The

stressors might be a consequence of physical injury, mechanical disruptions,

chemical changes or emotional factors. The body’s response to these factors

will depend on the magnitude of them, on the duration of the events and also

on the nutritional status of the patients. Complex sensory systems trigger

reflex nervous system responses to the stressors that alert the central

nervous system (CNS) of the disturbance. In the CNS, neurons of the

paraventricular nucleous of the hypothalamus elaborate corticotropin-

releasing hormone (CRH) and activate the hypothalamic-pituitary-adrenal

axis (HPA). In addition, other areas of the brain signal the peripheral

autonomic nervous system. These two latter systems elicit an integrated-

response, referred collectively as the “stress response”, which primarily

44    

controls bodily functions such as arousal, cardiovascular tone, respiration,

and intermediate metabolism. Other functions such as feeding and sexual

behavior are suppressed, as while cognition and emotion are activated. In

addition, gastrointestinal activity and immune/inflammatory responses are

altered.

Therefore, it’s crucial to understand that the disease process per se

impacts on eating patterns, by causing anorexia, thus hampering intake. The

disease may also raise basic energetic requirements and interfere with

absorption and excretion of nutrients. This explains the high prevalence of

malnutrition among hospitalized patients18-20.

Nutrition although fundamental to anyone’s survival has had for many

years a supporting role in patient care and, it still is nowadays not seen as a

sustaining therapy to most patients throughout the world. Even in referral

centers in the USA or other first world countries, it’s incredible to notice that

its importance from the administration perspective is not as relevant as

sophisticated procedures such as small bowel transplantation or new

diagnostic tools, not to mention the lack of medical awareness towards basic

nutritional issues such as the prevalence of malnutrition18, 51, 52. Major

investments in such sophisticated procedures are a reality, in detriment of

nutrition therapy teams which have decreased in American hospitals and in

some countries don’t even exist. One potential explanation for this is that

malnutrition/undernutrion is still under assessed 18, 20 and, with the booming

of obesity, diagnosing such condition is even more difficult for those not

aware of the problem. In addition, we lack good powered prospective clinical

trials to show that malnutrition is directly associated with poorer outcome,

longer length of hospital stay, higher mortality and increased costs. Upon

such reality, one is prone to question what have we missed to justify that

about 30 years after Butterworth’s paper “The skeleton in the hospital closet” 52, the prevalence of such condition is still highly prevalent in hospitalized

patients worldwide 18, 20, 53?

Putting more fire into the woods…..old paradigms still mark patient’s

nutritional treatments in the hospital setting as well as in the community.

Long fasting hours/days before and after surgery are a routine practice

45    

worldwide, despite its related reported side effects54, 55. In current surgical

practices it is advised that patients be treated under multimodal practices as

the ones proposed by Fearon et al in the enhancing recovery after surgery

protocol (Figure 8)54.

Figure 8 – Enhancing recovery after surgery protocol 54

Eating or being fed as soon as possible after surgery has also been

recommended as ways of decreasing post-operative intestinal dysfunction

(paralitic ileus), bacterial translocation and by so concomitantly decrease

overall complications, death rates and length of hospitalization. In the most

recent study on postoperative feeding, Lassen et al. 56 have shown that

patients undergoing major abdominal surgery who were early fed with

regular diets resumed bowel function significantly earlier and had decreased

total number of major complications, length of stay, and rate of post

discharge complications. Allowing patients to eat normal food at will from the

first day after major upper gastrointestinal surgery does not increase

morbidity compared with traditional care with nil-by-mouth and enteral

feeding.

 

46    

In hospital nutrition, unfortunately, is still based on mass treatments.

This is to say, very seldom are patients’ food preferences respected

individually. In such sense, this is another factor that contributes to the high

rate of malnutrition and great wastage of food in this setting. The provision of

good quality food, fluids, and nutritional care should be an integral part of the

therapeutic care in a hospital. Meeting patients’ nutritional requirements will

help them get well. Optimizing menu design, adapting menus, and improving

the mealtime atmosphere are vital steps to fight malnutrition in the hospital.

When a menu is planned, disease- or therapy-related feeding problems such

as loss of appetite, changes in taste perception, or difficulty chewing and

swallowing must be taken into account. On the one hand, the hospital’s

catering department must be able to deal with individual patients’ needs and

preferences as well as offering a balanced menu that meets the patients’

nutritional requirements. On the other hand, from an economic point of view,

food wastage should be minimized, since wastage can be as high as 67%57.

The term food chain (figure 9) has been adopted to emphasize that all stages

in the provision of food must be adequate, from screening of patients and

planning of menus to the distribution and serving of the food.

It is desirable for hospitals to appoint a multidisciplinary and

multiprofessional nutrition steering group, including the clinical nutrition team,

to oversee all aspects of nutritional care, from catering to artificial nutrition. A

failure at any point disrupts the system. The system on the ward should be

designed to prevent interruption of meals by procedures, rounds etc. Food

taste and intake should be monitored and audited regularly, with modification

of policies as necessary. Furthermore, quality control initiatives should

evaluate whether recommendations for adequate hospital nutrition are met.

Various aspects of food provision should be monitored regularly, including

portion control, presentation, flavor and texture, temperature, timing of

service, and patient satisfaction.

47    

Figure 9 – Food chain in the hospital setting 57

Food restrictions are routinely applied to certain groups of patients,

such as those with cancer, diabetes and renal diseases based on old

principles not supported anymore by current evidences (figure 10).

Physicians should be forbidden to forbid their patients from eating whatever

pleases them, especially in situations that anorexia prevails. There is very

few evidence to support most of the nutrition recommendations directed at

these groups of individuals.

As an example, renal patients are generally those suffering some of

the most restricted diets prescribed to any individual. These diets are very

much arguably and many of the restrictions contradict current

recommendations for healthy eating. Some of the most notably restrictions

are around consumption of fruit and vegetables due to their high potassium

content. However, most of the times, according to the patient’s treatment

regimen, this type of restriction is not at indicated at all. A recent study58

highlighted issues and beliefs, such as the importance of receiving dietary

advice at diagnosis from a renal dietitian, to limit confusion and conflicting

advice. It also identified the importance of diet as perceived by patients in

relation to their renal disease and the changes in perceived importance

48    

associated with disease progression. Dialysis patients ranked dialysis as

more important than diet whilst nephrology patients, although perceiving diet

to be important, had received little or no nutritional advice. Confusion and

frustration was expressed in trying to implement the restrictive dietary advice

especially if renal disease was coupled with other comorbidities.

1.5.5. Molecular gastronomy

Physicians try to understand the origin of certain diseases such as

cancer for example, molecular biologists explore the genome, embryologists

study the build-up of living organisms, nutritionists try to associate nutrients

with health and disease and chemists unravel the details of chemical

processes. Cooking is such an important part of our world (even the smallest

Figure 10 – Forbidden to forbid. Available at http://wwwihm.nlm.nih.gov/ihm/images/A/12/867.jpg

 

49    

flat has a room for it) that it is worth specific scientific studies. The scientific

discipline devoted to culinary transformations, and to gastronomical

phenomena in general has been called Molecular Gastronomy59. This

discipline is part of food science, but research is focused on (mainly home or

restaurant) culinary transformations and eating phenomena rather than the

physical and chemical structure of ingredients. As recipes describe culinary

transformations, it is useful to examine recipes, in order to understand the

scientific strategy of the discipline.

According to This59, the following recipe is from a culinary book

published in France at the beginning of the 20th century (Anonymous, 1905):

“Take a dozen pears of middle size, remove the skin and put them

immediately in cold water. Then melt 125 g of sugar with some water in a

pan at low heat: as soon as the sugar is melted, add the pears, add some

lemon juice if you want to keep the pears white; if you prefer them red, do not

add lemon juice and cook them pan lined with tin.”

In this recipe, the words in bold characters give a definition of the

dish; it can be observed that this definition here is less than 10% of the

recipe. The words in italics add ‘precisions’ (orders, orientations, steps to be

followed), a category that includes old wives’ tales, proverbs, and sayings. . .

Depending on the recipe and author, the precision content of recipes can

vary considerably; for example, in some recipes from the French cook Jules

Gouffe´ (1867), the precision percentage is nil. The pear recipe indicates the

scientific strategy of molecular gastronomy: it should model the definitions

and explore the precisions.

Describing ingredients and dishes is only one part of the modeling

process, the other part being culinary transformations. What does ‘cooking’

mean, in particular? Cooking is a complex chemical process that according to

the way it’s performed enhances tastes, disperses flavors, softens or hardens

ingredients and at the end offers one something that might be either

extremely delicious or something not even worth a try. To exemplify what

has been said, This 60 tells us that   “chefs cook green beans in boiling salty

water; when the beans are cooked (decided either by smell, texture or flavor),

50    

they are strained, then immediately refreshed in icy cold water in order to,

chefs say, “fix the chlorophyll”. When asked, chefs admit that “fixing the

chlorophyll” means keeping the brilliant green color of vegetables — but they

forget that raw green beans are actually less green than when they are

cooked! Is icy cold water useful to keep the green color?

This59 and his group investigated the matter further in terms of

chemical reactions. Chlorophyll pheophytinization (the replacement of the

magnesium atom by a proton, at the centre of the chlorophyll molecule)

changes the green color of chlorophyll into an olive–brown color. It has been

shown that the correlation between chlorophyll pheophytinization and the

green color (as measured by colorimetry) of cooked beans is poor. By UV

spectroscopy of extracted pigments, it has been found that cooling the green

beans in ice has no effect on the color.

Another very good example of cooking alchemy is the story of

mayonnaise. Discussion of mayonnaise could fill books, because the sauce

is very popular and it has generated many culinary precisions with different

assumptions and explanations for such phenomena that either explain or

justify its success or failure. It also helps to understand the reason why

culinary precisions arose.

Most modern mayonnaise recipes say to add oil to a mixture of egg

yolk and vinegar (definition), but many authors add precisions (orientations).

Some state that the temperature of the room where the mayonnaise is made

should not be too hot or that the sauce should be made in a vessel lying on

ice cubes; others state, on the contrary, that a cold room temperature is

responsible for failure; and others state that oil and eggs should be at the

same temperature. Other causes of failure are frequently given: for example,

many cooks, in particular in France, think that mayonnaise fails when it is

made by women having their periods, or that the cook should always turn the

spoon or whisk in the vessel in the same direction.

This tested all these precisions60 and it was easily seen that women’s

periods and the direction of whipping do not lead to failure. The question of

temperature was also checked, with eggs from the fridge (4 °C) and oil at

51    

room temperature (35 °C), or the reverse, and no effect of temperature was

observed. This was expected, because mayonnaise is ‘only’ an emulsion,

that is, a dispersion of oil droplets in water; the temperature range of the

emulsion stability is quite wide, and so temperature becomes only the main

factor for stability under the crystallization temperature of oil, or above protein

denaturation points (the first one is at 62 °C, for gamma livetin). However,

some precisions were correct. For example, it was sometimes written that oil

should be added ‘drop by drop’ at the beginning of the sauce preparation. It

is true that mayonnaise fails if too much oil is added first, as water is then

dispersed into oil, instead of oil into water. The latter is more stable because

of the particular nature of the surfactants from the yolks: proteins and

lecithins, which curve the oil/water interface so that oil forms droplets.

So what is the future of food once we start to explore it scientifically?

The difficult thing about the future is that it is hard to predict. We should avoid

making the same mistakes that French chemist Marcellin Berthelot made

about a century ago: he predicted that the success of organic chemistry

would allow us to abandon traditional food and, by the year 2000, eat

nutritive tablets instead61. He was obviously wrong—humans are living

organisms, with an extremely sophisticated sensory apparatus that has

evolved over millions of years to detect odour, taste, consistency,

temperature and more. The pleasure of eating involves all our senses and it

is obviously important for our wellbeing, as depicted throughout this review.

Obesity and other related diseases are growing, hospital nutrition is

still a huge challenge and the pleasure of eating cannot be measured based

solely on daily nutritional requirements. Hedonism must be a part of this

process as well as the chemistry of cooking. All these justify why scientists,

physicians, nutritionist, psychologist, chemists and cooks should all endeavor

efforts to understand each one’s role into this intricate process and should

develop strategies to help promote good healthy eating habits. For many

years and still current practice, most guides against obesity and other

related diseases have focused solely on eating habits, exercise and related

variables (figure 11). Nothing has been directed to scientific cooking as

52    

understanding the alchemy involved in the cooking and preparation process

of healthy meals.

Fig

Figure 11 – Be healthy. Available at http://wlewihm.nlm.nih.gov/ihm/images/A/25/622.jpg

Such efforts should be started early in life, as children must get more

information about food and food preparation, its benefits and consequences,

avoiding thus the fatal attraction to junk food, soft drinks and sweets.

Consequently, health programmes that promote a balanced diet cannot

succeed if people are unable to make intelligent choices about food.

However, traditional cooking is not a guarantee either for healthy food or for a

rational preparation of food. This is where the scientific programme of

molecular gastronomy can be useful. If we are able to use the knowledge

gained on food preparation, we might find new ways to make healthy food

more attractive, we might persuade more people to cook better food and, last

but not least, we might convince society to regard eating as a pleasure rather

than a necessity61. Without more knowledge, culinary books cannot be

regarded as reliable. Moreover, educational programmes cannot rely only on

traditional recipes, because products, methods and ingredients have

Available  

53    

changed over time. Cooking has to be explored scientifically if we want to

improve educational health programmes.

54    

2. CONCLUSION

“Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning.”  

Albert  Einstein,  1879  -­‐    1955  

55    

2. CONCLUSION

“We are not certain, we are never certain. If we were we could reach some conclusions, and we could, at last, make others take us seriously.”

Albert Camus, 1913 - 1960

Taste, nutrition, medicine, food, chemistry, gastronomy and molecular

gastronomy all intermingle. They are part of a science of many sciences

enrolled in the act of eating. They represent human history and evolution!

Therefore, it’s extremely difficult to separate them from this intricate web,

into science or art…….perhaps, they shall be the two! Somehow, similar to

health and disease, which are also two complete opposing words, although

almost paradoxically similar as they are side by side in the reality of life. So

should be taste, medicine, nutrition and molecular gastronomy…….

56    

3. FUTURE PERSPECTIVES

“When one door closes another door opens; but we so often look so long and so regretfully upon the closed door, that we do not see the ones which open for us.”

Alexander Graham Bell, 1847 - 1922

57    

3. FUTURE PERSPECTIVES

“The most pathetic person in the world is someone who has sight, but has no vision.”

Helen Keller, 1880 - 1968

I would very much like to see a future where all these arts and

sciences were approached by multiprofessional teams of experts rather than

individuals competing for the success of one over the other. Basic principles

of each of these arts and sciences should be taught to the general population

providing them with cornerstone information, so important to health, disease

prevention and treatment, not forgetting the crucial aspect of hedonism.

Courses such as the “Hautes Etudes du Gout” are a step towards this future.

58    

4. REFERENCES

“No finite point has meaning without an infinite reference point”

Jean Paul Sartre, 1905 - 1980

59    

4. REFERENCES

“Eat and drink such an exact Quantity as the Constitution of thy Body allows of, in reference to the Services of the Mind.”

Benjamin Franklin, 1796 – 1790

1.   Duffy   V.   Variation   in   oral   sensation:   implications   for   diet   and   health.   Current  Opinion  in  Gastroenterology  2007;23:171–7.  

2.   Rolls   E.   Taste   and   Related   Systems   in   Primates   Including   Humans.   Chem   Senses  2005;30(suppl  1).  

3.   Drayan  D.  Human  taste  genetics.  Annu  Rev  Genomics  Hum  Genet  2005;6:217-­‐35.  4.   Boughter   Jr   J,   Bachmanov   A.   Behavioral   genetics   and   taste.   BMC   Neuroscience  

2007;8(Suppl  3):1-­‐18.  5.   Schiffman  S.  Taste  quality  and  neural  coding:   Implications  from  psychophysics  and  

neurophysiology.  Physiology  &  Behavior    2000;69:147-­‐59.  6.   Williams   C.   Food   for   thought:   Brain,   genes,   and   nutrition.   Brain   research  

2008;1237:1-­‐4.  7.   Chapman   H,   Kim   D,   Susskind   J,   Anderson   A.   In   Bad   Taste:   Evidence   for   the   Oral  

Origins  of  Moral  Disgust.  Science  2009;323:1222-­‐6.  8.   Gigante  D.  Taste  a  literary  history.  New  Haven  Yale  University  Press;  2005.  9.   Merriam  Webster   Dictionaire.   (Accessed   April   1st   2009,   at   http://www.merriam-­‐

webster.com/thesaurus/art%5Bnoun%5D.)  10.   Medicine   and   art.   2007.   (Accessed   2009,   at  

http://www.medscape.com/viewarticle/561511.)  11.   AS.   L,   Petrucelli   R.   Medicine   an   illustrated   history.   New   York   Harry   N   Abrhams;  

1987.  12.   WHO.  Obesity  map.  In;  2009:http://www.who.int/bmi/index.jsp.  13.   Rose   K.   The   yellow   emperor's     classical   internal   medicine.   In;  

2009:http://books.google.com.br/books?id=qIfTD68k53gC&pg=PA6&lpg=PA6&dq=nei+ching+the+emperor&source.  

14.   Jasmuheen.  Living  on  Light   -­‐  The  Source  of  Nourishment   for   the  New  Millennium.  New  York:  KOHA  Publishing;  2nd  Rep  edition  1997.  

15.   Allison  S.  Malnutrition,  disease,  and  outcome.  Nutrition  2000;16:590-­‐3.  16.   Hill  J.  Jonathan  E.  Rhoads  Lecture.  Body  composition  research:  implications  for  the  

practice  of  clinical  nutrition.  J  Parenter  Enteral  Nutr    1992;16:197-­‐218.  17.   Paul  J.  Pope  John  Paul  II’s  Address  to  the  ICN.  Nutrition  2000;16:475-­‐77.  18.   Correia  MI,   Campos  AC.   Prevalence  of   hospital  malnutrition   in   Latin  America:   the  

multicenter  ELAN  study.  Nutrition  2003;19:823-­‐5.  19.   Correia   MI,   Waitzberg   DL.   The   impact   of   malnutrition   on   morbidity,   mortality,  

length  of  hospital   stay  and  costs  evaluated  through  a  multivariate  model  analysis.  Clin  Nutr  2003;22:235-­‐9.  

20.   Waitzberg  DL,  Caiaffa  WT,  Correia  MI.  Hospital  malnutrition:  the  Brazilian  national  survey  (IBRANUTRI):  a  study  of  4000  patients.  Nutrition  2001;17:573-­‐80.  

21.   Antwi   S.   Malnutrition:   missed   opportunities   for   diagnosis.   Ghana   Med   J  2008;42:101-­‐4.  

22.   Bejon   P,   Mohammed   S,   Mwangi   I,   et   al.   Fraction   of   all   hospital   admissions   and  deaths  attributable   to  malnutrition  among  children   in   rural  Kenya.  Am   J  Clin  Nutr  2008;88:1626-­‐31.  

60    

23.   Williams  C.  A  nutritional  disease  of  children  associated  with  a  maize  diet.  .  Arch  Dis  Child  1933;8:423.  

24.   Scrimshaw     N.   Fifty-­‐Five-­‐Year   Personal   Experience   with   Human   Nutrition  Worldwide.  Annual  Review  of  Nutrition  2007;27:1-­‐18.  

25.   Cope  M,  Allison  D.  Critical   review  of   the  World  Health  Organization's   (WHO)  2007  report   on   'evidence  of   the   long-­‐term  effects   of   breastfeeding:   systematic   reviews  and  meta-­‐analysis'  with  respect  to  obesity.  Obes  Rev  2008;9:594-­‐605.  

26.   Smith  R.  Editor's  choice  "Let  food  be  thy  medicine..."  BMJ  2004;328:210.  27.   Lonn   E.   Homocysteine   in   the   prevention   of   ischemic   heart   disease,   stroke   and  

venous  thromboembolism:  therapeutic  target  or  just  another  distraction?  Curr  Opin  Hematol  2007;14:481-­‐7.  

28.   Freedman  P.   Introduction   a   new  history   of   cuisine.   In:   Freedman  P,   ed.   Food   the  history  of  taste.  Los  Angeles  Thames  &  Hudson  2007:7-­‐34.  

29.   Waley-­‐Cohen  J.  The  quest  for  perfect  balance.  In:  Freedman  P,  ed.  Food,  the  history  of  taste.  Los  Angeles:  Thames  &  Hudson;  2007:99-­‐132.  

30.   Lyons   A,   Petrucelli   R.   Medicine   an   illustrated   history.   1   ed.   New   York:   Harry   N  Abrhams;  1877.  

31.   Miller   H.   The   pleasure   of   consumption.   In:   Freedman   P,   ed.   Food   the   history   of  taste.  Los  Angeles:  Thames  &  Hudson;  2007:135-­‐61.  

32.   Ritchie  C.  Food  and  civilization  how  history  has  been  affected  by  human  taste.  New  York:  Beaufort  Books;  1981.  

33.   Woolgar  C.  Feasting  and  fasting   In:  Freedman  P,  ed.  Food  the  history  of  taste.  Los  Angeles:  Thames  &  Hudson  2007:163-­‐231.  

34.   Cowan  B.  New  worlds,  new  tastes.  In:  Freedman  P,  ed.  Food  the  history  of  taste.  Los  Angeles:  Thames  &  Hudson  2007:197-­‐  231.  

35.   French   food   and   culture.   (Accessed   April,   2009,   at   http://www.food-­‐links.com/countries/france/french-­‐gastronomy.php.)  

36.   Drouard  A.  Chefs,  Gourmets  and  Gourmands.  In:  P  F,  ed.  Food  the  history  of  taste.  Los  Angeles:  Thames  &  Hudson;  2007:263-­‐300.  

37.   Kelly  I.  Cooking  for  kings.  The  life  of  the  first  celebrity  chef.  .  New  York:  Holtzbrinck  Publishers;  2003.  

38.   Brillat  Savarin  J.  The  physiology  of  taste.  Paris.  39.   Leonard   W,   Snodgrass   J,   Robertson   W.   Effects   of   brain   evolution   on   human  

nutrition  and  metabolism.  Annu  Rev  Nutr  2007;27:311-­‐27.  40.   Wardle   J,   Cooke   L.   Genetic   environmental   determinants   of   children's   food  

preferances.  BJN  2008;99:S15-­‐S21.  .  41.   Silverman  H.  Nutrition  and  ceremony.  Explore  2006;2:60-­‐1.  42.   Sobal   J,   Nelson   M.   Commensal   eating   patterns:   a   community   study.   Appetite  

2003;41:181-­‐90.  43.   Neumark-­‐Sztainer   D,   Wall   M,   Story   M,   Fulkerson   J.   Are   family   meal   patterns  

associated  with  disordered  eating  behaviors  among  adolescents?   J  Adolesc  Health  2004:350-­‐9.  

44.   Eisenberg   M,   Olson   R,   Neumark-­‐Sztainer   D,   Story   M,   Bearinger   L.   Correlations  between  family  meals  and  psychosocial  well-­‐being  among  adolescents.   .  A  Pediatr  Adolesc  Med  2004;158:792-­‐6.  

45.   National   Center   on   Addiction   and   Substance   Abuse   at   Columbia   University  (Accessed  2009,  at  http://www.casacolumbia.org/.)  

46.   Dowling   T.   'New   parenting',   psychotherapy,   prenatal   and   perinatal   care.   Nutr  Health  2007;19:81-­‐4.  

47.   Beauchamp  GK,  Mennella   JA.   Early   flavor   learning  and   its   impact  on   later   feeding  behavior.  J  Pediatr  Gastroenterol  Nutr  2009;48  Suppl  1:S25-­‐30.  

61    

48.   Mennella   J,   Jagnow   C,   Beauchamp   G.   Prenatal   and   postnatal   flavor   learning   by  human  infants.  .  Pediatrics  2001;107:E88.  

49.   Fox  MK,  Pac  S,  Devaney  B,   Jankowski   L.  Feeding   infants  and   toddlers   study:  What  foods  are  infants  and  toddlers  eating?  J  Am  Diet  Assoc  2004;104:s22-­‐30.  

50.   Wilmore  DW.  From  Cuthberston  to  fast-­‐track  surgery:  70  years  of  progress  reducing  stress  in  surgical  patients.  Ann  Surg  2002;263.  

51.   Howard   JP,   Bruce   J,   Powell-­‐Tuck   J.   Nutritional   support:   a   course   for   developing  multidisciplinary   clinical   teams.   Education   Committee,   British   Association   for  Parenteral  and  Enteral  Nutrition.  J  R  Soc  Med  1997;90:675-­‐8.  

52.   Butterworth  CE,  Jr.  Editorial:  Malnutrition  in  the  hospital.  JAMA  1974;230:879.  53.   Lean  M,  Wiseman  M.  Malnutrition  in  hospitals.  BMJ  2008;336:290.  54.   Fearon  KC,  Ljungqvist  O,  Von  Meyenfeldt  M,  et  al.  Enhanced  recovery  after  surgery:  

a   consensus   review  of   clinical   care   for   patients   undergoing   colonic   resection.   Clin  Nutr  2005;24:466-­‐77.  

55.   Nygren  J,  Hausel   J,  Kehlet  H,  et  al.  A  comparison   in   five  European  Centres  of  case  mix,  clinical  management  and  outcomes  following  either  conventional  or  fast-­‐track  perioperative  care  in  colorectal  surgery.  Clin  Nutr  2005;24:455-­‐61.  

56.   Lassen  K,  Kjaeve  J,  Fetveit  T,  et  al.  Allowing  normal   food  at  will  after  major  upper  gastrointestinal   surgery   does   not   increase   morbidity:   a   randomized   multicenter  trial.  Ann  Surg  2008;247:721-­‐9.  

57.   Iff  S,  Leuenberger  M,  Rosch  S,  Knecht  G,  Tanner  B,  Stanga  Z.  Meeting  the  nutritional  requirements   of   hospitalized   patients:   an   interdisciplinary   approach   to   hospital  catering.  Clin  Nutr  2008;27:800-­‐5.  

58.   Hollingdale   R,   Sutton   D,   Hart   K.   Facilitating   dietary   change   in   renal   disease:  investigating  patients'  perspectives.  J  Ren  Care  2008;34:136-­‐42.  

59.   This   H.   Modelling   dishes   and   exploring   culinary   'precisions':   the   two   issues   of  molecular  gastronomy.  Br  J  Nutr  2005;93  Suppl  1:S139-­‐46.  

60.   This  H.  Molecular  gastronomy.  Nat  Mater  2005;4:5-­‐7.  61.   This  H.  Food  for  tomorrow?  How  the  scientific  discipline  of  molecular  gastronomy  

could  change  the  way  we  eat.  EMBO  Rep  2006;7:1062-­‐6.