Chocolate and Other Cocoa Products: Effects on Human Reproduction and Pregnancy

Stay healthy | 2019

Eleonora Brillo* and Gian Carlo Di Renzo

Department of Obstetrics and Gynecology and Centre for Perinatal and Reproductive Medicine, S. Maria della Misericordia University Hospital, University of Perugia, 06132 Perugia, Italy

Prof. Di Renzo, Honorary Secretary of FIGO, is Professor and Chair at the University of Perugia (UOP) in Italy. He is Director of both the Reproductive and Perinatal Medicine Center and the Midwifery School at UOP. He is also Director of the Permanent International and European School of Perinatal and Reproductive Medicine (PREIS) in Florence. He holds multiple other positions including Founder & Editor-in-Chief of the Journal of Maternal Fetal and Neonatal Medicine based in London and Corresponding Editor of the American Journal of Obstetrics and Gynecology.

He is an Advisory Board Member for the March of Dimes Foundation based in New York. Further, he is a Fellow  ad eundem of RCOG and an Honorary Fellow of American  ACOG and Indian ICOG. He is also member of the WHO strategic Committee on “Maternal and Perinatal health”. Prof. Di Renzo is an Honorary Professor and Doctor Honoris Causa at 15 different Universities throughout Europe, Asia, South America, and the United States. He is an Academic Member of the Romanian and Russian Academy of Sciences . Prof. Di Renzo has received six awards  for his work in human reproduction and maternal-infant's health, scientific research, and teaching. He has organised more than 200 international congresses and courses, some of these are held regularly ( DIP, Birth, World Congress of Maternal Fetal and Neonatal Medicine, TWINS, etc ). His scientific production comprises over 1,200 papers of which more than 300 have been published in peer reviewed  international journals and 80 books. He has been an invited speaker in over 1,500 national and international congresses and meetings and in academic courses in over 100 countries. Prof. Di Renzo is also the President and Founder of the International Society of Chocolate and Cocoa in Medicine ( ISCHOM).

INTRODUCTION

Chocolate and cocoa products are obtained from a long and complex work process to which cacao beans are subjected.

Nowadays, a new trend in the food market shows a steady increase in the consumption of cocoa products, because they are widely appreciated for their hedonic value and their multiple health benefits. Cocoa products have increasingly become objects of scientific research mainly because of their interesting phytochemical composition. The scientific com-munity wonders whether chocolate and other cocoa products can be considered as a super fruit or as biofunctional food products.

The aim of this study is to conduct a systematic review of the literature on cocoa and chocolate constituents and on their effects on human health and particularly on reproduction.

MACRONUTRIENTS AND FATTY ACIDS PROFILE OF COCOA AND CHOCOLATE: QUANTITY AND EFFECTS ON HUMAN HEALTH

According to Directive 2000/36 EC, chocolate is defined as a food obtained from cocoa and sugars, containing at least 35% total dry cocoa, composed of not less than 18% cocoa butter and not less than 14% degreased dry cocoa. In addition to the minimum percentages of cocoa butter and total dry cocoa, a maximum of 5% fats cocoa butter equivalents (CBE) by weight of the finished product is allowed. Therefore, chocolate is certainly composed of cocoa solids and cocoa butter; then other ingredients are usually added such as sugar to sweeten and lecithin to emulsify. However, chocolate now commercially available often contains several other foods such as cereals, dry nuts, and fruits. The three main categories of chocolate, white, milk, and dark, have different contents of cocoa solids, cocoa butter, and some components of milk. Dark chocolate does not contain milk solids, or at least should not, whereas they are contained in chocolate milk and white chocolate. The latter has only the fat part of cocoa (cocoa butter) to which, among other ingredients, is added a large quantity of sugar. Generally, milk chocolate contains a lesser amount of the nonfat part of cocoa than dark chocolate, which nonetheless contains variable proportions of the nonfat part of the cocoa bean. The content of nutrients in chocolate depends, in part, on the percentage of the nonfat portion of cocoa: the amount of carbohydrates decreases and the fats increase approximately linearly with the increasing percentage of cacao content. As a result, a higher percentage of cocoa means a higher amount of calories. However, the more cocoa content, the higher the minerals6 and polyphenols contents are. Dark chocolate, even that at higher cocoa content, does not maintain the proportions of macro-nutrients found in cocoa beans.In fact, the main component is not fats, as in the case of beans, but carbohydrates followed by total fats, and this is due to the choice of adding a larger proportion of sugar, which exceeds the amount of fats. The quantity of cocoa butter and minerals in chocolate also depends on the geographical origin of the cocoa beans, in particular on the growing conditions. Even fatty acids, which in cocoa butter are mainly organized as triacylglycerols, have a pattern that is influenced by geographical origin. As a result, it may happen that some chocolate types have a healthier fatty acid profile than others. Normally the fatty acids most represented are stearic acid (C18:0), oleic acid (C18:1), and palmitic acid (C16:0), which together constitute >90%.8,9 Saturated fatty acids (SFA), with C18:0 and C16:0 as the main fractions, are present in the highest proportions. Among the unsaturated fatty acids, monounsaturated fatty acids (MUFA) content is higher than polyunsaturated fatty acids (PUFA): C18:1, which represents about 30% of the fatty acids present in TAG, is quantitatively the most important unsaturated fatty acids, followed by linoleic acid (C18:2). Trans fatty acids were found to be present in chocolate11 but in variable amounts,12 and seem to be contained in low concentrations.

Differently from most of the SFA (C16:0 included) evidence shows that C18:0 has a neutral effect and does not increase blood total and low-density lipoprotein (LDL) cholesterol levels; it does not significantly influence blood coagulation, fibrinolysis, thrombotic tendency, and cardiovascular disease compared with C18:1 and C18:2. Some doubt remains, however, concerning the effects of stearic acid on thrombosis, inflammation, and blood pressure.

Also because of the high fat content, chocolate has a high caloric value. Nevertheless, no positive correlation has been shown between chocolate consumption and body mass index (BMI) and, contrariwise, chocolate intake appears to have an inverse impact on BMI in men and women.

OTHER CONSTITUENTS OF COCOA AND CHOCOLATE: QUANTITY AND EFFECTS ON HUMAN HEALTH

Flavanols, a subgroup of dietary polyphenols present in many fruits and vegetables, may be associated with health benefits, particularly with reducing the risk of coronary diseases. Cocoa and chocolate products are rich in flavonoids, the most represented group of polyphenols, and flavanol monomers, procyanidin oligomers, and polymers are the most numerous flavonoids.

Even methylxanthines, which in cocoa are mainly theo-bromine (3,7-dimethylxanthine) and caffeine (1,3,7-trimethyl-xanthine),50 depend on the origin of cocoa beans: the theobromine/caffeine ratio and the amount of caffeine present in chocolate depend on the cocoa-growing geographical area.

The amount of methylxanthines is also different in the different types of chocolate. In fact, using food composition data from the U.S. Department of Agriculture (USDA) data-bases,6 it is possible to observe that the average caffeine content is 45 mg per 100 g of dark chocolate (45−59% cacao solids), 86 mg per 100 g of dark chocolate (60−69%), and 80 mg per 100 g of dark chocolate (70−85%). The average theobromine contents are 493, 632, and 802 mg, respectively.

Flavonoids and methylxanthines are the most recognizable active components of cacao. Although concerns regarding the bioavailability and the extent to which phenols are biologically active have not been completely clarified,51−57 numerous capa-bilities have been assigned to cocoa flavonoids. Several studies analyzing the biological properties of these molecules have provided considerable supportive evidence of flavonoid’s role in improving vascular functions, preventing related endothelial dysfunctions and diseases,58−66 reducing insulin-resistance indices (probably as a result of a decrease in insulin secretion67), increasing insulin-sensitivity,62,68 contributing to anti-inflammatory reactions,69−73 inhibiting platelet aggregation and activation,74−77 and decreasing blood pressure.60,68,78−81 However, a meta-analysis of randomized trials does not confirm the flavonoid effect on systolic blood pressure,67 whereas a second meta-analysis has found a small but statistically significant effect in lowering systolic and diastolic blood pressure in the short term. Multiple trials have emphasized that cocoa has the ability to change the lipid fraction not only by limiting its oxidation but also by directly altering the lipid profile of plasma, increasing high-density lipoprotein (HDL) and reducing LDL71,  and total cholesterol. Flavonoid effects on human total plasma antioxidant capacity, neurocognition, mood, and behavior remain controversial and limited. Some studies have shown how cocoa intake is correlated with a low prevalence of hypertension, atheroscle-rosis, dyslipidemia, and diabetes and cardiovascular disease as well as mortality and morbidity due to common causes. The protection of cardiovascular and endothelial tissue, as a consequence of chocolate consumption, may arise by the synergetic action of flavonoids, theobromine, and mag-nesium. Cocoa flavonoids also seem to improve intestinal flora. Even dark chocolate seems to change significantly gut microbial metabolism.

The effects of methylxanthines contained in cocoa and chocolate have been summarized in a recent review by Franco et al. Theobromine, the most abundant methylxanthine in cocoa and chocolate, can suppress cough and influence in a positive way cognitive performance and mood together with caffeine. In a study intended to probe the effects of theobromine on blood pressure, no change was observed on 24 h ambulatory or central systolic blood pressure after 3 weeks’ intake of a natural dose of theobromine cocoa (106 mg), whereas intake of theobromine-enriched cocoa (979 mg) resulted in increased 24 h ambulatory systolic blood pressure and lower central systolic blood pressure. According to the results of a study, the HDL cholesterol-raising effect of cocoa intake is mainly due to the theobromine content.

Enhancements in psychological functioning induced by con-suming chocolate with a high cocoa content are due, at least in part, to the combination of methylxanthines, biogenic amines, anandamide (N-arachidonoyl-ethanolamine), and N-acylethanolamines actions. The main monoamines contained in cocoa are phenylethylamine, tyramine, and tryptamine. Tyramine and phenylethylamine have the ability to act on different areas of the brain, which are responsible for mood control and the waking state. They are able to delay fatigue and induce the release of catecholamines (norepinephrine and dopamine) at the synaptic level, which consequently produces stimulation similar to that induced by amphetamine, including an attenuation of the sensation of hunger. Phenylethylamine, assisted by magnesium (found in abundance in chocolate) and small amounts of serotonin, acts on mood.

Anandamide, an endogenous lipid belonging to the class of endocannabinoids, acts as a cannabinoid receptor agonist, mimicking the central and peripheral action of cannabinoids such as 9-tetrahydrocannabinol (the active ingredient of cannabis extracts). Although an interesting double-blind trial has recognized a marginal role of all psychoactive substances apart from xanthine, the biological activity of amines and anandamide may contribute to the feeling of reward derived from the act of consuming chocolate and the pleasant post-consumption euphoria. Studies carried out on the abuse of stimulants suggest a causal relationship to self-therapy for mood control resulting from cocoa intake.

COCOA AND CHOCOLATE CONSTITUENTS: EFFECTS ON HUMAN REPRODUCTION

Cocoa consumption affects reproduction not only by its effect upon sexual appetite but also by possibly interfering with the etiology of subfertility. Cocoa polyphenols have been shown to be potent antioxidants, and oxidative stress (an imbalance be-tween pro-oxidants and antioxidants due to decreased anti-oxidant defense mechanisms or an increase in reactive oxygen and/or reactive nitrogen species) is known to be involved with the causes of male and female infertility, reproductive diseases (including endometriosis, polycystic ovary syndrome, and unexplained infertility), and pregnancy complications (namely, pre-eclampsia and miscarriages).

Although attempts have been made to prevent reproductive disorders through antioxidant supplementation, the effectiveness of this strategy has not been demonstrated. For this reason, positive contributions of the phytochemical cocoa in preventing reproductive problems can only be speculated, but the possible correlation continues to fuel exploration through high-quality clinical trials. Moreover, the bioactive constituents of cocoa may contribute to reducing reproductive difficulties through actions directly exerted on the vascular endothelium and circulation.

In further regard of its effects on reproductive capacity, it must also be noted that even in low doses, cocoa contains caffeine, a molecule known to cross the placental barrier freely and which is slowly metabolized during pregnancy.

The fetus does not have sufficient enzymes to inactivate caffeine; thus, its metabolites accumulate in the fetal rain. Caffeine, if consumed in large amounts, may seemingly result in a reduced fecundability, although other prospective studies have demonstrated either little or no effect or even an increased fecundability. Caffeine has also been positively correlated with spontaneous abortion, congenital malformation, fetal death, fetal growth restriction, preterm delivery, and decreased birth weight. Again, some studies have yielded conflicting results, although caffeine has been conclusively demonstrated to decrease fetal weight and increase the risk of “small for gestational age” fetal development. In any case, caffeine seems to compromise normal reproduction function and to increase embryo−fetal risks.

Accordingly, the World Health Organization’s recommended threshold of caffeine consumption (200 mg/day in Nordic countries and 300 mg/day equivalent to 4.6 mg/kg of body weight/day in a 65 kg person in the United States) should be well adhered to. Chocolate’s added contribution to caffeine intake should be noted, particularly when other drinks rich in caffeine are already included in a diet.

COCOA AND CHOCOLATE CONSTITUENTS: EFFECTS ON HUMAN PREGNANCY

During pregnancy so many hemodynamic and metabolic changes occur that considerable attention to maternal and fetal nutrition is warranted. From Prochownich’s early 20th century publication about the relationship of diet to pregnancy attention to maternal−fetal nutrition has grown in terms of improving the end point of fetal health globally. During gestation, biomolecular metabolism and cellular redox activity undergo changes that shift the balance in favor of oxidizing agents and pro-oxidants, thereby reducing total plasma antioxidant capacity in advanced gestation.

The oxidation−reduction imbalance leads to oxidative stress-linked pathological conditions concerning both the mother and the fetus and, relatedly, the susceptibility of embryonic and syncytiotrophoblastic cells to oxidative damage. The alteration of the redox status is a constant of gestation, but its extent is significantly higher in cases leading to spontaneous abor-tion and in pregnancies with pre-eclampsia conditions or with hypertension alone. The oxidative imbalance in pregnancy and the need for an additional caloric intake from the 10th to the 13th week of gestation represent valid reasons to choose foods with antioxidant properties. The availability of foods with these characteristics and the inclusion of these foods in the diet of pregnant women are considered new strategies and lead to scrupulous food choices that combine a modest energetic intake (between 100 and 400 kcal, as a function of the index of prepregnancy body mass) with a high content of antioxidant molecules nutritional profiles. Available scientific evidence suggests that chocolate with a high cocoa content, consumed daily in modest quantities (30 g/day for 24 weeks), may fit properly into this nutritional strategy without entailing negative consequences in terms of weight during various trimesters. Anyway, it is recommended not to overdo with consumption of chocolate and cocoa products because most of these are high-calorie foods. As a result, they should be consumed in moderation, especially during pregnancy, and the amount of chocolate to be consumed should be calculated on the basis of the specific calories of the chocolate chosen, the caloric intake derived from other foods, the physical activity level, and the maternal BMI.

Chocolate supplementation during pregnancy, from the end of the first trimester to term, appears to reduce systolic and diastolic blood pressure during the weeks of gestation (Table 1). A second study, a pilot randomized controlled trial, found no association between chocolate intake (20 g/day for 12 weeks) and blood pressure levels and even between chocolate con-sumption and flow-mediated dilation (Table 1). We believe that the diverging results on blood pressure are due, in part, to the intervention of control: in the first study, women of the control group did not consume chocolate by protocol, whereas in the second study, women in the control group consumed chocolate as in the experimental group but it had a lesser amount of flavanols (400 mg of total flavanols vs <60 mg). It could be that the absence of differences is due to similar effects of the two kinds of chocolate, which had the same nutrients and bioactive components, except for flavanols. It is reasonable to assume that the observed effects of chocolate are not solely and directly due to polyphenols content, but it is possible to assume the existence of synergistic interactions between bioactive com-pounds. In this way, the amount of polyphenols would not be so important. We think that the main reason for diverging results on blood pressure in the two studies is that the two protocols consisted of interventions with very different timing: one of about 27 weeks (from the end of the first trimester to term) and one of 12 weeks (from about the 12th week of gestation). We hope other studies will be carried out on this topic in order to understand the real effect of choc-olate consumption on maternal blood pressure in pregnancy. We propose that a placebo chocolate free of any bioactive compound be used in future studies.

It has been suggested that chocolate consumption in pregnancy could be a reasonable strategy to prevent pre-eclampsia. Considering the characteristics and risk factors of pre-eclampsia, including maternal hypertension, placental disease, endothelial dysfunction, oxidative stress, and lack of nitric oxide, it is reasonable to think about the possibility of preventing pre-eclampsia by up-regulating nitric oxide (NO) availability due to antioxidant activity and the induction of NO-dependent vasodilatation by cocoa. In this regard, two recent studies, a cohort study and a control case one, have detected chocolate consumption’s contribution in reducing risks of pre-eclampsia and gestational hypertension. Anyway, a case-control study conducted on 2769 women found no associatio between chocolate consumption and reduced occurrence of pre-eclampsia.

Probably the systematic review already planned will provide more detailed answers about the possible connections between chocolate consumption and the risk of pre-eclampsia.

Although not all of cocoa’s potential health benefits to preg-nant women have been clearly confirmed, chocolate con-sumption during pregnancy has proven positive in some accounts and harmless in others. Overall, there is a natural female preference for chocolate that becomes markedly apparent during pregnancy, with an increasing trend following the progress of gestation. Chocolate in the balanced diet of a pregnant woman can instill psychological well-being to both the pregnant woman (typically during the time of high emotional lability) and the future child. The mother’s prenatal stress experience significantly predicted the infant’s fear responses, but in this relationship, maternal chocolate consumption during pregnancy appears to have the role of modulator. In fact, choc-olate consumption in pregnancy seems to reduce the negative effect of prenatal maternal stress on infant temperament. Furthermore, daily consumption of chocolate during pregnancy seems to determine in infants at 6 months a greater positive reactivity and activity.

CONCLUSIONS

Evidence shows that chocolate is able to produce beneficial effects for human health. However, some cocoa activities on humans should be investigated again. Currently it is possible to conclude that consuming chocolate in moderation is good for human health. Chocolate can also be used in the diet of pregnant women because no negative effect was found for either maternal or fetal health. Conversely, favorable effects were observed for mother, fetus, and future child. Future studies will reveal whether the cocoa products have also preventive effects of some complications of pregnancy.

Furthermore, because chocolate has many bioactive com-pounds, we hope that in the near future the labels of cocoa products will also report the kind and amount of bioactive substances. In this way everyone may consciously choose what to buy and consume; moreover, pregnant women could control the levels of intake of caffeine

 

 

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Tiredness is a common thing among people of all ages, and can be caused by factors varying from the obvious lack of sleep to what we eat or drink, or serious medical conditions. While not unusual, when tiredness becomes constant and persistent with...

Stay healthy | 2017

20 Nov

Did you know that antibiotics can’t treat any disease? While it might sound like a silly question, a lot of people misuse antibiotics to treat colds or flus. Thus, they do more harm than good. Antibiotics only have the power to fight bacterial...

Stay healthy | 2017

19 Dec

We’re already so close to `the most wonderful time of the year`, the time that happily brings all families together. But how many of you think that right under your nose, someone might suffer from a seasonal affective disorder? According to Psychology...

Stay healthy | 2017

15 Jan

The prevalence of diabetes is a problem of modern society, which is why disease prevention has become an extremely important issue nowadays. In Romania, the PREDATORR study, conducted by the Romanian Society for Diabetes, Nutrition and Metabolic...

Stay healthy | 2018

23 Jan

A healthy diet is a topic most discussed by nutrition specialists because of the influence it has on the quality of life. Adopting a healthy diet, combined with sports, helps improve physical function, maintains a good mood and reduces joint pain....

Stay healthy | 2018

02 Feb

Infections with hepatic viruses HVB and HVC remain a global public health issue, with epidemiology in continuous change, determined by a series of factors, including the vaccination policy and the migration of the populations. These infections represent...

Stay healthy | 2018

06 Feb

Healthy nutrition and attention to daily activities are the solution for reducing the risk of illness and ensuring the quality of life. Acknowledging activities that benefit health and understanding harmful choices are our trump card. Among the...

Stay healthy | 2018

22 Feb

The XXIst century is often called the century of speed, of technological evolution and the Information Age. One of the symptoms most often felt in the third millennium is stress and constant pressure due to an ever busy lifestyle. This collective...

Stay healthy | 2018

08 Mar

The medical and scientific communities report that the preoccupation for building a professional life, translated into prolonged hours at work and constant stress, has an irrecoverable impact on one’s health. According to a report in the American...

Stay healthy | 2018

21 Mar

Sedentarism is a 21st-century issue characterized by an inactive lifestyle which can lead to weakening and atrophy of the muscles and an increased risk of injuries. In this context, more and more doctors recommend spending time outdoors and...

Stay healthy | 2018

12 Apr

Live healthy, live longer - recent research has shown that a balanced life means a longer life. The Journal of the American Geriatric Society published a study at the end of 2016 demonstrating that a healthy lifestyle can not only prolong life but...

Stay healthy | 2018

04 Apr

Prof. Dr. Werner Seebauer is, Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine –...

Stay healthy | 2018

24 Apr

The thyroid gland is a butterfly-shaped organ located in the lower front of the neck and has an essential role in the body's good functioning. For an in-depth understanding of the gland, it can be seen as a central unit that secretes hormones...

Stay healthy | 2018

31 May

Anxiety - a natural reaction to modern life, with physical and psychological effects. In the short term, this state is the awareness of an intense situation that prepares a person for a specific and significant action, be it a presentation, an interview or...

Stay healthy | 2018

01 Jun

Food is the fuel of life, as assimilated nutrients determine its quality, influencing health both in the short and long term. A varied diet helps build the resistance blocks which reside in our body in the form of antibodies that make up the immune system....

Stay healthy | 2018

14 Jun

Helicobacter Pylori (HP) is a human pathogen that is transmitted from human to human, producing active chronic gastritis in all colonized patients. HP infection is known and accepted as a major etiologic factor in gastric cancer, being known that at...

Stay healthy | 2018

04 Jul

Do you often participate with friends in the grill season? Are you wondering if red meat increases the risk of disease? Cancer, rheumatism and other chronic inflammatory diseases? Does it depend on the quality, type and method of preparation?Discover the...

Stay healthy | 2018

06 Jul

Cancer is one of the most widespread diseases in the world, and by 2030 it is estimated that the number of new cases will increase by 23.6 million per year. The degree of spread and effects on the body makes the care for prevention and treatment a matter...

Stay healthy | 2018

16 Jul

The community of Romanian expatriates in Europe counts over 3.5 million people, according to the latest estimates made by the Foreign Ministry. Whether they have gone on an experience exchange, or work in various fields, such as transport, HORECA, health...

Stay healthy | 2018

02 Aug

Do you often eat eggs or egg-products?Research shows - the answer to this question is quite complex  Prof. Dr. Werner Seebauer is, Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of...

Stay healthy | 2018

22 Aug

 Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2018

30 Aug

Family is a concept that defines the comfort zone of each person, the power source, the pattern of conduct, a safe space from where the journey of each of us begins. Building a family to ensure all of this for a child is a constant responsibility of any...

Stay healthy | 2018

14 Sep

The connection between oral and general health is a close one, which makes the responsibility for dental hygiene extremely important. Oral health offers us clues regarding the general state of health, also having direct effects over it. The emergence of...

Stay healthy | 2018

24 Sep

Prof. Dr. Werner Seebauer is, Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2018

27 Sep

The notion of food disorder involves a psychological problem, spread among women and men alike, covering a wide area of unhealthy eating habits, from compulsive eating to anorexia. Usually, this health problem manifests because of stress and excessive...

Stay healthy | 2018

18 Oct

What is the best strategy to recruit specialized workforce? How do companies manage to secure the loyalty of good employees? These two questions reflect the preoccupation of the HR and Management departments to create and maintain a proactive work...

Stay healthy | 2018

18 Oct

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2018

25 Oct

In the last few years, the business environment has gained momentum, and there is a new trend on the horizon: freelancers or small companies of two or three people who offer niche products or services. Often, they work on a project basis or deliver a...

Stay healthy | 2018

20 Nov

Healthy and happy employees are those who go beyond the target, working to achieve the company's goals and providing a proactive work environment. For these reasons, the investment in their well-being has become a priority for companies of all sizes, which...

Stay healthy | 2018

05 Dec

  Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2018

09 Nov

Workplace stress is a widespread factor and cause for many diseases often encountered among employees who use their healthcare insurance to make an appointment to the doctor. The data shows that on average one person has to juggle with 30 to 100 projects...

Stay healthy | 2018

14 Dec

Private health insurance covers the costs of a wide range of medical services, being valid for both consultations and treatments in case of illness. This ensures access to the best quality services at national and even international level, offering the...

Stay healthy | 2018

21 Dec

Sight is the sense that helps us to learn as much as possible about the surrounding environment. Therefore, the eyes must be as protected as possible from the disorders that may occur throughout life. Whether we are at work or at home, we must take all...

Stay healthy | 2018

23 Jan

More and more people understand the importance of accessing the best doctors and the latest treatments, which is why they choose private health insurance that guarantees the quality of their medical services. This trend is also noticeable among Romanians,...

Stay healthy | 2019

22 Jan

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

29 Jan

Children's success and happiness are among the main concerns of parents, this is why there are more and more books on parenting, more and more extracurricular activities to help children perform at school and more and more complex programs to prepare them...

Stay healthy | 2019

20 Feb

  Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

22 Feb

A healthy lifestyle requires a particular care of the body and mind, and those who desire such a lifestyle need to pay attention to a few essential rules. The most long-lived people in the world, the Japanese, pay great attention to the health of their...

Stay healthy | 2019

26 Feb

The liver is the largest gland in the human body, being a voluminous parenchymatous organ with a weight ranging from 1200 to 1500 mg. Like the pancreas, it has an exocrine function and endocrine function, but, unlike it, a single cell, the hepatocyte, is...

Stay healthy | 2019

28 Feb

Health is a subject people are more and more concerned with. We try to eat healthier, to find time to exercise or to have ourselves checked by a physician, all of which prove that we are aware that prevention is more important than treatment. We try to...

Stay healthy | 2019

19 Mar

  Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

21 Mar

The birth of a baby is not always free of complications. In some cases, the child could be diagnosed with a congenital malformation, and the cause can’t always be precisely established. From pregnancy and birth complications, to genetic malformations and...

Stay healthy | 2019

25 Mar

Health is the most valuable resource we posses and we need to enjoy it every moment of life. It is precisely because it is so important that it requires special care and each of us is responsible for the actions taken in this regard. One of the available...

Stay healthy | 2019

08 Apr

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

30 Apr

What are allergies, in reality? Allergies are a normal response of the immune system that identifies the intruder considered dangerous and triggers a series of defence mechanisms in order to eliminate it as soon as possible from our body. How and to...

Stay healthy | 2019

15 Apr

The difference between a healthy body and a weakened body lies in the daily choices we make, and our interaction with the outside world and our state of mind can be directly influenced by essential aspects such as nutrition. What does an appropriate...

Stay healthy | 2019

14 May

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

27 May

Physical condition has become a pillar in defining a good health condition, that is why food, which has a direct impact on the physical body, receives an increasing attention from people. Observing the meals of a day and the amount of physical effort we...

Stay healthy | 2019

15 May

The ever-increasing rhythm of daily activities can have a major impact on our health. We assume more and more responsibilities, we carry out more and more tasks at work, but also in our personal lives, we get involved in projects, and these things can...

Stay healthy | 2019

07 Jun

The moments spent with the family are some of the happiest moments in our lives, and summer holidays are an opportunity to build memories with loved ones. Whether we visit relatives from distant areas, whether we are on a trip to a foreign country, summer...

Stay healthy | 2019

25 Jun

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

26 Jun

Parachute jumping or scuba diving? Roving on canoe on a churning river or exploring caves? Our activities are becoming more and more diverse and involve a growing level of courage. We are looking for new ways to test our boundaries and live unique...

Stay healthy | 2019

28 Jun

Prof Irinel Popescu is a prominent surgeon and a member of the Romanian Academy of Sciences. He is a leader in surgical oncology and liver-related medical procedures. For the last three decades, Prof Popescu has been the pioneer and motivator of liver...

Stay healthy | 2019

08 Jul

Unpleasant or dangerous situations cause changes in the way our human body works. When, for example, a dangerous dog barks in our direction or a car approaches us at a speed in traffic, the body enters an alert state in order to prepare us to overcome the...

Stay healthy | 2019

15 Jul

How many times have you not put your mind to starting a new activity or giving up an unhealthy habit, only to observe, after a period, that you didn’t succeed in accomplishing the challenge? Reaching goals can sometimes be complicated, and it is therefore...

Stay healthy | 2019

17 Jul

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

14 Aug

As unusual as it may seem to us, there is a strong connection between our mental balance and the integrity of the intestinal microflora. The brain and gastrointestinal tract communicate directly through the intestine-microbiome-brain axis, which will...

Stay healthy | 2019

20 Aug

Nutrition is an essential aspect of our health; therefore, we must learn to choose products that are beneficial to us, which have high nutritional value and help the body to function properly. One of the important challenges we are witnessing today is...

Stay healthy | 2019

27 Aug

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

20 Sep

Prof Irinel Popescu is a prominent surgeon and a member of the Romanian Academy of Sciences. He is a leader in surgical oncology and liver-related medical procedures. For the last three decades, Prof Popescu has been the pioneer and motivator of liver...

Stay healthy | 2019

12 Sep

The physical condition is an essential factor in maintaining a good health and more and more Romanians are beginning to understand this reality. Equally, they become aware that attention and care for their own health is an accessible way to have a balanced...

Stay healthy | 2019

26 Sep

The birth of a child represents a one-of-a-kind moment for any mother. A new dimension is unfolded to her and she will need a period of adaptation, in which the support received from others is very important. The emotions felt by a mother after giving...

Stay healthy | 2019

08 Oct

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

15 Oct

Prof. Dr. Werner Seebauer is Dean of Studies – Association of German Preventologists, Head of Preventive Medicine Department of Institute of Transcultural Health Sciences (European University Viadrina) and Head of Preventive Medicine – NESA (The New...

Stay healthy | 2019

22 Oct

From the first moment of pregnancy, the bond between a mother and the child she is about to bring into the world becomes indestructible and will connect the two for the rest of their lives. The new mother will become the support for her little baby, and...

Stay healthy | 2019

29 Oct

It is no secret anymore that exercising is extremely important for our overall well-being, as it has a very poignant impact on health. Being fit is an essential condition for the daily activities, which is why exercising must become a...

Stay healthy | 2019

21 Oct

Prof. Irinel Popescu is a prominent surgeon and a member of the Romanian Academy of Sciences. He is a leader in surgical oncology and liver-related medical procedures. For the last three decades, Prof Popescu has been the pioneer and motivator of liver...

Stay healthy | 2019

05 Nov

  Private health insurances are a more and more accessed instrument due to the flexibility they offer to their beneficiaries. They guarantee access to the most efficient medical services in the country or abroad and create the necessary framework for...

Stay healthy | 2019

12 Nov

Second Opinion is becoming a more and more spread medical practice which offers patients the possibility to look for a higher certainty level in relation to a certain diagnosis or treatment.  Sometimes, the medical condition a person is diagnosed with...

Stay healthy | 2019

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