Eat Up — And Don't Forget the Palate Cleansers

DATE July 10, 2007 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Director of the National Institute on Drug Abuse Dr.
Nora Volkow on addiction, the brain and Leon Trotsky
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

Why do some drugs make you feel so good until they leave you feeling really
bad? Dr. Nora Volkow wants to know what addictive drugs do to the brain.
She's one of America's top researchers on the neurobiology of addiction. Her
research has contributed to the idea that addiction is a disease of the brain.
Volkow is the director of the National Institute on Drug Abuse. One of the
things she studies is how drugs affect the brain's chemical transmitters, like
dopamine, which is associated, among other things, with motivation, drive, and
pleasure.

Dr. Volkow, welcome to FRESH AIR. Why do drugs like heroin or cocaine
create, at least initially create, a sense of pleasure? What's happening in
the brain?

Dr. NORA VOLKOW: What happens is, when someone takes the drug acutely, their
dopamine will go up, very high concentrations. With repeated administrations,
your brain starts to adapt with undergoing a shifting on the threshold. As a
result of that, you will need more and more and more dopamine in order to have
the same perception. Your brain becomes tolerant to the effect, and these in
turn will contribute to you wanting to take the drug because, without it, you
no longer feel normal. In other words, it has changed from wanting to take
the drug because you like the way it made you feel, you wanted to get high, to
needing to take the drug because, otherwise, you do not feel normal.

GROSS: Now do different people have different amounts of dopamine in their
brain, and does that explain at all why some people seem more prone to drug
problems than others?

Dr. VOLKOW: Yes, definitely. There are very different ways--I mean, there
are many differences among people and the way that the dopamine system works.
For example, one of the variables that we know contributes to the differences
in activity of dopamine is your age. As you grow older, there is a decrease
in the function of the dopamine system, and it is believed that, in part, this
decrease in the function of the dopamine system is one of the reasons that may
underlie why, as you grow older, you're much less sensitive to the pleasurable
effects of drugs.

It is also believed that your genes may determine to a different or lesser
extent how sensitive your dopamine system is going to be. In other ways, how
much are you going to be activated by natural reinforcers as well as aversive
stimuli, which are dependant, those responses, on how sensitive the dopamine
system is. So it is your age, it is your genes. We also know that repeated
drug use decreases, long term decreases the activity of this dopamine system,
so if you've been smoking for years, if you've been drinking alcohol for
years, that's likely to decrease the activity of the dopamine system.

And finally, there is also evidence that there are environmental factors that
may be modulating how sensitive your dopamine system is. For example, if you
get an acute stress, that will activate the dopamine system, but if you are
continually exposed to stress, a chronic stress, that in turn produces the
opposite. You become much less sensitive. Your dopamine system is not so
reactive, so all of these factors contributed to the variability among all of
us.

GROSS: Now, what are some of the drugs that act in the way you're describing
on the dopamine system?

Dr. VOLKOW: All of the drug that are abused by humans, that have the
potential to produce addiction, whether they are legal--alcohol, nicotine--or
illegal--such as heroin, methamphetamine, amphetamine, marijuana--all of them,
all of them increase dopamine. They do it by different mechanisms.

Interestingly, though, there are some medications that can also do that and,
as a result of that, because they can increase dopamine, they can also produce
addiction. These--what are the three classes of medications that increase
dopamine that have this problem? One of them, the most important, is pain
medications that contain opioids. Opioids are the systems that are activated
by drugs like heroin and morphine. So analgesics activate the systems and it
is through this that they exert a very powerful analgesic effects, so that's
one of them.

The second class of drug is the stimulant medications, and these are drugs
like Ritalin or amphetamines that we use for the treatment of
attention-deficit hyperactivity disorder, ADHD. We also use them for the
treatment of narcolepsy. These drugs are called stimulants and they share
many pharmacological properties that are similar to both cocaine and
methamphetamine. And those they can also, if used inappropriately, can
produce addiction.

And finally, we have the type of drugs that we would describe as sedative
hypnotics, and this includes benzodiazepines and barbituates. These are drugs
that are frequently prescribed to help people that have problems with sleep,
sleep pattern. They're also prescribed as muscle relaxants. They can also
produce addiction.

GROSS: Now, it's through your research that you learned that cocaine actually
has a toxic effect on the brain. What is that toxic effect?

Dr. VOLKOW: Cocaine--it's not just my research. Actually, there's research
from many others, and cocaine can be toxic to the brain for more than one
mechanisms. I was initially interested because I was doing brain-imaging
studies of their first of their kind in cocaine abusers, and when I look into
their brains it looked like they had had small strokes, and this was at the
beginning of the '80s and at that time people thought that cocaine was a
pretty benign drug, so I was pretty shocked by the findings. Then it became
clear that indeed cocaine can trigger cerebral vascular accidents, and what is
that? That that could be a hemorrhage or a stroke. And it told us...

GROSS: A hemorrhage or a stroke?

Dr. VOLKOW: Yes. And what happens is cocaine increases, for one's blood
pressure but it also can decrease the diameter of the blood vessels, what we
call vassal constriction, and if your vassals constrict sufficiently, you can
actually deprive a certain area of the brain of blood. Now, the brain is
incredibly sensitive of lack of blood because it needs the oxygen to survive,
and that in turn produces ischemia, and depending on where it happens, you can
have--and how long it lasts--you can have just a transient sense of not being
able to move your face properly, or you can actually become blind or you can
become paralyzed. So that was the first study that I did, in fact, regarding
cocaine that related to its toxicity.

Subsequent studies have also shown, and this is also work from my colleagues
at Brookhaven National Laboratory, have shown that cocaine is also a local
anesthetic, and by being a local anesthetic, it increases the concentration of
an...(unintelligible)...calcium inside the cells in the brain, and these can
be very toxic to the cells, because if you accumulate it, eventually it can
actually kill those cells. So these are two mechanisms by why it is believed
cocaine can produce damage into the brain, and these are different from the
changes that account for what we call addiction, so these are the effects of
cocaine that can produce toxicity to the brain. And by the way, they can also
produce toxicity to other organs.

GROSS: So the descriptions of the stroke-like symptoms that cocaine can
produce in the brain, are they reversible, or is that permanent damage?

Dr. VOLKOW: It depends, it depends, as I was saying, first of all, on the
duration and the extent of the damage. If it's very temporary, then there's
significant recovery and you can recover completely, but if it has produced
long-lasting ischemia, then basically it becomes irreversible. You destroy
the brain tissue.

GROSS: Now, you've also concluded that addiction corrupts brain networks.
What does that mean?

Dr. VOLKOW: Well, what I would describe by that is repeated use of drugs in
those people that are vulnerable--it doesn't happen on everybody--those that
are vulnerable because they have the genetics, because they are at a stage in
their life where they are vulnerable, those individuals and those people that
repeated use of drugs leads to plastic changes in the brain that actually
ultimately undermine the function of circuits in our brain that allows us, for
example, exert self-control, that motivate and drives our behavior, and that
are also very much implicated in process of memory and learning. So that's
where the issue of the repeated use of drugs corrupts the brain in the sense
that it changes the way it functions. It actually changes its biochemistry
and function and that, in turn, of course, results in changes in behavior.

GROSS: My guest is Dr. Nora Volkow, the director of the National Institute
on Drug Abuse. She's also the great-granddaughter of Leon Trotsky and grew up
in a house he'd moved to in Mexico after finding asylum there. We'll talk
more after a break. This is FRESH AIR.

(Announcements)

GROSS: If you're just joining us, my guest is Dr. Nora Volkow. She's
director of the National Institute on Drug Abuse, which is part of the
National Institute of Health, and she's done a lot of original research on the
nature of addiction and what happens in the brain when somebody becomes
addicted.

So, learning all the things that you've learned about the effects of addictive
drugs on the brain and how that affects other types of thinking, what has that
led you to conclude about how we as a culture should deal with addiction? You
know, the criminal model, the medical model.

Dr. VOLKOW: I mean, in a way, I think that, as a culture, we have not done
very well in the way that we treat drug addiction. Even though we have been
educating now for years, drug addiction is a disease of the brain and, as
such, it should be treated medically, this concept has not been incorporated
on medical practice, and this, for example, is reflected by the fact that most
private medical insurances will not cover for the treatment of drug addiction,
and if they cover, most of them cover for it inadequately. And this really
stems from the belief that drug addiction is lifestyle choice, which is pretty
paradoxical, and I think...(unintelligible). Throughout all of these years as
a clinician, I've never--I mean, it's actually 26 years to be exact--never,
never, never met a person that was addicted who wanted to be addicted.
Addiction is not a choice. You choose, initially in adolescence, to
experiment with drugs, but a lot of young people in our country do experiment
with drugs, and only a few will become problematic users, and those outcomes
actually are not choices but they are biologically determined.

GROSS: So, you know, a lot of people say, `Well, marijuana is a gateway
drug.' Do you see it differently? Do you think, like, for somebody who's
prone to using drugs, who has that kind of like, you know, the right kind of
dopamine receptors and genetics and everything, that for them getting started
on marijuana might lead to other drugs, but it's not something inherent about
marijuana as a gateway drug?

Dr. VOLKOW: Well, I would put it differently. I would basically bring
forward that two are possible, and also I would like to take one step behind
and say, before marijuana, what studies have shown that appears preceding
marijuana is nicotine. So actually very early experimentation with cigarettes
increases the likelihood that then you will experiment with marijuana and that
then you will experiment with other drugs. So it's not just the concept of
marijuana being the gateway drug, but the possibility that early exposure to
certain drugs, and what are the drugs that young people are more likely to get
access if you're a child? They're much more likely to get cigarettes than it
is to get marijuana.

We're trying to understand actually whether, indeed, in a person that may not
have the genetic vulnerability, that, because of an environment that's very
permissive, they get access to cigarettes, and they smoke. Would that in and
of itself increase the risk of taking other drugs, or is it that they have the
genetic vulnerability that made them want to experiment very early on?

GROSS: Now, you mentioned that nicotine is the way a lot of people get
introduced to drugs. How would you describe nicotine as an addictive drug in
a scale of, you know, like, nicotine, cocaine, meth, heroin, you know, where's
nicotine?

Dr. VOLKOW: I can use a chemical measure, if you want me to, which is, all
of these drugs increase dopamine, and the ability of drugs to increase
dopamine is directly linked with their rewarding properties. So are there
drugs that increase dopamine more? Yes. Which is the drug that increases
dopamine the most? Methamphetamine. How does nicotine compare? Nicotine is
probably, with alcohol, one of the drugs that increases dopamine the least.
But you can smoke it, and as you're smoking you can also tracheate it.

There's another aspect that's very different about nicotine. You can take
this drug and continue with your life, meshing the drug taking with your work,
meshing the drug taking with your pleasure, which is not happening with other
drugs. I mean, you cannot just be snorting cocaine and working in a public
environment. Much harder to do. Nicotine allows you to actually marry the
drug to your everyday activities. And this is dangerous because one of the
things that we've come to understand--which, by the way, is absolutely
fascinating what drugs do--is that when you increase dopamine, what you are
doing to your brain is sending the signal that this is an experience that is
very salient. It's not just pleasure. Salient. And so you activate a memory
systems that will remember it. They will remember the episode, who was there,
but you will also remember the memory, and you will associate that memory and
that emotion, that emotion of the experience, not just with the drug but with
what surrounds you, and that's what we call conditioning. And the problem
about conditioning with drugs is that when you become addicted, an object or a
person that you've been conditioned to, because you've taken the drug with,
will by itself increase dopamine in your brain, triggering the desire to take
the drug.

GROSS: You know, there's been a lot of scare campaigns directed at teenagers
about all the things--like "this is your brain on drugs"--you know, about all
of the things, all of the damaging effects that drugs can have on your brain
if you start taking them. Do you think that that kind of scare campaign
directed at teenagers is effective?

Dr. VOLKOW: From studies that have been undergone to try to determine what
are the tactics that are most effective in decreasing the likelihood that kids
will take drugs, what is evident is that one of the best prevention strategies
you can do is to make the adolescent aware that other adolescents do not
approve of this behavior. So if the adolescent feels that the others are
taking it, they are much more likely to take the drug than if they feel that
the others are not. So if you mount a prevention campaign through
advertisements, through parent counseling, through school that makes
adolescents aware of that indeed other adolescents are not approving these
drugs, you're much more likely to succeed.

Now, coming specifically to the question to just sort of say, `OK, you take
your drugs and your brain is going to fry,' I think that those scare tactics
basically don't work, because adolescents are very smart, and they know many
kids who are taking drugs and their brains have not fried. Unfortunately,
they don't have the vision of what is going to happen to those adolescents
when they go into young adulthood. If they knew that, then they would be much
more likely to not want to take drugs. So, to me, the challenge is to be able
to provide them with information that is salient to them, that is emotionally
significant so that then that can minimize the likelihood that they will take
the drugs when other kids offer them to them.

GROSS: I think one of the problems people face who are addicted to something,
whether it's, you know, cigarettes or even food or something like, you know,
meth or heroine, is that there are certain triggers to you wanting the drugs,
so certain things that you associate with taking the drug, and if you make
that association you want the drug. I mean, the most obvious thing is like,
you have a cup of coffee, you want a cigarette with it. You're working on
ways that those kind of associations can be broken in order to help people
break the habit, whatever the habit is. Can you talk a little bit about what
kind of research is going on in that area now?

Dr. VOLKOW: Yeah. We are targeting two strategies. One of them, medication
that can interfere with the increases in dopamine that occur when you get
exposed to these conditioned responses and those that interfere with the
craving. But we're also working with new strategies for helping individuals,
through biofeedback, be better able to control those craving responses when
they experiencing them.

GROSS: Sometimes addicts don't seek help because there's such a stigma to
being an addict and they don't want to admit that they are. And also they
might be punished for admitting that they are, if they're addicted to an
illegal substance. Does that get in the way of the way you'd like to see
addiction treated?

Dr. VOLKOW: Of course, absolutely. And I think that's probably one of the
main issues. Eighty-five percent of individuals that are addicted and require
treatment will not seek treatment, so even if we had the medications--and we
have already treatments. We have treatments that work in drug addiction and
we cannot--the patients that are addicted to it cannot benefit because they
are not accepting that they have a problem and are not seeking help. And this
is driven by multiple factors. Of course, stigmatizing drug addiction is not
helping. The notion that people that react to patients that are addicted and
become judgmental, they are ashamed. The patients are ashamed to bring it up,
so they have to overcome that fear, and so if they are mistreated the
likelihood that they will come back is lower. They go to their doctors, and
the doctors may feel uncomfortable actually asking about drugs, so they don't,
and they want--the patients who are ashamed of their drug-taking behavior are
not going to bring it spontaneously. So we are missing a lot of unique
opportunities where we could bring this patient and engage them and motivate
them and refer them to proper treatment.

GROSS: Dr. Nora Volkow is the director of the National Institute on Drug
Abuse. We'll talk more about addiction in the second half of the show.

I'm Terry Gross, and this is FRESH AIR.

(Announcements)

GROSS: This is FRESH AIR. I'm Terry Gross, back with Dr. Nora Volkow, the
director of the National Institute on Drug Abuse. She's one of America's top
researchers on the neurobiology of addiction.

Now, we've been talking about drugs, but you're also studying obesity and
people who overeat and become obese as a result. Do you consider food an
addictive substance?

Ms. VOLKOW: Food can produce compulsive behavior of taking, and it can
produce devastating consequence to the person that cannot control it. So in
that respect, it has similarities to what we call addiction. However, because
there's not an official definition of what constitutes addiction to food and
what does not, I tend to be cautious about it. But what I can say is that,
yes, we have seen changes in the brain of pathologically obese patients that
are similar to those we have seen in people who are addicted to other drugs
like cocaine and alcohol. But we have also seen clear-cut differences in
obese patients that are not seen in patients that are addicted to drugs. So
their share certain systems and circuits and chemical, but there's also very
significant differences.

Food is probably--it's so extraordinarily important for survival that biology
has generated many systems to insure that you eat. And the system that is
shared between motivation for food and motivation for growth is that that
relates to the pleasure of the rewarding effects of food. But, of course, we
eat also because we need nutrition, we need glucose.

GROSS: So you can't stop eating. Like you can stop heroin, but you can't
stop eating.

Ms. VOLKOW: No. You cannot stop eating. You'll die.

GROSS: Yes.

Ms. VOLKOW: That, of course, makes it much harder.

I did a study, I think close to four years ago, in which we were exposing just
normal-weight people to food stimuli that they like in the scanner, so we were
imaging the brain while they saw this food. And they couldn't eat it, they
knew they couldn't eat it. But just seeing the food increased dopamine in
those pleasure centers of the brain, just like happens with drugs. And that
increased their desires to the food. So that made me think that every time
that I go and buy a book and I pay and they have all of these Godiva
chocolates, I think, my dopamine is going up in my brain and I have this
desires to eat them. And so these are reflect responses, conditioned
responses that makes it harder for society, where food is so widely available,
it's so appealing, it tastes so good and it's so cheap, that we can
actually--it's no wonder that we have no more of a problem of overweight than
what we already have.

GROSS: I'd like to hear your opinion on the medical use of marijuana.

Ms. VOLKOW: The medical use of marijuana. You know, marijuana activates the
reward centers, pleasure centers, by stimulating proteins that are there for
us to feel pleasure, to feel less pain, which we call the cannabinoid
receptors. So the cannabinoid receptors are proteins that are incredibly
abundant in our brain that subserve many functions. So it's not surprising
that, for example, you can target and develop medications that just--that can
activate these cannabinoid receptors, just like marijuana does, that could be
potentially very good medications for pain. There has also been interest for
these types of medication against nausea, so if you're in chemotherapy.
There's also been interest about these medications to enhance your appetite.
So if, for example, you have AIDS and you have no hunger, this is very
helpful. There's also been interest about glaucoma.

The problem with marijuana to treat these disorders is that when you are
taking marijuana, you're not just taking
that...(unintelligible)...cannabinoid, which is the one that activates the
receptors, because you're actually taking hundreds of chemical compounds. And
you are generating not just the pharmacological desirable effects, but also
undesirable effects, including, for example...(unintelligible). And that's
why, in my perspective, if you can generate compounds that can do the
pharmacological actions without the untoward effects, well, then use those.
You don't need to use marijuana.

GROSS: If you're just joining us, my guest is Dr. Nora Volkow. She's the
head of the National Institute on Drug Abuse, which is part of the National
Institute of Health.

Now, you come from a really interesting family, and it's quite a story. Your
great-grandfather was Leon Trotsky, the Russian revolutionary who split from
Lenin and was a leader of the Bolsheviks, who was exiled and wound up in
Mexico in the mid-'30s and was assassinated by one of Stalin's men in 1940.
You grew up in Mexico, in part, in the house where your great-grandfather
lived. I believe one of your grandfathers was shot to death in a Stalinist
prison. How aware were you of all of this history when you were growing up?

Ms. VOLKOW: Well, I was--I lived with it because I was born in the house
where Trotsky was killed, so even though my father had us living in a little
house by the side of the house where he had been killed, during the day we
will go and look at his books and play around with his clothes or the clothes
of his wife. And then over the weekends we would show the house to visitors
that came all over the world to see the house. So it was always very present.

At the same time, what was interesting was that we were not allowed to ask my
father about Trotsky when we were children because of the fear that this was
such a painful memory for him. And, indeed, my father did not speak about his
heritage until I was, I think, 14 or 15 years of age. That's the first time
he ever agreed to speak with a newspaper. He never wanted to speak about it.
I think it was very traumatic for him as a child.

GROSS: It was also the period of the Cold War.

Ms. VOLKOW: More than that, I think in this case it was just how hard. I
think that probably my father was of those that follow one of the ones
of--that suffered the most as a child, because his parents were taken away
from him. He was left an orphan very young, and...

GROSS: Taken away by Stalin?

Ms. VOLKOW: Yeah. I mean, he was taken away from his country, from his
sister, his mother commits suicide. His father is sent to a concentration
camp and disappear. His uncle, with whom he was living, also dies in Paris.
And then they have to take him. Leon Trotsky took care of him as a young boy.
But it must be very traumatic as a child to see all of these people you love
being killed.

GROSS: So did he try to protect you from all of those fears?

Ms. VOLKOW: Yes. I mean, my father didn't--I mean, I think that my father
actively protected us from getting involved when we were young on political
activities. I think he was--he felt that the price his family had paid was
just too great.

GROSS: And how did you start doing drug research?

Ms. VOLKOW: Well, I started doing drug research because I've always been
interested on human behavior, and the fascination about what motivates us to
do things, and what happens in people who are addicted when they no longer can
control their acts. So that notion of understanding what happens in the brain
of a person that even thought they say, `I don't want to do it,' they cannot
control it. And it fascinates me because it's at the essence of what we
consider free will, the ability for self control, the ability to exert
voluntary control over your behaviors. And in people that are addicted, this
is really badly undermined.

I wanted to understand why so that we could treat it. I mean, I've always
been interested on treating drug addiction as you treat the other medical
diseases. There's no reason why not. We just have not developed the
knowledge or we don't have sufficient medications. But I believe--firmly
believe--that we will. We need to invest in it. It's not going to happen
spontaneously or automatically. But, as we develop the knowledge and as we
invest on development of these medications, we will be able to offer
treatments, just like we offer now for epilepsy or we offer for depression.

GROSS: Have you ever tried drugs out of just like curiosity, since you study
them so much? Or did you ever try them before you started studying them, the
way so many young people do?

Ms. VOLKOW: You know, when I was--there are two things, basically. I live
in an incredibly protected environment when I grew up, and so I did not get
exposure to illicit substances. I think that the first time I was offered an
illicit substance was when I was in medical school, never in high school. So
as an adolescent, I was not ever even exposed to it. And by then, in medical
school--and I've always value enormously my brain--and so I did not want to do
anything that could jeopardize my ability to think or feel or experience. I'm
very sensitive to that.

However, when I was an adolescent, I was--since I was a little child,
actually--I was learning to speak French and I would goes to the class, and
there was this teacher, very glamorous French woman, and she smoked. So I
wanted to be like her and I tried to smoke, and I hated the way it made me
feel. And I try again, and I became nauseated. So after five or six times, I
just gave up. So I did try smoking. I must have been 15, 16 years of age.
But fortunately I had the genes that make me respond to it in an adversive
way.

GROSS: Just one more question. Is there a moment that you consider the most
exciting moment in your career, when you discovered something, say, through a
brain scan about the effects of a drug on the brain?

Ms. VOLKOW: You know, it's interesting, because when I--I wouldn't say
there's a particular one moment. It's almost--that's why I would sort of say
I'm so addicted to research because the moment that you can comprehend
something that someone else has not, or you see an association that clarifies
something, is extraordinary rewarding. It's almost--it's ecstatic. It's
incredibly pleasurable. And every time that I face myself with understanding
data that allows me to understand better a process, I would say I get very
excited. So it's hard for me to say which one has been the particular moment
that I was jumping up and down and said, `Oh, my God, this is extraordinary.'
I see myself getting--I look at the brain scan. I say, `This is
extraordinary.' I look at the data and, my God, what this data is telling me.
Actually I like data to surprise me. So I fortunately always get very excited
when something new and unexpected arrives.

GROSS: Well, Dr. Volkow, thank you so much for talking with us.

Ms. VOLKOW: You're very welcome.

GROSS: Dr. Nora Volkow is the director of the National Institute on Drug
Abuse.

Coming up, an interview not for the squeamish, about revolting food
delicacies. We heard from food scientist Massimo Marcone about his adventures
researching these delicacies. This is FRESH AIR.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Interview: Author and scientist Massimo Marcone discusses food
delicacies around the world
TERRY GROSS, host:

The so-called delicacies you're about to hear described are pretty revolting,
but food scientist Dr. Massimo Marcone says the foods he studies are not
"Fear Factor" foods, like fried cockroaches or earthworm cocktails. He
studies uncommon variations of perfectly respectable and mainstream foods,
like salad dressing oil from nuts excreted by goats. Marcone has traveled the
world researching bizarre delicacies. He teaches food science at the
University of Guelph in Canada. His new book is called "In Bad Taste? The
Adventures and Science Behind Food Delicacies." Marcone spoke to FRESH AIR's
frequent guest host Dave Davies.

DAVID DAVIES, host:

Well, Massimo Marcone, welcome to FRESH AIR. You begin your book by
describing a very rare and expensive coffee, kopi luwak. What's distinctive
about this product?

Dr. MASSIMO MARCONE: Kopi luwak is one of those very interesting foods that
have basically come from the back end of an animal. What happens is that
there's a palm civet, which is an animal much like a raccoon, that eats the
coffee cherries and then excretes them. And for the last 200 years, people
have been collecting them, washing them, roasting them, and this is kopi luwak
coffee.

DAVIES: Now, you said coffee cherries. And how is that--is that different
than coffee beans?

Dr. MARCONE: Yes. What happens is you have two coffee beans within a
cherry, so there's an outer parchment and flesh around the coffee seeds, and
that is our coffee cherry, and it's very sweet, and that's what the animal is
attracted to.

DAVIES: OK. Just describe it for us. When you're looking at a pile of this
animal excrement, do you actually see the coffee beans?

Dr. MARCONE: Yes. Really, you don't see very much of the brown organic
matter. Really what we see is a bunch of coffee beans which are stuck
together by this mucilage, which comes from the coffee cherry. So really we
don't--it doesn't look like regular feces as one would think of, you know, in
the kitty litter box. It's just coffee beans stuck together. It looks--has
a, very much like a spider type of shape to it.

DAVIES: How does the passage of the coffee beans through the digestive track
of this little animal, the civet, affect the bean and affect the flavor?

Dr. MARCONE: Well, the bean is affected on the surface, where we get certain
level of pitting, which ends up being a ballistics fingerprint of the bean
going through the GI tract. But also the gastric juices are getting into the
bean. They break down the proteins and then, through the roasting process,
these proteins react to form different flavor components in the coffee itself.

DAVIES: So did you actually brew coffee from the beans collected from this
animal's excrement?

Dr. MARCONE: I sure did. I was able to brew some of the coffee right in the
rainforest. What we had is we had a generator with us, and I had a brought
equipment to be able to roast up the coffee. So we were able to roast it up.
Depending upon on how long it took the people to find the coffee--so if they
were able to find it right after it had come out of the animal, it was of a
much superior quality than those coffee scats that had remained in the
rainforest for a few days. So we were able to grade them depending upon when
they were collected. So that was a new piece of information we had.

DAVIES: Now, this coffee, I'm sure, grows on trees, and one could harvest the
beans as others are done. Now, did you get some beans that had not been eaten
and excreted by this little animal and compare the taste of that coffee?

Dr. MARCONE: Yes. That was very important. That's what we call a control,
so the coffee that has not gone through the animal. And we were able to
guarantee that we had the proper control in that it is known that the civet
stays within a very small geographic location, and therefore when we find the
scat we would know that that would be the geographic location of where it had
consumed that coffee. So the control was easy to find. So I collected that,
and we were able to make a comparison. Now, organoleptically, or tastewise,
we could tell that kopi luwak had a more chocolate overtone. So the top note
was that of chocolate, and then it had two subnotes of an earthy-type and
musty-type flavor. So it's very distinct compared to the control itself.

DAVIES: And how expensive is this kopi luwak coffee?

Dr. MARCONE: Well, the kopi luwak coffee is, in fact, about $600 a pound, if
one can find it. But, again, it's not something that is very easy to find.
Usually people can only buy it in a quarter-pound lots, and usually, you have
to put your name in a cue, and there's usually about 300 people waiting to get
a quarter pound. So you don't always get it the season that you put your name
in for it.

DAVIES: And I guess there's an industry of people in these remote areas of
Indonesia that gather this excrement from the civet and collect the beans.

Dr. MARCONE: There is. And that's what sometimes leads to problems, in that
what I've seen in my study is that 42 percent of the kopi luwaks that are
being presented on the market as kopi luwak coffee are, in fact, adulterated
so they've had other coffees mixed in with them or are complete fakes.
There's not a tight control which occurs with kopi luwak coffee.

GROSS: You're listening to Dave Davies speaking with food scientist Massimo
Marcone, author of "In Bad Taste?" We'll hear more after a break. This is
FRESH AIR.

(Announcements)

GROSS: Let's get back to the interview that FRESH AIR's frequent guest host
Dave Davies recorded with Dr. Massimo Marcone, author of "In Bad Taste?" He's
a food scientist who travels the world, studying bizarre and kind of revolting
delicacies.

DAVIES: You write about a very strong and unusual cheese from Italy, whose
distinguishing characteristic is the presence of maggots. Did you believe
this story when you heard it?

Dr. MARCONE: Well, in fact, I was told about this story by my mother, who
remembers my grandfather consuming this cheese shortly after the second world
war. And so my mother says that she had consumed the cheese herself and quite
liked it. And so therefore I went to Italy to determine if I could find out
anything scientifically about this particular cheese and to find out where its
origin was. Was its origins from Sardinia, as people indicated? Or was it
more towards the center of Italy, where my grandfather was from? And it
really is a cheese that is like no other. It's a cheese with millions of
little maggots in it, and it's eaten, cheese and all. So you're eating the
maggots and the cheese, so it's a full package deal.

DAVIES: Tell us about your first encounter with this cheese, this casu marzu.

Dr. MARCONE: Well, this cheese is illegal to purchase and therefore it's
sold in the underground. And what happens is that unless you know people very
well, they're not going to sell it to you. Because they know that, you know,
they can get themselves into legal hot water if they do. So I had a
journalist and a linguist go out and get the cheese for me.

And I remember that when I walked into the apartment, the first thing that I
was met by was this strange odor, strong odor of cheese, which was, you know,
emanating from the kitchen. And as we got closer and closer--it's a cheese
that first you can smell it, and then you hear it. And the reason I say you
hear it is that those little maggots, those millions of little maggots that I
said are in the cheese, are literally jumping. And as they're jumping,
they're hitting the container that the cheese is in, and you can hear this
click, click, click sound from the maggots themselves. So it's a very
interesting--we usually don't think of hearing our food, but in this case you
can smell it, hear it and see it.

DAVIES: All right, so bring us to the moment of truth. You had some of this
cheese, maggots and all. What did it taste like?

Dr. MARCONE: Well, first of all, I didn't want to taste it because I
thought, `Oh, no. I can't do this. This is too bizarre.' So I finally
got--what they did, though, was they put it into the refrigerator for me to
quiet down the maggots so they wouldn't jump me as I was trying to consume
them, because they get all over you. They're on your clothes, in your hair as
you're trying to eat it. And it was--had a very distinct flavor to it. It
had a very strong, almost an itchy type of taste and sensation in your mouth.
And it was soft, like much like a Camembert cheese. And to be totally honest,
it was very pleasant to eat. It was something that, you know, without the
maggots, it would have been a perfectly good cheese that you would just say
it's great to eat.

DAVIES: And I have to ask, could you actually taste the maggots themselves
individually? Because they're in your mouth, too.

Dr. MARCONE: They're all in your mouth, too. But, really, you can't. You
don't even have the texture of the maggots, because they're really
incorporated into the cheese themselves. And I should say that they're very
small. They're almost microscopic in nature. They're not the big maggots
that we think of that are associated with rotting things. Really, the maggot
that we get is from a certain type of fly. It's not the housefly that is
producing the maggot but a certain type of fly which associates itself with a
dairy-type environment. And the maggots are very small, almost microscopic.
You can't see them.

DAVIES: What do the maggots do to the cheese?

Dr. MARCONE: Well, what happens is that the maggots themselves, they burrow
through the cheese and therefore they change the texture of the cheese to a
more softer type of cheese. And at the same time, they excrete certain types
of secretions, which really cause a change in flavor in the cheese. You get a
breakdown of the fat, and therefore you get that different flavor development
due to the maggots being present themselves. And we were able to test cheeses
that had not been infected with the maggots, and there was a very distinct
flavor difference. There wasn't that same type of strong, itchy flavors, I
would describe it as, in haute flavor that I would describe of the ones with
the maggots. Nor was it that soft. So the maggots were integral to the
production of this type of cheese.

DAVIES: Is this widely eaten in certain--or is it Italy and simply known that
you don't sell it openly but is consumed?

Dr. MARCONE: It's consumed in almost every region of Italy. Whether people
will tell you that they consume it or not, people know that people kind of
frown upon it, so sometimes they'll even keep it silent with regards to that.
This casu marzu is actually served as a centerpiece at certain weddings, also.
It's considered something of very high value, and so people want to have it as
part of their festivities. So it's very common throughout Italy.

DAVIES: And the noise adds to the occasion, too, also, I suppose.

Dr. MARCONE: Of course. It's there.

DAVIES: Why is this cheese illegal in Italy?

Dr. MARCONE: That was a question that was brought forward. And, really,
what I believe, and I stand to be corrected or not, that I submit that really
because Italy has a big cheese market and exports all over the world, they
really fear that if people know that they're into this type of cheese, that
they're consuming this, that it will be reflected badly upon the cheese
industry as a whole, and therefore they've put a ban in by saying, `Yes, we
know that people consume it, but it's illegal to purchase it, and therefore,
you know, we know what good cheese is and what bad cheese is.'

DAVIES: In your book, you describe tracking down these seemingly bizarre
foods that come, as you said, from the rear ends of animals or accompanied by
maggots, and discovered that in fact they really exist. Is there another
legendary food that you're ready to pursue? What's next for you?

Dr. MARCONE: Well, there's something that I'm going to be doing in the fall,
is I'm going to be going to China. I thought, well, kopi luwak was an, you
know, an anomaly, and then I find out for the tea drinkers out there there is
a tea which is produced, and it's consumed by an insect and excreted by an
insect, and they produce one of the best teas in the world. And so therefore
I'll be go off to China in the fall and be on that pursuit. But always
pursuing other foods.

And one could say to me, `Well, why does a scientist do that? Why does a
scientist in a very prestigious university'--we're considered the best food
science department in all of Canada--why do I go and do this type of research?
And really the reason why I do is partly to make up for the prejudism that I
had against foods. I really thought that I knew it all about these foods, and
I knew what foods ones could eat and what was good for you and what was bad
for you. And some of these "Fear Factor" foods that I'm looking at, I had all
my ideas why people should not be consuming them because they could cause harm
and so on and so forth. And what I found out was that, in many cases, these
foods are as harmless as other foods that we are presently consuming.

And therefore, I continue to go out. I continue to do the science behind
these foods and bring them to people's attention and so that, you know, we can
have a broader experience together of what these foods are and what the
science is behind them.

DAVIES: Well, Massimo Marcone, thanks so much for spending some time with us.

Dr. MARCONE: Well, absolutely. My pleasure.

GROSS: Massimo Marcone is the author of "In Bad Taste?" He spoke with FRESH
AIR's frequent guest host Dave Davies.

(Credits)

GROSS: I'm Terry Gross.
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