BMJ  2007;335:1287 (22 December), doi:10.1136/bmj.39415.755752.AD

Mixed messages

Dissent of the testis

¹ Faculty of Medicine and Dentistry, University of Bristol, Bristol BS2 8DZ, ² Department of Paediatrics, Royal Victoria Infirmary, Newcastle-upon-Tyne NE1 4 LP

We previously reported that two chocolates—Teasers and Truffles (Celebrations, Masterfoods UK, Melton Mowbray)—were strikingly similar to the 8 ml bead of the orchidometer used to assess testicular volume.¹ We therefore suggested that they could be used to stage puberty in males and, because of their wide availability and low cost, commended their use.

We were recently dismayed to discover that the manufacturer has changed the shape of both these chocolates. Both are now flat bottomed (figure), and even non-specialists will notice that they bear little resemblance to testes. More disturbingly, they are no longer much use for assessing testicular volume. Only one of six paediatric endocrine specialists (comprising trainees, consultants, and specialist nurses) felt confident that they could use the new Teasers or Truffles to gauge testicular volume relative to the 8 ml cut-off which indicates that puberty is proceeding satisfactorily.²

View larger version (12K): [in this window] [in a new window] [PowerPoint Slide for Teaching]   How Teasers changed: Conventional 8ml orchidometer bead (centre) with 2001 Teaser (right) and 2007 teaser (left)

 
This is a major setback for paediatric endocrinology, and the manufacturer’s decision to change the sweets’ morphology without consulting the medical profession is a further kick in the Teasers. Despite conveying our concerns to the manufacturer, we have received no clear explanation, nor any reassurance that this issue is being taken seriously.

We appreciate that marketing chocolates is a matter of great commercial sensitivity and hope that we have not inadvertently hit a delicate spot by drawing attention to the fact that these sweets looked and felt like testes. Our paper made it absolutely clear that both Teasers and Truffles tasted better than wooden orchidometer beads¹ and, we speculate, better than testes.

Clearly, the original design should be reinstated. With skilful marketing, this could play to the manufacturer’s advantage: by including a simple package insert with clear, easy-to-feel instructions, young males could self evaluate their pubertal status (while pointing out that this should ideally not be done at the point of sale). This could provide a rare opportunity for the chocolate industry to become palpably involved in public health promotion.

We feel it imperative for Masterfoods to restore Teasers and Truffles to their former aesthetic and functional glory. We therefore urge readers to sign the petition at chocnuts@bris.ac.uk.

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Competing interests:GW’s guest lecture to the Society for the Study of Ingestive Behaviour (Groningen, 2003) was sponsored by Masterfoods.

References

1. Bhalla P, Sally, Pippa, Williams G. An inexpensive and edible aid for the diagnosis of puberty in the male: multispecies evaluation of an alternative orchidometer. BMJ 2001;323:1486.[Free Full Text]
2. Tanner JM, Whitehouse RH. Clinical longitudinal standards for height, weight velocity and stages of puberty. Arch Dis Child 1976;51:170-9.[Abstract]

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