Chewing or mastication is the process by which food is crushed and ground by teeth. It is the first step of digestion, and it increases the surface area of foods to allow a more efficient break down by enzymes. During the mastication process, the food is positioned by the cheek and tongue between the teeth for grinding. The muscles of mastication move the jaws to bring the teeth into intermittent contact, repeatedly occluding and opening. As chewing continues, the food is made softer and warmer, and the enzymes in saliva begin to break down carbohydrates in the food. After chewing, the food (now called a bolus) is swallowed. It enters the esophagus and via peristalsis continues on to the stomach, where the next step of digestion occurs. Increasing the number of chews per bite increases relevant gut hormones. Studies suggest that chewing may decrease self-reported hunger and food intake. Chewing gum has been around for many centuries; there is evidence that northern Europeans chewed birch bark tar 9,000 years ago. Chewing, needing specialized teeth, is mostly a mammalian adaptation that appeared in early Synapsids, though some later herbivorous dinosaurs, since extinct, had developed chewing too. Nowadays, only mammals chew in the strict sense of the word, though some fishes have a somewhat similar behavior. Neither birds, nor amphibians or any living reptiles chew. Premastication is sometimes performed by human parents for infants who are unable to do so for themselves. The food is masticated in the mouth of the parent into a bolus and then transferred to the infant for consumption. (Some other animals also premasticate.) Cattle and some other animals, called ruminants, chew food more than once to extract more nutrients. After the first round of chewing, this food is called cud. Chewing is important and beneficial for overall health. If food is not chewed correctly it can cause choking and other digestive problems. Chewing motor program Chewing is primarily an unconscious (semi-autonomic) act, but can be mediated by higher conscious input. The motor program for mastication is a hypothesized central nervous system function by which the complex patterns governing mastication are created and controlled. It is thought that feedback from proprioceptive nerves in teeth and the temporomandibular joints govern the creation of neural pathways, which in turn determine duration and force of individual muscle activation (and in some cases muscle fiber groups as in the masseter and temporalis).