foods to modify mood or affect, and indications that the medical-therapeutic use of particular foods may ultimately be a matter of mood-alteration. The identification of particular items as comfort food may be idiosyncratic, though patterns are detectable. In one study of American preferences, "males preferred warm, hearty, meal-related comfort foods (such as steak, casseroles, and soup) while females instead preferred comfort foods that were more snack related (such as chocolate and ice cream). In addition, younger people preferred more snack-related comfort foods compared to those over 55 years of age." The study also revealed strong connections between consumption of comfort foods and feelings of guilt. Comfort food consumption is seen as a response to emotional stress and, consequently, as a key contributor to the epidemic of obesity in the United States. The provocation of specific hormonal responses leading selectively to increases in abdominal fat is seen as a form of self-medication. Further studies suggest that consumption of comfort food is triggered in men by positive emotions, and by negative ones in women. The stress effect is particularly pronounced among college-aged women, with only 33% reporting healthy eating choices during times of emotional stress. For women specifically, these psychological patterns may be maladaptive. A therapeutic use of these findings includes offering comfort foods or "happy hour" beverages to anorectic geriatric patients whose health and quality of life otherwise decreases with reduced oral intake. By region A partial list by region of comfort foods around the world. Afghanistan Comfort foods in Afghanistan are: Aushak – stuffed dumplings and sauce Bolani – filled flatbread Borani Banjan or Borani-e-Banjan – baked eggplant with yogurt sauce Borani Kadoo or Borani-e-Kado – sweet and savory braised pumpkin with yogurt sauce Chainaki – Chalaw or Challow – steamed rice with spices Kabuli palaw or Qabuli Pulao – steamed rice with raisins, carrots, and lamb Karahai – meat cooked in a traditional karahi pot Kebab – grilled skewered meat Korma Gosht or Qorma-e-Gosht – braised meat Mantu – meat-stuffed dumpling Naan – flatbread Sabzi Palu – spinach (sabzi) with spices Sher Berinj – rice pudding Australia, New Zealand and South Africa Comfort foods in Australia, New Zealand and South Africa may include: Braised lamb shanks Bread and butter pudding Butterscotch apple dumplings Casserole (beef or chicken) Chicken soup Golden syrup pikelets Honey and oat slices Hot chips Lamingtons Mashed potatoes Meat pie Pea and ham soup Pie floater