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Chocolate: It is REALLY Good for you!!!!

August 29, 2009

Prompted by a press release of a new article in the Journal of Internal Medicine, a high familial risk of cardiovascular disease, interest by my friends at Askinosie Chocolate (www.askinosie.com) and my own personal curiosity I have decided to investigate the strength and claims of the health affects of chocolate!!!! Yes, I know you all are terribly excited about the prospect of  your health care provider writing a prescription, at your next visit, for daily consumption of chocolate. I must admit that after doing the research I may be doing just that… (along with my prescriptions for daily naps, weekly massages and a good vigorous stroll around the block every day)…

Chocolate. You know it, you love it. Chocolate was first discovered by the Myan civilizations in Mexico and Central America between 250-900 B.C. When the Spanish invaded, chocolate was brought to Europe in 1528 where it spread through the upper classes. The first house of chocolate was built in London in 1657 but chocolate did not become widely available in the U.S. until the 1800’s. Actually we can thank the U.S. government and WWI for the big uptick in American chocolate, as chocolate was provided to U.S. soldiers as part of their rations… interestingly it resisted spoilage which is now attributed to ‘flavonoids’, which we will be discussing in a minute. (Engler, 2006)

The Power of Chocolate. Chocolate derives its healing power from its FLAVONOIDS. These are micronutrients that are derived from plants (think green tea, red wine, etc…)  and help prevent oxidation by radicals on cells in the body. Put simply,  they prevent destruction and attack on cells. Apparently chocolate’s specialty is cardiac related cells…. I found four things over and over and over in the literature that chocolate flavonoids do….

1. They decrease platelet aggregation (meaning your platelets don’t stick together and cause clots.. that might clog arteries and vessels)

2. They cause dilation of cardiac vessels (which means more blood to the heart… and that is GREAT)

3. They also dilate other arteries causing decreases in blood pressure

4. They decrease the levels and effects of bad cholesterol (also known as LDL cholesterol).

5.  They do it quickly. Most of the effects were noted in as little as 2 hours, lasting about 8 hours total, and most of the research only had people treated for 2-4 weeks to note changes in LDLs! (but you have to do it everyday…. the effect was usually a daily dose)

(Allen et al., 2008; Engler et al., 2006; Flammer et al., 2007, Hermann et al., 2006; Janszky et al., 2009; Strandberg et al., 2008).

The Evidence. I was literally overwhelmed by the amount of evidence supporting chocolate, mostly dark with 70% or greater coco content, as an improver of cardiac health. Below is just an overview of a few of the articles with their target population and effects.

—- Allen et al., (2008) —- This research, published in the Journal of Nutrition, was the mother of all research experiments, the Randomized Controlled Trial that was Double Blinded (for those of you who are into that research thing out there… I am sure you are impressed). 49 men and women between the ages of 24-70 were fed dark chocolate twice daily for 2 weeks and then serum cholesterol was retested. The decrease in serum cholesterol was significant with the dark chocolate group experiencing a 2-5% decrease in LDLs over the control group and a decrease in systolic blood pressure of nearly 6 mmHg. For you doubters out there, all were placed on an American Heart Association style diet for 2 weeks prior to research to help with controls.

—-Engler et al., (2006) – This is a terrific overview article published in Nutrition Reviews. Engler and colleagues reviewed over 20 different articles on all work done up to 2004 on chocolate for the effects of chocolate on cardiac function. Yes indeed, chocolate had a strong antioxidant affect in 9 different studies, vasodilation in 6 different studies, decrease in blood pressure in 3 different studies, and decreased platelet aggregation in 6 different studies.

—-Flammer et al., (2007) – In this article, published in Circulation, 22 post heart transplant patients were placed into a double blind randomized controlled trial for the effects of dark chocolate on coronary vasomotion (heart vessel size that can be related to spasm/dilation) and reaction of endothelial cells of heart vessels. They found that in the dark chocolate group there was a significant increase in the dilation of heart vessels, the ability of endothelial cells to cause dilation of vessels, and decreases in platelet adhesion.

— Hermann et al., (2006) – In an excellent article published in Heart Hermann and colleagues looked at 25 male smokers for the effect of 74% dark chocolate on cardiac function. In the end, the dark chocolate group had increase in antioxidant status, decrease in platelet function, and increase in cardiac vessel dilation.

—Janszky et al., (2009) – As noted previously, this latest research looked at the LONG-TERM effects of chocolate… not something everyone else is doing. They also looked at all chocolate, not just dark, but you have to understand that within their study population even milk chocolate is about 30% coco… not so in the U.S.. The large sample of 1169, non-diabetic, patients who had been hospitalized a heart attack, looked backward at chocolate consumption the previous 12 months before heart attack. The results were impressive. As the frequency of chocolate consumption went up, the risk of death from MI went down…. the lowest risk group were those who had consumed chocolate 2 times a week or more. (If you are into epidemiology statistics the risk ratio went like this (less than one is considered a protection from disease)…. 0.73 – < 1 time/month, 0.56 – 1 time/week, 0.34 – 2 time/week or >)

—Hamed et al., (2008) – Examined healthy subjects in relation to the effects of dark chocolate and found that after 7 days of dark chocolate once per day that their LDL count decreased by 6%, HDL count (the good cholesterol that protects your heart) increased by 9%, antioxidant levels were up and WOMEN had a decrease in serum CRP.

Chocolate might also be a great mood enhancer?—Strandberg et al., (2008) – This was one of the first studies to examine long-term chocolate consumption as it related to PSYCHOLOGICAL HEALTH…. In a long standing cohort, group of guys they had been studying since the 1960s, with a sample size of 1367 elderly men… they found that those who reported regular chocolate consumption were happier, had significantly less feelings of loneliness, less depression, and more plans for the future than those who did not like or eat chocolate.

Studies of the Future… Preeclampsia risk? — Triche et al. (2008) – In an impressive long-term research study of 2291 pregnant women between 1996-2000 it was found that women who reported chocolate consumption were less likely to develop preeclampsia and had higher cord blood  levels of theobromine (a fancy chocolate derivative) and the higher these levels were the lower the risk of developing Preeclampsia. (Preeclampsia can be a deadly illness that develops in pregnant women near delivery and causes high blood pressure, liver malfunction, possible fetal death and seizure… http://www.preeclampsia.org/about.asp)

Now that you know…. So, now that you know how good chocolate is for you I suggest you eat some in small amounts (1-2oz), once to twice a day. I suggest that you visit your local chocolatier and buy some good dark chocolate. May I also suggest that you find a good bean-to-bar chocolate maker who buys chocolate beans at fair trade price from the farmers… then you will be doing good for yourself and others…. enough typing…. I am going to get mine now!

References

Allen et al., (2008). Daily consumption of a dark chocolate containing flavanols and added sterol esters affects cardiovascular risk factors in a normotensive population with elevated cholesterol. Journal of Nutrition, 138; 725-731.

Engler et al., (2006). The emerging role of flavonoid-rich cocoa and chocolate in cardiovascular health and disease. Nutrition Reviews, 64(3), 109-118.

Flammer et al., (2007). Dark chocolate improves coronary vasomotion and reduces platelet reactivity. Circulation.
2007;116:2376-2382.)

Hamed et al., (2008). Dark chocolate effect on platelet activity, c-reactive protein and lipid profile: A pilot study. Southern Medical Journal, 101(12) 1203-1208.

Hermann et al., (2006). Dark chocolate improves endothelial and platelet function. Heart 92, 119-120.

Janszky et al., (2008). Chocolate consumption and mortality following a first acute mycardial infaction: the Stockholm heart epidemiology program. Journal of Internal Medicine. doi: 10.1111/j.1365-2796.2009.02088.x

Strandberg et al., (2008). Chocolate, well-being and health among elderly men. European Journal of Clinical Nutrition. 62, 247-253

Triche et al., (2008). Chocolate consumption in pregnancy and reduced likelihood of preeclampsia. Epidemiology. 19, 459-464.

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