Hepatitis Social Community
1.94k Members
Avatar universal

Largest Study to Date Links Chocolate to Lower BP and CV Risk

Largest Study to Date Links Chocolate to Lower BP and CV Risk

Lisa Nainggolan
April 1, 2010 (Nuthetal, Germany) — The largest observational study so far to examine the association between chocolate consumption and risk of cardiovascular disease has found that those who ate the most chocolate--around 7.5 g per day--had a 39% lower risk of MI and stroke than individuals who ate almost no chocolate (1.7 g per day) [1].

Lead author Dr Brian Buijsse (German Institute of Human Nutrition, Nuthetal, Germany) told heartwire : "This shows that habitual consumption of chocolate is related to a lower risk of heart disease and stroke that is partly explained by blood-pressure reduction. The risk reduction is stronger for stroke than for MI, which is logical because it appears that chocolate and cocoa have a pronounced effect on BP, and BP is a higher risk factor for stroke than for MI." Buijsse and colleagues report their findings online March 31, 2010 in the European Heart Journal.

However, Buijsse cautions that only small amounts of chocolate were associated with the benefits and it is too early to give recommendations on chocolate consumption: "Maybe it's a boring message, but it's a little too early to come up with recommendations, because chocolate contains so many calories and sugar, and obesity is already an epidemic. We have to be careful." However, he added, that if people did want to treat themselves, they would be better off choosing small amounts of chocolate, preferably dark chocolate, over other sweet snacks. "We know it is the cocoa content in chocolate that is important, so the higher the cocoa content, the better."

Dr Steffen Desch (University of Leipzig, Heart Center, Germany), who was not involved with this study but who has performed research on the effects of chocolate on blood pressure, told heartwire : "This is an interesting study that adds to the growing body of evidence that flavanol-rich chocolate might be associated with health benefits. Several epidemiological studies (including the Zuphten Elderly Study, by the same first author) and even more physiological trials have been published before."

"What is missing now is a large-scale randomized trial of flavanol-rich chocolate versus control. The most reasonable end point would probably be the change in blood pressure between groups." However, Desch added, "the major problems in designing such a study are the lack of funding and finding an appropriate control substance. To the best of my knowledge, there is no commercially available flavanol-free chocolate that offers the distinct bitter taste and dark color inherent to cocoa-rich chocolate."

Biggest Chocolate Consumers Had Lowest Blood Pressure

Buijsse and colleagues followed 19 357 people, aged between 35 and 65, who were participants in the Potsdam arm of the European Prospective Investigation into Cancer (EPIC). They received medical checks, including blood pressure and height and weight measurements at the start of the study (1994–1998), and they also answered questions about their diet, lifestyle, and health, including how frequently they ate 50-g bars of chocolate.

The research was conducted before the health benefits of chocolate and cocoa were recognized, so no differentiation was made between milk, dark, and white chocolate in the study. But in a subset analysis of 1568 participants later asked to recall their chocolate intake over a 24-hour period, 57% ate milk chocolate, 24% dark chocolate, and 2% white chocolate.

Participants were divided into quartiles according to their level of chocolate consumption. Those in the top quartile, eating around 7.5 g of chocolate a day, had blood pressure that was about 1 mm Hg (systolic) and 0.9 mm Hg (diastolic) lower than those in the bottom quartile.

In follow-up questionnaires, sent out every two or three years until December 2006, the participants were asked whether they had had a heart attack or stroke, information that was subsequently verified by medical records from general physicians or hospitals. Death certificates from those who had died were also used to identify MIs and strokes.

"Our hypothesis was that because chocolate appears to have a pronounced effect on blood pressure, chocolate consumption would lower the risk of strokes and heart attacks, with a stronger effect being seen for stroke,” explained Buijsse.

Those Eating Most Chocolate Had Half the Risk of Stroke

During the eight years, there were 166 MIs (24 fatal) and 136 strokes (12 fatal); people in the top quartile had a 27% reduced risk of MI and nearly half the risk (48%) of stroke, compared with those in the lowest quartile. The relative risk of the combined outcome of MI and stroke for top vs bottom quartile was 0.61 (p=0.014).

The researchers found that lower baseline blood pressure explained 12% of the reduced risk of the combined outcome, but even after taking this into account, those in the top quartile still had their risk reduced by a third (32%) compared with those in the bottom quartile over the duration of the study.

To put this in terms of absolute risk, Buijsse said if people in the group eating the least amount of chocolate increased their chocolate intake by 6 g a day, 85 fewer heart attacks and strokes per 10 000 people could be expected to occur over a period of about 10 years.

He says it appears that flavanols in chocolate are responsible for the beneficial effects, causing the release of nitric oxide, which contributes to lower BP and improves platelet function.

Dr Frank Ruschitzka (University Hospital, Zurich, Switzerland) agrees. He said in a European Society of Cardiology statement [2]: "Basic science has demonstrated quite convincingly that dark chocolate particularly, with a cocoa content of at least 70%, reduces oxidative stress and improves vascular and platelet function."

Only Small Amounts of Chocolate Beneficial; Don't Eat Too Much

Buissje said this work builds on his earlier small trial--the Zuphten Elderly Study--performed in 500 men in Holland, which showed that chocolate consumption lowered overall cardiovascular mortality. "Due to the small size of this study, we were not able to differentiate between stroke and MI in this, but now we are able to look at stroke and MI separately, so it's a nice addition," he notes.

And the findings are in line with an intervention study that showed that eating around 6 g of chocolate a day--one small square of a 100-g bar--might lower CV disease risk, he says. "So the effects are achieved with very small amounts."  

British Heart Foundation dietician Victoria Taylor made the same point: "It's important to read the small print with this study. The amount consumed on average by even the highest consumers was about one square of chocolate a day or half a small chocolate Easter egg in a week, so the benefits were associated with a fairly small amount of chocolate.

"Some people will be tempted to eat more than one square; however, chocolate has high amounts of calories and saturated fat . . . two of the key risk factors for heart disease," she noted in a statement [3].

Ruschitzka similarly urged caution: "Before you rush to add dark chocolate to your diet, be aware that 100 g of dark chocolate contains roughly 500 calories. As such, you may want to subtract an equivalent amount of calories, by cutting back on other foods, to avoid weight gain."

The researchers report no conflicts of interest.
27 Responses
250084 tn?1303311035
Diane....I like that higher level for just that reason, I eat less of it, satisfies the chocolate urge with less damage to the hips :)

Brent. lol....on all 3 comments!

I'm not reading merrybes (sorry:)...I want to stay with the 'it's good for me thought'.

NyDeb! Yes, that's exactly what I thought they were! Hah!
96938 tn?1189803458
I wonder if it's avAiLAable in IV form.
179856 tn?1333550962
LOL our new treatment, wine and chocolate who needs interferon for anything anymore! yay! Well at least after a couple wines and a box of chocolates I wouldn't care anymore that's the truth ;)
Avatar universal
While I have never mainlined chocolate of any kind, let alone dark chocolate, I think experiential evidence is overwhelmingly sufficient to indicate that doing chocolate in IV form takes all the pleasure out of it.  I'd rather let an 85% cocoa content square of dark chocolate melt slowly in my mouth than miss all the pleasure entirely by pumping it in my arm and missing my tastebuds entirely.  While I can't cite any PubMed studies to back that up, I'm pretty secure in stating that adherence would be overwhelmingly higher if it's ingested orally rather than via IV.
163305 tn?1333672171
Yum, not that's my kind of preventive medicine.
163305 tn?1333672171
I wish medhelp had a way to correct misspelled posts. The above is supposed to say now, not, not. And although I caught it and hit  stop!! it was too late.
Avatar universal
I definitely want to let it melt in my mouth!
179856 tn?1333550962
........and not in my hands ;)
Avatar universal
Cocoa - The Super Healthy Fruit

You may be surprised to learn that cocoa is actually a FRUIT - and even more surprised to learn that it is actually one of the most healthy fruits commonly eaten by man!

Recent research studies have shown a link between cocoa and cardiovascular health, with reduced risk of blood clots, strokes, and heart attacks.

Cornell University food scientists discovered that cocoa powder has nearly twice the antioxidants of red wine, and up to three times the antioxidants found in green tea.

Raw cocoa has the highest antioxidant value of all the natural foods in the world!

The ORAC score per 100 grams of unprocessed raw cacao is 28,000, compared to 18,500 for Acai Berries, 1,540 for Strawberries, and only 1,260 for raw Spinach. The ORAC score for a typical manufactured Dark Chocolate is an impressive 13,120 - although one unique, organic, and non-roasted brand of Dark Chocolate has a much higher ORAC score. But for Milk Chocolate the ORAC score is much lower at 6,740.

Cocoa also appears to have anti-aging and anti-inflammatory properties. And cocoa is a good source of the minerals magnesium, sulphur, calcium, iron, zinc, copper, potassium, and manganese; plus some of the B Vitamins.

Avatar universal
And it tastes good too ........by the way.
Avatar universal
Neither comes close to the high concentration of flavanol antioxidants in raw cocoa/cacao beans - 10 grams of flavanols per 100 grams.

ORAC Score - A Measure of Antioxidant Quality
The current standard for testing and measuring the antioxidant properties of various foods is called the ORAC Score. ORAC is an abbreviation for "Oxygen Radical Absorption Capacity" - which is a measure of the amount of free radicals that can be neutralized by a certain mass of a food substance (usually cited as "per gram" or "per 100 grams" of the food substance).

The higher the ORAC score, the higher the concentration of antioxidants present in the food. (Source: US Department of Agriculture / Journal of the American Chemical Society.)

Free radicals are molecules that are missing one or more electrons and are therefore chemically imbalanced with a positive electrical charge. They are created in several kinds of chemical reactions which take place in our bodies, such as when we burn energy by working our muscles. To balance their charge, these radical molecules will seek to attract or "steal" electrons from other molecules - including the molecules which make up the DNA in your body's cells which is the blueprint for producing new cells, and the mitochondria in your cells which create the energy to sustain the cells.

Cells with damaged mitochondria are weak and have lower energy and less resistance to disease. When the DNA of a cell is damaged by the action of free radicals, the result is the creation of imperfect new cells - or even malignant new cells which form tumors and cancers.

Free radicals are the cause of most degenerative diseases, premature aging, and the creation of cancer cells.

Antioxidants are molecules which have one or more extra electrons and are chemically imbalanced with a negative electrical charge, so they can attract and "donate" an electron to a positively-charged free radical molecule, which balances its electrical charge and thus neutralizes it. So that "thieving" radical molecule which is now electrically balanced no longer needs to "steal" electrons from the molecules which form our body's cells.

Avatar universal
I hear its great on peeps ;^)
Have an Answer?
Top Hepatitis Answerers
317787 tn?1473362051
683231 tn?1467326617
Auburn, WA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
In You Can Prevent a Stroke, Dr. Joshua Yamamoto and Dr. Kristin Thomas help us understand what we can do to prevent a stroke.
Smoking substitute may not provide such a healthy swap, after all.
How to lower your heart attack risk.
Trying to lose weight? Grab a snack that works with your diet, not against it. Check out these delicious, slimming foods.
Trying to lose weight? Grab a snack that works with your diet, not against it. Check out these delicious, slimming foods.
How eating more salt may actually save your life.