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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.
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.
Best Answer
I love chocolate, and still indulge from time to time...but I will have to be the killjoy here on one point only...the sugar content and the way this triggers too much insulin as well as too much fat storage in the liver need to be weighed.
Yes chocolate is high in omega 3's...that's a good thing...but ONLY if they haven't taken out the cacao fat and substituted another kind. (you have to read the fine print here because lots of chocolate has had another fat added and the cacao butter removed....
usually they use soy, palm and a few others...none of which is good for us..
plus, like I said...it half fat, and half pure sugar...so a little restraint might be in order.
here's a good primer on it....I am trying to raise my omega 3 profile also, but using sardines and an ALA supplement to get there...not that I would't prefer to use chocolate...but let's not loose sight of what we know about the liver and fat metabolism.
Easing Liver Inflammation: Balancing Omega-3's and Omega-6's
February 22, 2010
Although both are required for a healthy immune response, learn why those with inflammation of the liver should favor omega-3 fatty acids over omega-6's.
by Nicole Cutler, L.Ac.
Considered to be essential fatty acids, omega-3 fatty acids and omega-6 fatty acids are both necessary for human health. There are many reasons that health conscious individuals increase their consumption of omega-3 laden foods, while reducing their omega-6's. Upon recognizing why health professionals advise consuming more omega-3's than omega-6's, those with liver disease have every reason to follow suit.
Taken for everything from depression to heart disease to arthritis, the primary therapeutic action of omega-3 fatty acids is squelching inflammation. For decades, omega-3's have proven their ability to improve inflammatory conditions. Because hepatitis falls under this umbrella, this liver condition benefits from omega-3 fatty acid consumption.
Hepatitis literally means inflammation of the liver, and is involved in most types of liver disease, including:
· Viral Hepatitis: when hepatitis is caused by a virus - this includes Hepatitis B and Hepatitis C
· Alcoholic Hepatitis: when hepatitis is caused by alcohol, common in alcoholics
· Steatohepatitis: when fatty liver disease escalates and causes inflammation
The Inflammatory Pump
To address its current needs, the body is always trying to strike the right balance between inflammation and anti-inflammation. In achieving this balance, omega-3 fatty acids and omega-6 fatty acids are known to have opposing roles. The following events maintain this inflammatory pump:
· When an infection or foreign invader is detected, the immune system triggers production of Prostaglandin II.
· To quarantine the infection or invader, Prostaglandin II produces an inflammatory response that sends white blood cells to the affected area.
· Almost immediately, the immune system also triggers the production of Prostaglandin I to suppress inflammation and begin the healing process.
The balance between omega-3 and omega-6 fatty acids can affect the inflammatory pump's balance, because of their role in making prostaglandins:
· Omega-3 fatty acids are a necessary component in the production of Prostaglandin I.
· Omega-6 fatty acids are a necessary component in the production of Prostaglandin II.
Omega-3's and Omega-6's
Consequently, omega-3's are needed to suppress inflammation and encourage healing, while omega-6's are needed to initiate the inflammatory response. Nutritionists believe that a ratio of 2:1 of omega-6 fatty acids to omega-3's help keep the inflammatory pump in balance.
A suspected culprit of today's high rate of inflammatory diseases, many of our modern day food choices are rich in omega-6 fatty acids and stingy in omega-3's. In fact, experts estimate that the typical American diet contains 14 - 25 times more omega-6 fatty acids than omega-3's.
· Omega-6's are found in certain seeds and nuts, and the oils extracted from them. Refined vegetable oils (like soybean, corn, sunflower, safflower and cottonseed oils) are high in omega-6's and are used in a majority of fast foods, snack foods, cookies, crackers and sweets. According to Dr. Andrew Weil, soybean oil alone is now so ubiquitous in fast foods and processed foods that an astounding 20 percent of the calories in the American diet are estimated to come from this single source.
· Omega-3's are found in the fat of cold water fish, such as salmon, sardines, herring, mackerel, black cod and bluefish; other seafood including algae and krill; and some plant sources, especially walnuts and flax seeds.
Because it prevents infection from spreading to nearby tissues and organs, inflammation is a crucial process. However, too much inflammation has the opposite effect - and can easily harm neighboring structures. This is frequently the case in liver disease where hepatitis (liver inflammation) damages nearby liver cells.
Omega-3 fatty acids extinguish the flames of inflammation and omega-6 fatty acids fan those flames. To keep liver inflammation at bay and prevent that inflammation from damaging the liver, those with liver disease are likely to benefit from boosting their dietary intake of omega-3's, while simultaneously curbing foods full of omega-6 fatty acids.
Yes chocolate is high in omega 3's...that's a good thing...but ONLY if they haven't taken out the cacao fat and substituted another kind. (you have to read the fine print here because lots of chocolate has had another fat added and the cacao butter removed....
usually they use soy, palm and a few others...none of which is good for us..
plus, like I said...it half fat, and half pure sugar...so a little restraint might be in order.
here's a good primer on it....I am trying to raise my omega 3 profile also, but using sardines and an ALA supplement to get there...not that I would't prefer to use chocolate...but let's not loose sight of what we know about the liver and fat metabolism.
Easing Liver Inflammation: Balancing Omega-3's and Omega-6's
February 22, 2010
Although both are required for a healthy immune response, learn why those with inflammation of the liver should favor omega-3 fatty acids over omega-6's.
by Nicole Cutler, L.Ac.
Considered to be essential fatty acids, omega-3 fatty acids and omega-6 fatty acids are both necessary for human health. There are many reasons that health conscious individuals increase their consumption of omega-3 laden foods, while reducing their omega-6's. Upon recognizing why health professionals advise consuming more omega-3's than omega-6's, those with liver disease have every reason to follow suit.
Taken for everything from depression to heart disease to arthritis, the primary therapeutic action of omega-3 fatty acids is squelching inflammation. For decades, omega-3's have proven their ability to improve inflammatory conditions. Because hepatitis falls under this umbrella, this liver condition benefits from omega-3 fatty acid consumption.
Hepatitis literally means inflammation of the liver, and is involved in most types of liver disease, including:
· Viral Hepatitis: when hepatitis is caused by a virus - this includes Hepatitis B and Hepatitis C
· Alcoholic Hepatitis: when hepatitis is caused by alcohol, common in alcoholics
· Steatohepatitis: when fatty liver disease escalates and causes inflammation
The Inflammatory Pump
To address its current needs, the body is always trying to strike the right balance between inflammation and anti-inflammation. In achieving this balance, omega-3 fatty acids and omega-6 fatty acids are known to have opposing roles. The following events maintain this inflammatory pump:
· When an infection or foreign invader is detected, the immune system triggers production of Prostaglandin II.
· To quarantine the infection or invader, Prostaglandin II produces an inflammatory response that sends white blood cells to the affected area.
· Almost immediately, the immune system also triggers the production of Prostaglandin I to suppress inflammation and begin the healing process.
The balance between omega-3 and omega-6 fatty acids can affect the inflammatory pump's balance, because of their role in making prostaglandins:
· Omega-3 fatty acids are a necessary component in the production of Prostaglandin I.
· Omega-6 fatty acids are a necessary component in the production of Prostaglandin II.
Omega-3's and Omega-6's
Consequently, omega-3's are needed to suppress inflammation and encourage healing, while omega-6's are needed to initiate the inflammatory response. Nutritionists believe that a ratio of 2:1 of omega-6 fatty acids to omega-3's help keep the inflammatory pump in balance.
A suspected culprit of today's high rate of inflammatory diseases, many of our modern day food choices are rich in omega-6 fatty acids and stingy in omega-3's. In fact, experts estimate that the typical American diet contains 14 - 25 times more omega-6 fatty acids than omega-3's.
· Omega-6's are found in certain seeds and nuts, and the oils extracted from them. Refined vegetable oils (like soybean, corn, sunflower, safflower and cottonseed oils) are high in omega-6's and are used in a majority of fast foods, snack foods, cookies, crackers and sweets. According to Dr. Andrew Weil, soybean oil alone is now so ubiquitous in fast foods and processed foods that an astounding 20 percent of the calories in the American diet are estimated to come from this single source.
· Omega-3's are found in the fat of cold water fish, such as salmon, sardines, herring, mackerel, black cod and bluefish; other seafood including algae and krill; and some plant sources, especially walnuts and flax seeds.
Because it prevents infection from spreading to nearby tissues and organs, inflammation is a crucial process. However, too much inflammation has the opposite effect - and can easily harm neighboring structures. This is frequently the case in liver disease where hepatitis (liver inflammation) damages nearby liver cells.
Omega-3 fatty acids extinguish the flames of inflammation and omega-6 fatty acids fan those flames. To keep liver inflammation at bay and prevent that inflammation from damaging the liver, those with liver disease are likely to benefit from boosting their dietary intake of omega-3's, while simultaneously curbing foods full of omega-6 fatty acids.
Whats the the hell is a peens.... i thinkn its aball peen hammer of some sort,or am i thinkn its something to to with the gear shift of my car?With all the chocolate covered body parts and stuff,ya think we all were in a chocolate factory.
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Who are Top Answerers?
Thanks to all the members who are an integral part of the community, MedHelp has become a destination for people looking for answers to their medical questions. As the community has grown, so has the number of questions on the site. While the top community members devote time each day to helping others get answers or support in their time of need, there seem to always be more questions than answers.
In order to continue fostering a community where people can come to find support, we want to highlight our members who provide a lot of that support. Members will see an icon following the user names of the top answerers in each community based upon how many people they have helped and the quality of their answers. We hope that MedHelp will continue to be a place where people can find help and support.
What are Badges?
The icons following a user name are called Badges and represent the level of help and support provided to the community. There will be a formula that determines achievement of different levels of Badges and, in general, it may be influenced by the following factors: community response to your messages and the amount of contributions that a user makes to the forums. This ensures that the people we recognize as being the most helpful are helping as many people as possible through quality answers.
Well hello Mikesimon! Last I was here for a bit you were MIA for awhile. Good to see you!
And your news is even better! As I am a chocolate addict for yrs, no other sweets, just chocolate. Nothing covered, no nuts, fruits, candies, just the hard stuff, straight chocolate.
My BP has always run low too.
I'm in on this one!
Ladies.....I am lost on the chocolate 'peeps'? I saw the peep show pic, I know what peeps are, what the heck do you mean 'peeps' are for guys and 'peens are for girls? (now using my imagination I have come up with an idea??)
Yahhh chocolate! Too bad I've gained 10 lbs and put it away for awhile!
And your news is even better! As I am a chocolate addict for yrs, no other sweets, just chocolate. Nothing covered, no nuts, fruits, candies, just the hard stuff, straight chocolate.
My BP has always run low too.
I'm in on this one!
Ladies.....I am lost on the chocolate 'peeps'? I saw the peep show pic, I know what peeps are, what the heck do you mean 'peeps' are for guys and 'peens are for girls? (now using my imagination I have come up with an idea??)
Yahhh chocolate! Too bad I've gained 10 lbs and put it away for awhile!
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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!