Chocolate and the Risk of Coronary Artery Disease

Chayakrit Krittanawong, MD, of the Baylor College of Medicine, was part of a group of physician scientists conducting an observational study involving regular chocolate consumption and the risk of developing coronary artery disease. Their research was recently published in the European Journal of Preventive Cardiology. In what was called “a systematic review and meta-analysis” they analyzed data from 336, 289 participants, participating in six studies, looking at chocolate consumption, coronary artery disease, acute coronary syndrome and acute myocardial infarction.

If you consumed chocolate 3.5 times or more a month, or more than one time per week, you were considered a high chocolate consumer. High chocolate consumers turned out to have a lower risk of coronary artery disease of about 8%.

This is great news for chocolate lovers. However, readers must remember this is an observational study and cannot link cause and effect. It did not factor in obesity, lipid levels, presence of diabetes, cigarette smoking history, activity level, family history of premature coronary artery disease or other dietary habits.

Is it possible that chocolate lovers eat more fruits and vegetables than non-chocolate consumers? Could it be that chocolate lovers eat a healthy Mediterranean Diet more frequently than non-chocolate consumers?

This study clearly didn’t answer those questions. What it does say to me is that if you reduce your cardiovascular risk factors, as best you can, eating chocolate occasionally may not hurt.

Chocolate as a Cough Suppressant

Well before Valentine’s Day, and conspicuously in the middle of cold and flu season, Alyn Morice of the University of Hull in Yorkshire, England published a study showing that dark chocolate derivatives may be more effective than codeine in suppressing a cough. In a small study of 163 individuals, each with a cough due to an infection, her group randomly assigned them to a group receiving a codeine based cough syrup or a chocolate cocoa based syrup called Rococo. Their results showed that within two days the chocolate based recipients felt significant improvement in their cough compared to the codeine based group. A similar study had previously been performed at the imperial College in London showing that theobromine, a product in cocoa, is superior to suppressing coughs over codeine.

Professor Morice believes the properties in cocoa are demulcent and help relieve irritation and inflammation. “This simply means it is stickier and more viscous than standard cough medicines, so it forms a coating which protects nerve endings in the throat which trigger the urge to cough. This demulcent effect explains why honey and lemon and other sugary syrups help.” They believe chocolate has additional helpful ingredients so much so that they advise sucking on a piece of dark chocolate as a mechanism of relieving a cough. We now have some science to back mom’s hot chocolate and hot cocoa for a cold and a cough.

Hot Cocoa And Other Foods May Boost Brain Power

G. Desideri, PhD, of the University of L’Aquila in Italy performed a controlled double blind study that looked at the effects of cocoa flavonoids on cognitive function in seniors who were mildly cognitively impaired.  The data was presented in the online journal Hypertension and reviewed in the University Of Pennsylvania School Of Medicine online journal MedPage.  Existing “evidence” suggests eating flavonoids, polyphonic compounds from plant-based foods, may confer cardiovascular (heart and blood vessel) benefits.  Flavonols are a type of compound found in abundance in tea, grapes, red wine, apples and cocoa products including chocolate.

Desideri and associates looked at 90 seniors diagnosed with minimal cognitive impairment (MCI) who were randomly assigned to drink cocoa for eight weeks containing high, intermediate and low levels of flavanols per day.  They found improvement in the cognitive performance of those in the high and intermediate flavanol intake groups.   They additionally noted improvements in blood pressure and insulin resistance for these same groups. Systolic blood pressure decreased 10 mm in the high intake group and 8.2 mm in the intermediate group. A drop in diastolic blood pressure was noted as well.     There was no elevation of blood cholesterol or triglyceride levels in any of the groups and blood sugar actually decreased in the high and intermediate intake groups.

They concluded that “regular dietary inclusion of flavanols could be one element of a dietary approach to maintaining and improving not only cardiovascular health but also, specifically, brain health.”

Clearly more research is needed but initial studies like this certainly encourage clinicians to feel comfortable suggesting that a cup of hot cocoa, a glass of red wine (in moderation), red grapes and dark chocolate are healthy as well as pleasurable.

Dark Chocolate: Cardiovascular Prevention

A study from Australia predicts that if 10,000 men with big bellies and the “metabolic syndrome” (abdominal obesity, diabetes, hyperlipidemia , hypertension)  ate 100 grams of  dark chocolate daily, it would prevent 70 non-fatal and 15 fatal heart attacks per year.  The total yearly cost of the chocolate is less than $50 per patient.   Recent studies have shown that dark chocolate can reduce high blood pressure and lower lipids.  This study was based on a model that predicted the effects of dark chocolate lasting for 10 years when, in fact, true research studies have not lasted that long.

This is a promising avenue of research involving a food substance that most of us enjoy.  For my patients, almost any food in moderation produces success.