Most dietary recommendations start with the word "don't." Don't eat anything fried, fattening, or fun. Don't eat so much, and don't drink so much -- don't, don't, don't. In fact, it comes as a surprise when a delicious food item makes it to the "do eat" list, particularly when that food item ranks among the most beloved of all edibles. And so, the recent glut of studies finding that chocolate may benefit health seems almost too good to be true.
One study out of Germany adds weight to the pro-chocolate evidence, making it appear that the cosmic plan isn't so punishing, after all. The study, published in The European Heart Journal, followed 19,357 adults for 10 years. The researchers found that those subjects who ate just a tiny 7.5 gram square of chocolate every day lowered their risk of heart attack by 27 percent and reduced their risk of stroke by a whopping 48 percent when compared to those subjects who ate less or none. The chocolate-eating subjects also had lower blood pressure.
As for the amount of chocolate the subjects consumed, alas -- it wasn't exactly a hungry-teen-sized chunk. A regular Hershey's bar weighs an ounce and a half; so 7.5 grams comes to about one-quarter of an ounce, meaning that the subjects ate the measly equivalent of one-sixth of a Hershey candy bar daily, or about seven large chocolate chips. That's not exactly a party-sized portion, but compared to taking cholesterol pills for prevention, it's a hands-down winner in the flavor department.
Study director Dr. Brian Buijsse says, "To put it in terms of absolute risk, if people in the group eating the least amount of chocolate (of whom 219 per 10,000 had a heart attack or stroke) increased their chocolate intake by six grams a day [again, approximately one chocolate square], 85 fewer heart attacks and strokes per 10,000 people could be expected to occur over a period of about 10 years." The researchers did not account for type of chocolate consumed, although seemingly as an afterthought, they asked 1,568 of the participants to describe the chocolate they ate in the last 24 hours and found that 57% ate milk chocolate, 24% dark chocolate, and two percent white chocolate.
If there's a catch, it's certainly not that those who ate the most chocolate also had healthier diets overall. In fact, the chocolate lovers ate less vegetables and fruits than did the control group. "Despite lower intakes of fruits and vegetables, they still had a lower risk of heart disease," said Dr. Buijsse.
Also, the study was not funded by the chocolate industry, as were some of the earlier researches, but rather, by the German government and the European Union. It follows on the heels of previous research that reviewed three earlier studies. One of those studies reviewed data on 34,000 postmenopausal women enrolled in the Iowa Women's Health Study and found that eating the equivalent of a chocolate bar weekly reduced stroke risk by 22 percent. Another of the studies followed 1100 subjects and found that eating a few chocolate bars a week reduced the risk of dying from stroke by 46 percent.
Researchers attribute the dark chocolate natural heart health benefits to the flavonoids and flavonols in cacao, which may increase the elasticity of blood vessels and improve platelet function. Dark chocolate, which contains a higher percentage of cocoa than other chocolates, ostensibly contains a correspondingly higher percentage of these antioxidants. "Flavanols appear to be the substances in cocoa that are responsible for improving the bioavailability of nitric oxide from the cells that line the inner wall of blood vessels" says Dr. Buijsse. "Nitric oxide is a gas that, once released, causes the smooth muscle cells of the blood vessels to relax and widen; this may contribute to lower blood pressure. Nitric oxide also improves platelet function, making the blood less sticky."
Ever since the word got out from earlier studies about these benefits, many nutrition-conscious individuals (with a sweet tooth) have been buying up bars of 70-percent-plus chocolate. But is the evidence convincing enough to ensure that they're making a good choice? First, consider the fact that no matter how you package it, chocolate contains plenty of calories. A three-and-a-half ounce bar of chocolate (either milk or dark) has about 500 calories, and if you eat one of those weekly, your waistline will show it. It works out to about six extra pounds of body fat a year you have to account for.
Dr. Buijsse suggests a fix: "Small amounts of chocolate may help to prevent heart disease, but only if it replaces other energy-dense food, such as snacks, in order to keep body weight stable." Of course, there's also the saturated fat and sugar content to worry about, and in many cases, additives and pesticide residue (unless you go organic). Plus, high cocoa content doesn't always mean high flavonoid content. Because flavonoids lend cocoa a bitter flavor, many manufacturers remove them. (And just when you thought you were doing something good for yourself!) The less processing cacao undergoes, the more flavonols remain, so it's important to find a brand that retains the antioxidants. Some manufacturers have been experimenting with ways to preserve the optimal amount.
So, should you start eating a chocolate square a day to keep the doctor away? The experts aren't sure, given all the potential pitfalls. "It's a little early to make recommendations [about chocolate consumption]," says Dr. Buijsse. "But a future recommendation could be that if people eat a small amount of chocolate, they can replace it for something else, maybe leaving out a snack or another sweet." He says more studies are needed. In the meantime, if you choose to believe that the universe is benign, after all, and chocolate really is good for you, your best bet probably is to eat a small amount of raw organic cacao nibs daily, since they're totally unprocessed and so contain the highest flavonol content and the lowest amount of the health-compromising ingredients.