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Hot Chocolate for High Blood Pressure?
It's a good idea for those with high blood pressure to make sure they're getting enough fruits and vegetables in their diet. Not just for overall health, but because the polyphenols, or flavonoids, in fruits and vegetables have been linked with reduced blood pressure and lower risk of heart disease. Yet the foods with the largest amounts of polyphenols are not foods at all but beverages - tea and cocoa. 

Why Do You Crave Chocolate at That Time of the Month?
Chocolate cravings are an interesting phenomenon: over 45% of undergraduate women in the United States report having a regular craving for chocolate, and over 90% of women admit to craving chocolate at least once in their lives. Oddly enough, this phenomenon seems to be largely limited to adults in North American countries - other cultures do not seem to crave chocolate any more than they might crave anything else.

Plant Sterols in Chocolate
I'm sure you've seen them at the supermarket: foods that have been enriched with plant sterols. These compounds have been shown to help improve cholesterol scores - so much so that the FDA has approved the use of a health claim about it on foods that contain plant sterols. The American Heart Association actually recommends that you include 2 grams of plant sterols per day as part of a healthy diet.


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Does eating chocolate prevent diabetes?

a slice of chocolate cheesecake garnished with curls of chocolate and a sliced strawberry

As I've noted in the past, medicine is not like algebra, where if A = B and B = C, then A = C. So if a food contains an ingredient, and that ingredient has been linked with a certain positive or negative effect, it does not necessarily follow that the food will also have that effect. (Boy, it would be great if it did!) In medicine, it's critical to connect those dots with specific research.

Chocolate is a case in point. Cocoa, from which chocolate is made, is high in flavonoids (an antioxidant) and contains both caffeine and magnesium. All three of those ingredients have been separately linked to a reduced risk of diabetes, while cocoa and chocolate have been linked with reduced oxidative stress, inflammation, and insulin resistance - all three of which are associated with diabetes.

A team of researchers from Harvard Medical School and Tokyo Medical University in Japan sought to connect the dots between cocoa, chocolate, and diabetes (Am J Clin Nutr 2015;101:362-7). The made use of data collected through The Physician's Health Study I and The Physician's Health Study II, two long-term, large-scale observational studies that followed a total of ~37,000 male physicians for as many as 32 years. The data gathered through those studies included yearly dietary questionnaires as well as information regarding health, physical activity, demographic information, and height/weight.

The researchers were able to determine which participants developed diabetes over the course of the study and compare the reported chocolate intake of those participants with that of those who did not develop diabetes.

After taking into account such factors as age, Body Mass Index, level of exercise, and intakes of certain foods (including whole grains and nuts), the researchers initially found an inverse relationship between chocolate intake and risk of developing diabetes: those who ate more chocolate were less likely to develop diabetes. Upon closer analysis of different subgroups of the participants, however, they found that only those men who were under 65 and of clinically normal Body Mass Index actually enjoyed this reduced risk: the effect disappeared for those who were overweight or over 65.

What this means for you

This is a good example of needing to use caution in interpreting the results of research. Observational studies like these don't prove that one thing causes another - they show that when one thing happens, another thing also happens a certain percentage of the time. In this study, those who were younger and of normal weight were less likely to develop diabetes - and that's not surprising, statistically speaking, regardless of how much chocolate they might have reported eating. The other problem is that it was impossible to tell what kind of chocolate the participants ate. Dark chocolate? Milk chocolate? Chocolate with nuts? Chocolate spreads like Nutella? This study is interesting and adds to our knowledge that cocoa is good for you, but it's not conclusive. Sorry, chocolate lovers.

First posted: February 25, 2015