Is chocolate really associated with better health?

It seems that study after study has been touting the benefits of chocolate – eat more of the (delicious!) dark stuff and you might find yourself losing weight, suffering fewer or less severe heart attacks, possessing cleaner arteries, and having a lower blood pressure. Despite the theoretical explanations for chocolate’s health benefits, it is usually found packaged and processed along with some other not so healthy ingredients including saturated fat, sugar, and even lead from the manufacturing process. But the studies keep coming, and as a purported health food chocolate is gaining a celebrity status akin to red wine, coffee, and whole grains.

Are the studies claiming a diet rich in chocolate may be beneficial to human health subject to bias and promotion? Is there a connection between the facts that chocolate, wine, and coffee are the products of multi-billion dollar industries and their frequent mentioning in the health press? Do our collective cravings lead us to read what we want to read? Why is no one talking about sunchokes? Do we just want to believe in the prudence of our indulgences, or is there some kind of chocolate conspiracy going on?

A quick review of recent diet, nutrition and weight loss journal articles shows a few well-placed chocolate findings:

An article published in the Archives of Internal Medicine last month found that frequent chocolate consumption was associated with lower body mass index. The authors posited that substances called catechins, which are derived from cocoa, might increase metabolic activity, muscle performance, and lean muscle mass. The study even found that chocolate eaters tended to consume more total calories and saturated fat, but tended to have lower weight.

Another study found that chocolate consumption is associated with a lower risk of bad cardiovascular outcomes such as heart disease and stroke. The authors reviewed seven observational studies with a follow up time of 8-16 years, and found in their pooled analysis that those persons eating chocolate more than 5 times per week had an almost 40% reduction in any cardiovascular disease and a 30% reduction in stroke. They speculate that polyphenols present in cocoa products may be the source of this benefit, but caution that the sugar-laden products, if eaten excessively, could produce the unwanted effects of weight gain, diabetes, and obesity.

And finally, a study published in the Archives of Internal Medicine found that women who ate chocolate frequently had a lower risk of being hospitalized or dying from atherosclerotic heart disease. Flavinoids were singled out as the micronutrients most likely to explain this beneficial result from chocolate consumption.

By contrast there were no recent articles that I could find about sunchokes, a homely vegetable with a pasty, sullen and downright mealy consistency, bereft of a worldwide industry that might promote its invigorating primacy among life-extending vegetables. No one seems to revere the sunchoke, except perhaps for the Native Americans who first cultivated it. The Englishman John Goodyear was quoted in 1621 as having described the sunchoke thusly:

… which way soever they be dressed and eaten, they stir and cause a filthy loathsome stinking wind within the body, thereby causing the belly to be pained and tormented, and are a meat more fit for swine than men.

To be fair, most of the chocolate scientific authors are quick to point out that their studies are of inferior quality to the gold standard of scientific evidence – no randomized, double-blind, placebo-controlled, prospective trials have been carried out to really assess the associations between diets rich in chocolate and weight loss, cardiovascular health, and overall healthier body mass index. Most conclude with a tongue in cheek nod to the obvious guilty pleasures the authors took in absolving themselves of the guilt one might otherwise feel eating sugary, velvety, succulent dark chocolate confections. And articles that glorify our guilty pleasures, whether they be indulging in heavenly dark chocolate or a morbid fascination with Brad Pitt, tend to garner attention and readership.

So is there a chocolate conspiracy? I think so. I do hope these associations with better health, lower body mass index, and reduced cardiovascular risk are one day proven by real prospective trials. In the meantime I am eating more chocolate than sunchokes for reasons other than weight loss goals.

By way of contrast, at least one negative article has been published about chocolate. It shines a light on a possible association between higher chocolate consumption and depression. It was difficult to say which came first, the Ghirardelli or the sertraline, the chicken or the egg, the sunchoke or John Goodyear’s bowel troubles. But those who ate more chocolate were found to have more depressive symptoms upon screening.

But I wonder, did any of us bother to read that one?

“Dr. Charles” is a family physician who blogs at The Examining Room of Dr. Charles.