Showing posts with label chocolate. Show all posts
Showing posts with label chocolate. Show all posts

Wednesday, July 17, 2013

Chocolate and Your Health: Is It Good or Bad For You?

I'm sure you are licking your lips hoping I say good, but I can't satisfy your hunger for an answer until I first review with you what is chocolate.

Chocolate is a processed product derived from the seed of the tropical Theobroma cacao tree. Due to the intense bitter taste of the seeds of the cacao tree, the seeds must be fermented to develop the flavor. After fermentation, the beans are dried, cleaned, and roasted, with the shell removed to produce cacao nibs. The nibs are grounded into cocoa mass, which is pure chocolate. This cocoa mass, which is usually liquefied then molded with or without added ingredients, is called chocolate liquor. The liquor may be processed into two components: cocoa solids and cocoa butter. Unsweetened baking chocolate (bitter chocolate) contains primarily cocoa solids and cocoa butter in varying proportions.

In summary, a naturally occurring product goes through a chemical process during which a number of additional ingredients are typically added to produce the product that many people crave. Not surprisingly, when man starts fooling around with nature, the result is usually not so good for you. Chocolate is no exception.

Most commercially available chocolate consumed today combines cocoa solids, cocoa butter or other fat, with some amount of sugar. Milk chocolate is usually a sweet chocolate that additionally contains milk powder or condensed milk. White chocolate is actually not considered a chocolate at all because it contains no cocoa solids. There are little health benefits in milk chocolate and no health benefits whatsoever in white chocolate. Zero. Nada. Zilch. Sorry. However, dark chocolate has it's own story.

So when one asks if chocolate is healthy, one must first clarify about which chocolate they are inquiring and also clarify what they mean by healthy.

Let's take a closer look at what's in cacao. The cacao seed contains alkaloids such as theobromine, phenethylamine and caffeine that all may have a physiological effects on the body and are linked to serotonin levels in the brain. Having a physiological affect on the body or brain per se does not make something healthy any more than a drug that has the same effects. For the most part, medications are necessary evils that provide some critical benefits when used properly to treat disease, but are not generally health promoting products (with some rare exceptions) in the absence of disease. In other words, just because something has an effect on your body doesn't make it necessarily good for you. Think illicit drugs.  While cacao may have a role to play in promoting health because of some of its natural constituents such as flavonals and falvonoids, its healthiness really depends on its form and the amount consumed.

Chocolate also contains a wide range of antioxidants that includes soluble phenolic compounds (phenolic acids, catechin, epicatechin, and proanthocyanidins), insoluble polymeric phenolics and methylxanthines. I won't bore you here with a nutrition lesson, but natural occurring antioxidants in their natural state (not processed or extracted) are generally healthy in reasonable amounts. For more on antioxidants, please see my prior blogs on this topic at http://mdprevent.blogspot.com/2012/06/can-we-prevent-aging-national-institute.html and http://mdprevent.blogspot.com/2013/01/the-case-against-antioxidants.html)

So what does the science show in regards to the consequences to one's health from eating chocolate?

Please find below a nice summary taken from Wikipedia about the pros and cons of chocolate. Notice in the "positive" section, the word "may" always figures prominently. Why? The answer is that studies of chocolate are often limited, poorly constructed, paid for by chocolate manufacturers, and/or don't usually fully account for other dietary and lifestyle factors. For example, consuming a lot of chocolate containing fat is less problematic when you otherwise limit your saturated fat intake. Studying chocolate out of context is like saying that eating a low fat dairy diet is healthy and then failing to mention that the comparison was made to a full fat dairy diet instead of a non-dairy diet. (Side note: actual study played that deceptive game).  My review of the chocolate studies reveals such fundamental flaws in study design, which by and large, makes such studies unreliable.Nevertheless, her's some of the studies.


Health effects


Chocolate with various fillings.
Positive
Negative
  • Chocolate is believed to cause heartburn because of one of its constituents, theobromine, relaxes the oesophageal sphincter muscle, hence permitting stomach acidic contents to enter into the oesophagus.[81] Theobromine is also toxic to many animals because they are unable to metabolize it (see theobromine poisoning).[3]
  • The unconstrained consumption of large quantities of any energy-rich food, such as chocolate, without a corresponding increase in activity, is thought to increase the risk of obesity. Raw chocolate is high in cocoa butter, a fat which is removed during chocolate refining, then added back in varying proportions during the manufacturing process. Manufacturers may add other fats, sugars, and milk as well, all of which increase the caloric content of chocolate.
  • Chocolate and cocoa contain moderate to high amounts of oxalate,[82][83][84][85][86][87] which can cause some health concerns particularly for individuals at risk for kidney stones.[88]
  • Chocolate absorbs lead from the environment during production, and there is a slight concern of mild lead poisoning for some types of chocolate. In a study from Nigeria, the average lead concentration of cocoa beans was less than 0.5 ng/g, among the lowest reported values for a natural food, with lead concentrations ranging from 70–230 ng/g for raw and processed cocoa.[89] These measurements "are consistent with market-basket surveys that have repeatedly listed lead concentrations in chocolate products among the highest reported for all foods. One source of contamination of the finished products is tentatively attributed to atmospheric emissions of leaded gasoline, which is still being used in Nigeria."[89] The figures are still comparatively low when compared to 200,000 ng, which is the WHO tolerable daily limit for lead consumption.[90]
  • Research on elderly people showed chocolate might cause osteoporosis.[91]
  • A few studies have documented allergic reactions with chocolate in children.[81]
  • There is some evidence that chocolate may be addictive.[92][

    Really? No kidding. So as you can see, the balance swings in the wind on this one. So how does one decide? Let's look at some other factors.
    There is also much to say about the fat in chocolate. The most important thing is that most chocolate products contains both healthy and unhealthy fats, the three main fats being oleic (monounsaturated fats) and stearic and palmitic (both saturated fats). The jury is still out whether or not these fats are good or bad for you. Certain camps of opinion are adamantly opposed to them, particularly if you have heart disease, while others favor their use in small amounts. My take-away - limit the intake of these saturated and monounsaturated fats in any form, but do not try to avoid them completely. Nevertheless, typically, the less sugar in a chocolate product, the more fat and vice a versa. You have to read the labels.

    Like most people, I like chocolate. However, when I shop for chocolate, I read the labels extremely carefully looking for serving size (at least a third of the bar), very limited added sugar (less than 4 grams per serving), a high percentage of cacao, (Usually 70% or more. By the way, beware of high cacao seducing you into a false sense of security that the product is healthy because the added sugar and fat will quickly eliminate any benefits of the chocolate's flavonals and phenols. ) and finally, no runaway fats (which means look for products that contain less than 15% of the recommended daily fat allowance per serving).

    The truth be told is such products with little sugar, high cacao, and reasonable fat usually don't excite the common palate and aren't too popular. Not surprisingly, I often find them selling at a discount. Nice. 
    So in summary, given the nature of processing cacao into chocolate and the common addition of other ingredients to make the chocolate palatable, chocolate can truthfully not be called a healthy food. However, eaten in moderation in small quantities as described above per recommended serving size, added sugar, percentage of cacao, and amount of fat, a daily serving of DARK chocolate can be enjoyed with little worry to one's health. (but don't feed it to your dog or cat as it can be toxic to them). Also, don't drink it with milk as milk binds the phenols. which is the "healthiest" part of the chocolate.
    Bon appetit!

Friday, June 1, 2012

I'm Sorry To Be A Party Pooper, But...

Many people love chocolate for obvious reasons. When they hear it's good for them, that's just frosting on the cake (pun intended). Over the next day or so, you are going to see and hear a tsunami of headlines, yet again, about the heart benefits of eating dark chocolate. The headlines will blare how dark chocolate prevents cardiovascular events.

This breaking news will be the result of a modeling study that predicts that patients with metabolic syndrome who eat dark chocolate every day could have 85 fewer events per a population of 10,000 over 10 years. The study, conducted by Chris Reid, PhD, of Monash University in Melbourne, Australia and colleagues was supported by a grant from a pharmaceutical company.  (For more about metabolic syndrome, please read end of blog).

The researchers used a Markov model to assess health effects and associated costs of daily consumption of plain dark chocolate compared with no chocolate in a population with metabolic syndrome but without diabetes or cardiovascular disease.

That's my first problem with the study.

It wasn't a gold standard randomized double blind controlled study. It wasn't even a good observational study. It was a mathematical calculation, and at that it only showed a benefit of .85 (yes, point eighty five) fewer heart related events per 100 people, and of the heart events, they are predicting .15 fewer events leading to death. That means for every 1000 people who eat the chocolate, there would be 1.5 fewer deaths.

Okay, you say, I get to eat chocolate and maybe I'll be the one guy or gal out of a thousand that benefits from it. So here's my real problem with the study. As a modeling study, it also made assumptions about the type of chocolate that was consumed. The researchers wrote, ""Evidence to date suggests that the chocolate would need to be dark and of at least 60% to 70% cocoa, or formulated to be enriched with polyphenols." There is no reference to the sugar content of the chocolate.

True, dark chocolate in high concentrations (usually over 75% cacao) contains polyphenols, which are healthful antioxidants. However, the sweetness in the dark (or sometimes called bittersweet) chocolate always comes from added sugar of one sort or another. This sugar is usually not healthy and is also fattening.

I know from personal experience that when I added for the purported health benefit (and the taste) one small piece (1/8 of a bar) of dark chocolate a night with 75% cacao (the higher the cacao the more sugar needed to make it enjoyable), my weight started to slightly increase from that one solo change. I stopped the practice.

If you think that this was a study that should make you go out and buy some dark chocolate, here is what the researchers said about their own study.

Reid and colleagues noted that the study was "limited by its reliance on the Framingham algorithm, which may underestimate risk in a high-risk population, and by assumptions about the risk of death following a cardiovascular event." Furthermore, "the study was also limited by the assumption that the benefits of dark chocolate, which have only been observed in short-term trials, extend to 10 years."

By the way, there are many non-processed rich sources of polyphenols in fruits and vegetables such as blueberries, black berries, strawberries, red grapes, eggplant, etc., so you don't need to eat chocolate to get your daily dose.

In conclusion, dark chocolate is better than regular chocolate. The higher the percentage of cacao, the more healthy polyphenols it contains, but watch out for the increase in carbohydrates. Nibble on no more than 1/8 of a bar at any given time. Most importantly, if you want to eat it, do it for the taste, because the heart benefits are still inconclusive.

More on Metabolic syndrome

From PubMed

Insulin resistance syndrome; Syndrome X

Metabolic syndrome is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke and type 2 diabetes .

Causes, incidence, and risk factors

Metabolic syndrome is becoming more and more common in the United States. Some estimate it as affecting 25% of the U.S. population. Researchers are not sure whether the syndrome is due to one single cause, but all of the risks for the syndrome are related to obesity.

The two most important risk factors for metabolic syndrome are:
  • Extra weight around the middle and upper parts of the body (central obesity). The body may be described as "apple-shaped."
  • Insulin resistance, in which the body cannot use insulin effectively. Insulin is needed to help control the amount of sugar in the body. As a result, blood sugar and fat levels rise.
Other risk factors include:
  • Aging
  • Genes that make you more likely to develop this condition
  • Hormone changes
  • Lack of exercise
People who have metabolic syndrome often have two other problems that can either cause the condition or make it worse:
  • Excess blood clotting
  • Low levels of inflammation throughout the body

Symptoms

  • Extra weight around your waist (central or abdominal obesity)

Signs and tests

According to the American Heart Association and the National Heart, Lung, and Blood Institute, metabolic syndrome is present if you have three or more of the following signs:
  • Blood pressure equal to or higher than 130/85 mmHg
  • Fasting blood sugar (glucose) equal to or higher than 100 mg/dL
  • Large waist circumference (length around the waist):
    • Men - 40 inches or more
    • Women - 35 inches or more
  • Low HDL cholesterol:
    • Men - under 40 mg/dL
    • Women - under 50 mg/dL
  • Triglycerides equal to or higher than 150 mg/dL
Tests that may be done to diagnose metabolic syndrome include:
  • Blood pressure measurement
  • Fasting glucose test
  • HDL cholesterol level
  • LDL cholesterol level
  • Total cholesterol level
  • Triglyceride level

Treatment

The goal of treatment is to reduce your risk of heart disease and diabetes. Your doctor will recommend lifestyle changes or medicines to help reduce your blood pressure, LDL cholesterol, and blood sugar.
Recommendations include:
  • Lose weight. The goal is to lose between 7% and 10% of your current weight. You will probably need to eat 500 - 1,000 fewer calories per day.
  • Get 30 minutes of moderate intensity exercise, such as walking, 5 - 7 days per week.
  • Lower your cholesterol using weight loss, exercise, and cholesterol lowering medicines, if needed.
  • Lower your blood pressure using weight loss, exercise, and medicine, if needed.
Some people may need to take daily low-dose aspirin.
People who smoke should quit.

Expectations (prognosis)

People with metabolic syndrome have an increased long-term risk for developing cardiovascular disease and type 2 diabetes.

Complications

  • Atherosclerosis
  • Diabetes
  • Heart attack
  • Kidney disease
  • Nonalcoholic fatty liver disease
  • Peripheral artery disease
  • Stroke