A recent popular article in the telegraph titled “Eating chocolate every day good for your health”, discusses how chocolate affects the body. The article was written in light of a new study published in the British Journal of Nutrition that investigated the association between daily chocolate consumption, liver function and the observation of cardiovascular risk factors.
The study took a random sample of 1,153 people aged 18-69 years old to participate in the cross-sectional Observation of Cardiovascular Risk Factors in Luxembourg study. The study found that consuming chocolate each day could help prevent heart disease and diabetes risk. The researchers found those who ate 100 g of chocolate a day (equivalent to a bar) had reduced insulin resistance and improved liver enzymes¹. Insulin resistance is a well-established risk factor to cardiovascular disease¹.
Important things to consider:
- Amount of chocolate
100 grams (3.5 ounces) or a bar of chocolate is quite a fair amount of chocolate. Eating this amount of chocolate is fairly high in calories (600 calories) & high in sugar and therefore, it’s not something you should be consuming daily. Especially, if you do not have a high level of physical activity as this could easily lead to weight gain.
- Type of chocolate
It is important to remember dark chocolate, not heavily processed chocolate such as milk & white chocolate is associated with health benefits. Unlike the processed chocolate, cocoa and dark chocolate is antioxidant rich (includes include polyphenols, flavanols & catechins), rich in soluble fibre and minerals². In addition, the fatty acid profile of cocoa and dark chocolate is more favourable².
- Strength of evidence
This was a cross-sectional study which found an association and so it is not possible to conclude cause and effect. The study found that those who claimed to eat chocolate, were younger and more physically active. It is hard to know how much confounding factors influenced the findings. Physical activity improves insulin sensitivity so how much does this influence the inverse association between chocolate consumption and insulin sensitivity?
The authors of the study acknowledge the studies weaknesses and the authors concluded that further observational research and randomised controlled studies are needed to understand the role chocolate may play in insulin resistance and cardiometabolic disorders¹.
However, there are randomized control trials (RCT’s) that have shown consuming dark chocolate can improve several important risk factors for heart disease. In RCT’s, consuming dark chocolate has been found to lower blood pressure³˒⁴, oxidised LDL cholesterol (10) and reduce insulin resistance⁵˒⁶.
So…should health professionals recommend chocolate consumption to individuals to protect against heart disease?
To conclude, there isn’t enough evidence that consuming chocolate directly reduces an individual’s heart disease risk. However, there is convincing evidence that cocoa and dark chocolate consumption reduces cardiovascular disease risk factors. It is important to take this into consideration.
Unfortunately, I don’t think at this point it can be a recommendation and this is because I think it would be hard to recommend dark chocolate consumption without a guideline of how much chocolate would be of clinical significance to reduce heart disease risk factors.
However, I don’t think that cocoa or dark chocolate consumption should be discouraged. If a patient revealed that they consume dark chocolate in their dietary assessment, the health professional should encourage them to consume it in moderation and purchase dark chocolate with a cocoa content higher than 70% and engage in physical activity.
Research strongly suggests that consuming foods rich in phytochemicals⁷, including fruit, vegetables & dark chocolate, may help prevent disease. Therefore, I believe it would be good for health professionals to recommend people to consume more phytochemical rich foods.