From Today's Chicago Tribune..
Prescription: Chocolate?
Cocoa's flavanols may or may not boost your heart health, but the dose sure goes down easily
By Rick Asa
Special to the Tribune
Published February 9, 2005
As guilty pleasures go, chocolate has to be at the top of the list. But would it still be as pleasing if the guilt went away?
Food scientists are compiling strong evidence that chocolate, or more accurately its cocoa foundation, contains plant chemicals called flavanols that offer cardiovascular protection in several ways.
But before you gleefully start planning dinners around big chocolate Easter rabbits keep in mind that the studies on chocolate and humans, like those involving other phytochemical-laden foods, remain an inexact science. Research has yet to determine, for example, whether the observed benefits will translate to the population at large and how much is enough.
Another obstacle is taste; generally speaking, the less processed chocolate is, the higher the flavanol levels and the higher the bitterness and astringency.
Even before chocolate studies picked up steam in the past five years, scientists suspected that connection, having observed that indigenous populations that consume a high level of cocoa have a reduced risk of heart disease, said Carl Keen, chairman of the nutrition department at the University of California, Davis.
The Kuna Indians of the San Blas Islands off Panama, for example, historically have had extremely low blood pressure. They also drink a lot of locally grown, minimally processed cocoa high in flavanols.
Most chocolate we eat today is made from cocoa beans that have been stripped of the flavanols during a heating and chemical process that removes bitterness and prepares them for the mass market. The relatively bitter Kuna drink, on the other hand, would be an acquired taste that has little in common with our hot cocoa.
According to a study at the University of Glasgow, in Scotland, we would have to eat twice as much milk chocolate to obtain the same amount of flavanols as in bittersweet dark chocolate.
Keen was among the first researchers to show that gently processed, high-flavanol cocoa indeed has a biological effect.
He and other researchers have since shown that flavanols can:
- Help the blood protect against oxidation damage
- Reduce the risk of blood clots, an aspirinlike effect
- "Turn on" the production of nitric oxide, a key molecule in blood that helps protect blood vessels, lower blood pressure and increase circulation in the extremities
- Help reduce cytokines, compounds that increase damage to cardiovascular tissue
Not so fast with health claims
The inevitable backlash--we're talking about chocolate and a deeply engrained public perception here--has already begun.
When a St. Louis artisanal confectioner hired a university-based dietitian to lend credibility to its claims that its chocolates contain ingredients "linked to improved cardiovascular health," the activist Center for Science in the Public Interest quickly swooped in, saying the claims are putting the marketing cart in front of the science horse.
"Chocolate isn't broccoli," said Bonnie Liebman, director of nutrition at CSPI. "Antioxidant claims [for all foods] have been around for some time and in general have lost favor because of disappointing results on studies for vitamins E and C.
"The evidence could get stronger," Liebman allowed, but to date "no studies show that people who eat chocolate are healthier."
Oddly enough, Mars Inc., one of the biggest chocolate producers in the world, agrees. Its head of research, Harold Schmitz, insisted that Mars has invested tens of millions of dollars into cocoa and flavanol studies to "make sure the story is right in a sustainable way," noting that all of Mars' studies have been peer reviewed and are replicable.
"We really get concerned when we see the truncated headline `health chocolate,'" he said. "We're concerned because the science does not support chocolate as `healthy.' The science supports the claims that certain types of cocoa or certain types of chocolate can make a contribution to cardiovascular health.
"Most cardiologists would agree that nitric oxide is the central paradigm and we can quantify that. So we at least have a starting point to do dose-response studies [in humans]. The world of science will be hearing from Mars and our research collaborators on studies directly addressing this over the next two years," Schmitz said.
Go ahead, enjoy
From her clinical perspective, dietitian Lynn Danford, a nutrition specialist and research coordinator at the Northwestern Memorial Hospital Lynn Sage Cancer Center, noted that cocoa has been in the food supply for hundreds of years and was used medicinally by ancient civilizations in South and Central America. Though chocolate may not appear on a food pyramid anytime soon as an essential nutrient, she said, "it certainly can be enjoyed without the guilt which is too commonly associated with pleasurable foods in our culture."
Danford said her advice to most patients is to include chocolate in their diet if they enjoy it.
"The bottom line is, chocolate is not a necessity, but it is certainly an enjoyable part of our diet. The universal advice, everything in moderation, applies quite well to this delicious food."
So far, Mars has used its extensive cocoa research to coat Dove bars with a high-flavanol dark chocolate and produce an extremely high-flavanol bar called CocoaVia (available only online at cocoavia.com). It may bring a high-flavanol, powdered cocoa called CocoaPro to the market within a year.
When it comes to the artisanal chocolate that sells so well around Valentine's Day, that's a leap Schmitz said will be some time in coming.
First, people will need to perceive chocolate differently. This "reinvention of chocolate," as Schmitz puts it, would shift public perception from guilty indulgence to functional food, or at least separate the two.
There always will be those willing to give their right ventricle for a sublime truffle that tickles their taste buds. In the future, however, the rest of us may not have to compromise taste for health benefits.