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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Saturday, February 1, 2014

THE TRUTH ABOUT CHOCOLATE & HEART HEALTH

Valentine’s Day is a big chocolate holiday.  With the frequent chocolate-is-good-for-you stories in the media we might think we are doing our health a favor by digging into a box of chocolates.  But, is chocolate really good for us?  Pure cocoa bean powder, the nonfat portion of the bean is rich in healthy antioxidant flavanols.  However, the amount of pure cocoa in your favorite chocolaty treats is likely not enough to help your health while the amount of cocoa butter (the fat component of the cocao bean), fats and sugar does add up to a serious serving of calories and cholesterol raising saturated fats.

The cocao bean is one of the richest food sources of a group of plant substances called flavanols.  Other foods, such as tea, red wine, berries, and some fruits, especially the skins of apples, contain flavanols but none is as high concentrations as the cocoa bean.   Chocolate, as we know it, is a combination of cocoa bean powder, cocoa butter and other fats, and sugar.  In the finished product, there is actually not that much cocoa bean powder.  And, unfortunately, the flavanol content takes a hit when raw cocoa beans are converted into chocolate. How big a hit depends on how the cocoa is processed. 

A closer look at the research on chocolate & health…
© Blood Flow:  There is good evidence that consumption of large amounts of flavanols consistently improves blood vessel wall function in individuals regardless of whether they are young and healthy or have coronary artery disease, diabetes or high blood pressure.  It appears that flavanols increase the body's ability to synthesize nitric oxide, which triggers the dilation (relaxing) of arteries and allows for increased blood flow.  When arteries do not dilate but are stiff the heart has to work harder. In a study funded by chocolate maker Hershey, researchers found that blood flow in the arteries increased within two hours after older people consumed high doses of flavanols (180, 465, or 1,095 mg), but not in those who got 70 mg.

© Blood pressure.  A 2012 review of 15 randomized controlled trials that lasted from 2 to 18 weeks concluded that a high consumption of flavanols (an average of 560mg per day which is equivalent to the amount in almost 3 Hershey's Dark Chocolate bars) can lower blood pressure by 2-3 mm Hg in the short term.

© Weight Loss: There have been some observational surveys that have sampled individuals and found that those who weigh less also report consuming more chocolate.  This has led some to conclude that chocolate helps with weight loss.  However when the persons in the studies who have a weight-associated illness such as diabetes or heart disease are excluded from the analysis, the association of chocolate eating with less weight disappears.  Researchers hypothesize heavier participants are eating less chocolate because they're trying to eat healthier given their health problems.   

And, in studies that happen over a period of time, the opposite trend emerges – with higher chocolate consumption comes more weight gain.  For example, more than 12,000 U.S. residents aged 45-64 were weighed in the late 1980s and were asked, among other things, how often they ate a serving of chocolate. Six years later, they were weighed and asked about chocolate again. In this study over time, greater chocolate consumption was linked to greater weight gain and those eating the most chocolate gained the most weight.  People who consumed just an ounce of chocolate at least once a week gained an average of 2.4 pounds over the six years. 

Getting your flavanols fix...
So, while getting at least 200mg of flavanols per day can improve blood flow and blood pressure, eating chocolate will not necessarily add that many flavanols to your diet because processing cocoa beans destroys flavanols. How much is lost depends on the beans and the processing.  Labeling a chocolate bar as having, say, “70% cacao” is not a reliable guide to the amount of flavanols because one cannot tell how heavily that cocoa was fermented or processed, both of which destroy flavanols.

How to get 200 mg? Two ounces of dark chocolate would probably do but keep in mind it comes with an average of more than 300 calories.  Many cocoa mixes contain cocoa that has been "processed with alkali" (also called "Dutch-process") and this process effectively destroys the all flavanol content.  Milk chocolate has less cocoa and more sugar than dark chocolate, so it would take 10 ½ oz. (almost 1,600 calories' worth) to give you 200 mg of flavanols! 

A better calorie option is half an ounce of baking chocolate for 70 calories or two tablespoons of an unsweetened pure cocoa powder (like Hershey's or Nestle Toll House, which have around 20 calories). Try mixing these into your coffee, warm milk, oatmeal, or yogurt. Also, Mexican mole sauces are a flavorful way to incorporate unsweetened cocoa into your diet.


Article adapted from: Nutrition Action Healthletter, December 2013, pg.8-11.

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