Can dark chocolate intake decrease depressive symptoms? Is chocolate intake linked to a higher risk of atrial fibrillation? New research examines the impact that chocolate has on various health conditions.
According to the National Confectioners Association (NCA), chocolate accounts for 60% of the $35 billion US confectionery industry with US sales of chocolate totaling >$21 billion every year. Also, according to the NCA, 83% of consumers believe chocolate is part of a happy, balanced lifestyle. How accurate is that notion? Numerous studies have been published recently that investigated the various effects that chocolate consumption has on depression, acne, cardiovascular health, and various other conditions. What did these studies find? And is chocolate actually beneficial to patients’ everyday health? Identify which of the 8 statements above on the outcomes of these studies are true or false to find out.
Question 1. True or false? High daily chocolate consumption is associated with a higher risk of Afib.
Answer: False. Two Swedish cohort studies of >72 000 adults found no association between consuming more extreme amounts of chocolate (≥1 serving/day) and Afib (HR 0.96; 95% CI 0.83-1.11). Researchers also conducted a meta-analysis of 5 cohort studies and found similar results with patients who increased their chocolate intake by 2 servings/week (HR 0.97; 95% CI 0.94-1.01).1
Question 2. True or false? Adults who eat dark chocolate are 70% less likely to report depressive symptoms.
Answer: True. In a recent cross-sectional survey of 13 626 US adults aged ≥20 years, those who reported any dark chocolate intake had 70% lower odds of reporting clinically relevant depressive symptoms vs those who did not report any chocolate intake.2
Question 3. True or false? The same survey found that adults who consumed higher amounts of any chocolate per day had higher odds of depressive symptoms vs those who consumed no chocolate.
Answer: False. In the same cross-sectional survey of US adults, participants who reported the highest daily consumption of any chocolate (104-454g) had 57% lower odds of depressive symptoms vs those who reported no chocolate intake.2
Question 4. True or false? Consuming high amounts of chocolate during pregnancy can decrease a woman’s risk of developing GDM.
Answer: True. A recent study of >84 000 pregnant women with a median gestational age of 12 weeks was the first prospective cohort study to examine the association between chocolate intake and risk of GDM. Median chocolate intake was split into 4 quartiles, the lowest, 0 g/week; the highest 87.5 g/week). Women in the highest quartile had a lower risk of developing GDM vs those in the lowest quartile (OR=0.76, 95% CI: 0.66-0.86).3
Question 5. True or false? Consuming chocolate ≥3 days/week has been found to increase acne in adolescents and young adults.
Answer: True. A recent study that examined 558 patients with acne aged 10-24 years found that consuming chocolate ≥3 days per week was associated with acne development (OR=2.19; 95% CI: 1.36–3.53).4
Question 6. True or false? Regular consumption of dark chocolate with LCC vs HCC can improve cardiovascular health in young adults.
Answer: False. A new randomized study evaluated dark chocolate consumption among 30 healthy patients aged 18-27 years who either ingested 20 g/day of dark chocolate with LLC (~55%) or HCC (~90%) for 30 days. Results showed that regular intake of HCC improved vascular function by reducing central brachial artery pressures and promoting vascular relaxation.5
Question 7. True or false? Prevalence of hypertension was found to be lower among patients who consumed chocolate on a daily basis vs those who consumed no chocolate.
Answer: True. A recent study found that among 350 patients with first myocardial infarction, 43.2% of those who consumed a median of 21.5g of chocolate per day developed hypertension vs 62.3% of patients who did not consume any chocolate. Also, patients who consumed chocolate daily had a lower prevalence of diabetes vs those who did not (13.5% vs 25.7%, respectively) and smoking was less common among those who had chocolate daily than those who did not (24.3% vs 37.7%, respectively).6
Question 8. True or false? The same study found a lower prevalence of alcohol and drug use among patients who consumed chocolate daily.
Answer: False. Patients who consumed chocolate daily also consumed greater amounts of alcohol (40.5%) vs those who did not eat chocolate (26.4%); 9.5% of patients who consumed chocolate also used drugs vs 3.3% of those who did not eat chocolate daily.6
1. Larsson SC, Drca N, Jensen-Urstad M, Wolk A. Chocolate consumption and risk of atrial fibrillation: Two cohort studies and a meta-analysis. Am Heart J. 2018;195:86-90.
2. 2. Jackson SE, Smith L, Firth J, et al. Is there a relationship between chocolate consumption and symptoms of depression? A cross-sectional survey of 13,626 US adults [published ahead of print July 29, 2019]. Depress Anxiety. doi: 10.1002/da.22950.
3. Dong JY, Kimura T, Ikehara S, et al. Chocolate consumption and risk of gestational diabetes mellitus: the Japan Environment and Children's Study [published ahead of print July 24, 2019]. Br J Nutr. 2019:1-27. doi: 10.1017/S0007114519001806.
4. Aalemi AK, Anwar I, Chen H. Dairy consumption and acne: a case control study in Kabul, Afghanistan. Clin Cosmet Investig Dermatol. 2019;12:481-487.
5. Pereira T, Bergqvist J, Vieira C, et al. Randomized study of the effects of cocoa-rich chocolate on the ventricle-arterial coupling and vascular function of young, healthy adults. Nutrition. 2019;63-64:175-183.
6. Duarte HM, Rocha de Oliveira MC, Jung R, et al. Association between chocolate consumption and severity of first infarction [published ahead of print]. Int J Cardiovasc Sci. 2019.