Chocolate & Health: Fact or Fiction?

“Chocolate Is Good For The Heart”

“When making chocolate chip cookies, you don’t measure using cups, you measure by heart”

…but how good is chocolate when it comes to heart health?

First, what is heart health?

A healthy heart typically has a low resting pulse rate and a strong, steady beat. This is affected strongly by exercise habits, and diet plays only a support role (can’t exercise without energy from food!).

It is also important to have blood pressure within a healthy range (with high blood pressure being a more common problem than low, so things that lower blood pressure are generally considered good).

• Flavanols, flavonoids, and polyphenols in chocolate contribute to lower blood pressure
• Dark chocolate is best for these, as milk chocolate contains much less cocoa solids and more unhelpful fats
• White chocolate contains no cocoa solids and is useless for this
• Some of the fats in most commercial chocolate can contribute to atherosclerosis which raises blood pressure and ultimately can cause heart attacks.
• If you’re diabetic, you will probably not get the usual heart-related benefits from chocolate (sorry)

The Verdict: dark chocolate, in moderation, can support good heart health.

“Chocolate Is Good For The Brain”

Chocolate has been considered a “brain food”… why?

• The brain uses more calories than any other organ (chocolate has many calories)
• The heart benefits we listed above mean improved blood flow—including to your brain
• Chocolate contains phenylethylamine, a powerful chemical that has a similar effect to amphetamines… But it’s metabolized in digestion and never makes it to the central nervous system (so basically, this one’s a miss; we had a good run with the other two, though!)

The Verdict: dark chocolate, in moderation, can support good brain health

“Chocolate Is An Aphrodisiac”

“If chocolate be the food of love, pass me that cocoa; I’m starving”

Most excitingly, chocolate contains phenylethylamine, the “molecule of love” or, more accurately, lust. It has an effect similar to amphetamines, and while we can synthesize it in the body, we can also get it from certain foods. But…

Our body is so keen to get it that most of it is metabolized directly during digestion and doesn’t make it to the brain. Also, chocolate is not as good a source as cabbage—do with that information what you will!

However!

Chocolate contains theobromine and small amounts of caffeine, both stimulants and both generally likely to improve mood; it also contains flavonoids which in turn stimulate production of nitric oxide, which is a relaxant. All in all, things that are convivial to having a good time.

On the other hand…

That relaxation comes specifically with a reduction in blood pressure—something typically considered good for the health for most people most of the time… but that means lowering blood pressure in all parts of your body, which could be the opposite of what you want in intimate moments.

Chocolate also contains zinc, which is essential for hormonal health for most people—the body uses it to produce testosterone and estrogen, respectively. Zinc supplements are popularly sold to those wishing to have more energy in general and good hormonal health in particular, and rightly so. However…

This approach requires long-term supplementation—you can’t just pop a zinc tablet / bar of chocolate / almond before bed and expect immediate results. And if your daily zinc supplementation takes the form of a 3.5oz (100g) bar of chocolate, then you may find it has more effects on your health, and not all of them good!

The Verdict: dark chocolate, in moderation, may promote “the mood”, but could be a double-edged sword when it comes to “the ability”.

“Chocolate Is Good During Menstruation”

The popular wisdom goes that chocolate is rich in iron (of which more is needed during menstruation), and indeed, if you eat 7oz (150g) of dark chocolate made with 85% cocoa, you’ll get a daily a dose of iron (…and nearly 1,000 calories).

More bang-for-buck dietary sources of iron include chickpeas and broccoli, but for some mysterious reason, these are not as commonly reported as popular cravings.

The real explanation for chocolate cravings is more likely that eating chocolate—a food high in sugar and fat along with a chemical bombardment of more specialized “hey, it’s OK, you can relax now” molecules (flavanols/flavonoids, polyphenols, phenylamines, even phenylethylamine, etc) gives a simultaneous dopamine kick (the body’s main “reward” chemical) with a whole-body physiological relaxation… so, little wonder we might crave it in times of stress and discomfort!

The Verdict: it helps, not because it serves a special nutritional purpose, but rather, because the experience of eating chocolate makes us feel good.

Fun fact: Tiramisu (this writer’s favorite dessert) is literally Italian for “pick-me-up”

Which Addiction-Quitting Methods Work Best?

In Tuesday’s newsletter we asked you what, in your opinion, is the best way to cure an addiction. We got the above-depicted, below-described, interesting distribution of responses:

• About 29% said: “Addiction cannot be cured; once an addict, always an addict”
• About 26% said “Cold turkey (stop 100% and don’t look back)”
• About 17% said “Gradually reduce usage over an extended period of time”
• About 11% said “A healthier, but somewhat like-for-like, substitution”
• About 9% said “Therapy (whether mainstream, like CBT, or alternative, like hypnosis)”
• About 6% said “Peer support programs and/or community efforts (e.g. church etc)”
• About 3% said “Another method (mention it in the comment field)” and then did not mention it in the comment field

So what does the science say?

Addiction cannot be cured; once an addict, always an addict: True or False?

False, which some of the people who voted for it seemed to know, as some went on to add in the comment field what they thought was the best way to overcome the addiction.

The widespread belief that “once an addict, always an addict” is a “popular truism” in the same sense as “once a cheater, always a cheater”. It’s an observation of behavioral probability phrased as a strong generalization, but it’s not actually any kind of special unbreakable law of the universe.

And, certainly the notion that one cannot be cured keeps membership in many 12-step programs and similar going—because if you’re never cured, then you need to stick around.

However…

❝What is the definition of addiction?

Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.

Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.❞

~ American Society of Addiction Medicine

Or if we want peer-reviewed source science, rather than appeal to mere authority as above, then:

❝What is drug addiction?

Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control. Those changes may last a long time after a person has stopped taking drugs.

Addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of an organ in the body, both have serious harmful effects, and both are, in many cases, preventable and treatable.❞

~ Nora D. Volkow (Director, National Institute of Drug Abuse)

Read more: Drugs, Brains, and Behavior: The Science of Addiction

In short: part of the definition of addiction is the continued use; if the effects of the substance are no longer active in your physiology, and you are no longer using, then you are not addicted.

Just because you would probably become addicted again if you used again does not make you addicted when neither the substance nor its after-effects are remaining in your body. Otherwise, we could define all people as addicted to all things based on “well if they use in the future they will probably become addicted”.

This means: the effects of addiction can and often will last for long after cessation of use, but ultimately, addiction can be treated and cured.

(yes, you should still abstain from the thing to which you were formerly addicted though, or you indeed most probably will become addicted again)

Cold turkey is best: True or False?

True if and only if certain conditions are met, and then only for certain addictions. For all other situations… False.

To decide whether cold turkey is a safe approach (before even considering “effective”), the first thing to check is how dangerous the withdrawal symptoms are. In some cases (e.g. alcohol, cocaine, heroin, and others), the withdrawal symptoms can kill.

That doesn’t mean they will kill, so knowing (or being!) someone who quit this way does not refute this science by counterexample. The mortality rates that we saw while researching varied from 8% to 37%, so most people did not die, but do you really want (yourself or a loved one) to play those odds unnecessarily?

See also: Detoxification and Substance Abuse Treatment

Even in those cases where it is considered completely safe for most people to quit cold turkey, such as smoking, it is only effective when the quitter has appropriate reliable medical support, e.g.

• Without support: 3–5% success rate
  • The study: Shape of the relapse curve and long-term abstinence among untreated smokers
• With support: 22% success rate
  • The study: Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Noninferiority Trial

And yes, that 22% was for the “abrupt cessation” group; the “gradual cessation” group had a success rate of 15.5%. On which note…

Gradual reduction is the best approach: True or False?

False based on the above data, in the case of addictions where abrupt cessation is safe. True in other cases where abrupt cessation is not safe.

Because if you quit abruptly and then die from the withdrawal symptoms, then well, technically you did stay off the substance for the rest of your life, but we can’t really claim that as a success!

A healthier, but somewhat like-for-like substitution is best: True or False?

True where such is possible!

This is why, for example, medical institutions recommend the use of buprenorphine (e.g. Naloxone) in the case of opioid addiction. It’s a partial opioid receptor agonist, meaning it does some of the job of opioids, while being less dangerous:

SAMSHA.gov | Buprenorphine

It’s also why vaping—despite itself being a health hazard—is recommended as a method of quitting smoking:

Vaping: A Lot Of Hot Air?

Similarly, “zero alcohol drinks that seem like alcohol” are a popular way to stop drinking alcohol, alongside other methods:

How To Reduce Or Quit Alcohol

This is also why it’s recommended that if you have multiple addictions, to quit one thing at a time, unless for example multiple doctors are telling you otherwise for some specific-to-your-situation reason.

Take care!