Multiple cardiac benefits result from frequent consumption of dark chocolates rich in flavanols, including our response to stress.
Recently when talking with my 7-year-old daughter, I asked her what was the best food she could eat for a snack. As the daughter of a cardiologist you may imagine that she would have been taught the enduring virtues of eating fruits and vegetables and how these are the best foods to use as snacks. She told me that my question was easy and replied, “the best snack is chocolate.” I asked her where she learned that and she told me her mother told her so. How can you really argue against that logic?
This question posed to my daughter then led to more investigation during my clinic. I asked many patients informally what were their favorite snacks. Since they were in a cardiologist’s office they would often say some sort of fruit or vegetable and then add they only consume it in a small quantity.
I then would ask, “now what really is your favorite snack?”
I particularly enjoyed the response of a couple in their mid 70s. I have seen both of them both for atrial fibrillation for over 5 years. She said, “my true favorite snack is chocolate.” Then almost immediately after, as if there was a sense of guilt in admitting this, she said, “but chocolate is healthy right? I try to eat dark chocolate.” Her husband laughed at her and said she eats more than dark chocolate. He then replied, “my favorite snack is anything you put in front of me.” In my informal poll of true favorite snacks, chocolate was mentioned in about two thirds of my patients. Most of my patients felt dark chocolate in particular was healthy.
Dark chocolate and other cocoa products have gained a lot of attention worldwide as dietary supplements to improve heath. These products are rich in in flavanols. Flavanols are felt to mediate some of the heart healthy properties of chocolate. Flavanols are also found in many other food sources felt to be heart healthy such as grapes, apples, blackberries, legumes, red wine, and green tea. But of all of these food sources, the relative concentration of flavanols is highest in chocolate. As you may have guessed, dark chocolate contains much higher concentrations of flavanols compared to milk or white chocolate. In some chocolates the production process all but eliminates flavanols.
What Are the Heart and Vascular Benefits of Eating Dark Chocolate?
Lower Blood Pressure. Consumption of cocoa increases nitric oxide, studies show. For a good review of benefits, see Cocoa and Cardiovascular Health. Nitric oxide is a naturally occurring chemical in our bodies. Nitric oxide acts on small receptors in our blood vessels and prompts the vessels to dilate. This process lowers blood pressure. High blood pressure as discussed in many of my prior columns is associated with many types of heart disease including heart failure, atrial fibrillation, and atherosclerosis. High blood pressure is also associated with cognitive decline, dementia, and stroke.
Coronary Artery Health and Stability. As our arteries become diseased from atherosclerosis, plaques grow and over time begin to impair blood flow. If the surface of these plaques becomes disrupted or inflamed the plaques may ulcerate. The body responds to the ulceration by forming a clot in an effort to heal the wound. This process can lead to a heart attack. Cocoa may help stabilize plaques and minimize their risk of rupture by reducing smooth muscle cell proliferation (a process that causes plaques to grow), platelet adhesion (a process that results in clot formation in the artery), and preventing leukocyte adhesion and migration (processes that causes these plaques to become inflamed and unstable).
Lower Cholesterol. People with elevated total cholesterol with increased levels of low-density lipoprotein (LDL) cholesterol have a higher risk of cardiac disease, in particular coronary atherosclerosis and heart attacks. Flavanols reduce cholesterol absorption in our gastrointestinal track and also the synthesis of LDL cholesterol, research shows. They may also help raise high-density lipoprotein (HDL) cholesterol, the part of our cholesterol that is felt to be protective of heart disease, a clinical trial reported. Lower LDL and higher HDL levels after cocoa consumption were seen in people with both normal cholesterol levels to begin with and those with elevated levels that needed treatment. Multiple medications reduce LDL cholesterol, but very few things and essentially no medications raise HDL cholesterol consistently.
Dark Chocolate Changes Our Body’s Response to Stress
My wife often says, “I eat chocolate when I am stressed.” As I mentioned in a prior column, stress and our response to it can be a very potent risks of heart disease. In this regard, what if chocolate can improve how we respond to stress?
This brings me to the newest study regarding dark chocolate that I found very interesting. When we are stressed our body signals out chemicals that raise our blood pressure and help us fight the stressor. These chemicals or hormones are stored in the brain (pituitary gland), the adrenal glands, and other parts of the nervous system. A rececent study looked at how the body responded to stress by measuring these chemicals (cortisol, epinephrine, adrenocorticotropic hormone [ACTH], and norepinephrine) in 31 men consuming dark chocolate (“Noir 72 percent”; Chocolat Frey AG, Buchs/Aargau, Switzerland) versus 34 men that received a placebo chocolate that did not contain flavanols. The men then underwent a significant stress.
The stress was a 5-minute mock job interview and then a 5-minute mental arithmetic task in front of an audience. It is probably easy for most of us to imagine feeling very stressed if we had to try to solve a complex math problem in our head in 5 minutes while others watched, or we had to receive an intense job interview.
What these researchers found about the effect of chocolate was significant. Those men consuming dark chocolate had lower levels of cortisol and epinephrine after the stress. Although their brain response to stress was similar (ACTH levels were identical in both groups) the body’s response to the brain signals of stress was blunted. In particular, the response of the adrenal gland, which produces cortisol, was much less. Less released cortisol and epinephrine with stress is important as these are strong stimulants of the heart and blood vessels. With repetitive stress over time, both the heart and blood pressure have be negatively effected. Finally, since the body response was less significant, men consuming dark chocolate reported having less feelings of stress during the process.
My daughter was right, dark chocolate or chocolate rich in flavanols is a healthy food choice. The benefits of dark chocolate need to be carefully considered with the calories consumed, but in general there are multiple heart-related advantages with frequent consumption. In addition, as my wife mentioned to me, dark chocolate also may help you deal with stress, not only how you perceive it mentally, but also how your body responds to it.
Tai chi is a form of gentle #exercise that experts say can help improve your mood, reduce stress, and help keep your heart healthy. This #HarvardHealth online course is the perfect way to try #taichi from home and get dozens of proven health benefits. https://bit.ly/2LmAfLM
I’m not a regular drinker, nor a teetotaler. But like many people, I enjoy the occasional glass of wine with dinner, and nothing tastes better than an ice-cold beer on a sweaty summer day. Besides, some alcohol is a toast to my long-term heart health. At least that’s what the science says, right? Not really. When it comes to alcohol and heart health, the existing research is quite conflicting — some studies say alcohol improves heart health, while others imply the opposite.
Alcohol and heart health: What’s the real story?
The problem with most alcohol-related research is that it consists almost entirely of observational studies that only show an association, according to Dr. J. Michael Gaziano, a preventive cardiologist with Harvard-affiliated Brigham and Women’s Hospital’s Division of Aging and VA Boston.
So far, the strongest evidence with heart health has shown that alcohol can increase levels of HDL (good) cholesterol. HDL works to keep LDL (bad) cholesterol from clogging your arteries by moving it to the liver, where it’s broken down and removed from the body. Many studies have found that the combination of high HDL and low LDL levels protects against heart attacks and stroke. “However, this is not the most important factor in preventing heart disease, and there are other ways to increase HDL than drinking alcohol, such as regular exercise,” says Dr. Gaziano.
Quantity is a key factor when it comes to alcohol and heart health
While moderate amounts of alcohol can offer some heart benefits, too much can have damaging effects.
For instance, the more alcohol you drink at one time, the higher your heart rate gets, according to research from the European Society of Cardiology. A sudden spike in heart rate is potentially dangerous to people with heart conditions, as it could trigger arrhythmias (irregular heartbeats).
A study in the April 14, 2018, issue of The Lancet looked at the drinking habits of almost 600,000 people without heart disease, and found that people who had 10 or more drinks per week died one to two years earlier compared with those who drank five drinks or fewer per week. Having 18 drinks or more per week cut life expectancy by four to five years.
Focus on moderation
The lack of consistent data means that the takeaway message here is moderation — and the importance of avoiding excessive and binge drinking.
How much is considered moderate? A safe amount is no more than a drink per day, says Dr. Gaziano. “In terms of heart health, there does not appear to be more benefit beyond one daily drink.”
Of course, alcohol content can vary with the type and size of drink. In the United States, a standard drink is approximately 14 grams of pure alcohol, which equates to any one of these:
12 ounces of regular beer
5 ounces of wine
1.5 ounces of 80-proof distilled spirits
1 ounce of 100-proof spirits.
To get a more accurate analysis of your drink in terms of alcohol content per serving size, use this drink calculator from the National Institutes of Health.
One type of drink isn’t better than another, as your body reacts to alcohol the same whether it’s from beer, wine, or spirits, according to Dr. Gaziano.
Matthew Solan is the former executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical … See Full Bio
Our honey is 100% pure, just like nature intended. By supporting us, you’re also supporting a whole eco-system, that’s pretty cool, right? One jar of honey can help trees, flowers and other plants thrive! #HaughtonHoney#Honey#EcoSystem#Sustainability#BeeFarmer