Let's say that you weren't all that impressed with
yesterday's randomized, double-blind, placebo-controlled study of 20 patients with heart failure over 4 weeks comparing flavanol-rich chocolate to cocoa-liquor-free chocolate. Just like any good salesperson might do, I'd like to direct your attention to a
systematic review & meta-analysis to be published in next month's American Journal of Clinical Nutrition in which the authors assessed 42 randomized controlled trials of varying duration, but acute & short-term (
<18wks) involving just shy of 1,300 participants.
Their (short & sweet) conclusion? Chocolate, cocoa & cocoa flavan-3-ols, compared to controls, improved flow mediate vasodilation, diastolic blood pressure, mean arterial pressure, triglycerides, fasting insulin & insulin resistance (as measured & calculated via HOMA-IR). Higher doses of flavan-3-ols were found to improve systolic blood pressure, too. The statistics for increasing HDL while lowering LDL weren't as impressive after taking into account the usual suspects.
The good news is that these were all randomized studies. In other words, they demonstrated cause & effect. The not-good-enough news is that we need trials of longer duration with outcome measures that really matter. Granted we talk all day with our patients about insulin resistance, blood pressure & cholesterol (triglycerides), but if we're going to recommend adding to one's diet dark chocolate (which is an acquired taste when you bite into 70% cacao), we also need to take into account the calorie issues. After all, as a nation, we're already fat enough as it is. So consider reminding your patients to substitute rather than add an extra 50g of chocolate daily that just might put us over the edge. To paraphrase
Monty Python's The Meaning of Life, a
wafer-thin mint anyone?
No comments:
Post a Comment