Chocolate is Finally Put to the Test

Oct 10 Chocolate copy.jpeg

Botanically speaking, seeds are small embryonic plants--the whole plant stuffed into a tiny seed and surrounded by an outer layer packed with vitamins, minerals, and phytochemicals to protect the seedling plant's DNA from free radicals. No wonder they're so healthy. By seeds, using the formal definition, we're talking all whole grains; grains are seeds--you plant them and they grow. Nuts are just dry fruits with one or two seeds. Legumes (beans, peas, and lentils) are seeds, too, as are cocoa and coffee beans. So, finding health-promoting effects in something like cocoa or coffee should not be all that surprising. There is substantial evidence that increased consumption of all these little plants is associated with lower risk of cardiovascular disease.

Of course, much of chocolate research is just on how to get consumers to eat more. While it didn't seem to matter what kind of music people were listening to when it came to the flavor intensity, pleasantness, or texture of a bell pepper, people liked chocolate more when listening to jazz than classical, rock, or hip hop. Why is this important? So food industries can "integrate specific musical stimuli" in order to maximize their profits. For example, purveyors may play jazz in the background to increase consumers' acceptance of their chocolates. Along these lines, another study demonstrated that people rated the oyster eaten "more pleasant in the presence of the 'sound of the sea' than in the presence of 'farmyard noises.'"

You'd think chocolate would just sell itself, given that it's considered the most commonly craved food in the world. The same degree of interest doesn't seem to exist as to whether or not Brussels sprouts might provide similar cardiovascular protection. So, it's understandable to hope chocolate provides health benefits. Meanwhile, despite their known benefits, Brussels sprouts don't get the love they deserve.

One of the potential downsides of chocolate is weight gain, which is the subject of my Does Chocolate Cause Weight Gain? video. Though cocoa hardly has any calories, chocolate is one of the most calorie-dense foods. For example: A hundred calories of chocolate is less than a quarter of a bar, compared to a hundred calories of strawberries, which is more than two cups..

A few years ago, a study funded by the National Confectioners Association--an organization that, among other things, runs the website voteforcandy.com--reported that Americans who eat chocolate weigh, on average, four pounds less than those who don't. But maybe chocolate-eaters exercise more or eat more fruits and vegetables. The researchers didn't control for any of that.

The findings of a more recent study published in the Archives of Internal Medicine were less easy to dismiss and there were no apparent ties to Big Chocolate. The researchers reported that out of a thousand men and women they studied in San Diego, those who frequently consumed chocolate had a lower BMI--actually weighed less--than those who ate chocolate less often. And this was even after adjusting for physical activity and diet quality. But, it was a cross-sectional study, meaning a snapshot in time, so you can't prove cause and effect. Maybe not eating chocolate leads to being fatter, or maybe being fatter leads to not eating chocolate. Maybe people who are overweight are trying to cut down on sweets. What we need is a study in which people are followed over time.

There was no such prospective study, until now. More than 10,000 people were followed for six years, and a chocolate habit was associated with long-term weight gain in a dose-response manner. This means the greatest weight gain over time was seen in those with the highest frequency of chocolate intake. It appears the reason the cross-sectional studies found the opposite is that subjects diagnosed with obesity-related illnesses tended to reduce their intake of things like chocolate in an attempt to improve their prognosis. This explains why heavier people may, on average, eat less chocolate.

To bolster this finding came the strongest type of evidence--an interventional trial--in which you split people up into two groups and change half their diets. Indeed, adding four squares of chocolate to peoples' daily diets does appear to add a few pounds.

So, what do we tell our patients? In 2013, researchers wrote in the American Family Physician journal that "because many cocoa products are high in sugar and saturated fat, family physicians should refrain from recommending cocoa...." That's a little patronizing, though. You can get the benefits of chocolate without any sugar or fat by adding cocoa powder to a smoothie, for example. Too often, doctors think patients can't handle the truth. Case in point: If your patients inquire, one medical journal editorial suggest, ask them what type of chocolate they prefer. If they respond with milk chocolate, then it is best to answer that it is not good for them. If the answer is dark chocolate, then you can lay out the evidence.


Even better than dark chocolate would be cocoa powder, which contains the phytonutrients without the saturated fat. I've happily (and deliciously) created other videos on cocoa and chocolate, so check out Update on Chocolate, Healthiest Chocolate Fix, A Treatment for Chronic Fatigue Syndrome, and Dark Chocolate and Artery Function.

Whether with Big Candy, Big Chocolate, or some other player, you always have to be careful about conflict of interest. For more information, watch my Food Industry Funded Research Bias video.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Original Link

Chocolate is Finally Put to the Test

Oct 10 Chocolate copy.jpeg

Botanically speaking, seeds are small embryonic plants--the whole plant stuffed into a tiny seed and surrounded by an outer layer packed with vitamins, minerals, and phytochemicals to protect the seedling plant's DNA from free radicals. No wonder they're so healthy. By seeds, using the formal definition, we're talking all whole grains; grains are seeds--you plant them and they grow. Nuts are just dry fruits with one or two seeds. Legumes (beans, peas, and lentils) are seeds, too, as are cocoa and coffee beans. So, finding health-promoting effects in something like cocoa or coffee should not be all that surprising. There is substantial evidence that increased consumption of all these little plants is associated with lower risk of cardiovascular disease.

Of course, much of chocolate research is just on how to get consumers to eat more. While it didn't seem to matter what kind of music people were listening to when it came to the flavor intensity, pleasantness, or texture of a bell pepper, people liked chocolate more when listening to jazz than classical, rock, or hip hop. Why is this important? So food industries can "integrate specific musical stimuli" in order to maximize their profits. For example, purveyors may play jazz in the background to increase consumers' acceptance of their chocolates. Along these lines, another study demonstrated that people rated the oyster eaten "more pleasant in the presence of the 'sound of the sea' than in the presence of 'farmyard noises.'"

You'd think chocolate would just sell itself, given that it's considered the most commonly craved food in the world. The same degree of interest doesn't seem to exist as to whether or not Brussels sprouts might provide similar cardiovascular protection. So, it's understandable to hope chocolate provides health benefits. Meanwhile, despite their known benefits, Brussels sprouts don't get the love they deserve.

One of the potential downsides of chocolate is weight gain, which is the subject of my Does Chocolate Cause Weight Gain? video. Though cocoa hardly has any calories, chocolate is one of the most calorie-dense foods. For example: A hundred calories of chocolate is less than a quarter of a bar, compared to a hundred calories of strawberries, which is more than two cups..

A few years ago, a study funded by the National Confectioners Association--an organization that, among other things, runs the website voteforcandy.com--reported that Americans who eat chocolate weigh, on average, four pounds less than those who don't. But maybe chocolate-eaters exercise more or eat more fruits and vegetables. The researchers didn't control for any of that.

The findings of a more recent study published in the Archives of Internal Medicine were less easy to dismiss and there were no apparent ties to Big Chocolate. The researchers reported that out of a thousand men and women they studied in San Diego, those who frequently consumed chocolate had a lower BMI--actually weighed less--than those who ate chocolate less often. And this was even after adjusting for physical activity and diet quality. But, it was a cross-sectional study, meaning a snapshot in time, so you can't prove cause and effect. Maybe not eating chocolate leads to being fatter, or maybe being fatter leads to not eating chocolate. Maybe people who are overweight are trying to cut down on sweets. What we need is a study in which people are followed over time.

There was no such prospective study, until now. More than 10,000 people were followed for six years, and a chocolate habit was associated with long-term weight gain in a dose-response manner. This means the greatest weight gain over time was seen in those with the highest frequency of chocolate intake. It appears the reason the cross-sectional studies found the opposite is that subjects diagnosed with obesity-related illnesses tended to reduce their intake of things like chocolate in an attempt to improve their prognosis. This explains why heavier people may, on average, eat less chocolate.

To bolster this finding came the strongest type of evidence--an interventional trial--in which you split people up into two groups and change half their diets. Indeed, adding four squares of chocolate to peoples' daily diets does appear to add a few pounds.

So, what do we tell our patients? In 2013, researchers wrote in the American Family Physician journal that "because many cocoa products are high in sugar and saturated fat, family physicians should refrain from recommending cocoa...." That's a little patronizing, though. You can get the benefits of chocolate without any sugar or fat by adding cocoa powder to a smoothie, for example. Too often, doctors think patients can't handle the truth. Case in point: If your patients inquire, one medical journal editorial suggest, ask them what type of chocolate they prefer. If they respond with milk chocolate, then it is best to answer that it is not good for them. If the answer is dark chocolate, then you can lay out the evidence.


Even better than dark chocolate would be cocoa powder, which contains the phytonutrients without the saturated fat. I've happily (and deliciously) created other videos on cocoa and chocolate, so check out Update on Chocolate, Healthiest Chocolate Fix, A Treatment for Chronic Fatigue Syndrome, and Dark Chocolate and Artery Function.

Whether with Big Candy, Big Chocolate, or some other player, you always have to be careful about conflict of interest. For more information, watch my Food Industry Funded Research Bias video.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

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Bile Binding Beets

NF-Jan21 Which Vegetable Binds Bile Best.001.jpeg

In my video Breast Cancer and Constipation, I discussed how fruits and veggies bind carcinogenic bile acids in our gut. Since bile acids are absorbed back into our systems, they may increase our risk of not only colon cancer but also other cancers as well. In light of this, researchers publishing in the journal, Nutrition Research, concluded that to "lower the risk of diet and lifestyle-related premature degenerative diseases and to advance human nutrition research, relative bile acid-binding potential of foods and fractions need to be evaluated."

They found that some vegetables bind bile acids better than others. We know that those eating more plant-based diets are at a lower risk of heart disease and cancer. This could partly be because of phytonutrients in plants that act as antioxidants and potent stimulators of natural detoxifying enzymes in our bodies. Veggies can also lower cholesterol and detoxify harmful metabolites, functions that can be predicted by their ability to bind bile acids.

A group of USDA researchers studying this topic discovered three important things. First, they found an over five-fold variability in bile acid binding among various vegetables that had similar fiber content, suggesting that bile acid binding is not just related to total dietary fiber content (as previously thought), but instead some combination of unique phytonutrients yet to be determined.

Second, they discovered that steaming significantly improves the bile acid binding of collards, kale, mustard greens, broccoli, peppers, cabbage, beets, eggplant, asparagus, carrots, green beans, and cauliflower, suggesting that in this way steaming vegetables may be more healthful than those consumed raw.

Finally, they ranked multiple vegetables for bile binding ability. Which vegetables kicked the most bile butt? (in my video, Which Vegetable Binds Bile Best?, you can see a visual comparison of bile binding ability.) Turnips turned up last. Then came cabbage, cauliflower, bell peppers, spinach, asparagus and green beans. Mustard greens and broccoli were better. Eggplant, carrots and Brussels sprouts basically tie for the #5 slot. Then collards at #4. Kale got the bronze, okra the silver, and beets the gold. Kale, surprisingly, got beet.

The researchers concluded that inclusion of all these vegetables in our daily diets should be encouraged. When consumed regularly, they concluded, these vegetables may lower the risk of premature degenerative diseases and improve public health.

More raw versus cooked comparisons in

Beets also have a number of other remarkable properties. Check out my video series on Doping with Beet Juice as well as Hearts Shouldn't Skip a Beet, and Whole Beets vs. Juice for Improving Athletic Performance.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Robert Couse-Baker / Flickr

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Foods With Natural Melatonin

 

 

 

 

 

 

 

 

Foods With Natural Melatonin

We know that inadequate sleeping is associated with changes in diet—people tend to eat worse—but what about the opposite question: Can food affect sleep? In a study on kiwifruit, this seemed possible (see Kiwifruit For Insomnia), but the mechanism the researchers suggested for the effect—the serotonin levels in kiwifruit—doesn’t make any sense, since serotonin can’t cross the blood-brain barrier. We can eat all the serotonin we want and it shouldn’t affect our brain chemistry. A different brain chemical, though, melatonin, can get from our gut to our brain.

Melatonin is a hormone secreted at night by the pineal gland in the center of our brain to help regulate our circadian rhythm. Supplements of the stuff are used to prevent and reduce jet lag, and about 20 years ago MIT got the patent to use melatonin to help people sleep. But melatonin "is not only produced in the pineal gland—it is also naturally present in edible plants."

That might explain the results of a study, “Effects of a Tart Cherry Juice Beverage on the Sleep of Older Adults with Insomnia” (See Tart Cherries for Insomnia). The research group had been doing an earlier study on tart cherry juice as a sports recovery drink. There’s a phytonutrient in cherries with anti-inflammatory effects on par with drugs like aspirin and ibuprofen, so the researchers were trying to see whether tart cherry juice could reduce muscle soreness after exercise. During the study, some of the participants anecdotally noted that they were sleeping better on the cherries. That was unexpected, but the researchers realized that cherries were a source of melatonin so they put them to the test.

The reason they chose older subjects is that melatonin production tends to drop as we age, which may be one reason why there’s a higher insomnia rates among the elderly. So, they took a group of older men and women suffering from chronic insomnia and put half on cherries and half on placebo. They couldn’t use whole cherries for the study—how could you fool people with a placebo cherry? So they used cherry juice versus cherry Kool-Aid.

They found that participants did in fact sleep a little better on the cherry juice. The effect was modest, but significant. Some, for example, fell to sleep a few minutes faster and had 17 fewer minutes of waking after sleep onset (waking up in the middle of the night). It was no insomnia cure, but it helped—without side effects.

How do we know it was the melatonin, though? They repeated the study, this time measuring the melatonin levels, and indeed saw a boost in circulating melatonin levels after the cherry juice, but not after the Kool-Aid. Similar results were found in people eating the actual cherries—seven different varieties boosted melatonin levels and actual sleep times. The effects of all the other phytonutrients in cherries can’t be precluded—maybe they helped too—but if it is the melatonin, there are more potent sources than cherries.

Orange bell peppers have a lot, as do walnuts—and a tablespoon of flaxseeds has about as much as a tomato. See the chart in my video Tart Cherries for Insomnia. The melatonin content of tomatoes was suggested as one of the reasons traditional Mediterranean diets were so healthy. They have less melatonin than the tart cherries, but people may eat a lot more tomatoes than cherries. Sweet cherries have 50 times less melatonin than tart ones; dried cherries appear to have none.

A few spices are pretty potent: just a teaspoon of fenugreek or mustard seeds has as much as a few tomatoes.  The bronze and silver go to almonds and raspberries, though. And the gold goes to gojis. Goji berries were just off the charts.

Aren’t goji berries really expensive, though? Not if you buy them as lycium berries. Check out my video Are Goji Berries Good for You?

I’ve previously explored Human Neurotransmitters in Plants in the context of boosting serotonin levels in the brain to improve mood. See:

Melatonin may also play a role in cancer prevention. See Melatonin & Breast Cancer. 

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Elizabeth / Flickr

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