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:

Original Link

Music as Medicine

Music as Medicine.jpeg

We've been playing music since the Paleolithic Era, 40,000 years ago. Music as therapy has been documented since at least biblical times. The first music therapy experiment was published in the Journal of the American Medical Association in 1914. As to why he placed a phonograph in the operating room as his patients lay fully conscious and awake during surgery, the surgeon explained it was "a means of calming and distracting my patients from the horror of the situation."

Now that we have anesthesia, music is used to calm nerves before surgery. Normally we use Valium-type drugs like midazolam (sold as Versed), but they can have a variety of side effects, including sometimes even making people more agitated. A study from Sweden sought to determine if relaxing music has a greater anxiety-reducing effect than a standard dose of midazolam. Researchers whipped out some Kenny G, and the music worked significantly better than the drug. Those listening to Mr. G had lower anxiety scores, heart rates, and blood pressures. This is perhaps the first report of any anti-anxiety therapy working not only as good as, but even better than, benzodiazepine drugs. The difference in side effects of relaxing music compared to the drug is obvious: There were none. Soft jazz causes no post-operative hangover. The researchers suggest we should start using music instead of midazolam.

Music may also reduce anxiety and pain in children undergoing minor medical and dental procedures, helping with blood draws and shots. It may even reduce the pain of spinal taps. However, Mozart is evidently powerless against the pain of circumcision.

It doesn't take a randomized controlled trial to demonstrate that listening to music can be relaxing. Tell me something I don't know. Well, if you take someone with a latex allergy and inject their skin with latex, they get a big, red, angry bump. But if you repeat the test after they've been listening to Mozart for 30 minutes, they develop a much smaller bump (as you can see in my video, Music as Medicine). That is, they have less of an allergic reaction. If you think that's wild, get ready for this: Beethoven didn't work. The subjects had the same reaction before and after listening to his music! Schubert, Hayden, and Brahms didn't work either, as all failed to reduce the allergic skin response. The reducing effect on allergic responses may be specific to Mozart.

So Mozart's looking pretty good, but what if he could be suppressing our immune systems in general? That would not be good. The same researchers also injected a chemical that causes reactions in everyone, not just in allergic people. Mozart had no effect. It seems Mozart suppresses only the pathological allergic reaction. If that isn't crazy enough for you, the researchers drew subjects' blood after the music, stuck their white blood cells in a petri dish with a little latex, and measured the allergic antibody response. The white blood cells from those exposed to Mozart had less of an allergic response even outside the body compared to cells taken from Beethoven blood. How cool is that?

Music may even impact our metabolism. This inquiry started with a 2012 study published in the journal Pediatrics, which found the resting energy expenditure (the number of calories burned when just lying around) was lower in preterm infants when researchers piped in Mozart. This may explain why infants exposed to music put on weight faster, so much so they are able to go home earlier.

Gaining weight faster is great for premature babies, but not necessarily for adults. Could listening to music slow our metabolism and contribute to weight gain? Well, one study found no effect on adults. But the researchers used Bach, not Mozart. Bach doesn't cause a drop in energy expenditure in babies either. These data suggest there may be "more a 'Mozart effect' than a universal 'music effect'."

What if we just listen to music of our choice? Does that affect our metabolism? We didn't know... until now. It turns out that listening to music appears to actually increase our metabolic rate, such that we burn an average of 27.6 more calories a day just lying in bed. That's only like six M&M's worth, though, so it's better to use music to get up and start dancing or exercising. Music can not only improve exercise enjoyment but also performance--a way to improve athletic performance that's legal.

Male bodybuilders may be less enthused music's effects. After listening to music for just 30 minutes, testosterone levels drop 14% in young men and go up 21% in young women. Do all kinds of music have this effect or just some types? Thirty minutes of silence had no effect on testosterone levels at all, while a half-hour of Mozart, jazz, pop, or Gregorian chants (no relation :) all suppressed testosterone. What about a half-hour of people's personal favorites? Testosterone levels were cut in half! Testosterone decreased in males under all music conditions, whereas testosterone increased in females. What is going on? Well, in men, testosterone is related to libido, dominance, and aggressiveness, whereas women get a bigger boost in testosterone from cuddling than from sex. So maybe we evolved using music as a way to ensure we all got along, like a melodious cold shower to keep everyone chill.

Is that crazy or what? I'm fascinated by the whole topic. For more, see Music for Anxiety: Mozart vs. Metal.

Sounds are the only sensory-stimulators that can have an effect on us--so can scents! See:

Exposure to industrial pollutants may also affect both allergic diseases and testosterone levels:

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:

Image Credit: Sally Plank. This image has been modified.

Original Link

Music as Medicine

Music as Medicine.jpeg

We've been playing music since the Paleolithic Era, 40,000 years ago. Music as therapy has been documented since at least biblical times. The first music therapy experiment was published in the Journal of the American Medical Association in 1914. As to why he placed a phonograph in the operating room as his patients lay fully conscious and awake during surgery, the surgeon explained it was "a means of calming and distracting my patients from the horror of the situation."

Now that we have anesthesia, music is used to calm nerves before surgery. Normally we use Valium-type drugs like midazolam (sold as Versed), but they can have a variety of side effects, including sometimes even making people more agitated. A study from Sweden sought to determine if relaxing music has a greater anxiety-reducing effect than a standard dose of midazolam. Researchers whipped out some Kenny G, and the music worked significantly better than the drug. Those listening to Mr. G had lower anxiety scores, heart rates, and blood pressures. This is perhaps the first report of any anti-anxiety therapy working not only as good as, but even better than, benzodiazepine drugs. The difference in side effects of relaxing music compared to the drug is obvious: There were none. Soft jazz causes no post-operative hangover. The researchers suggest we should start using music instead of midazolam.

Music may also reduce anxiety and pain in children undergoing minor medical and dental procedures, helping with blood draws and shots. It may even reduce the pain of spinal taps. However, Mozart is evidently powerless against the pain of circumcision.

It doesn't take a randomized controlled trial to demonstrate that listening to music can be relaxing. Tell me something I don't know. Well, if you take someone with a latex allergy and inject their skin with latex, they get a big, red, angry bump. But if you repeat the test after they've been listening to Mozart for 30 minutes, they develop a much smaller bump (as you can see in my video, Music as Medicine). That is, they have less of an allergic reaction. If you think that's wild, get ready for this: Beethoven didn't work. The subjects had the same reaction before and after listening to his music! Schubert, Hayden, and Brahms didn't work either, as all failed to reduce the allergic skin response. The reducing effect on allergic responses may be specific to Mozart.

So Mozart's looking pretty good, but what if he could be suppressing our immune systems in general? That would not be good. The same researchers also injected a chemical that causes reactions in everyone, not just in allergic people. Mozart had no effect. It seems Mozart suppresses only the pathological allergic reaction. If that isn't crazy enough for you, the researchers drew subjects' blood after the music, stuck their white blood cells in a petri dish with a little latex, and measured the allergic antibody response. The white blood cells from those exposed to Mozart had less of an allergic response even outside the body compared to cells taken from Beethoven blood. How cool is that?

Music may even impact our metabolism. This inquiry started with a 2012 study published in the journal Pediatrics, which found the resting energy expenditure (the number of calories burned when just lying around) was lower in preterm infants when researchers piped in Mozart. This may explain why infants exposed to music put on weight faster, so much so they are able to go home earlier.

Gaining weight faster is great for premature babies, but not necessarily for adults. Could listening to music slow our metabolism and contribute to weight gain? Well, one study found no effect on adults. But the researchers used Bach, not Mozart. Bach doesn't cause a drop in energy expenditure in babies either. These data suggest there may be "more a 'Mozart effect' than a universal 'music effect'."

What if we just listen to music of our choice? Does that affect our metabolism? We didn't know... until now. It turns out that listening to music appears to actually increase our metabolic rate, such that we burn an average of 27.6 more calories a day just lying in bed. That's only like six M&M's worth, though, so it's better to use music to get up and start dancing or exercising. Music can not only improve exercise enjoyment but also performance--a way to improve athletic performance that's legal.

Male bodybuilders may be less enthused music's effects. After listening to music for just 30 minutes, testosterone levels drop 14% in young men and go up 21% in young women. Do all kinds of music have this effect or just some types? Thirty minutes of silence had no effect on testosterone levels at all, while a half-hour of Mozart, jazz, pop, or Gregorian chants (no relation :) all suppressed testosterone. What about a half-hour of people's personal favorites? Testosterone levels were cut in half! Testosterone decreased in males under all music conditions, whereas testosterone increased in females. What is going on? Well, in men, testosterone is related to libido, dominance, and aggressiveness, whereas women get a bigger boost in testosterone from cuddling than from sex. So maybe we evolved using music as a way to ensure we all got along, like a melodious cold shower to keep everyone chill.

Is that crazy or what? I'm fascinated by the whole topic. For more, see Music for Anxiety: Mozart vs. Metal.

Sounds are the only sensory-stimulators that can have an effect on us--so can scents! See:

Exposure to industrial pollutants may also affect both allergic diseases and testosterone levels:

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:

Image Credit: Sally Plank. This image has been modified.

Original Link