Dr. Mercola Interviews Dr. Golomb

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It's a real pleasure to once again interview Beatrice Golomb, MD, PhD, who has a number of diverse areas of expertise, and many in which we share an interest. The subject of this interview is chocolate.

There have been quite a few interesting scientific studies emerging about chocolate over the past few years. There's also a lot of confusion about chocolate – what type to eat and how much, types to avoid, etc., so I hope to dispel some of the myths on this subject.

Chocolate can be used therapeutically, but only if it's the right kind. Chocolate is like anything else: garbage in, garbage out. Consuming poor quality chocolate, such as chocolate loaded with sugar and chemicals, is no more beneficial to your body than a drinking a soda.

Chocolate Terminology

It's first helpful to understand the distinction between cacao, cocoa and chocolate. Here are some definitions:

  • Cacao refers to the plant, a small evergreen tree of the species Theobroma cacao, cultivated for its seeds, also known as cacao beans or cocoa beans
  • Cocoa: Refers to the powder made from roasted, husked and ground cacao seeds, from which most of the fat has been removed
  • Cocoa butter: The fat component of the cacao seed
  • Chocolate: The solid food or candy made from a preparation of cacao seeds (roasted); if the cacao seeds are not roasted, then you have u201Craw chocolate,u201D which is also typically sweetened

Is ChocolateYOUR Favorite Vegetable?

The number of health benefits now associated with the cocoa bean is really quite impressive, including benefits to your heart and blood vessels, brain and nervous system, improved insulin sensitivity, and even possibly slowing down the rate at which you age. Cacao's benefits are related to compounds naturally occurring in the bean, including epicatechin and resveratrol.

Cacao contains an antioxidant called epicatechin, thought to help shield your nerve cells from damage. Norman Hollenberg, a professor of medicine at Harvard who has spent years studying the Kuna people of Panama who consume up to 40 cups of cocoa a week, believes epicatechin is so important it should be considered a vitamin. The Kuna have less than a 10 percent risk of stroke, heart failure, cancer and diabetes, which are the most prevalent diseases ravaging the Western world.

Besides epicatechin, cacao is also high in resveratrol, a potent antioxidant found in red wine, known for its ability to cross your blood-brain barrier to help protect your nervous system.

One 2012 meta-analysis found that eating chocolate could slash your risk of cardiovascular disease by 37 percent and your stroke risk by 29 percent. Another 2012 meta-analysis, this one in the UK1, found that cocoa/chocolate lowered insulin resistance, reduced blood pressure, increased blood vessel elasticity, and slightly reduced LDL.

Dr. Golomb explains how the health benefits ofcocoa require a relatively narrow dose range. There is a u201CGoldilocks curveu201D – too little or too much means no significant benefit occurs. Dr. Golomb reports that, in a rat study done at UC San Diego:

u201C…Epicatechin derived from cocoa has favorable effects, but with a relatively tight dose response range. A modest amount consumed every day by these rats increased the production of mitochondria (energy-producing elements in cells), increased capillary action (meaning access to blood, oxygen, nutrients, etc. of muscle tissue), and actually lead to weight loss despite no fewer calories consumed and despite increased muscle capacity and endurance in these rats.u201D

The following table highlights the wide range of positive health benefits science suggests are conferred by the cocoa bean. (To read the studies, go to the chocolate page at GreenMedInfo.com.)

Anti-inflammatory Anti-carcinogenic Anti-thrombotic, including improving endothelial function Lowers Alzheimer's risk Anti-diabetic and anti-obesity Anti-inflammatory (including 17 percent reduction in C-reactive protein) Cardioprotective (including lowering blood pressure, improving lipid profile, and helping prevent atrial fibrillation) Improved liver function for those with cirrhosis Neuroprotective Improves gastrointestinal flora Reduces stress hormones Reduces symptoms of glaucoma and cataracts Slows progression of periodontitis Improves exercise endurance May help extend lifespan Protects against preeclampsia in pregnant women Cocoa and Your Blood Vessels

One of the ways chocolate can provide cardiovascular benefit is by assisting with nitric oxide metabolism, as described in an article by Ori Hofmekler2 .

In addition to being essential for muscle function, sexual health, and insulin sensitivity, nitric oxide protects your heart by relaxing your blood vessels and thereby lowering your blood pressure. However, nitric oxide production produces adverse reactions and toxic metabolites, which must be neutralized by your body so they don't result in oxidative damage to your blood vessel lining (by peroxynitrite oxidation and nitration reactions). Cocoa polyphenols protect your body from these metabolites and help counter the typical age-related decline in nitric oxide production3.

What to Look for When Selecting Chocolate

The closer your cocoa is to its natural raw state, the higher its nutritional value. Ideally, your chocolate or cocoa should be consumed raw (cacao).

When selecting chocolate, you can optimize its nutritional punch by looking for higher cacao and lower sugar content. In general, the darker the chocolate, the higher the cacao. However, cacao is fairly bitter, and the higher the percentage cacao, the more bitter it is. The flavanols are what make the chocolate bitter, so manufacturers often remove them. But, it's those flavanols that are responsible for many of chocolate's health benefits.

To counteract the bitterness, most chocolate is sweetened, so it's a matter of balancing nutritional benefit with palatability.

Although raw cacao is the most nutritious form, most of the health studies to date involve consumption of cocoa or chocolate, not raw cacao. But the results are STILL significantly positive.This fact suggests a good portion of the nutritional benefit of chocolate is retained after processing. Your goal then is to find a chocolate that's as minimally processedas possible, but still palatable. You don't want to eliminate too many of the health benefits by eating a product that contains a lot of sugar and chemicals. Choose chocolate with a cocoa/cacao percentage of about 70 or higher.

If you can tolerate the flavor of raw cacao, then that's the absolute best option.

Milk chocolate is not a good choice as it contains pasteurized milk, which is not good for you, and largequantities of sugar. White chocolate is also high in sugar and contains none of the phytonutrients, so is not a good choice either. Dark chocolate is your best option.

How to Make Your Own Chocolate

That is why I believe that, if you are convinced of the value and benefits of chocolate,  one of the best ways to consume it is to make it from high quality materials yourself.  I describe how to do that in the video below.  This is a recipe I created from scratch and there are no specific measurements. You can simply use raw cocoa butter and that will give you a finished candy that melts, or you can add raw pastured butter and coconut oil, which have their own health benefits. If you use these ingredients the candy will melt at a lower temperature and you will most likely need to keep it in the refrigerator to keep it from melting.

Ingredients to Steer Clear Of

Read your labels carefully and evaluate each product for the following:

  • Type of sweetener: Not only should you choose chocolate with low sugar content, but you should also look at what form of sugar it contains. Honey is sometimes used to sweeten raw chocolate products, which is a good choice (in moderation). If you can find chocolate sweetened with stevia or lo han, that would be preferable to cane sugar, fructose or high fructose corn syrup. Strictly avoid any product containing artificial sweeteners.
  • Fructose will reverse some of the positive benefits of chocolate. For example, fructose breaks down into a variety of waste products that are bad for your body, one of which is uric acid. Uric acid drives up your blood pressure by inhibiting the production of nitric oxide in your blood vessels, which helps your vessels maintain their elasticity. So, excess fructose can lead to elevated blood pressure, as a result of nitric oxide suppression.

  • Genetically engineered cocoa beans: Select chocolate products that are certified organic so that you be sure they aren't genetically engineered (GE). Most chocolate today (even dark chocolate) is GE, unfortunately4. Also opt for fair-trade products.
  • Type of fat: Fat in chocolate, as long as it's the right kind, is a good thing. It slows down the absorption of sugar, lessening the insulin spike. Ideally, the type of fat in your chocolate bar should be what is contained in the natural plant – cocoa butter. The primary fatty acid in cocoa butter is stearic acid, which is the only saturated fat that favorably affects HDL, without adversely affecting LDL, according to Dr. Golomb.
  • Coconut oil would be the next best fat in chocolate. Make sure you avoid soybean oil (and any other form of soy), and other vegetable oils and trans fats.

How Much Chocolate Should You Eat and How Often?

There are no hard and fast rules when it comes to dosing yourself with chocolate. But here are some basic guidelines.

In general, it seems preferable to consume smaller amounts of chocolate at more frequent intervals, much like the principle of split dosing for supplements, in order to ensure a steadier stream of nutrients in your bloodstream. According to Dr. Golomb, studies show people eating chocolate more than five times per week have a lower body mass index. That said, if you eat chocolate 20 times a day, you're going to have a problem due to the sheer quantity you're consuming! Daily consumption in divided doses (two to three times per day) is probably beneficial, as long as you aren't going overboard in quantity, and as long as you're eating high quality chocolate.

According to Ori Hofmekler2, in order to fully benefit from chocolate, you'd have to consume about 3.5 to 7 ounces per day. He states:

u201CThe problem is that even the healthiest dark chocolate brands today are not designed for such a large consumption.Yes, a moderate serving of three to four ounces of dark chocolate per day may be sufficient enough to affect your blood sugar and waist size.u201D

There is no simple answer. It depends on your insulin sensitivity, your activity level, your overall health, and the particular composition of the chocolate you're eating. You'll just have to exercise your best judgment here. If you avail yourself of a chocolate free of these additives and very low in sugar, then you can consume more of it without the downside.

Ori also writes:

u201CWhen purchasing chocolate, check the ingredients on the back label. If the chocolate has a sugar additives such as cane sugar, malt, maple, honey, dates, rice syrup, tapioca syrup, coconut sugar, molasses or fructose, stay away or restrict consumption of this product. And the same holds true for chocolates made with sugar alcohol or artificial sweeteners, which are known for their bloating, digestive disrupting and toxic side effects.u201D

If Chocolate Causes You Adverse Reactions…

A certain group of people has trouble sleeping when they use caffeine, and some of the compounds in chocolate, such as theobromine, do have caffeine-like effects. Some people are slow to metabolize caffeine, whereas others metabolize it quickly and are not adversely affected. If you don't usually have a problem with chocolate but suddenly develop one, it's possible you could be reacting to something in that particular chocolate.  Dr. Golomb points out that recently, copper has been appearing chocolate crops, originatingin fungicides, and this includes organic chocolate crops.

She states:

u201CHigh copper to zinc ratios have been linked unfavorably to depression, aggression, and various other things, which you know, some studies actually seem to link chocolate consumption at least observationally to.u201D

Also, in  2005, some processed chocolate was found to be contaminated with lead. When this was discovered, it was assumed the cocoa plants had been tainted by leaded gasoline. However, lead levels were found to be 60 times higher than could be accounted for by this, and it was never determined whether the lead contamination came from the shipping orthe manufacturing process.