Article to yesterdays afib and dark chocolate

[kocoach]

Heart Matters

More than a magazine: information, inspiration and support

Heart Matters magazine

Activity

Medical

Real life

News

Nutrition

Research

Wellbeing

Home

Information & support

Heart Matters magazine

News

Behind the headlines

Chocolate and atrial fibrillation

Will eating chocolate reduce your risk of atrial fibrillation?

Squares of milk chocolate

26th May 2017

Eating a moderate amount of chocolate has been linked to a reduced risk of atrial fibrillation (AF), new research has suggested, but is the picture really that simple?

AF is one of the most common forms of abnormal heart rhythm and a major cause of stroke. AF often doesn’t cause any noticeable symptoms but can sometimes be felt as an irregular and sometimes fast heartbeat or pulse.

The researchers, from Harvard University, looked at 55,502 participants from the Danish Diet, Cancer and Health Study. They followed them up for an average 13.5 years, during which time there were 3,346 cases of AF. People who previously had AF or cancer, or who hadn’t provided adequate information on their chocolate consumption, were not included in the study.

At the end of the study period, the researchers found that on average, the people who ate chocolate had a lower risk than people who didn’t eat any chocolate. The researchers categorised people according to gender and how much chocolate they ate.

The researchers found that on average, the people who ate chocolate had a lower risk than people who didn’t

For men, the biggest reduction in risk was seen in people who ate 2-6 servings of chocolate a week – this was linked to a 23 per cent lower risk of AF. For women, the biggest reduction in risk was if they ate one serving of chocolate a week, in which case they had a 21 per cent lower risk of AF.

It is important to note that this is an association, not cause and effect.

A portion of chocolate was defined as 1 ounce (about 30g). To put this in perspective, a regular bar of Dairy Milk is 45g, and a Wispa bar is 30g.

Regardless of their chocolate intake, the rate of AF was lower among women than men. But both sexes had a lower risk of AF with higher levels of chocolate intake.

The researchers' theory is that the cocoa in the chocolate and the compounds known as flavanols that can come with this may be responsible for the improvements seen in blood pressure and cholesterol levels, as well as decreasing the risk of some of the negative changes in the heart that can lead to atrial fibrillation.

They added that “a typical 100 calorie serving of dark chocolate” (this would typically be around 17g or 5 small squares of chocolate) contains 36 mg of magnesium, which has blood-pressure lowering and antiarrhythmic effects. “These properties may explain the lower cardiovascular risk associated with moderate chocolate intake,” they noted in the report.

Most chocolate eaten is Denmark is milk chocolate, so the researchers suggested that their findings may underestimate the protective effects of dark chocolate.

The research adjusted for weight to make sure that differences in weight did not affect the findings. But we do know that obesity is a risk factor for atrial fibrillation, and chocolate is a high-calorie food – so if you put on weight due to eating more chocolate, this won’t help your risk of AF or your health.

The research

Importantly, the researchers only knew participants’ chocolate intake at the start of the study and (for most participants) after five years, which is a huge limitation. The end result is based on figures after an average of 13.5 years of follow up. We don’t know whether the participants’ chocolate consumption changed during that time.

They also do not know whether it was dark or milk chocolate that the participants were eating.

The end result is based on figures after an average of 13.5 years of follow up

The researchers thought that flavanols, which there are more of in dark chocolate that contains more cocoa, were the cause of cardiovascular benefits.

These results also cannot necessarily be applied to the USA; as chocolate in Europe has a higher cocoa content than chocolate in the United States (minimum 30 per cent for milk chocolate in Europe, compared with minimum 10 per cent in the US).v

The research was based in two specific areas of Denmark – the Aarhus and Copenhagen areas, and all participants were 50-64 years old, and mostly European, which could limit how generalizable these results are to other populations.

A strength of the study is the large number of participants, and that the research took into account participants lifestyle, medical history, and overall calorie intake, so it is less likely that these factors were behind the result that they found.

The BHF view

Victoria Taylor, Senior Dietitian at the British Heart Foundation, said: “Chocolate, or rather, the cocoa it contains, has previously been linked to a variety of cardiovascular benefits and in this case, people who ate more had a lower risk of developing atrial fibrillation.

“However, although this is a large study, it is only observational and so other factors could also be responsible for the effects seen. The type of chocolate eaten wasn’t recorded either, therefore we can’t directly translate these findings into recommendations.

“We need additional research to look more carefully at exactly how much cocoa would need to be consumed and how frequently, to see the same benefit.

“If you eat chocolate, keep your portions small and go for dark chocolate with the highest cocoa content,” she recommends.

A reduction in risk of AF isn’t the same as “saving” your heart

Media coverage

The story was widely covered, including in the Daily Mail, Telegraph and the Express.

The coverage was mostly accurate but it failed to mention that the chocolate consumption was only measured at the beginning and five years into the study, which is an important limitation to consider.

The Mail headline “Chocolate six days a week will save your heart, chaps... but sorry, ladies, it's only once for you” may have been overstating matters. A reduction in risk of AF isn’t the same as “saving” your heart, as there are many other types heart problems (including coronary heart disease) and eating chocolate will not cure any heart problems that you already have.

[stoneyrosed]

One portion of chocolate sends me straight into AF. I can eat a packet of mints containing a high sugar content and have no problems. So whatever is in the chocolate especially milk it kicks of my AF make no mistake.

[kocoach in reply to stoneyrosed]

That makes two of us I know then that's affected by it.

[RoyMacDonald in reply to stoneyrosed]

Why eat chocolate with cows milk then? The majority of the World population is allergic to milk. (including me) I eat 100% dark chocolate. Calms my heart. I'm 79 now. If my 12 year old grandson has anything with cows milk in it he has to go to hospital due to his allergic reaction. He eats dairy free milk chocolate.

All the best.

Roy

[kocoach in reply to RoyMacDonald]

Thank You, I try and eat it because all you read or hear about is how good these things are for your health, they forget to mention as long as you're in good health. Thank You for insight.

[Autumn_Leaves]

Neither the BHF article or the sensationalist Daily Mail headline are relevant to people who already have AF. It was a prospective cohort study ie taking a specific population and observing their lifestyle factors and long term health outcomes. There was an association between reported chocolate consumption and the risk of developing AF, but that isn’t the same thing as stating that chocolate prevents AF. Reduced risk doesn’t mean zero risk. People who already had AF were excluded in this study

This was not a clinical trial of chocolate to test its effects on people with AF. To my knowledge, no such thing exists.

Nobody needs to eat bars of chocolate to consume the nutritional benefits of cocoa. You can add it to chilli — it doesn’t have to be used in sweet foods. you can add it porridge, you can make banana ‘nice cream’ with no added sugar, or add some cacao nibs to mixed nuts. If you have a blender you can make a ‘snickers’ style smoothie with banana, peanut butter and cocoa powder. Get curious and look online for recipe ideas. Think outside the chocolate box!

[kocoach in reply to Autumn_Leaves]

Point well taken, unfortunately I'm just a lonely, tired, single guy with no friends or relatives to help and that wants things like food and such without the hassle and time it takes to make. Hence I venture out and try what I know I shouldn't and BAM, afib.

[Autumn_Leaves in reply to kocoach]

It’s not very good when you’re trying to help yourself and end up doing the opposite. I’ve done similar.. This is the problem with a lot of online information. You probably haven’t done any long term damage and if anything you’ve learned something about how your own body reacts to specific triggers. It’s not easy being isolated either. I don’t think people realise that there’s a lot more to health and wellbeing than following this or that diet and counting steps every day. Emotional and social factors play a role too.

[kocoach in reply to Autumn_Leaves]

You're so right, one starts learning so much when all alone, no friends no relatives no one to count on but ONE only. Life seems to get very intense during those times. Thank You

[Tarikor in reply to Autumn_Leaves]

Quite right! The darker the chocolate is, the more it contains compounds that are STIMULANTS to the body and the heart. Every single time I have indulged in chocolate, my heart warns me and when I started trying very dark chocolate (90% to 95% Lindt dark chocolate) a few weeks ago, it hit me like a sledgehammer.

So no, chocolate is almost as bad as coffee for me.

[OzJames]

the study excluded people who have had AF. What they should have done was included those with AF history then compared that group with the larger group

[Autumn_Leaves in reply to OzJames]

Or alternatively, just not bother reading articles with dramatic headlines and over simplistic conclusions.

We’re not discussing the original study here but articles about the study which are somewhat skewed. A study of the lifestyle factors of a population and the resulting overall long term health outcomes isn’t designed to ‘test’ the impact of chocolate on people with AF/without AF.

It’s worth pointing out that articles written by journalists are not original source material. Features in the Daily Mail are not the same as peer-reviewed scientific research published in reputable scientific journals.

[kocoach in reply to Autumn_Leaves]

Well Put! Thank You

[Autumn_Leaves in reply to kocoach]

Finding information online is a quagmire. There’s so much rubbish and not much of it is helpful or useful.

[kocoach in reply to OzJames]

Do we ever rid ourselves of afib? Going on 30+ years it seems as once it rears it's ugly head it's here to stay.

[GrannyE in reply to kocoach]

Even if it goes, with most people, you know it will come back sooner or later. I have come to the conclusion that as long as it is not of the thumping or really bad fluttering light headed variety I can live with it - I just have to restrict what I do.

[RoyMacDonald]

Well, I'm free of it if I eat (I did change my diet dramatically) and rest properly. I never read newspaper articles though, as they generally wind me up due to their sensationalist nature. I was only was diagnosed with it about 7 years ago though. I'm 79 now.

All the best.

Roy