Special Diets

• By Suzanne Dixon, MPH, MS, RD

Can Chocolate Keep Heart Disease in Check?

Type 2 diabetes can increase the risk of developing heart disease, but fortunately, a healthy lifestyle can help ensure a healthy ticker. Along with being physically active, using diabetes medications as needed to keep blood sugar under control, and maintaining a healthy body weight, eating chocolate—particularly if it’s enriched with flavonoids—may be another way to stay heart smart.

Flavonoid-enriched chocolate improved long-term heart disease risk

Chocolate-covered heart health

To study the effects of flavonoids—nutrients found in a variety of foods such as tea, herbs and spices, onions, wine, dark chocolate, and berries—on heart-disease risk in women with diabetes, researchers randomly assigned 118 postmenopausal women to eat 1 ounce of flavonoid-enriched chocolate or 1 ounce of regular chocolate daily for one year. The women were 51 to 74 years old at the start of the study, were instructed to eat equal portions of chocolate with lunch and dinner each day, and were taking medications, such as insulin or cholesterol-lowering drugs, as needed, to manage long-term heart disease risk.

Compared with the women eating regular chocolate, several health markers were favorably changed in the women eating the flavonoid-enriched chocolate, including reductions in:

• insulin levels and insulin resistance,
• total cholesterol,
• LDL (“bad”) cholesterol,
• the ratio of LDL to HDL (“good”) cholesterol, and
• ten-year-total coronary heart disease risk per the UK Prospective Diabetes Study algorithm measurement.

The flavonoid supplemented group also showed improved insulin sensitivity. There were no differences in blood pressure, an indicator of long-term glucose control (hemoglobin A1c), or glucose levels between the two groups.

Get your flavonoid fix

This study found that flavonoid-enriched chocolate improved long-term heart disease risk in postmenopausal women with type 2 diabetes. The flavonoid-enriched chocolate was made especially for this study, so it is not available on store shelves at this time. However, our tips can help you get your flavonoid fix, with or without chocolate.

• The enriched chocolate provided 90 mg of a type of flavonoids called epicatechin. The best sources of epicatechin include dark chocolate—the darker the better, so go for 70% or higher cocoa content—green and black tea, red wine, lentils, black-eyed peas, purple and red berries, and apples—especially the skins.
• The flavonoid-enriched chocolate also provided 100 mg of isoflavones. The best sources of this flavonoid include soy foods, such as edamame, tofu, tempeh, and soymilk.
• Dark chocolate has long had a reputation for being heart healthy, but be sure you account for the extra calories if you are adding dark chocolate into your existing diet. The study participants ate about an ounce of chocolate per day. An ounce of 70% dark chocolate provides about 160 calories. If you don’t offset those extra calories by eating a little less of something else, that could add up to nearly 17 extra pounds of body weight a year!

(Diabetes Care 2012;35:226–32)