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Title: Association between more frequent chocolate consumption and lower body mass index

Authors: B Golomb, S Koperski, H White

Reference: Arch Intern Med 2012; 172(6):519-521
http://bit.ly/HbxTlw

Reviewer: Robert Goldberg, PhD, Contributing editor, ProCor; Professor of Medicine and Epidemiology, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA

Reviewer comments: Consuming calories in excess of what might be considered optimal or desirable inevitably leads to weight gain and a higher body mass index (BMI). While a number of different diets have been proposed and studied over the years with regards to their overall health effects, including CVD and its risk factors, recent interest has focused on the potentially intriguing role of chocolate and its antioxidant effects on weight. Interest in this topic is due in part to the highly desirable taste of various forms of chocolate and its purported beneficial effects on blood pressure, insulin sensitivity, and serum cholesterol levels.

Using data from approximately 1000 men and women age 20-85 years from the San Diego area without diabetes or CVD who were being screened for participation in a clinical research study, the authors found that more frequent chocolate consumption was related to a lower BMI, both in univariate and multivariable adjusted findings. While the results of this cross-sectional study are intriguing, they nonetheless need to be interpreted with appropriate caution and replicated in further studies. This is because of the cross-sectional nature of the present study, reliance on self-reported data, possible contributory effects of other potentially confounding factors, and different types of chocolate consumed. Finally, and because chocolate is rich in sugar and fat, one cannot cavalierly recommend the increased ingestion of chocolate, despite its wonderful taste and antioxidant powers. This is certainly an intriguing finding, especially for chocoholics, but additional and more refined studies are needed, including assessment of chocolates that differ in their preparation, fat, and sugar content, before this tasty treat can be recommended as a possible weight loss measure.

Purpose of study: To examine, in a cross-sectional manner, the association between chocolate consumption and BMI

Location of study: California, US

Study design: Cross-sectional

Results: The authors collected information from approximately 1000 men and women (mean age was 57 years) who completed a food frequency questionnaire (FFQ) which collected information about the consumption of various foods, including fruits, vegetables, and chocolate. These individuals were being screened for possible participation in a clinical research study that was to examine the noncardiac effects of statins. Study participants were also asked about their participation in regular physical activity and their height and weight were recorded at an initial screening exam. Approximately two thirds of study subjects were men, the mean BMI of study participants was 28, and consenting subjects ate chocolate, on average, two times/week.

Frequency of chocolate consumption was associated with greater caloric and saturated fat intake but not to higher levels of physical activity.

In both univariate and in a series of multivariable adjusted analyses, controlling sequentially for age, sex, physical activity, calories, and fruit and vegetable intake, more frequent chocolate consumption was related to a significantly lower BMI. In contrast to the frequency of chocolate consumed, the amount of chocolate consumed was not related to BMI in a positive or negative manner.