Pre-Diabetes Part 4: The Chocolate Effect

by John Douillard, DC
Link for article on Life Spa


As I wrap up this series on blood sugar and pre-diabetes, it seems only fitting to end by discussing the good and the not so good of chocolate. The research is compelling – there are so many studies touting the health benefits of cacao. The Greeks called it theobromo or "food of the gods". Others called it the "food of the devil" – suggesting there may be a “dark side” to chocolate.

Let’s dip into the very controversial issue of chocolate: is it for the gods, the devil, or just us regular folk?

This article also contains my conclusion to the entire Pre-Diabetes four-part series. After dedicating the past four weeks to the study and exploration of this newly documented cultural epidemic, I’ll tell you my final thoughts on what needs to be done to get us – and our addiction to the sweet taste – back on track.

What We Mean When We Say “Chocolate”

Chocolate, like coffee and tea, is loaded with over 300 powerful chemicals and antioxidants that deliver numerous health benefits, according to one report on the British Broadcasting Corporation.

But let’s be clear from the start: not all chocolate is created equal. It is the cacao in the chocolate that delivers these health benefits, not the added milk or sugar.

The benefits of cacao are generally noticeable in dark chocolate, with a cacao content of 70% or more. In this article, when I talk about the “benefits of chocolate,” I am referring to the constituents and effects of the cacao bean, not chocolate energy bars, cakes, or other chocolate treats.

Let’s take a look at some of the major constituents of chocolate.

The Power of Chocolate – Unpacking the Components

As many of us know from experience, chocolate releases neurotransmitters called endorphins (also called “endogenous morphine”) in the brain, which can deliver feelings of euphoria and comfort - thus its role as a leading comfort food.

Chocolate also contains a chemical called theobromine, (from the Greek Theobromo) which, interestingly, is both a stimulant and a sedative. It provides mental and physical relaxation while also delivering an energy boost similar to the effect of caffeine.


Caffeine is also a key component. As we know, caffeine is a stimulant. You can read more about caffeine here.

Chocolate is also rich in the amino acid tryptophan, which is a precursor to the neurotransmitter serotonin. Serotonin is known as the anti-depressant, anti-anxiety neurotransmitter. This chemical reaction takes place in the intestinal tract, which may explain in part why the "happy" effect of chocolate is so instant.

It doesn’t end there. Chocolate is also rich in an even more potent neurotransmitter called phenylethylamine which has given chocolate nicknames like “the love drug" and "chocolate amphetamine". It is the phenylethylamine that may be responsible for the studies connecting chocolate to blood pressure and blood sugar changes, as well as the feeling of excitement and alertness that are often associated with the feeling of falling in love.

Perhaps the most interesting chemical found in chocolate is called anandamide, which comes from the Sanskrit word ananda, meaning "bliss". This chemical is so fascinating in that it is very similar to THC (tetrahydrocannabinol), the active constituent in marijuana. Anandamide activates dopamine receptors in the brain - dopamine is a neurotransmitter that delivers a heightened sense of wellbeing or "high". It is sometimes called the "I’ve gotta have it" hormone because, when the brain becomes familiar with the effects of a dopamine-triggering substance like chocolate, seeing, smelling, or even thinking about that substance triggers the brain to send out the message, “I’ve gotta have it, now!”

Chocolate also has two chemicals (N-linoleoylethanolamine and N-oleolethanolamine) that inhibit or slow the breakdown of the anandamide, allowing the bliss chemical to linger for hours.

As you can see, chocolate has a potent effect on our minds and bodies on many levels.

Is it Addictive?

We can thank the entire rainbow of brain boosting chemicals listed above for the addictive nature of chocolate. Although, it should be mentioned that most of these chemicals exist in very small quantities, leading some researchers to believe the amounts are not sufficient to make a psychological difference.

On the other hand, many of us can likely attest to that certain something about chocolate that keeps us coming back for more.

The Research

While chocolate is most often thought of as a mood-altering comfort food, it is loaded with heart-healthy flavonoids. These flavonoids are the same constituents that give red wine, grapes, and berries their dark color and antioxidant effect. Interestingly, in all the studies I have seen, white chocolate –which is devoid of these flavonoids—offered none of the cardiovascular benefits seen in dark chocolate.

In one study, 34,000 postmenopausal women who were put on a high flavonoid diet including chocolate had a 22% lower risk of developing coronary artery disease. (1)

In another study, men who consumed high amounts of cacao (2.3g/day) had a 50% lower risk of developing cardiovascular disease compared to men who did not consume cacao. (2)

Blood pressure and cholesterol levels were lowered with only 6g of dark chocolate a day. (3)

In another study, 20 subjects with high blood pressure who ate 100g of dark chocolate saw a significant drop in blood pressure and a 10% drop in cholesterol. (4).

The Reality

Unfortunately, with one third of the American adult population qualifying as pre-diabetic, it is impossible for me to say that chocolate is a health food, even with all of its documented benefits. As a culture, we have over-indulged in the sweet taste, and we now need to address that excess by balancing the other side (see my discussion of the six tastes in Pre-Diabetes Part 3).


Sweet tastes are everywhere: in bread, pasta, rice, corn, fruit, fruit juice, and, of course, desserts. The bitter foods that offset the sweet taste are mostly found in bitter leafy green veggies and berries. The good news is that the cacao bean, much like the coffee bean, is actually bitter in nature. In this respect, both coffee and cacao are quite medicinal.

The question is: is this a medicine that we should be ingesting every day? And, is this a medicine that is appropriate for this culture at this time?

Sugar Content in Chocolate

Dark Chocolate (40g of 70% cacao)

- Calories 213

- Fat 16 g

- Saturated fat 11g

- Sugar 12g


Milk Chocolate 40grams


- Calories 230

- Fat 15 g

- Saturated fat 9g

- Sugar 20g


To Indulge, or Not to Indulge?

Mostly, the cacao in dark chocolate is highly processed and loaded with sugar. While a higher cacao content indicates a lower sugar content, it still delivers quite a jolt of sugar and insulin to the bloodstream, heart and arteries.

If you do not have any pre-diabetic issues and your fasting first morning blood sugars are between 75-85mg/dL, (find out more about home-testing your blood sugar here) then one or two small pieces a week of the darkest chocolate you can enjoy after a meal may be fine.

Remember, unlike coffee, the amounts of chocolate that were found to deliver the most therapeutic effects were very small. It doesn’t take much sugar to over-stimulate the nervous system and push blood sugars to dangerously high levels.

The Larger Issue: In Conclusion to the Pre-Diabetes Four Part Series

After dedicating the past four weeks of newsletters to the study and exploration of pre-diabetes, and, before that, decades worth of patients struggling - sometimes unknowingly - with their blood sugar, here are my final thoughts about how to get our taste buds back on track:


I believe that we must, for optimal health, break the addiction to the sweet taste and to legal and so-called healthy stimulants like coffee, cacao, tea, energy drinks and sweets.

In a way, many Americans are legal drug addicts!

All of the above activate dopamine receptors in the brain – dopamine is the neurotransmitter behind this phenomenon that we call “addiction.” The dopamine activation in turn creates a neural pathway in the brain that convinces us, "I am not satisfied until I have that coffee, tea, chocolate, sex, money, fame, the list goes on. On a more fundamental level, it may be our cultural addiction to sweets and stimulants that drives an incessant need to consume that is shared by many Americans.

Many of us are addicted to one activity or another, one food or another. Unless we have those things in our day, we do not feel content. We are often only content when consuming, acheiving or stimulating ourselves. As I mentioned, this is an addiction to dopamine, the "I gotta have it" hormone, which literally delivers the "high" that we seem to be perpetually seeking.


Perhaps it is this addiction that is underlying our cultural depression, anxiety and discontentment.


According to Ayurveda, a great effort is made to still and silence the mind while our culture seems set on over-stimulating it. Yoga has replaced meditation, shopping has replaced sitting on the back porch, and soccer tournaments have replaced family picnics. Somewhere in the past 20 years, we have lost the desire and know-how to still the mind and simply be at peace.


Chocolate of any kind is a stimulant. Yes, it has medicinal properties (barring the sugar), but if chocolate or the next exotic stimulant becomes our only avenue to contentment - then I think we have lost something most precious to the human mind - its own silence!


Perhaps experiencing our true nature of joy, love, and being happy for no reason, starts with experiencing the silence within. To begin to move towards that, step one would be to acknowledge and break the insidious addictions that keep us from being present with ourselves.



References

1. Amer J Clin Nutri. March 2007

2. Archives Internal Medicine. 2006

3. JAMA. July, 2007

4. Journal of Hypertension. 2005