Clinical Geriatrics

February has always been one of my favorite months. It marks the beginning of noticeably longer days and the early stages of spring, at least where I currently live. It is also the month of my mother’s and daughter’s birthdays and the time we celebrate Valentines Day, a day we express affection and solidify relationships. Although commercial interests have perhaps benefited most from this special day with the rise of Valentines cards and gifts, it is also a holiday associated with chocolate, a food with perhaps greater benefit than we had previously thought.

Chocolate is made from cocoa beans found within the pods of the cacao tree. This tree itself was named Theobroma cacao, or “food of the gods,” by the famous Swedish botanist Linnaeus. Cassanova was said to have consumed chocolate before entertaining his many paramours. An ancient people from Central America drank a water-based drink made from cocoa beans that, when mixed with dried chilis and other native ingredients, was called “kakawa” and was thought to improve “lovemaking.” While many crave this food and enjoy its decadent texture and flavor, most fear its fat content and relative high calories. Some have argued that it is capable of increasing our endogenous opioids, and thus may become an addiction.

We now know from a growing body of literature that chocolate may have other possible benefits. Chocolate has been found to contain relatively high amounts of antioxidants in the form of polyphenols that are derived from natural flavonoids in the cocoa bean. These compounds are similar to those found in red wine, olive oil, and green tea, and are thought to have the potential to protect one from heart disease by reducing the oxidation of low-density lipoproteins, as well as inhibiting blood platelet aggregation. While this is definitely “food for thought,” just how much chocolate one needs to eat to see a benefit remains uncertain, though likely in excess of 100 grams a day based on some preliminary data from a laboratory at my institution. At this level of intake, if it did become a regular addition to one’s diet, any positive effect from the chocolate must be carefully weighed against the potential negative effect of increased adiposity resulting from this added calorie intake. I leave it up to the readers to best determine how they would like to proceed with this knowledge. The next time I reach for a dark chocolate bar at the checkout counter of my supermarket, however, I will be better able to at least defend my choice and feel less guilty while I enjoy one of life’s small pleasures.

Dr. Gambert is Chairman, Department of Medicine, and Physician-in-Chief, Sinai Hospital of Baltimore, and Professor of Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.