According to a study discussed on MedPage Today, it appears that my dark chocolate addiction will pay off...both in terms of health and finance :)
Dark Chocolate: Sweet Prevention for CV Events
By Kristina Fiore, Staff Writer, MedPage TodayPublished: May 31, 2012
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Dark chocolate may be an inexpensive way to help prevent cardiovascular events in patients at risk for heart disease, researchers found.
A modeling study predicts that patients with metabolic syndrome who eat dark chocolate every day could have 85 fewer events per 10,000 population over 10 years, Chris Reid, PhD, of Monash University in Melbourne, and colleagues reported online in BMJ.
At a cost of only $42 per year, treatment with dark chocolate falls into an acceptable category of cost-effectiveness, at an incremental cost-effectiveness ratio (ICER) of $50,000 per years of life saved.
"Chocolate benefits from being by and large a pleasant, and hence sustainable, treatment option," they wrote. "Evidence to date suggests that the chocolate would need to be dark and of at least 60% to 70% cocoa, or formulated to be enriched with polyphenols."
Several recent studies have suggested that eating dark chocolate has blood-pressure and lipid-lowering effects. To assess whether it could be an effective and cost-effective treatment option in patients potentially at risk for cardiovascular events, the researchers looked at data from patients in the Australian Diabetes, Obesity, and Lifestyle study.
They used a Markov model to assess health effects and associated costs of daily consumption of plain dark chocolate compared with no chocolate in a population with metabolic syndrome but without diabetes or cardiovascular disease.
The investigators also used risk-prediction algorithms and population life tables to determine the probability of patients developing or dying from heart disease or other noncardiovascular causes each year.
Data on the blood-pressure-lowering effects of dark chocolate were taken from a meta-analysis of 13 randomized controlled trials, and lipid-lowering effects from a meta-analysis of eight short-term trials.
Costs were taken from a review of the costs of cardiovascular complications in a healthy population, and included the direct costs of myocardial infarction and stroke.
They calculated the number of deaths prevented by determining the difference in the number of deaths between those consuming and not consuming dark chocolate.
The final model included a total of 2,013 patients with metabolic syndrome, mean age 53.6, mean systolic blood pressure 141.1 mmHg, mean total cholesterol 6.1 mmol/L, mean HbA1c 34.4 mmol/mol, and mean waist circumference 100.4 cm.
Reid and colleagues found that daily consumption of dark chocolate -- a polyphenol content equivalent to 100 grams of dark chocolate -- can reduce cardiovascular events by 85 per 10,000 population over 10 years.
Specifically, with 100% compliance, treatment would prevent 70 non-fatal and 15 fatal cardiovascular events per 10,000 population over that time. The authors noted that this was a "best case scenario" analysis.
When compliance was reduced to 90%, the number of preventable non-fatal and fatal events fell to 60 and 10, respectively, and at a compliance of 80%, was reduced to 55 and 10, respectively. Even at these levels, however, daily dark chocolate was still considered an effective and cost-effective intervention strategy, they wrote.
At a cost of $42 per person per year, dark chocolate prevention strategies came to an estimated ICER of $50,000 per years of life saved -- a figure well within typical cost-effectiveness thresholds, the researchers said.
That $42 could be spent on advertising, educational campaigns, or subsidization of dark chocolate in higher-risk populations, they wrote.
Reid and colleagues noted that the study was limited by its reliance on the Framingham algorithm, which may underestimate risk in a high-risk population, and by assumptions about the risk of death following a cardiovascular event.
The study was also limited by the assumption that the benefits of dark chocolate, which have only been observed in short-term trials, extend to 10 years. Still, they concluded that the findings suggest dark chocolate may be an effective and cost-effective strategy for preventing heart disease in patients with metabolic syndrome.
Diet Sodas and Death
I've posted about the health consequences of artificial sweeteners before but had to post this new information I read this morning. Dr. Weil writes...
"Drinking diet sodas daily is associated with an increased chance of suffering a heart attack, stroke, or of dying due to conditions that affect the circulatory system. This news follows an analysis of data gathered from more than 2,500 participants in New York City that looked at the relationship between drinking sodas (diet or regular) and cardiovascular disease risks. No association was found with consuming regular soft drinks or drinking diet sodas more moderately (between one a month and six a week), but the investigators found that compared to individuals who drink no diet sodas, those who drink them daily were 43 percent more likely to have a heart attack, stroke or other vascular event. The researchers said that the reasons for this association are unclear and that more research is needed. The study was published online on Jan. 27, 2012 in the Journal of General Internal Medicine."
Pretty crazy stuff. Quit the addiction and drink water flavored with your favorite fruit - raspberries, strawberries, peaches, etc. Jazz it up even more by using carbonated water - seltzer. These drinks are very refreshing, without any calories and 100% na-tu-ral! Enjoy!
Well, who would have thunk it? DIET soda has just been implicated in leading to higher risks of cardiovascular disease, even when compared to its sugar laden sibling, regular soda! (Read the article at http://www.medpagetoday.com/MeetingCoverage/ASA/24788utm_content=GroupCL&utm_medium=email&impressionId=1297326971891&utm_campaign=DailyHeadlines&utm_source=mSpoke&userid=267423)This news is probably quite shocking to the average American who likely consumes at least one soda (be it diet or regular) a day. It's even quite shocking to the medical community and those of us who stay up-to-date in the medical/nutrition world.
Soda, in and of itself, is deeply ingrained in American culture. We drink it in our homes, our offices, at parties and especially at sports events. I fondly remember delving into the enjoyment and crisp taste of my uncle's caffeine-free Diet Coke as a child. In fact, I would look forward to drinking his "adult" soda anytime I was at my aunt and uncles' house (which was often as a child...they lived 3 houses down from mine in SW Houston). I would sit and watch TV with my uncle (after my homework was done of course and my potato chips with a side of ketchup were eaten!) and carefully demise a plot to steal his Diet Coke that sat next to him in a glass filled almost to the brim with ice.
And so my love affair with Diet Sodas began! And trust me, this love was intense!! In high school, I would enjoy an occasional diet fountain drink when eating fast food with friends, which occurred about once or twice a week. In addition, I'd indulge in the sweet calorie-free deliciousness of a diet soda during my lunch hour sometimes instead of an after-lunch dessert. By college, I was up to 1-2 diet sodas a day and by medical school, I was fully addicted, consuming three 16 oz Diet Pepsi bottles A DAY! You may as well have run a hosepipe of the stuff directly down my throat as that was exactly what I was doing while I studied.
In short, diet soda was my crack. I suffered daily, intense cravings for my sodas; often going to far lengths to obtain it. I never lost my grip on reality or an ability to function because of my addiction, but I was definitely hooked. At one point, my dental hygienist informed me of the high acid content of these sodas and it's potential wear on my teeth. At another point in time, I was warned of the osteoporotic (bone thinning) effects of the phosphates in diet sodas. But I didn't care...I was focused on when I'd get my next fix. Diet soda was not only a sweet after-meal treat for me, it also served as my caffeine fix. (I had not yet made the transition to coffee that only came in residency when I had no choice but to submit to a higher concentration of caffeine...to think of how much more efficient I could have been had I submitted earlier). To me, there was nothing better than a cold, freshly bought diet soda from fountain at restaurants, convenient shops, etc...that was heaven! (Btw, my transition to Diet Pepsi came in college when I discovered the sweeter taste of this brand to that of Diet Coke.)
Slowly, as medical school continued and the stress and lack of "me time" intensified, I began to notice some downfalls to my habit. A) I'd heard about possible health effects of aspartame and diet sodas in general, including neurotoxicity and osteoporosis, respectively; B) it was costly, about $5 a day to maintain at such high levels; C) my teeth were becoming yellower and seemed to becoming more translucent when I examined them in the mirror; and D) the GAS was unbearable!! So, slowly, I decided to switch to only Splenda-containing diet drinks. And suddenly, I felt better about the world.
But even then, the gas and tooth translucency continued. So much so, that it became physically painful to drink a soda. My life-long inability to burp (only my close friends know this about me) was coming back to haunt me! But no matter how hard I tried to learn to burp, the task was impossible. So, I did what most human beings do...I adapted. I would open my diet sodas (Pepsi One at this point) and carefully place them in my refrigerator so that they would not have any opportunity to spill. Then, after a few hours of "off-gassing", I would indulge. But even then, it was still painful to drink the small amounts of carbonation in the drinks. So, I adapted again...I left them open overnight and would enjoy them the next morning or afternoon. I was back in the game and much more comfortable!
But even then, I knew this was a habit I needed to break. Yes, aspartame and other sugar substitutes had been implicated in causing cancer in lab rats, but I knew that was in such extreme amounts that the odds of this happening to me was slim to none. But, as I learned more about the business of these products and the chemicals that are so pervasive in our food supply, I finally made the decision to break my addiction and forever free myself of cravings for diet soda. And so, the "Diet Soda Diet" began! As part of my diet, I only allowed myself ONE can of gas-less diet soda a day (Splenda only). Slowly, my cravings became less intense and less frequent and after a few months, I was no longer in the clutches of diet soda entrapment! I could once again enjoy a glass of water without thinking about when and where I'd get my next fix. I was free and so was the horribly painful, informidable gas I had lived with for >20 years!!
That doesn't mean that I don't still have occasional cravings for the chemically manufactured sweet drink, but I am definitely much more in control of my desires and am no longer a slave to them. To this day, there is often nothing more satisfying than a crisp, freshly opened can of diet soda (although I am very picky about which ones I will consume now), however, I generally limit my consumption to special events/occasions, such as birthdays, Super Bowl parties, etc.
The news that diet sodas may contribute to cardiovascular disease is not necessarily intuitive in my mind, but, it provides me with yet another weapon in my arsenal against a life-long addiction with the tasty chemically manufactured beverage. I hope my actions as a child, teenager and young adult can be overridden by the improvements I've made in my diet and physical well-being overall and I urge you to consider changing your habits towards the chemicals you may be addicted to (be it, diet sodas or processed meats, sugars, etc). I'm happy to help along the way and would LOVE to hear your diet "product" addiction story below!
Have a fabulous day!
Dr. Maltz earned a Medical Degree and Master in Public Health from the University of Texas Medical Branch (UTMB) in Galveston, TX. She completed a combined Internal and Preventive Medicine Residency at UTMB in June, 2011. She then completed a 2-year Integrative Medicine Fellowship at Stamford Hospital in Stamford, CT, during which she simultaneously underwent an intensive 1000-hour curriculum created by The University of Arizona Integrative Medicine Program founded by Dr. Andrew Weil.