In short: Is all chocolate bad for us or is there such a thing as 'healthy chocolate'? We explore the perils of milk chocolate and the blessings of dark chocolate. We also look at whether healthcare professionals take their own advice, whether it is better to be a Quality Street chocolate or a Roses chocolate if you want to survive in the average hospital ward and we reveal the chocolate preferences of nurses and doctors!
People think of chocolate in lots of different ways. Some (not many) can’t stand it and steer clear of it at all costs, others turn to chocolate when they want some form of comfort and most of us struggle to resist it. Eating chocolate has also been linked to how we feel. Some authors argue that we overindulge in chocolate as an attempt to self-sooth when we get upset. A study by Rose and colleagues published in 2010 in Archives of Internal Medicine found that people eat more chocolate the more depressed they are. As health professionals you know we are going to try to convince you to eat a balanced, healthy, not too fattening diet; with the average chocolate bar falling clearly under the ‘treat’ category. However, it also seems that we are not appreciating chocolate fully -- dark chocolate in particular. The long held perception that most chocolate products have high sugar content and therefore are generally bad for you has been balanced by some of the positive health benefits that we might experience if we consume small amounts of untreated dark chocolate rich in flavonoids. A paper in 2003 by Serafini and colleagues published in Nature argued that dietary flavonoids from chocolate, in particular epicatechin, may promote cardiovascular health as a result of direct antioxidant effects or through antithrombotic mechanisms. They showed that consumption of plain, dark chocolate resulted in an increase in both the total antioxidant capacity and the amount of epicatechin in blood, although this was reduced when milk was added to the plain dark chocolate. So, steer clear of milk chocolate if you can.
So, we wondered what would happen when healthcare professionals were presented with chocolate? Given their advice to others, would they abstain when presented with chocolate? A recent covert observational study by Gajendragadkar and colleagues (2013) published in BMJ put tins of chocolates on a hospital ward and looked at what happened. The median survival time of chocolates was just 51 minutes and were eaten following an exponential decay process, which is fancy math speak for a lot of chocolates flying rapidly at the beginning and then people becoming a bit shier when only a few remained. Quality Street chocolates survived longer than Roses chocolates. They also found a distinction for preference of chocolate by profession. Healthcare assistants and nurses accounted for 28% of the total chocolates consumed (54 out of 191 chocolates consumed by each group). Doctors were the third biggest consumers, accounting for 15% (29 out of 191) of the total chocolates consumed. There was a trend that healthcare assistants and nurses preferred Roses chocolates, whereas doctors preferred Quality Street chocolates. The rationale for Drs preferring Quality Street to Roses remains unclear. Even healthcare professionals indulge when given the opportunity. Availability and accessibility seem to be two of the biggest determinants of whether we consume chocolates or not.
The message here is simple: not all chocolate is bad, those with high sugar/milk content tend not to be particularly healthy, but dark chocolate can have some positive benefits if consumed in moderation. If you keep chocolate around you are more likely to eat it, even if you are a healthcare professional! Of course, a healthy balanced diet combined with exercise is the key to a healthy lifestyle. Although, given the above we can all feel slightly less guilty when we treat ourselves with a piece of dark chocolate.