February 6, 2014

Frequent Chocolate Consumption May Lower BMI

Findings may put to rest patients' concerns about gaining weight from eating chocolate
Previous studies have linked chocolate consumption with decreased risk of cardiovascular disease, but patients are still hesitant to increase consumption for fear of weight gain. This study will put those fears to rest.


Golomb BA, Koperski S, White HL. Association between more frequent chocolate consumption and lower body mass index. Arch Intern Med. 2012 Mar 26;172(6):519-521.


Dietary information was collected from study participants using the Fred Hutchinson Food Frequency Questionnaire (FFQ). Body mass index (BMI) was calculated and compared to chocolate consumption.  Separate calculations were made adjusting for total calories, fruit, vegetable, and saturated fat intake. Exercise frequency was also calculated. Mood was evaluated by having subjects complete the Center for Epidemiological Studies depression scale (CES-D). 


The study used data obtained from 972 men and women aged 20–85 (mean age=57) from San Diego, Calif., without known cardiovascular disease or diabetes and with LDL cholesterol between 115 and 190 mg/dL. These participants were being screened for a study on noncardiac effects of statins.

Study Medication and Dosage

Frequency and quantity of chocolate were compared to BMI. No details on type of chocolate were collected.

Outcome Measures

BMI was calculated as weight in kilograms divided by height in meters squared.

Key Findings

Frequency of chocolate consumption was linked to lower BMI (unadjusted, P=0.01). Chocolate consumption was not linked to greater activity (P=0.41). 

Practice Implications

Most of our patients, even if they are aware that chocolate is good for their health, still assume that eating chocolate will lead to weight gain and hesitate to eat it regularly. This paper suggests that the opposite is actually true. We should popularize this information amongst our patients and actively encourage them to eat chocolate frequently.
We could remind our patients of the cardiovascular benefits from eating chocolate that have been reported in recent years. For example, Mostofsky reported that women consuming 1 to 3 servings of chocolate per month compared with those who reported never eating chocolate had a 26% lower risk of heart failure. Those consuming 1 to 2 servings per week had a 32% risk decrease.1 We could quote Reid’s meta-analysis of 13 studies that “dark chocolate is superior to placebo in reducing systolic hypertension,”2 or remind them that Janszky et al reported that compared with people who never eat chocolate, those who ate chocolate even less than once a month had a 27% reduced risk of mortality in those who had a first heart attack. Eating chocolate once a week dropped their risk of dying by 46%, twice per week by 66%.3  Even if we quote all these statistics, the fear that eating chocolate will ‘make them fat’ still will prevent many people from eating chocolate. Thus emphasizing this current paper may be useful as our experience suggests that the promise of weight loss is often the best patient motivator we can find.

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  1.  Mostofsky E, Levitan EB, Wolk A, Mittleman MA. Chocolate intake and incidence of heart failure: a population-based prospective study of middle-aged and elderly women. Circ Heart Fail. 2010;3(5):612-616.
  2.  Ried K, Sullivan T, Fakler P, Frank OR, Stocks NP. Does chocolate reduce blood pressure? A meta-analysis. BMC Med. 2010;8:39
  3.  Janszky I, Mukamal KJ, Ljung R, Ahnve S, Ahlbom A, Hallqvist J. Chocolate consumption and mortality following a first acute myocardial infarction: the Stockholm Heart Epidemiology Program. J Intern Med. 2009;266(3):248-257.