Christopher Labos: No, chocolate is not good for you. I am sorry

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This is a story about chocolate. This is the story of how chocolate went from desert to healthy food and back again. Except most people miss the end of the bad-for-you part of the chocolate.

When it comes to the science of chocolate, we must first address an important point. The chocolate you eat is not the chocolate they use in their research, at least in most cases. Studies usually use cocoa bean extract. An overpriced item to buy for Valentine's Day because you didn't plan to buy it when it was on sale.

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Cocoa bean extract has been an interesting target for drug research because it contains many molecules that may have potential medical benefits. Chocolate sold in stores, on the other hand, is loaded with fat and sugar to make it tastier. Without them, pure cocoa would be too bitter and too unpleasant for most people. But their addition destroys any of the supposedly healthy antioxidants the original beans may have.

People often argue that dark chocolate, which is high in cocoa and therefore low in milk, is healthier. Comparatively speaking, it is healthier because it contains less sugar. But it still contains a significant amount, and mass consumption of any chocolate product leads to weight gain.

There are studies examining chocolate consumption in populations. The Danish Diet, Cancer and Health Study, Women's Health Study, and Physicians' Health Study looked at people's dietary habits to see if chocolate consumption was associated with a reduction in a specific arrhythmia, atrial fibrillation. These types of studies are always problematic because they rely on people accurately recalling past food intake. But even if you take them at face value, they have produced inconclusive results. Only the first two offered an advantage. There was no third.

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Observational studies such as these often produce conflicting results due to differences between groups and the perennial problem of poor recall. Randomized trials are usually better and more reliable.

There are several blood pressure trials that have compared a flavonol-rich cocoa product with a placebo or flavonol-free cocoa powder. A Cochrane review of 35 trials found that flavonol-rich cocoa products reduced blood pressure, but did so by less than two points. Lowering your blood pressure from 148 to 146 is unlikely to provide much medical benefit, given how much fat and sugar is consumed with cocoa.

A definitive test of chocolate's medical benefits was to come from the COSMOS study. COSMOS was a large randomized trial that tested cardiovascular and cognitive outcomes. It used cocoa extract, not chocolate, and was partially funded by the chocolate company Mars, but it was still considered the most promising piece of research in the pipeline.

When results were published in 2022, cocoa extract did not improve cardiovascular outcomes and did not improve memory scores on any of the cognitive tests. Eating pure chocolate is doubtful.

The announcement of COSMOS did not generate many headlines. Ask most people and they'll probably tell you about studies linking chocolate consumption to Nobel Prizes. Negative studies don't get much press, while positive studies, on the other hand, are spread far and wide. Although most of them are sponsored by chocolate companies, there is no shortage of positive studies.

The totality of the evidence does not show that eating chocolate is good for the heart, good for the brain, or good in any way. This does not mean that you should not eat chocolate. You can and probably will on Valentine's Day. You can't fool yourself into thinking it's healthy.

Christopher Labos is a Montreal physician, host and author of the Body of Evidence podcast Does coffee cause cancer?

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