Clinical Briefs
With Comments from John La Puma, MD, FACP
Calcium Absorption and Chocolate
June 2001; Volume 4; 71
Source: Shahkhalili Y, et al. Calcium supplementation of chocolate: Effect on cocoa butter digestibility and blood lipids in humans. Am J Clin Nutr 2001;73:246-252.
The digestibility of cocoa butter was reported in animal but not human studies to be low (60-70% and 89-94%, respectively). These differences could be due to the much higher ratio of calcium (Ca) to fat (by weight) in the diet of rats (0.04-0.18) than in that of humans (0.01). We investigated whether supplementation of chocolate with 0.9% Ca (by weight), as an integral part of a Western diet, reduces absorption of cocoa butter and hence the digestible energy value of chocolate. We also assessed the effect of Ca supplementation on the blood lipid profile. Ten men were fed control diets containing 98-101 g/d chocolate with or without a 0.9% Ca supplement (0.9 g Ca/d) for two periods of two weeks each. The study was conducted using a randomized, double-blind, crossover design under free-living conditions but with strict control of food intake. We found that Ca supplementation of chocolate increased fecal fat twofold (from 4.4 g/d to 8.4 g/d; P < 0.0001) and reduced the absorption of cocoa butter by 13.0%. This was due mainly to an increase in the excretion of palmitic and stearic acids (3.4 g/d), which reduced the absorbable energy value of the chocolate by approximately 9%. This supplementation also reduced plasma LDL cholesterol by 15% (P < 0.02); HDL cholesterol was unchanged. We conclude that Ca supplementation can be used as a means of reducing the absorbable energy value of chocolate. Supplementation with 2.25% CaCO3 had no effect on the taste of chocolate, was well tolerated by the subjects, and reduced LDL cholesterol in a short-term study.
Comment
Can chocolate really be good for you? Can taking calcium with your chocolate reduce the number of calories in each morsel? Apparently so. Though desserts are generally no place to look for nutrition, chocolate has many redeeming factors in small amounts—really small amounts.
There are three types of chocolate for these purposes: dark, milk, and white. Dark chocolate has the most cacao bean; white chocolate usually has none. Milk chocolate is dark chocolate plus sugar, cream or milk, and often, hydrogenated vegetable oil. White chocolate does not contain cacao normally and is primarily or all hydrogenated vegetable oil, just like Crisco and most stick margarine.
Dark chocolate has the most proanthocyanidins, which are flavonoids that function as antioxidants and as pigments. Proanthocyanidins are also found in other high-flavonoid foods: cranberries, onions, grapes, and other berries. The compounds also appear to reduce LDL oxidation and act synergistically with stronger antioxidants, including vitamins C and E.
This study was sponsored by Nestlé in Switzerland, and indeed, most chocolate research is industry-funded (as most pharmaceutical research is industry-funded). Still, on the basis of this study, I have begun swallowing a 500 mg tablet of calcium carbonate together with the savored morsels of 70% cacao dark chocolate I buy regularly, one little chip at a time. No weight loss yet, but I like knowing that there could be. And of course, I love the flavor, texture, and taste.
Recommendation
For your patients who love chocolate, and want to reduce its caloric value, supplemental calcium may actually work, including the calcium-containing chocolate chews commercially available for about 10 calories each. One ounce of chocolate is small, so savor it.
June 2001; Volume 4; 71
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