Dear Doctor Column, February 9, 2004

Addicted to chocolate? You're not alone.

Question:

Is chocolate physically addictive? If I don't eat some every day, I feel like I'm going through withdrawal. And, is it true that chocolate is good for your heart?

Answer:

Trust us, you're certainly not alone in your desire to eat some chocolate each day. The average American consumes about 10 pounds of chocolate a year. And, although "chocoholics" report cravings, feel unhappy without it, and swear they'll do anything to get it, chocolate is not physically addictive in the way nicotine and narcotics are.

Rather, cravings for chocolate and happiness from eating it may be learned behaviors from childhood. "If you eat your vegetables, you can have chocolate for dessert," may strike a familiar chord. Also, "chocolate attacks" may occur simply because it tastes so good. Thanks to cocoa butter, chocolate has a luxurious, melt-in-your-mouth quality that makes it hard to resist.

Chocolate also is rich in calories and saturated fat, but in moderate amounts, it can be part of a healthy diet. Much depends on how the chocolate is made and which ingredients come with the chocolate, such as nuts, cream, or coconut. An ounce of dark, milk, or semisweet chocolate has approximately 150 calories and 10 grams of fat (which account for 65% of the calories). If you savor chocolate-covered nuts, you can easily tack on more grams of fat and calories.

Chocolate is cholesterol-free, since it comes from cocoa beans, a plant product. Milk chocolate may contain a small amount of cholesterol, because the added milk is an animal product. Although the fat in chocolate is highly saturated, most of it comes in the form of stearic acid, which does not boost blood cholesterol levels as much as other saturated fatty acids do. A few small studies even suggest that chocolate might be good for the heart and circulation.

One reported this year in the Journal of the American Medical Association showed that about 3 ounces of dark chocolate a day helped lower blood pressure in older people with isolated systolic hypertension (a type of high blood pressure in which only the upper number of a pressure reading is high). Another study demonstrated that chemicals in chocolate known as flavonoids can help arteries stay flexible. Earlier studies suggest that chocolate makes platelets less sticky and protects LDL (bad) cholesterol from oxidation, both of which could prevent heart attacks and strokes.

Interestingly, teens eat the most chocolate. It also is favored by women aged 30 to 49 years, says a USDA survey. And, people tend to eat more chocolate during cold weather; consumption ebbs in the summertime.

Despite its world-wide popularity, chocolate myths abound. You'll be happy to know, however, that science hasn't found a chocolate connection to the following conditions:

• Acne. Twenty years of research have shown that diet has nothing to do with acne. Studies have failed to find any link between chocolate, even huge amounts of it, and skin eruptions. It's simply coincidental, doctors say, that teens battle the effects of puberty, such as acne, while also eating more than their share of chocolate candy.
• Allergy. A food allergy causes specific reactions, such as a sudden outbreak of hives or a more severe life-threatening reaction associated with wheezing, shortness of breath, and low blood pressure (anaphylaxis). Peanuts and seafood are common causes of food allergies. Although it can occur, a true allergy to chocolate is extremely rare.
• Migraines. A host of foods including peanuts, cheese, alcohol, and chocolate contain phenylethylamine, a chemical that can dilate blood vessels in the brain and has been incriminated as a possible trigger for headaches, particularly migraines. However, a carefully controlled study from the University of Pittsburgh cast doubt on chocolate's role in migraines. The researchers found women suffering from chronic headaches experienced no increase in headaches after consuming chocolate compared with women given carob —- a substance that tastes like chocolate. The authors of the study suggested that chocolate's reputation as a headache inducer arose because a craving for sweets often precedes a headache.
• Love. Valentine's Day wouldn't be complete without a symbolic heart-shaped box of chocolate candies, yet researchers haven't identified any substance in chocolate capable of arousing romantic intentions. Although phenylethylamine contained in chocolate does play a role in emotional arousal, studies fail to prove eating chocolate affects brain levels of this chemical, and hence, your emotions.
• Energy. Chocolate contains caffeine, but only in small amounts. You'd have to eat a pound of milk chocolate to get the stimulant effect of 1 or 2 cups of brewed coffee.
• Tooth decay. Actually, chocolate is less harmful to teeth than some other foods with the same sugar content. The reason — plain chocolate bars are not sticky and clear out of the mouth quickly. In addition, cocoa contains substances that may inhibit the growth of bacteria that coalesce to form plaque, which eventually leads to cavities and gum disease.

On the flip side, there are some problems connected with chocolate. It may promote heartburn — a backup of stomach acids into the esophagus. People who suffer from heartburn are advised to cut down on chocolate.

To many people, no food tastes better or works as well to console, reward, or to say, "I love you." Although there is no nutritional reason to indulge in chocolate, there is no reason not to enjoy the pleasures of chocolate every now and then.