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Study: Dark Chocolate Consumption Lowers Risk of Type 2 Diabetes
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Pharmacists play an essential role in educating patients about various health-related topics, including type 2 diabetes and nutrition.
Dark chocolate consumption has been associated with a lower risk of type 2 diabetes (T2D), but this association was not seen with milk chocolate, according to results of a study published in BMJ. Investigators state that further research with randomized controlled trials are needed to confirm these findings and explore the mechanism of action.1
Chocolate and Diabetes | Image Credit: © Agnes | stock.adobe.com
“Our findings suggest that not all chocolate is created equal,” Binkai Liu, doctoral student in the department of nutrition at Harvard T.H. Chan School of Public Health, said in a news release. “For anyone who loves chocolate, this is a reminder that making small choices, like choosing dark chocolate over milk chocolate, can make a positive difference to their health.”2
According to the American Society of Health-System Pharmacists, patient education and counseling are interrelated, and the organization states that pharmacists should go beyond the minimum requirements. Pharmacists should encourage patients via education and counseling while eliminating any barriers to these services. As far as counseling points, pharmacists should be aware of nonprescription options, disease management, and disease-specific information.3
In the current study, investigators used data from the Nurses’ Health Study, Nurses’ Health Study II, and Health Professionals Follow-Up Study. In the primary analysis, patients with diabetes, cardiovascular disease, and cancer (except non-melanoma skin cancer) at baseline were excluded. In the secondary analysis, the same patients were excluded if they self-reported one of the 3 previous disease states.1
Diet was assessed ever 4 years with a food frequency questionnaire, with questions about chocolate consumption including “how often do you consume milk chocolate (bar or pack)” and “how often do you consume dark chocolate.” Investigators also identified T2D via self-reports based on biennial follow-up questionnaires, and the diagnosis was confirmed by study doctors. Weight loss was self-reported at baseline and followed up in biennial questionnaires.1
A total of 192,208 individuals were included in the total chocolate intake analysis, and 111,654 were included in the chocolate subtypes analysis. Across all cohorts, patients who had higher levels of chocolate intake had higher energy intakes, saturated fats, and added sugar, according to the study investigators. Dark chocolate intake was also associated with higher Alternative Healthy Eating Index and consumption of fruit, vegetables, epicatechin, and total flavonoids. These associations were inverse for milk chocolate.1
Investigators found that individuals reporting consumption of 5 servings or more per week of any chocolate had a 10% lower rate of T2D compared with individuals who never consumed chocolate. Additionally, consumption of 5 servings or more per week of dark chocolate showed a 21% lower risk, and there were no significant associations found between milk chocolate and T2D. Furthermore, investigators found that milk chocolate, but not dark chocolate, was associated with weigh gain.1
“We were surprised by the clear split between dark and milk chocolate’s impact on diabetes risk and long-term weight management,” Qi Sun, MD, associate professor in the departments of nutrition and epidemiology at Harvard T.H. Chan School of Public Health, said in the news release. “Even though dark and milk chocolate have similar levels of calories and saturated fat, it appears that the rich polyphenols in dark chocolate might offset the effects of saturated fat and sugar on weight gain and diabetes. It’s an intriguing difference that’s worth exploring more.”2
REFERENCES
1. Liu B, Zong G, Zhu L, et al. Chocolate intake and risk of type 2 diabetes: prospective cohort studies. BMJ. 2024;387:e078386. Published 2024 Dec 4. doi:10.1136/bmj-2023-078386
2. Eating dark chocolate linked with reduced risk of type 2 diabetes. News release. Harvad T.H. Chan School of Public Health. December 4, 2024. Accessed December 6, 2024. https://www.eurekalert.org/news-releases/1066724
3. ASHP guidelines on pharmacist-conducted patient education and counseling. Am J Health Syst Pharm. 1997;54(4):431-434. doi:10.1093/ajhp/54.4.431
