February 12th, 2007
With Valentine’s Day approaching, there are several factors to consider when giving and receiving the traditional gift of the holiday: chocolate. Discover what types of chocolate you can enjoy while still supporting the health of your liver.
by Nicole Cutler, L.Ac.
The holiday of love is upon us, putting the pressure on to produce a thoughtful, romantic gesture for someone special. Heart shaped boxes of chocolate, candy with love messages, and pricey bouquets of flowers line store shelves and shop windows, beckoning us to choose the perfect gift for Valentine’s Day. When giving a Valentine’s Day gift to someone with liver disease, keeping in mind that there are ways to support their liver health will be the most appreciated gift you can give. Since wading through the health claims or risks of various indulgences can be both overwhelming and confusing, our experts have assembled some pointers for choosing a liver conscious treat.
In general, candy contains a high percentage of sugar and fat. While indulging in a little celebratory bit of sugar and fat won’t kill most people, these ingredients do have an indirect, negative effect on liver health. Ingestion of sugar stresses the liver by stimulating the pancreas to secrete insulin for dropping blood-sugar levels, increasing the liver’s processing load. Additionally, this increase in insulin promotes the storage of fat, promoting the progression of fatty liver disease. Increasing fat intake may result in fatty deposits within the vascular system, heightening blood flow-related health conditions. One of these risks is portal hypertension, the condition where clogging of the primary blood vessel feeding the liver increases blood pressure.
A long-time favorite gift for Valentine’s Day is the purported aphrodisiac and mood elevator, chocolate. However, chocolate harbors a few concerns for someone with liver disease.
• Copper – Before considering chocolate as a gift option, many people with liver disease have extra reason to avoid the treat. Individuals with cirrhosis of the liver or impaired bile flow (such as in Wilson’s disease or primary biliary cirrhosis) may have an excessive amount of copper in their liver. If laboratory tests confirm copper excess, most doctors recommend avoiding foods rich in copper such as chocolate.
• Ingredients and Interactions – Made from the cocoa bean, the process of making chocolate is complex. The harvested beans are dried, fermented, roasted then ground to yield chocolate liquor. While the general assumption that liquor perpetuates liver disease is accurate, this does not necessarily apply to chocolate liquor. A non-alcoholic liquid, chocolate liquor is approximately 50 percent cocoa solids and 50 percent cocoa butter. The liquor can then be processed to make chocolate bars. The quality of chocolate is often defined by the amount of cocoa solids remaining in the finished product—the more solids, the better the chocolate.
In addition to iron, copper, magnesium, phosphorous and potassium, chocolate possesses one of the highest antioxidant levels of any food. Chocolate’s high flavanoid content, a type of antioxidant, boosts healthy cholesterol levels by preventing blood platelets from clumping together. While this property is desired for most of us, it is a cause for caution in individuals on blood-thinning medications. Many physicians advise against chocolate ingestion for their patients on warfarin or coumadin therapy. Primarily due to its caffeine content, some additional potential drug interactions with chocolate apply, including:
• MAO Inhibitors – The caffeine in chocolate could cause dangerous drug interactions.
• Stimulants – Stimulant drugs such as Ritalin can amplify the stimulant effects of chocolate.
• Other drugs – Chocolate may interfere with the action of drugs used to prevent heart arrythmias or treat insomnia, heartburn, ulcers or anxiety.
Flavonoids, which are found in the cocoa bean, provide chocolate’s healthful, anti-oxidant benefits. Of the three basic types of chocolate treats – dark, milk and white – only dark chocolate is recognized as a positive addition to the diet. This is because dark chocolate contains the highest cocoa content and therefore a higher percentage of flavanoids.
White chocolate is really not chocolate at all. Its cocoa content is nonexistent and thus, there are no flavanoids. Very sweet, white chocolate is loaded with sugar and fats.
Milk chocolate is a sweet, milk-flavored chocolate and usually contains about 20% of cocoa solids. Candy bars and other chocolate candies are typically made of milk chocolate. It contains cocoa, and in turn, flavanoids, but it is diulted by sugar and powdered or condensed milk, and is to be avoided.
Dark chocolate, which is also known as semi-sweet or bittersweet chocolate, contains up to 75% of cocoa solids and only a little, if any, added sugar. As a treat, its flavor is rich and intense. Morsels used for baking chocolate chip cookies are made of dark chocolate, as are many candies. Various research studies have concluded that dark may demonstrate the following benefits:
• lowering blood clot risk
• improving vascular function by relaxing blood vessels
• keeping cholesterol from gathering in blood vessels
• improving insulin resistance, reducing obesity, fatty liver disease and diabetes risk
Since a person with liver disease must be extra vigilant about any ingested toxins due to the additional liver strain this poses, products grown with pesticides represent a valid concern. When it comes to pesticide use on cocoa plants, the US Food and Drug Administration’s (FDA) Total Diet Study has found residues of multiple pesticides in many chocolate products. Although the FDA works to ensure that the level of pesticide residue is within the Environmental Protection Agency’s established tolerances, people with liver concerns will likely opt for chocolates without any pesticide residue. Buying organic chocolate is the solution for avoiding pesticide-laden cocoa.
While the type of chocolate chosen can exert influence on your health, consumers must still be mindful of eating it in moderation. Even when choosing wisely, chocolate is still a high-calorie, high-fat food.
As mid-February rolls around, there are various factors to consider for a person with liver disease. If none of the mentioned health or drug restrictions apply, giving organic, dark chocolate with a high percentage of cocoa solids may be one of the most thoughtful gifts. If high copper levels or a cautioned medication applies to your valentine, choose something safe, such as flowers, to demonstrate your love. You can always print out this article for your sweetheart as proof that you care about their health, which is really the most romantic gift of all.
www.americanheart.org, Dark Chocolate may reduce blood pressure, improve insulin resistance, American Heart Association, Inc., July 2005.
www.clinicalstudies.info.nih.gov, Effects of Cocoa Consumption on Insulin Sensitivity and Capillary Recruitment in Subjects with Essential Hypertension, National Institutes of Health, 2007.
www.grinningplanet.com, “Ant” isn’t necessarily the worst part of “Chocolate-Covered Ant”, Mark Jeantheau, February 2004.
www.healthlibrary.epnet.com, Chocolate, EBSCO Publishing, 2007.
www.heartinfo.org, Let Dark Chocolate Be Your Valentine, Janice Billingsley, ChoiceMedia Inc., 2007.
www.inmamaskitchen.com, Chocolate Facts, Diana Farrell Serbe, inmamaskitchen.com, 2007.
www.medicalnewstoday.com, Dark Chocolate Lowers Blood Clot Risk, MediLexicon International Ltd., November 2006.
www.puritanspride.com, Chocolate, Healthnotes, Inc., 2007.
www.scnm.edu, Chocolate: Still a Favorite on Valentine’s Day, Dr. Mona Morstein, Southwest College of Naturopathic Medicine, January 2006.
www.webmd.com, Which Chocolate is Healthiest for Heart?, Jeanie Lerche Davis, WebMD, Inc., January 2003.
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