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It's pretty much unimaginable that anyone reading this would not by now have heard about the cardiovascular benefits of dark chocolate, both in terms of preventing cardiovascular disease and even improving cardiovascular (athletic) performance. And you've probably heard the news that chocolate is good for brain health & cognition as well. Nevertheless, this new study [1], posted by Al, is noteworthy for several reasons.


In it, researchers followed 530 elderly people over four years to see how their dietary habits, particularly wrt chocolate consumption, correlated with cognitive decline. The first surprising thing was the magnitude of the benefits of chocolate on cognitive health. Even after controlling for a host of potentially confounding risk factors, they found that chocolate consumption was associated with a whopping 40% reduction in likelihood of cognitive decline over the four year period.


That's the good news. The not-so-good news is that this benefit was only seen in participants who eschewed caffeine. In fact, if limited to folks who consumed less than 75mg of caffeine a day (~1 cup of coffee), the cognitive protection associated with chocolate was even greater - a 50% lower risk of cognitive decline. They don't report it explicitly in the abstract (full text not available), but presumably caffeine drinkers did not see a significant cognitive benefit (nor harm!) from also consuming chocolate. 


This suggests the cognitive benefits of chocolate overlap and are hence redundant with (and not additive with) the beneficial effects of coffee/tea polyphenols and/or the caffeine they contain. Nevertheless, I'm going to continue consuming both cacao and caffeine products, because this is only one study, and heck, I enjoy them both .





[1] J Alzheimers Dis. 2016 May 6. [Epub ahead of print]

Chocolate Consumption is Associated with a Lower Risk of Cognitive Decline.

Moreira A, Di?genes MJ, de Mendon?a A, Lunet N, Barros H.


Cocoa-related products like chocolate have taken an important place in our
food habits and culture. In this work, we aim to examine the relationship
between chocolate consumption and cognitive decline in an elderly
cognitively healthy population. In the present longitudinal prospective
study, a cohort of 531 participants aged 65 and over with normal Mini-Mental
State Examination (MMSE; median 28) was selected. The median follow-up was
48 months. Dietary habits were evaluated at baseline. The MMSE was used to
assess global cognitive function at baseline and at follow-up. Cognitive
decline was defined by a decrease =/> 2 points in the MMSE score between
evaluations. Relative risk (RR) and 95% confidence interval (95% CI)
estimates were adjusted for age, education, smoking, alcohol drinking, body
mass index, hypertension, and diabetes. Chocolate intake was associated with
a lower risk of cognitive decline (RR = 0.59, 95% CI 0.38-0.92). This
protective effect was observed only among subjects with an average daily
consumption of caffeine lower than 75 mg (69% of the participants; RR =
0.50, 95% CI 0.31-0.82). To our knowledge, this is the first prospective
cohort study to show an inverse association between regular long-term
chocolate consumption and cognitive decline in humans.


Adenosine A2A receptors; Alzheimer?s disease; chocolate; cognition;
prevention; theobromine


PMID: 27163823

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The paper isn't yet available, so I suppose we should all just be patient. I'm speculating, however, that this relates to the presence of caffeine itself, as well as other methylxanthines, in chocolate. Some of the same investigators have previously found a fairly low (62 mg) threshold of caffeine intake to be associated with reduced risk of cognitive decline.(1) Chocolate consumers who don't consume other caffeine sources might therefore also be found to be at lower risk if the association with caffeine intake with lower risk is causal, whereas a protective effect of chocolate mediated by caffeine would simply be swamped (rather than nullified in some deleterious way) in consumers of other sources of the drug.


It's worth noting that the association of caffeine intake with reduced risk of cognitive decline and/or AD has been inconsistent in different epidemiological studies, and is often confined to women (including in (1)) and to consumers of larger amounts of coffee (2-3 C+) and thus caffeine (200-400 mg+) (unlike the >62 mg in  (1), and much more caffeine than is present in a modest dose of chocolate).



1:  Santos C, Lunet N, Azevedo A, de Mendonça A, Ritchie K, Barros H. Caffeine intake is associated with a lower risk of cognitive decline: a cohort study from Portugal. J Alzheimers Dis. 2010;20 Suppl 1:S175-85. doi: 10.3233/JAD-2010-091303. PubMed PMID: 20182036.

2: Carman AJ, Dacks PA, Lane RF, Shineman DW, Fillit HM. Current evidence for the use of coffee and caffeine to prevent age-related cognitive decline and Alzheimer's disease. J Nutr Health Aging. 2014 Apr;18(4):383-92. doi: 10.1007/s12603-014-0021-7. Review. PubMed PMID: 24676319. Consumer-friendly digest version here.

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