Currently browsing posts about: Chocolate

As I pretty much demonstrate every Monday, industry-funded studies almost invariably produce results favoring the sponsor’s interests.

But here we have a rare exception to the rule:

• The study: Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial.  The American Journal of Clinical Nutrition,Volume 119, Issue 1, January 2024, Pages 39-48.
• Objective: “To test whether daily supplementation with CE, compared with placebo, produces better cognitive change over 2 y.”
• Conclusions: “Among 573 older adults who underwent repeat in-person, detailed neuropsychological assessments over 2 y, daily CE supplementation, compared with placebo, showed no overall benefits for global or domain-specific cognitive function. Possible cognitive benefits of CE among those with poorer diet quality warrant further study.”
• Funding: The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) is supported by an investigator-initiated grant from Mars Edge, a segment of Mars dedicated to nutrition research and products, which included infrastructure support and the donation of study pills and packaging. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging.

Comment: Why anyone would think that cocoa extract would have any efffect at all on cognitive function is beyond me, but I, in sharp contrast to Mars, am not trying to sell cocoa extract or convince anyone that M&Ms are a health food.  But, as seems invariably the case, the investigators did give Mars a small break in favorably finding “possible” cognitive benefits of cocoa extract for people eating terrible diets.  My prediction: further studies will not find benefits of cocoa extract—or M&Ms—on cognitive function even though eating M&Ms can be lots of fun.

I am suddenly deluged with items about chocolate, which seems to raise any number of food politics issues.

For today, let’s deal with three: content of toxic heavy metals, research conflicts of interest, and claims of sustainability,

I.  Heavy metals. I learned about this one from Food Safety News (FSN): Consumer Reports finds one-third of chocolate is high in heavy metals: CR today released test results that have it urging Hershey’s to get harmful lead and cadmium out of its chocolate products.

FSN conveniently provided a link to the full CR report, which says.

When we tested dark chocolate bars last year, we found lead or cadmium levels above CR’s thresholds in 23 of 28 bars, or 82 percent of them. Our results this time were similar. Of the seven bars we tested, five, or 71 percent, were above our levels for lead, cadmium, or both…Eating an ounce of four others would put you over our limit for lead.

Food Safety News also reports: Chocolate makers say they have heavy metals issue under control: The National Confectioners Association (NCA) : “Chocolate and cocoa are safe to eat and can be enjoyed as treats as they have been for centuries,” NCA says. “Food safety and product quality remain our highest priorities,… Continue Reading

ConsumerLab does its own testing for toxins in Dark Chocolate, Cocoa & Cacao Products.

Which dark chocolate and cocoa products are best?  Be careful! Several cocoa powders, cacao nibs, and some dark chocolates failed to pass our review due to contamination with high levels of cadmium, a toxic heavy metal (see What CL Found).

II.  Conflicts of interest. ConsumerLab also commented on cocoa flavanols.

Furthermore, levels of potentially beneficial cocoa flavanols ranged from just 1 mg to 374 mg in cocoa powders and mixes, 2 mg to 351 mg in dark chocolates, and 2 mg to 993 mg in supplements. Products also vary widely in calories per serving.

This took me right to an e-mail from a reader, Thijs van Rens, Professor of Economics, University of Warwick,.  He wanted me to see something he had read in The Conversation: “Flavanols are linked to better memory and heart health – here’s what foods you can eat to get these benefits.”

He pointed out that the author “…received research funding from Mars, Inc., a company engaged in flavanol research and flavanol-related commercial activities.”  He added:

I got suspicious about the funding when I read this:  “This is why flavanols extracted from cocoa are an ideal model, as they contain the two main types of flavanols.”

In fact, I was going to comment and complain about The Conversation publishing something like this, until I noticed the one-but-last paragraph:

“It’s also important to note that while the flavanols used in many studies were extracted from cocoa, unfortunately chocolate (even dark chocolate) is a very poor source of flavanols – despite what some headlines might claim. This is because these flavanols are lost during processing.”

Not sure what to make of the article. On the one hand, the author clearly states not to eat chocolate for this reason and the funding is clearly disclosed. On the other hand, how many readers will get to the one-but-last paragraph and check the disclosure statement. On balance, I could imagine Mars Inc. would be quite happy about this article.

Indeed yes.  That’s why they paid for it (but see clarification below)

III.  Sustainability.  This also came in a e-mail, this time a press release from Chocolate Scorecard, a group that rates chocolate companies on practices related to traceability, wages, child labor, deforestation, agroecology, etc.  Its key messages:

• Sustainability claims of chocolate companies cannot necessarily be trusted.
• Only 11% of chocolate companies can fully trace where their cocoa comes from – without knowing they cannot claim sustainability.
• Farmers need to be paid more for their cocoa to ensure a sustainable life.

“100% sustainably sourced cocoa,” says the sign on the stand promoting a well-known chocolate brand in the supermarket. The message is not one you can necessarily trust.

…A recent report by Oxfam claims that the “net income of farmers decreased by an estimated 16.38% between the 2019/20 and 2021/22 harvesting season.” When the price of cocoa increases everything else a farmer purchases increases in price, leaving worse off in reality. This is associated with increases in profits in chocolate companies.

The Chocolate Scorecard is a collective of 37 NGO’s and Universities. They are calling on chocolate companies to commit to a ‘living income’ for cocoa farmers.

And you thought you were just eating candy.

Additions

Readers wrote to remind me to add:

• John Oliver’s brilliant piece on low wages and child labor among chocolate workers.
• Food Empowerment Project’s Chocolate List (of chocolate companies not using child labor)

Clarification

The author of the flavanol article wrote to say that my comment could be interpreted as suggesting he was paid to write it, which he was not.  That was not my intention and I apologize for giving that impression.  I do see research or commentary paid for by food companies, but such instances are rare. The “funding effect,” as I discuss in my book Unsavory Truth, gives the appearance of conflicted interest no matter what its actual level of influence.

Chocolate for breakfast? Kellogg’s + Hershey’s collab takes cereal to new heights in IndiaThe breakfast cereal giant has joined forces with one of the largest chocolate manufacturers in the world to launch Kellogg’s Hershey’s Chocos on the Indian market…. Read more

When I saw this, I wondered what was new here.  We already have plenty of chocolate breakfast cereals, organic and not, most of them aimed at kids.

These, for example:

At best, these cereals have some cocoa in them, usually as the 5th ingredient or less.

I can’t find an ingredient list for the cereal aimed at India, but I did find one for similar products sold in other countries.

Chocolate is the first ingredient!

Candy for breakfast!

Yum!

In February, the USDA proposed rules for sugars in school meals.  These meant:

Flavored milks would be limited to no more than 10 grams of added sugars per 8 fluid ounces for milk served with school lunch or breakfast. For flavored milk sold outside of the meal (as a competitive beverage for middle and high school students), the limit would be 15 grams of added sugars per 12 fluid ounces.

The International Dairy Foods Association says it can and will do this as part of an effort “to preserve flavored milk options as part of the National School Lunch and Breakfast programs. USDA currently has proposed one option to provide only unflavored milk for school-aged children grades K-8.”

Among milk options available in schools, low-fat flavored milk is the most-consumed beverage for students regardless of grade, IDFA says. Flavored milk products such as chocolate milk offered in schools today contain an average of just 8.2 grams of added sugar per serving.

The Sugar Association, no surprise, supports continued use of sugary milk in schools—for its own particular reason.

As the ‘Healthy School Milk Commitment’ moves forward, it is important that alternative sweeteners are not encouraged or deployed as a frontline sugar reduction strategy for flavored milk served in schools.

The use of low- and no- calorie sweeteners in products intended primarily for both children and adults has increased by 300% in recent years, and their presence in food products is easily cloaked from consumers because of FDA’s arcane and outdated food labeling requirements.

As the health effects of sugar substitutes on children are not adequately studied, we should proceed cautiously when it comes to initiatives that incentivize the use of these ingredients.

We support flavored milk products, which provide important nutrients and are always a fan-favorite among school students in our nation’s schools, and caution against the use of sugar substitutes to meet sugar reduction commitments in the milk consumed by our nation’s school children.

That is a new argument (to me, at least).  Here are some old ones (with my comments):

• Chocolate milk has lots of nutrients (it also has lots of sugar).
• Kids won’t drink plain milk (they will, actually)
• Kids won’t get those nutrients if they don’t drink milk (they can get them from other foods).

But New York City has a handout on why plain milk is preferable.  It’s worth a look.

Mars convinces emerging market consumers to eat more chocolate, the Financial Times reports.

Mars has embarked on a drive to convince developing country consumers to eat more chocolate, claiming it is on track to double the value of its confetionery sales in emerging markets in teh five years to 2024….”The amount of chocolate that an Indian or Mexican consumes is 10 times or less than a European…So there is a gigantic opportunity take that low…per capita consumption closer to Europe.”

[In response to a question about the health effects of eating more chocolate] “To continue to be a super successful snacking company, we need to evolve our portfolio…and offer choices….If you go to India, you go to Mexico right now, you will see new offerings [from] us that are playing at the lower price point that didn’t exist [before].”

Lead and cadmium could be in your dark chocolate,says Consumer Reports.

CR tested a mix of brands, including smaller ones, such as Alter Eco and Mast, and more familiar ones, like Dove and Ghirardelli.

For 23 of the bars, eating just an ounce a day would put an adult over a level that public health authorities and CR’s experts say may be harmful for at least one of those heavy metals. Five of the bars were above those levels for both cadmium and lead. Read more about how CR tested dark chocolate (PDF).

NCA [National Confectioners Association] issues statement on Consumer Reports study into heavy metals in chocolate and cocoa.

Chocolate and cocoa are safe to eat and can be enjoyed as treats as they have been for centuries.  The…guidelines cited in the Consumer Reports study are not food safety standards…cadmium and lead are present in cocoa and chocolate due to soil and that bean cleaning during processing cocoa beans reduces lead and cadmium in chocolate products.

[and, of course] Food safety and product quality remain our highest priorities and we remain dedicated to being transparent and socially responsible.

Hershey debuts plant-based Reese’s and chocolate bar: The confections, which will hit shelves in March and April, are made with oats. This will be the first time the company offers permanent products in the category.

Comment

I don’t particularly like dark chocolate anyway.  Milk chocolate will have fewer heavy metals because it contains less cocoa and the Consumer Reports article is quite clear on which chocolates have fewer heavy metals.

But all of these items are about how to sell more chocolate which, alas, is not exactly a health food.  Do people in Mexico and India need more chocolate in their diets?  of course not, but chocolate companies “need” more sales regardless of health consequences.

This is about profits to shareholders, not public health.

And of course chocolate has a place in healthy diets—just not one that requires eating more of it.

Here’s what the FDA is doing these days.

To  my astonishment, the FDA says it will allow a health claim for cocoa flavanols and reduced risk of cardiovascular disease.

OK, it’s a qualified health claim, but still.  The whole thing is absurd.

Qualified health claims are just that; they have to include the qualifier which usually says there’s no or not much research to back up the claim.

The FDA gives several examples of what it will allow.  Here are two:

• “Cocoa flavanols in high flavanol cocoa powder may reduce the risk of cardiovascular disease, although the FDA has concluded that there is very limited scientific evidence for this claim.”
• “Very limited scientific evidence suggests that consuming cocoa flavanols in high flavanol cocoa powder, which contains at least 4% of naturally conserved cocoa flavanols, may reduce the risk of cardiovascular disease.”

The FDA also says:

This qualified health claim only applies specifically to cocoa flavanols in high flavanol cocoa powder and foods that contain high flavanol cocoa powder. The claim does not apply to regular cocoa powder, foods containing regular cocoa powder, or other food products made from cacao beans, such as chocolate.

Not that anyone can tell the difference.

This silliness came about because  of a petition from the chocolate company, Barry Callebaut AG in Switzerland.

My surprise was that Callebaut was behind the petition, not Mars.

Mars, after all, has been funding this kind of research for years (see my industry-funded study of the week from March 2022).

I can’t wait to see how Callebaut or Mars will use this claim.  I haven’t seen it anywhere yet.  Let me know if you do.

New product launches

• Why Kraft Heinz is making Macaroni & Cheese ice cream and Grey Poupon wine:  The launches are part of an effort to build relevance for iconic brands in a way that aims to combine whimsy and consumer interest into items that attract both social media attention and sales.
• A delightful soft drink mashup: Pepsi and Peeps team up for marshmallow-flavored cola, out now:  The Pepsi X Peeps drink, described as having a “pillowy-soft marshmallow cola flavor,” will be available in mini-can multipacks and 20 oz. bottles.
• Upcycling sawdust to make alternative oils and fats:  Estonian start-up ÄIO joins the ranks of those brewing solutions to replace palm oil, coconut oil and animal fats with sustainable and healthier alternatives…. Read more

Chocolate hazards

• BBC News Mars Wrigley factory fined after two workers fall into chocolate vat: Two workers were rescued when a hole was cut in the bottom of a partly-full Mars Wrigley chocolate tank.  Read More
• UK Police force cracks case of 200,000 stolen Cadbury Creme Eggs from lock-up: A chocolate egg-snatcher is facing a jail sentence after being caught red-handed with a trailer load of Cadbury Crème eggs worth more than £31,000 ($37,000)…. Read more

Research breakthroughs

• Review calls for more studies on cinnamon and cognitive function:  Cinnamon and its bioactive compounds may support brain function and slow cognitive impairment associated with neurodegenerative diseases, suggests a new review published in the journal Nutritional Neuroscience…. Read more

Comments

Sigh.

Marshmallows and upcycled sawdust.  Yum?

Chocolate is always in the news for one reason or another.

As for cinnamon and cognitive function, if only.  The authors declare no conflicted interests.

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For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

I learned about this one from a PR tweet from @Brigham Research: “Dr. JoAnn Manson…& colleagues report the main findings of the first ever randomized trial of a cocoa flavanol supplement on cardiovascular disease endpoints.”

Its spectacular results:  Supplementation with cocoa flavanols led to a 27% reduction in deaths from cardiovascular disease among all participants taking the supplement, and a 39% reduction in those deaths when they excluded participants who did not take the pills properly.

From taking cocoa flavanol supplements?

Who paid for this?

Bingo.

The study (still in preprint): Effect of Cocoa Flavanol Supplementation for Prevention of Cardiovascular Disease Events: The COSMOS Randomized Clinical Trial.  Sesso HD, et al.  American Journal of Clinical Nutrition, nqac055, https://doi.org/10.1093/ajcn/nqac055

Conclusion: “Cocoa extract supplementation did not significantly reduce total cardiovascular events among older adults but reduced CVD death by 27%….”

Funding: “The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) is supported by an investigator-initiated grant from Mars Edge, a segment of Mars dedicated to nutrition research and products, which included infrastructure support and the donation of study pills and packaging…[and other sources].

Conflicts of interest: Drs. Sesso and Manson reported receiving investigatorinitiated grants from Mars Edge, a segment of Mars Incorporated dedicated to nutrition research and products, for infrastructure support and donation of COSMOS study pills and packaging,
Pfizer Consumer Healthcare (now part of GSK Consumer Healthcare) for donation of COSMOS study pills and packaging during the conduct of the study. Dr. Sesso additionally reported receiving investigator-initiated grants from Pure Encapsulations and Pfizer Inc. and honoraria
and/or travel for lectures from the Council for Responsible Nutrition, BASF, NIH, and American Society of Nutrition during the conduct of the study. No other authors reported any conflicts of interest.

Comment: Déjà vu all over again.

Mars, as I described in detail in Unsavory Truth, has been trying to make you think that chocolate is a health food (M&Ms!) for decades. It created a special brand, CocoaVia, for this purpose.  Here is an excerpt:

In 1982, Mars established a chocolate research center in Brazil.[i]  Its scientists were particularly interested in cocoa flavanols, a category of flavonoids with antioxidant, anti-inflammatory, and other heart-healthy effects.  Through the 1980s and 1990s, Mars’ scientists produced studies suggesting such benefits.

Alas, cocoa flavanols come with complications.  They taste bitter (dark chocolate contains more of them).  They are present in such small amounts that you would have to eat a quarter to a full pound of chocolate a day to achieve cardiovascular benefits.[ii]  Worse, they are destroyed by traditional chocolate processing.[iii]  The losses may explain why a Hershey-funded clinical trial failed to find neuropsychological or cardiovascular benefits from eating dark chocolate when compared to a placebo.[iv]

But to return to CocoaVia: Mars developed a process to preserve the cocoa flavanols during processing, and combined the rescued flavanols with cholesterol-lowering plant sterols to make chocolate bars and chocolate-covered almonds.  By 2002, the company decided that it had enough research to promote CocoaVia candies as heart-healthy.[v]  As the New York Times put it, Mars was on a “corporate quest to transform chocolate into a healthy indulgence.”[vi]  Mars marketed the candy bars—two a day, no less—as a means to increase blood flow, lower blood pressure, and reduce the risk for heart disease.

The FDA takes a dim view of unproven claims like “chocolate prevents heart disease.”  In 2006, the agency sent Mars a warning letter complaining that claims like “promotes a healthy heart” and “now you can have real chocolate pleasure with real heart health benefits,” were false, misleading, and easily misinterpreted…Chocolate, the FDA pointed out, is high in saturated fat (it didn’t mention sugar).   Furthermore, the claim “Cocoa Via Chocolate Bars contain natural plant extracts that have been proven to reduce bad cholesterol (LDL) by up to 8%,” meant that Mars was advertising chocolate as a drug.  If Mars wanted to make drug claims, it would need to conduct clinical trials to prove that eating CocoaVia chocolate bars prevented heart disease.[vii]

Rather than run the financial and scientific risk of doing that, Mars gave up on candy bars and began marketing CocoaVia in pills and powder as a “daily cocoa extract supplement.”  In doing this, Mars could take advantage of the more lenient marketing claims allowed by the Dietary Supplement Health and Education Act (DSHEA) of 1994. This act permits “structure/function” claims, those proposing that a supplement is good for some structure or function of the body.  Under DSHEA, the labels of CocoaVia are allowed to say that these supplements “promote a healthy heart by supporting healthy blood flow.”

To convince people to take CocoaVia supplements, Mars funds research.  In 2015, it funded studies demonstrating that cocoa flavanols are well tolerated in healthy men and women,[viii] support healthy cognitive function in aging,[ix] can reverse cardiovascular risk in the healthy elderly,[x] and improve biomarkers of cardiovascular risk.[xi]

Lest the “eat more chocolate” implications of these studies be missed, Mars issued a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”[xii]  The company followed this announcement with a full-page ad in the New York Times quoting a dietitian: flavanols “support healthy blood flow…which allows oxygen and nutrients to get to your heart more easily.”  …The ad directed readers to more information on a paid ad on the Times’ Website.  You have to look hard in these ads to discover that Mars owns CocoaVia; the company’s name only appears in barely legible print as part of the trademark.[xiii]

But Mars, which already has funded “more than 150 peer-reviewed scientific papers and [has] approximately 100 patents globally in the field of cocoa flavanols”[xiv] has more ambitious research plans.  In 2014, the company announced that in partnership with the National Heart, Lung, and Blood Institute it would provide “financial infrastructure support “ for an ambitious placebo-controlled, randomized trial of the effects of cocoa flavanols alone or in combination with vitamin supplements, on heart disease and cancer risk in 18,000 men and women over the age of 60.[xv]  The five-year trial, called the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), has evolved somewhat since then.  It now lists Brigham and Women’s Hospital in Boston as the sponsor, and Mars as a “collaborator” along with the Fred Hutchinson Cancer Research Center in Seattle and Pfizer. NIH seems no longer to be involved.[xvi]

We now have the result of this trial.  Even though cocoa flavanol supplements did not reduce cardiovascular events, Mars got its money’s worth from what must have been a very expensive study.

Tomorrow: a second report from this trial, with surprising results.

References

[i] Mars, Inc.  The history of CocoaVia.  CocoaVia.com

https://www.cocoavia.com/how-we-make-it/history-of-cocoavia

[ii] Vlachojannis J, Erne P, Zimmermann B, Chrubasik-Hausmann S.  The impact of cocoa flavanols on cardiovascular health.  Phytother Res.  2016;30(10):1641-57.

[iii] Andres-LaCueva C, Monagas M, Khan N, et al.  Flavanol and flavonol contents of cocoa powder products: influence of the manufacturing process.  J Agric Food Chem. 2008;56:3111-17.

[iv] Crews WD, Harrison DW, Wright JW.  A double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adults.  Am J Clin Nutr. 2008;87(4):872-80.

[v] Meek J.  Chocolate is good for you (or how Mars tried to sell us this as health food).  The Guardian, Dec 23, 2002.

https://www.theguardian.com/uk/2002/dec/23/research.highereducation

[vi] Barrionuevo A.  An apple a day for health?  Mars recommends two bars of chocolate.  NY Times, Oct 31, 2005.

The FDA considers candy bars to be foods labeled with Nutrition Facts panels.  Supplements are labeled with Supplement Fact panels.

[vii] FDA.  Inspections, compliance, enforcement, and criminal investigations.  Warning letter to Mr. John Helferich, Masterfoods USA.  FDA, May 31, 2006.  http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2006/ucm075927.htm

[viii] Ottaviani JI, Balz M, Kimball J, et al. Safety and efficacy of cocoa flavanol intake in healthy adults: a randomized, controlled, double-masked trial.  Am J Clin Nutr. 2015;102(6):1425-35.

[ix] Necozione S, Raffaele A, Pistacchio L, et al.  Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study—a randomized controlled trial  Am J Clin Nutr. 2015; 101:538-48.

[x] Heiss C, Sansone R, Karimi H, et al.  Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.  Age. 2015;37:56.

[xi] Sansone R, Rodriguez-Mateos A, Heuel J, et al.  Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study.  Brit J Nutr. 2015;114(8):1246-55.

[xii] Mars Center for Cocoa Health Science.  Press release: Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.  MarsCocoaScience.com, Sep 9, 2015.  http://www.marscocoascience.com/news/cocoa-flavanols-lower-blood-pressure-and-increase-blood-vessel-function-in-healthy-people.

[xiii] CocoaVia.  Cocoa’s past and present: a new era for heart health.  NY Times, Sep 27, 2015.  http://paidpost.nytimes.com/cocoavia/cocoas-past-and-present-a-new-era-for-heart-health.html?_r=0

[xiv] Mars Symbioscience.  Explore Mars Symbioscience.  Mars.com.

http://www.mars.com/global/brands/symbioscience

[xv] Mars.  Largest nutritional intervention trial of cocoa flavanols and hearth (sic) health to be launched.  MarsCocoaScience.com, Mar 17, 2014.

http://www.marscocoascience.com/news/largest-nutritional-intervention-trial

[xvi] The trial is registered at COcoa Supplement and Multivitamin Outcomes Study (COSMOS).    ClinicalTrials.gov.

https://clinicaltrials.gov/ct2/show/NCT02422745

[xvii] ASRC (Advertising Self-Regulatory Council).  NAD recommends Mars modify certain claims for CocoaVia cocoa extract.  ASRCReviews.org, Aug 11, 2016.

http://www.asrcreviews.org/nad-recommends-mars-modify-certain-claims-for-cocoavia-cocoa-extract/