Currently browsing posts about: Chocolate

Kristy Leissle.  Cocoa.  Polity, 2018.

This book is flat-out about the politics of worldwide cocoa production: who holds power in the marketplace, sets prices, establishes the terms of trade, establishes and enforces standards of quality, and pays workers decently.

As for the sustainability of the cocoa industry, Leissle offers this definition:

sustainable cocoa is compensated well enough that farmers want to continue growing it as their primary employment, within a climatic environment that can support its commercial existence over the long term.  Compensation calculations must include the price paid for cocoa, but also how much it costs to grow—including costs of farming inputs; political social and economic costs associated with land ownership and crop sale; personal energy costs of farming; and opportunity costs of growing something else, such as food for subsistence.

She ends with this thought:

Though incomes for farmers and chocolate makers or company owners are unlike to equalize, we can still emphasize that all types of labor deserve attention and appropriate compensation….From there, the conversation begins.  For cocoa farmers to make a dignified living and for consumers to continue enjoying chocolate, sustainability must involve placing the highest possible value on cocoa at every step, from seed to taste bud.

If you wonder why food is worth talking about, Cocoa is an excellent illustration of how even something used to make candy connects to many of the most important social, economic, and political issues faced by today’s world.

Since it’s Valentine’s Day (have a happy one), we might as well talk about a candy company, in this case, Mars, Inc.

Mars, Inc., one of the defectors from the Grocery Manufacturers Association (see yesterday’s post) has also withdrawn from membership in and support of the International Life Sciences Institute (ILSI), a group that claims to be independent  but in fact is funded by hundreds of food and beverage companies (hence: front group).

ILSI’s positions on food issues are decidedly pro-industry, and so are the results of its sponsored research.  Mars couldn’t take it anymore.

Mars told Politico Pro (this may be behind a paywall):

After careful consideration, Mars will end its relationship with the International Life Sciences Institute (ILSI) by the end of 2018, and is withdrawing from ILSI’s nutrition committees immediately,” the company said in a statement to POLITICO. “Increasingly, the presentation of certain studies by ILSI has been at odds with our position and principles. Mars has a long history of engaging in external research that is evidence-based and data-driven, particularly in the area of promoting public health. We wish to thank ILSI for its partnership.

Mars announces this departure as a component of its new research and engagement policy.

The policy applies to all of Mars’ partnerships with universities, governmental and non-governmental organizations, foundations, individuals, food companies, and trade associations (like ILSI).

Here is my summary of the policy’s long list of principles:

• High scientific standards in all animal and human research
• Full disclosure of funding and potential conflicts of interest
• Appropriate standards of authorship
• Funding not linked to achievement of a specific research outcome

I know that everyone loves chocolate, but to snort???

The FDA, ever on the job, has issued a warning letter to Arco Globus Trading that its snortable Coco Loko product–cocoa powder infused with caffeine, gingko, taurine, and guarana–is being marketed illegally as an unapproved street drug.

the claims made in your promotional materials for Legal Lean Syrup and Coco Loko demonstrate that these products are intended to be used as alternatives to illicit street drugs…With respect to Coco Loko, a powder substance, you describe it in your labeling as a “snuff” and you promote it to be “snorted” (inhaled intranasally).  Intranasal administration of a powder substance can trigger laryngospasm or bronchospasm and induce or exacerbate an episode of asthma.  Furthermore, the ingredients listed on the product label for Coco Loko include taurine and guarana.  The safety of these ingredients for intranasal administration has not been evaluated.

I can’t find an official website for the product (it seems to have disappeared) but the FDA says that Coco Loko does not qualify as a supplement (it is snorted, not eaten, and it actually intended for use as a street drug:

• “Endorphin rush . . . it triggers a positive feeling of well being in your body similar to morphine.”
• “Serotonin rush . . . will produce an elevated mood and a state of euphoria similar to the feeling of ecstasy.”
• “Euphoric energy . . . Raw cacao will give you a steady rush of euphoric energy . . ..”
• “Raw cacao . . . is also known to help with anxiety and to reduce stress.”
• Coco Loko Review by I Suck At Talking (Youtube video on your website): “Raw cacao is linked to numerous health benefits . . . lower blood pressure and improved blood circulation . . ..” (1:04 – 1:13)

Snorting cocoa powder?  Really?  Not a good idea (even though no calories that way).

You can’t make this stuff up either.

I was interviewed by Cindy Kuzma, a reporter for VICE, about research on chocolate.  Her story is here.  Her questions were great (I wish all reporters asked such interesting questions).  Here’s our Q and A:

CK:  I noticed you haven’t written about chocolate for a while—perhaps it has been quiet on that front, or there are just a lot of other things happening! But another study about its health benefits, this time in regards to atrial fibrillation, brought it to my editors’ attention. Rather than just report on those findings they’ve asked me to take a broader view of the issue, which I appreciate.

MN: First let me comment on this study.  It is trying to tell me that 1-3 ounces of chocolate a month produces measurable health benefits?  That seems incredible and probably is, particularly because nothing is said about dose relationships.

CK:  How do you explain briefly to consumers why studies of health benefits linked to a single food are problematic/not terribly useful at best? (You’ve used the term “nutrifluff” before; is that still what might apply here?)

MN: People eat many different kinds of food every day.  The authors of this study say confounding factors might be involved.  That means that people who eat moderate amounts of chocolate (1-3 ounces a month is not much) might eat healthier diets, exercise more, or have other habits that reduce atrial fibrillation.

CK:  When it comes to chocolate specifically—how has industry shaped the public discussion of chocolate’s health benefits? MARS has obviously played quite a crucial role with its whole Center for Cocoa Health Science and its marketing of the CocoaVia supplement … how much influence has that single company had, and how would you advise consumers to view the research/claims tied to that type of industry funding?

MN: Mars is careful to say that cocoa processing into chocolate normally destroys flavonoids, which is why it developed a special preservation process and provides flavonoids in capsules, not chocolate.  But people tend to interpret the studies as “chocolate is really good for me.”  The study at issue here is independently funded.  In general, industry-funded studies come to conclusions favorable to the sponsor.  They require especially cautious interpretation.  But this one does too because it does not seem plausible.

CK: Like much of the research on the purported health benefits of chocolate, the new findings about atrial fibrillation come from an observational study. How do you typically explain the limitations of this type of research, and what the average health news consumer might not understand about the differences between correlation and causation?

MN: This study obtained information about chocolate consumption from food frequency questionnaires in which people tick off the number of times they have eaten a food in a week, month, or year, depending on how the question is asked.  I find these things impossible to fill out because I can’t remember at that level of specificity.  Chocolate shows up as a factor but other foods might too.  That’s why you can’t say chocolate is a cause of reduced atrial fibrillation; that observation could be due to any number of other factors.

CK: Even in randomized controlled trials—what other factors might wise consumers keep in mind when evaluating research? (I’m thinking about how often studies use the types or amounts of chocolate people regularly eat, rather than extracts/purified versions/large quantities, as well as whether they evaluate clinically significant outcomes like disease and mortality vs. isolated biomarkers or other less meaningful endpoints.)

MN: Interpretation of studies always has to be done in the context of everything else that is known about the topic.  One study should not change food choices, especially if it is industry-sponsored.  Anytime I hear “everything you thought you knew about nutrition is wrong,” a red flag goes up.  That’s not how science works.

CK:  Anything else you’d say overall about the role of a food like chocolate in a nutritious diet, and how much these health claims should/shouldn’t influence individuals’ regular habits?

MN: Chocolate is candy, not a health food.  Candy in moderation is just fine.  Every food in moderation is just fine.  Maybe the people in that study practiced moderation pretty easily and that’s why they came out as healthier.

I’m in Mexico City doing talks for El Poder del Consumidor, the advocacy group in part responsible for Mexico’s soda tax.  I had some time to be a tourist yesterday afternoon and got to see the Diego Rivera murals at the Palacio Nacional.

These are enormous, and stunning.  They deal with the history of Mexico in conflict and in peace.  Look closely, and you see Rivera’s deep respect for Mexico’s traditional food culture.

Along the corridor flanking the main mural, for example, is a painting above a plaque listing what the world owes Mexico—corn, obviously—but also beans, tobacco (oops), chocolate, hemp, and tomatoes.

Other panels also deal with corn—in this one, production.

Another shows how corn is used.

The corner panel at the end of the corridor is devoted to chocolate.

Along the way, quieter panels display the harvest of fruits and vegetables.

Leave the Palacio, cross the Zócolo, and you come to the Coca-Cola bar and toy store.

A brief look at Mexico’s food culture, then and now.

In case you were wondering why food companies would bother to sponsor research, consider CocoaVia, a chocolate derivative.

At the New York Times’ Food for Tomorrow conference last week, Mars, Inc., gave out samples of CocoaVia cocoa extract.

Here’s the one with sweetened dark chocolate.

And here’s the health claim.

Mind you, “Promotes a healthy heart by supporting healthy blood flow” is not an FDA-approved health claim.  CocoaVia is being marketed as a dietary supplement, not a food.   The label says it’s a “daily cocoa extract supplement,” and has a Supplement Facts label rather than the Nutrition Facts label used for foods.

It’s interesting that Mars, Inc. originally marketed CocoaVia as chocolate bars.  The FDA considers candy bars to be foods, labeled with Nutrition Facts.

But by marketing CocoaVia as a supplement, Mars, Inc. can take advantage of the permissive marketing allowed by the Dietary Supplement Health and Education Act of 1994.  This act allows “structure/function” claims on supplements like the one used by CocoaVia.  By marketing CocoaVia flavanols as supplements, Mars, Inc. does not have to adhere to the FDA’s more restrictive requirements for health claims on food packages.

I’m surprised that Mars, Inc. is using the supplement route because the company has gone to a lot of trouble to establish a scientific basis for a health claim for its processed cocoa flavanols.

Is it possible that Mars, Inc. thinks the cocoa flavanol claim won’t hold up to FDA scrutiny.

Here again are the three studies funded by Mars, Inc. (I posted them as examples of industry-funded studies with results favorable to the sponsor’s interest).

1. 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, by Daniela Mastroiacovo, Catherine Kwik-Uribe, Davide Grassi, Stefano Necozione, Angelo Raffaele, Luana Pistacchio, Roberta Righetti, Raffaella Bocale, Maria Carmela Lechiara, Carmine Marini, Claudio Ferri, and Giovambattista Desideri.  Am J Clin Nutr 2015; 101:538-548 doi:10.3945/ajcn.114.092189.

• Conclusion: These data suggest that the habitual intake of flavanols can support healthy cognitive function with age.
• Sponsor: Mars, Inc.

2.  Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.  Christian Heiss & Roberto Sansone & Hakima Karimi & Moritz Krabbe & Dominik Schuler & Ana Rodriguez-Mateos & Thomas Kraemer & Miriam Margherita Cortese-Krott & Gunter G. C. Kuhnle & Jeremy P. E. Spencer & Hagen Schroeter & Marc W. Merx & Malte Kelm & for the FLAVIOLA Consortium, European Union 7th Framework Program.  AGE (2015) 37: 56 DOI 10.1007/s11357-015-9794-9

• Conclusion: CF [cocoa flavanol] intake reverses age-related burden of cardiovascular risk in healthy elderly, highlighting the potential of dietary flavanols to maintain cardiovascular health.
• Funding: …Additional funding was provided by an unrestricted grant by MARS, Inc…MARS, Inc. provided the standardized test drinks used in this investigation. HS is employed by MARS, Inc., a member of the FLAVIOLA research consortium and a company engaged in flavanol research and flavanol-related commercial activities.

3.  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.  Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

• Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
• Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… H. S. is employed by MARS Inc., a member of the Flaviola research consortium and a company engaged in flavanol research and flavanol-related commercial activities. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].

To publicize this research, Mars, Inc.

• Issued a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”
• Placed this ad in the September 27, 2015 New York Times. 

• Gave out samples to participants at the New York Times’ conference.

My interpretation: Mars, Inc. must expect to make some serious money on this supplement—more than enough to pay for all the research and marketing.

As for whether cocoa flavanols really do support healthy blood flow, or whether this is just the standard hyperbole only to be expected from supplement marketers, I’m reserving judgment until I see the results of independently funded studies.

Sunday’s New York Times carried this full-page advertisement.

The ad is from Cocoa Via, a company owned by Mars.  It quotes a dietitian stating that cocoa flavanols “support healthy blood flow…which allows oxygen and nutrients to get to your heart more easily.”

The ad directs you to the full story at nytinmes.com/cocoavia (where you see more ads).

I posted the science behind this ad earlier this month in my collection of industry-funded studies with results favorable to the sponsor’s interests.  To repeat:

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.  Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

• Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
• Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… H. S. is employed by MARS Inc., a member of the Flaviola research consortium and a company engaged in flavanol research and flavanol-related commercial activities. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].
• Comment: Lest the “eat more chocolate” message of these studies be missed, Mars sent out a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”

Now we have a full-page ad in the New York Times.

Here’s what the ad does not say:

• CocoaVia is owned by MARS, Inc (this appears nowhere in the ad).
• Flavanols are usually destroyed during normal cocoa processing.
• Most chocolate contains few flavanols; CocoaVia’s process preserves some of the flavonols in very dark chocolate.
• Flavonol-rich or not, chocolate candy is not a health food.

Like most conflicted research, this is about marketing—hence, the ad—not science.

Here’s the latest collection of 5 studies funded by food companies or trade associations, all with results that favor the sponsor’s interests.  I’ve just reviewed them and found a couple of duplicates, so this is a corrected score.  The correct score is 55 industry-funded studies with positive results vs. 3 with results unfavorable to industry—since mid-March.

I’m particularly interested in the unfavorable category.  If you run across any, please send.

Jejunal Casein Feeding Is Followed by More Rapid Protein Digestion and Amino Acid Absorption When Compared with Gastric Feeding in Healthy Young Men. Joanna Luttikhold, Klaske van Norren, Nikki Buijs, Marjolein Ankersmit, Annemieke C Heijboer, Jeannette Gootjes, Herman Rijna, Paul AM van Leeuwen, and Luc JC van Loon. J. Nutr. 2015; 145:2033-2038 doi:10.3945/jn.115.211615.

• Conclusions: Jejunal feeding of intact casein is followed by more rapid protein digestion and AA absorption when compared with gastric feeding in healthy young men. The greater postprandial increase in circulating EAA concentrations may allow a more robust increase in muscle protein synthesis rate after jejunal vs. gastric casein feeding.
• Funding: Supported by Nutricia Research, Utrecht, Netherlands. J Luttikhold was employed by Nutricia Research; K van Norren is a guest employee of Nutricia Research; and LJC van Loon has served as a consultant for Nutricia Research.  [Note: Nutricia Research is a subsidiary of Danone].

Higher Total Protein Intake and Change in Total Protein Intake Affect Body Composition but Not Metabolic Syndrome Indexes in Middle-Aged Overweight and Obese Adults Who Perform Resistance and Aerobic Exercise for 36 Weeks. Wayne W Campbell, Jung Eun Kim, Akua F Amankwaah, Susannah L Gordon, and Eileen M Weinheimer-Haus. J. Nutr. 2015; 145:2076-2083 doi:10.3945/jn.115.213595.

• Conclusions: In conjunction with exercise training, higher TPro [total protein] promoted positive changes in BC [body composition] but not in MetS [metabolic syndrome] indexes in overweight and obese middle-aged adults. Changes in TPro from before to during the intervention also influenced BC responses and should be considered in future research when different TPro is achieved via diet or supplements.
• Funding:  Supported by the US Whey Protein Research Consortium (to WWC) among others.  WW Campbell was a member of the National Dairy Council Whey Protein Advisory Panel while the research was being conducted.

Intense Sweeteners, Appetite for the Sweet Taste, and Relationship to Weight Management.  France Bellisle.  Current Obesity Reports March 2015, Volume 4, Issue 1, pp 106-110 10.1007/s13679-014-0133-8

• Conclusion: While many of the existing studies cannot identify any causal links between use of LES [artificial, low-energy sweeteners] and appetite for sweetness, randomized trials in children and adults suggest that use of LES tends to reduce rather than increase the intake of sugar-containing foods and to facilitate, rather than impair, weight loss.
• Conflict: Parts of [this study] are extracted from a non-published document for which the author received an honorarium from the International Sweeteners Association (ISA).  France Bellisle is a member of the Scientific Advisory Board for General Mills and has received travel reimbursement and honoraria for contributions in scientific congresses from Mondelez, ISA, and General Mills.

Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.  Christian Heiss & Roberto Sansone & Hakima Karimi & Moritz Krabbe & Dominik Schuler & Ana Rodriguez-Mateos & Thomas Kraemer & Miriam Margherita Cortese-Krott & Gunter G. C. Kuhnle & Jeremy P. E. Spencer & Hagen Schroeter & Marc W. Merx & Malte Kelm & for the FLAVIOLA Consortium, European Union 7th Framework Program.  AGE (2015) 37: 56 DOI 10.1007/s11357-015-9794-9

• Conclusion: CF [cocoa flavanol] intake reverses age-related burden of cardiovascular risk in healthy elderly, highlighting the potential of dietary flavanols to maintain cardiovascular health.
• Funding: …Additional funding was provided by an unrestricted grant by MARS, Inc…MARS, Inc. provided the standardized test drinks used in this investigation. HS is employed by MARS, Inc., a member of the FLAVIOLA research consortium and a company engaged in flavanol research and flavanol-related commercial activities.

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.  Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

• Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
• Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… H. S. is employed by MARS Inc., a member of the Flaviola research consortium and a company engaged in flavanol research and flavanol-related commercial activities. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].
• Comment: Lest the implicit (but never stated directly) “eat more chocolate” message of these studies be missed, Mars sent out a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”