Chalk up another health benefit for dark chocolate?

Does chocolate need an image makeover?

With sinful-sounding names like Devil's Food, Chocolate Decadence, and my new favorite, Deathcake Royale, chocolate is often presented as wickedly delicious and even a bit dangerous. But could this rep be a bad rap? More studies are showing that dark chocolate on its own—stripped away of accompanying creams, frostings, and fillings—may actually be quite healthful (at least when eaten in moderation).

The latest findings come from a review of studies looking at dark chocolate and the risk of stroke. The researchers found three studies that met their quality criteria. One concluded that eating dark chocolate made no difference to stroke risk. But another found that eating small amounts each week reduced the risk of stroke by 22 percent, and the third reported that people were 45 percent less likely to die after a stroke if they regularly ate chocolate.

This review joins an array of studies suggesting that eating dark chocolate may be good for you in one way or another. Dark chocolate (usually described as containing at least 70 percent cocoa solids) is rich in plant pigments called flavonoids, which have been linked to a lower risk of heart disease and cancer. And research also suggests that eating dark chocolate may help lower stress.

But before you start thinking of dark chocolate as a health food, here are a couple things to consider:

• Eating small amounts of dark chocolate has been linked to health benefits—but not bingeing on triple-layer chocolate confections with lots of added sugars, creams and fats (as I did on Valentine's day with the Death Cake—yum, and yikes). And even chocolate on its own can be high in calories and fat, so don't overdo.
• Much of the research on chocolate (including the new review) is based on observational studies. This means researchers focused on one aspect of people's lives (i.e., how much chocolate they ate) and then looked to see what happened to them. This type of study can't tell us for sure whether eating chocolate was what really made a difference. For example, people who ate dark chocolate regularly might be doing so because they'd heard it was healthy. That suggests they are interested in their health, so they might also be more likely to exercise and eat plenty of fruits and vegetables, and less likely to smoke. It's likely that their overall lifestyle would have a bigger effect than eating dark chocolate.

What you need to know. We don't yet know whether eating small amounts of dark chocolate regularly will decrease your risk of having a stroke or other health problems. But it's unlikely to be harmful and—if you enjoy chocolate—quite likely to be delicious.

—Sophie Ramsey, patient editor, BMJ Group

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