Is your favorite chocolate safe to eat? The good, the bad, and the ugly about chocolate.

When I was in Mexico I visited a chocolate museum. It’s hard to get through the exhibit without drooling since the rich, sweet odors permeate every room. The last stop before the exit was a large display of chocolate that was for sale. Chocolate made from coarsely ground cacao, sugar, and cinnamon. Chocolate with chile, nuts, and spices, and mole sauce cooked for half a day and filled with more than a dozen spices. The Mexicans know how to make chocolate!

And it’s no wonder. Cacao plants were grown in Mexico 4,000 years ago, and the Olmec, one of the earliest civilizations in Latin America, turned the bitter cacao beans into cocoa, which they drank and used as medicine. Later, the Mayans came up with a brew made of roasted cacao seeds, chilies, water, and cornmeal. The Aztecs used cacao beans as currency and believed that chocolate was a gift from the god Quetzalcoatl. They drank it as a delicious foamy beverage, an aphrodisiac, and as a preparation for war.

When the Spanish arrived, they brought nuts and spices with them. This is where the common practice of adding almonds and cardamom to Mexican chocolate stems from.

So thanks to the Mexicans and Spanish, we have the amazing pleasure of drinking and eating chocolate. In addition to its delectable taste, chocolate offers numerous health benefits. But there’s a big difference between eating dark chocolate and milk chocolate. Dark chocolate has the highest percentage of cocoa solids and cocoa butter, as well as sugar and cocoa bean powder. It also contains flavonoids, plant-based compounds that have anti-inflammatory and antioxidant properties that support immunity. Additionally, it contains magnesium, sulfur, calcium, iron, zinc, copper, potassium, and manganese, which are essential minerals. Dark chocolate also contains epicatechin and gallic acids which support the heart, act as anticarcinogens (anti-cancer), and support brain health and mental clarity.

Milk chocolate contains milk powder, sugar, and a small percentage of cocoa solids and cocoa butter. It has a creamier and sweeter taste. It contains less than 10 percent of cocoa versus the minimum of 35 percent cocoa that dark chocolate contains, which means it doesn’t offer nearly the number of health benefits as dark chocolate.

Nutritionists recommend consuming chocolate products that contain 70% to 80% cocoa. If you just want pure and simple health benefits, forego the chocolate and take raw cacao capsules. Although I definitely wouldn’t recommend giving your sweetheart a bottle of cacao capsules on Valentine’s Day. Indulge in the good-tasting stuff!

If chocolate is so good for you, what’s all the fuss about it containing heavy metals?

Consumer Reports recently created a brouhaha about lead and cadmium found in popular dark chocolate bars. In fact, cadmium and lead were found in all 28 dark chocolate bars that were tested. The levels of both lead and cadmium were highest in: Theo organic pure dark 70% cocoa, Theo organic extra dark pure dark chocolate 85% cocoa, Green & Black’s organic dark chocolate 70% cacao, Trader Joe’s The dark chocolate Lover’s chocolate 85% cacao, and Lily’s extremely dark chocolate 85% cocoa.

The safer choices were: Mast organic dark chocolate 80% cocoa, Ghiradelli intense dark chocolate 86% cacao, Valrhona Albinao dark chocolate 85% cacao, Taza chocolate organic delicious dark chocolate 70% cacao, and Thiradelli intense dark chocolate twilight delight 72% cacao. Click here to find out about other brands and bars: https://www.consumerreports.org/health/food-safety/lead-and-cadmium-in-dark-chocolate-a8480295550/

What’s so terrible about heavy metals?

Regular and long-term exposure to just small amounts of heavy metals can result in a number of health problems. The biggest danger is for pregnant women and young children because the metals can cause developmental problems and even lead to lower IQ. But all adults should be concerned because frequent exposure can result in kidney damage, reproductive problems, hypertension, and immune system suppression.

Dark chocolate contains more heavy metals than milk chocolate because it contains at least 65 percent cacao by weight.

Play it safe.

If you’re addicted to dark chocolate, find a brand that is considered “safer” and contains a lower cacao percentage. Treat dark chocolate as a treat and limit yourself to one ounce, and trade it for milk chocolate half of the days you normally consume it. Don’t assume that organic dark chocolate is safer because it isn’t. Check the Consumer Report list (link is above). And severely limit the amount of dark chocolate that you give young children.

Remind me again why chocolate is good for you.

10 reasons to eat chocolate

  1. Chocolate is an aphrodisiac. Legend has it that the Aztec emperor Montezuma was said to consume large amounts of the cocoa bean to fuel his libido. Today, scientists attribute the aphrodisiac qualities of chocolate to two chemicals: 1) tryptophan, which is a building block of serotonin, a brain chemical involved in sexual arousal. And, 2) phenylethylamine, a stimulant related to amphetamine, that is released in the brain when people fall in love. What about you? Do you experience a heightened sense of arousal after eating dark chocolate?
  2. Chocolate contains good-for-you antioxidants Chocolate comes from the cacao bean, which thrives in hot, rainy climates in South America, Africa and Indonesia. Similar to grapes, the local soil and climate affects the taste of the harvested beans. When you buy a chocolate bar that has the percentage number on the bar wrapper, that represents the weight that comes from the cacao bean content, according to Robert L. Wolke, author of What Einstein Told His Cook: Kitchen Science Explained. The higher the number, the lower the percentage of sugar and the more bitter and complex the flavor, he says. And the higher the number the more antioxidants.
  3. Cacao is rich in essential minerals: magnesium, sulfur, calcium, iron, zinc, copper, potassium and manganese, all essential minerals . . . and antioxidants that support immune health.
  4. Chocolate reduces your risk of Type 2 Diabetes Researchers discovered that the flavanols in chocolate have beneficial effects on insulin resistance, a risk factor for Type 2 diabetes. In a 30-year-long study of 953 men and women from the Maine-Syracuse Longitudinal Study (MSLS), researchers found that the individuals who never or rarely ate chocolate had a significantly higher chance of developing Type 2 diabetes after five years when compared to individuals who ate chocolate more than once a week. Habitual chocolate intake and type 2 diabetes mellitus in the Maine-Syracuse Longitudinal Study: (1975-2010): Prospective observations.
  5. Protects you from heart disease A 2012 report published in the American Journal of Clinical Nutrition found that dark chocolate has a beneficial effect on blood pressure, vascular dilation and cholesterol levels, and can play a role in reducing metabolic precursors that lead to diabetes and eventually to heart disease. However, a study published in October 2016 (John Wiley & Sons, Ltd.) found that out of 32 cocoa product samples analyzed, the cocoa flavanol dose must be about 900 mg or above to decrease blood pressure, and contain 100 mg of epicatechin. So if you want to eat chocolate for health benefits, be sure to check the ingredient label. The aim of the study was to review the effect of cocoa flavanols on cardiovascular health, with emphasis on the doses ingested, and to analyze a range of cocoa products for content of these compounds. PubMed was searched from 2010 to locate systematic reviews (SR) on clinical effects of chocolate consumption.
  6. Supports mental function. A recent analysis of several studies on the effects of cocoa polyphenols on cognition in healthy adults found that they enhanced memory and executive function. https://pubmed.ncbi.nlm.nih.gov/31933112/ In an earlier study carried out by the University of L’Aquila in Italy, 90 elderly participants with mild cognitive impairment (MCI) drank cocoa containing high, medium, or low levels of flavonoids. At the end of the eight-week study, researchers found improvements in motor response, working memory, task switching, and verbal memory in the participants who drank cocoa with a higher flavanol content. (Hypertension, Aug. 14, 2012) Alzheimer’s and dementia patients are especially fond of sweets because the taste of sweetness is the last taste to disappear. Another study that evaluated the effect of cocoa flavonoids on cognitive function, blood pressure control and metabolic function in the elderly also found positive results. https://pubmed.ncbi.nlm.nih.gov/25733639/ So if your loved one has Alzheimer’s or dementia, indulge him/her in chocolate. Just remember not to overdo it and make sure to include good dental hygiene in your loved one’s daily regimen.
  7. Helps you think better after a sleepless night. The next time you have a bad night’s sleep, instead of indulging in a cup of Joe drink hot chocolate. Sleep deprivation is a risk factor for cardiovascular disease, and scientists have found that flavanol-rich chocolate counteracted vascular impairment after sleep deprivation and restored working memory performance. Their theory is that the study’s participants had improved cognitive performance because of the effects of cocoa flavonoids on blood pressure and blood flow.Flavanol-rich chocolate acutely improves arterial function and working memory performance counteracting the effects of sleep deprivation in healthy individuals.
  8. Is good for your gut. Cacao stimulates the production of healthy microbes in the colon.  Studies show that the microbes break down the undigested fiber in the cocoa, creating usable short-chained fatty acids, such as butyric, propionic, and acetic acids. These fatty acids promote the growth of healthy gut bacteria, which strengthens the intestinal barrier and prevents harmful microorganisms and antigens from invading the digestive tract.
  9. May help protect you from cancer. Cacao has the biggest concentration of flavonols ( a class of flavonoids) of all foods per weight. Flavonols contain cancer-protective properties. Studies in humans have shown that flavonol-rich diets are associated with a decrease in cancer risk. One gram of cacao contains over 30 mg of flavonols, and 31 mg a day is ideal. But be careful. Don’t use this as an excuse to eat a bar of dark chocolate every day instead of eating fruits and vegetables, because fruits and veggies offer lots of fiber, vitamins, and minerals that aren’t all found in cacao.
  10. Makes you feel gooood Scientists have discovered why chocolate uplifts your mood. Serotonin is the neurotransmitter responsible for keeping us happy, and cacao stops the amino acid tryptophan from breaking down. Since tryptophan is one of the amino acids that make serotonin this, in turn, limits the breakdown of serotonin. https://pubmed.ncbi.nlm.nih.gov/25733639/

I’m making strawberries dipped in chocolate this Valentine’s Day.

I might even make Chocolate souffle if I’m really feeling indulgent. Substitute coconut sugar or raw sugar, if you like. This recipe is easier than you’d think, so don’t let the word souffle scare you off. It’s well worth the time and little effort it takes.

Chocolate Souffle

Ingredients

  • 1⁄3 cup sugar, plus additional for sprinkling
  • 5 ounces bittersweet chocolate chips
  • 3 large egg yolks, at room temperature
  • 6 large egg whites
  • 1⁄8 tablespoon butter

Directions

  • Preheat oven to 375°F.
  • Measure out sugar, chocolate and separate eggs.
  • Butter soufflé dish entirely and then add sugar (additional) coating the entire dish.
  • Melt chocolate in a double boiler, or directly on the stove.
  • Add yolks to chocolate (this will harden the chocolate so don’t be alarmed).
  • Beat egg whites with a pinch of salt. Slowly add sugar, a little at a time. Beat until egg whites hold stiff peaks.
  • Fold white mixture into chocolate slowly and stir until smooth.
  • Pour into large soufflé dish or 4 ramekins and run the end of your thumb around inside to remove any extra batter.
  • Bake until puffed and crusted on top but still jiggly in center, 20 to 25 minutes.
  • Serve immediately with whipped cream or ice cream.

This recipe has become one of my new favorites.

Chocolate zucchini bread

Ingredients

  • 2 cups grated zucchini
  • 2 eggs
  • 1/2 cup unsweetened applesauce
  • 1/2 cup maple syrup (add 3/4 cup if you like it sweet, I don’t)
  • 1 tsp baking soda
  • 1 tsp baking powder
  • 1/2 tsp salt
  • 1/3 cup unsweetened cocoa or cacao powder
  • 2 cups flour of your choice. I use 1 cup almond meal and 1 cup whole wheat
  • 1/2 cup semi-sweet chocolate chips

Directions

  • Preheat oven to 350 degrees. Spray loaf pan with oil or rub with butter.
  • In a large bowl mix egg, applesauce, maple syrup, baking soda and baking powder, and salt.
  • Add cocoa powder and whisk until well combined.
  • Add flour and mix until combined. Add 1/4 cup of chocolate chips.
  • Pour batter into pan and sprinkle remaining chips on top.
  • Bake 40-50 minutes or until an inserted toothpick comes out clean. Be careful not to hit a melted chocolate chip.
  • Let cool before slicing.

Yay chocolate! Have a very happy Valentine’s Day!

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Are you a good candidate for the new Alzheimer’s drug?

Patient getting an IV infusion

On January 6, 2023, the FDA approved Leqembi, the first drug shown to slow Alzheimer’s. Leqembi (Lecanemab) is manufactured by the Japanese drugmaker Eisai and co-developed by Eisai and Biogen. The drug is for patients with mild or early-stage Alzheimer’s dementia.

How does it work?

Lecanemab is an antibody that removes sticky deposits of the protein amyloid beta from the brain. Leqembi (the brand name in the US) neutralizes the protein and marks it for clearance by the immune system before clumping occurs. The result is fewer beta-amyloid aggregates, or plaques, in the brain, potentially slowing the progress of the disease. Results from a late-stage study showed that the drug reduces the rate of cognitive decline in patients with early Alzheimer’s by 27%.

How is it given?

Leqembi is administered intravenously once every two weeks to patients who have a diagnosis of early or mild Alzheimer’s. During the first 14 weeks of taking the drug, patients must be closely monitored and get brain scans to make sure there is no brain swelling.

What are the risks?

Cerebral edema, also called ARIA-E, is the main risk. It involves the breakdown of the tight endothelial junctions of the blood-brain barrier and results in the accumulation of fluid in the brain. In general, common side effects of ARIA-E include easy bruising/bleeding, numbness/tingling of the hands/feet, unsteadiness, unexplained muscle weakness, vision changes, muscle joint pain, butterfly-shaped rash on the nose and cheeks, symptoms of heart failure (including shortness of breath, swelling ankles/feet, and unusual tiredness. Patients who have chest pain or seizures should get medical help immediately.

Biogen has issued these warnings and precautions: Leqembi can cause amyloid-related imaging abnormalities-edema (ARIA-E) and -hemosiderin deposition (ARIA-H). ARIA-E can be observed with MRI imaging as brain edema or sulcal effusions, and ARIA-H as microhemorrhage and superficial siderosis. ARIA is usually asymptomatic, although serious and life-threatening events, can occur including seizures. They are rare, however.

Reported symptoms associated with ARIA may include headache, confusion, visual changes, dizziness, nausea, and gait difficulty. Focal neurologic deficits may also occur. Symptoms associated with ARIA usually resolve over time.

In one study listed on Biogen’s news release (although it doesn’t say how many patients were treated) 3% of the patients who took the drug had symptomatic ARIA. It resolved itself in 80% of those patients. One patient had a brain hemorrhage after one treatment with the drug. https://investors.biogen.com/news-releases/news-release-details/fda-approves-leqembitm-lecanemab-irmb-under-accelerated-approval

The majority of ARIA-E radiographic events occurred early in treatment (within the first 7 doses), although ARIA can occur at any time and patients can have more than one episode. Other studies have reported that patients taking Leqembi who had brain hemorrhages died. This information is on the Biogen news release, also. https://investors.biogen.com/news-releases/news-release-details/fda-approves-leqembitm-lecanemab-irmb-under-accelerated-approval

Patients who have had a cerebral hemorrhage, aneurysm, brain lesions, stroke, brain contusion, or other brain and vascular pathologies are advised to not take the drug because there is a risk of a brain hemorrhage. Most doctors would not administer the drug in any of these cases.

How much does Leqembi cost?

A year’s treatment will cost about $26,500. Currently, there are few options outside of self-pay. Most of the patients who are potential candidates for the drug are on Medicare, and the Federal program’s coverage is very limited, so far. Patients who can pay out of pocket will be able to start the treatment if they are a good candidate for Leqembi and are able to find a doctor and health care system to work with.

So far, Soleo Health is the sole specialty pharmacy distributor for Leqembi. Soleo Health will distribute Leqembi to provider offices and infusion centers, and administer it across the company’s ambulatory infusion centers nationwide, including those operated by its provider division, Virtis Health. This division offers therapeutic and diagnostic services to people with complex diseases requiring special management.

The company reported that it operates more than 40 infusion centers across the U.S.

Patients treated with Leqembi also can receive support through Soleo Health’s Alzheimer’s disease Therapeutic Care Management Center, or TCMC, whose interdisciplinary staff includes physician specialists, nurse practitioners, registered nurses, therapy-care pharmacists, reimbursement specialists, and patient care ambassadors. The center is supported by the company’s nationwide specialty pharmacies, Soleo Health stated.

More information on Soleo Health’s services for Leqembi and Alzheimer’s disease is available by contacting its Alzheimer’s TCMC at 844-960-9090 or via email at alzheimers@soleohealth.com.

Is it worth the risk?

This is a tough question. If I were in the position of deciding whether to put my loved one on Leqembi I’d have to think long and hard if the risk of their having a brain bleed and possible hemorrhage is worth the possibility of living six months, nine months, or a year or two longer without dementia. On the other hand, it’s too early to know just how beneficial the drug will be. I’d probably not be first in line and would wait a bit to see how much Leqembi is helping and whether Medicare is going to cover at least part of the cost.

Maybe Leqembi will turn out to be the silver bullet we’ve been waiting for, and will totally clear out the amyloid plaques. Now wouldn’t that be fantastic?!

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.