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The Limits Of Medicine

The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7480.1447 (Published 16 December 2004) Cite this as: BMJ 2004;329:1447

Rapid Response:

One hundred grams of dark chocolate a day?

Sirs:

I am professionally unqualified to comment on the Polymeal proposal.
However one aspect of it disturbed me enough when reading of it in the
Guardian to search out the full version in the BMJ. I am not particularly
interested in having this response published but suggest the BMJ staff
perform a simple test for side effects.

I am a big fan of Droste Extra Dark chocolate and consume a 100g bar
weekly. While young adults may tolerate it, for some fraction of the
Polymeal's target group of age "over 55", that much chocolate can act as a
powerful laxative. Chocolate is reported to have a wide variety of
effects on humans, not all of them positive. 100g is a large dose!

Further, this age group also experiences a slower metabolism and an
increased incidence of late-onset diabetes. The label on the Droste bars
indicates 600 calories! 45 grams of fat, 28g of which is saturated. 18g
of carbohydrates, 12g of which are simple sugars. 600 calories is a big
fraction of the recommended daily maximum, and the fat/satuarted fat
content is significant. My personal contention is that the stearic acid
in dark chocolate is not absorbed well, especially if it is excreted
rapidly. However, the sugar will be absorbed, and quickly -- just check
blood sugar after consuming a Droste bar! Assuming the entire 600
calories is absorbed, that number is not good since it pushes more
nutritious food out of the diet. As for a 5mm reduction in systolic blood
pressure, fine. But it's somewhat moot if the individual adds several
pounds due to consuming that much chocolate every day. There is a
definite correlation between weight and blood pressure, no?

Chocolate bars using artificial sweeteners are hard to find and
expensive. I have never seen dark versions. Unsweetened "baker's
chocolate" is expensive and unpalatable; there is a reason commercial dark
chocolate candy stays below 75% cocoa. A commercial dessert might be
created using unsweetened chocolate and artificial sweetener, but the cost
might put it beyond the reach of pensioners in the "over 55" age group.
Also, the 45g of fat would remain.

My suggestion: an unscientific study of side effects by BMJ staffers
"of a certain age". Obtain and consume 100g dark chocolate bars and note
any intestinal effects. It goes well with a cup of tea, but some subjects
should consume with a meal. A personal blood sugar meter can provide some
interesting comparisons versus the non-participants.

A fun follow-up would be to test another recommendation: that adults
consume a cup of oatmeal a day (one presumes this is a cooked measure).
Have some BMJ staffers try this (I do it) and estimate the midday
explosion hazard if all workers in a crowded office had this breakfast.
For additional excitement, have the subjects also eat 100g of dark
chocolate... One wonders if researchers actually try these proposals.

A variant on dark chocolate is dark chocolate-covered espresso beans
that are available at many specialty coffee shops and coffee bars. These
merit their own study, although they are too expensive for a Polymeal. I
have not noticed any laxative effects; they are a good stimulant, don't
spill or become cold -- ideal for long-distance car journeys.

Competing interests:
None declared

Competing interests: No competing interests

17 December 2004
Brian Converse
reader - not health professional
North Kingstown, RI 02852