Chocolate positively impacts patients, with PAD

by Dr. Alan Kadish

I want to know how to get paid to eat chocolate and run a study like this………only slightly kidding. 

Here is another study, although with a small number of patients, that shows that food can be medically functional and responsible for a significant measurable impact on a disorder that is both uncomfortable and debilitating.

Peripheral Artery Disease (PAD) decreases the amount of blood available to your you lower legs, typically. It can be caused by a number of disorders including arteriosclerosis, inflammation and occlusive causes.

We use a non-invasive measurement referred to as the ankle brachial index (ABI) using our ultrasound to diagnose this disorder in addition to thermography and a comprehensive history, with blood chemistry..

I’d like to suggest that the 40 grams of chocolate used in this study, equivalent to 1/2 of a chocolate bar might be problematic from a caloric point of consideration . At 200+ calories per day it would not take long to see the results in this extra intake.

The ingredient responsible for the response is called a polyphenol. This is a class of chemicals that has multiple members with different molecular weights and actions. There are substantial differences when you consider the absorption and the action of the class of polyphenols. So if you’re inclined to be scientific, one needs to know the exact class member and a host of other factors to know if it has the potential to affect a specific pathway and how to deliver an adequate dose.

And make no mistake in the chocolate form. It has to be dark chocolate which means typically ~75% or greater.  The study used 85% cocao so for most a bit of taste adjustment will be in order.

As a note a number of chocolate manufactures have been breeding for higher polyphenol content in their cacao crops, for many years. Unfortunately currently  most of the manufacturers are currently not aware or not listing the amount of polyphenols on a label…..yet.

With that in mind one might do better to consider polyphenols from a host of other supplemental sources.  There are over 100 foods and herbs that contain polyphenols. Foods including grape skins and seeds to pomegranates from olive oil to flax seeds contain memeber of this chemical family. 

There are no lack of natural therapeutics to address PAD. At the Center, we integrate the use of HBOT, dietary changes, supplements and physical medicine to positively change the course of this disorder. Often with significant responses the translate to better ability to walk longer distances ,with much less pain.

Ready for some relief, call us at : 503-688-9510

  • Original Research
    • Vascular Medicine

Dark Chocolate Acutely Improves Walking Autonomy in Patients With Peripheral Artery Disease


Background NOX‐2, the catalytic subunit of NADPH oxidase, has a key role in the formation of reactive oxidant species and is implicated in impairing flow‐mediated dilation (FMD). Dark chocolate exerts artery dilatation via down‐regulating NOX2‐mediated oxidative stress. The aim of this study was to investigate whether dark chocolate improves walking autonomy in peripheral artery disease (PAD) patients via an oxidative stress‐mediated mechanism.

Methods and Results FMD, serum levels of isoprostanes, nitrite/nitrate (NOx) and sNOX2‐dp, a marker of blood NOX2 activity, maximal walking distance (MWD) and maximal walking time (MWT) were studied in 20 PAD patients (14 males and 6 females, mean age: 69±9 years) randomly allocated to 40 g of dark chocolate (>85% cocoa) or 40 g of milk chocolate (≤35% cocoa) in a single blind, cross‐over design. The above variables were assessed at baseline and 2 hours after chocolate ingestion. Dark chocolate intake significantly increased MWD (+11%; P<0.001), MWT (+15%; P<0.001), serum NOx (+57%; P<0.001) and decreased serum isoprostanes (−23%; P=0.01) and sNOX2‐dp (−37%; P<0.001); no changes of the above variables were observed after milk chocolate intake. Serum epicatechin and its methylated metabolite significantly increased only after dark chocolate ingestion. Multiple linear regression analysis showed that Δ of MWD was independently associated with Δ of MWT (P<0.001) and Δ of NOx (P=0.018). In vitro study demonstrated that HUVEC incubated with a mixture of polyphenols significantly increased nitric oxide (P<0.001) and decreased E‐selectin (P<0.001) and VCAM1 (P<0.001).

Conclusion In PAD patients dark but not milk chocolate acutely improves walking autonomy with a mechanism possibly related to an oxidative stress‐mediated mechanism involving NOX2 regulation.

Clinical Trial Registration URL: Unique identifier: NCT01947712.

Copyright Center of Health™ 7/2014  For permission to reprint this article, please contact the author.

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Dr. Kadish is an unusual physician often referred to as a "doctor detective". His expertise is the evaluation and treatment of complex disorders, typically after other physicians have been stumped, is renowned. He provides care for all family members and has additional training in autistic spectrum disorders and chronic complex diseases.