Chronic fatigue syndrome patients who ate small amounts of specially formulated dark chocolate every day showed significant reductions in fatigue in a placebo controlled trial.

Dark chocolate has received a lot of attention in recent years for its potential health benefits. Studies have found it may help reduce the risk of heart disease, cancer, and stroke. It has also been shown to have pain killing properties, amongst other benefits. Now a new study has found that a specially formulated dark chocolate can reduce self-reported levels of fatigue in chronic fatigue syndrome patients.

The study was carried out by a team of researchers at Hull and East Yorkshire Hospitals NHS Trust in the UK, headed by Professor Steve Atkin, a Consultant Endocrinologist.

A group of chronic fatigue syndrome patients were given 45g of specially formulated high polyphenol chocolate every day for eight weeks. A break of two weeks was followed by the volunteers being given a placebo in place of the chocolate without their knowledge. The results showed that the CFS patients reported suffering significantly less fatigue whilst eating the chocolate. They also reported that high levels of fatigue returned when the chocolate was switched for the placebo.

Professor Atkin said “No one has examined the effects of chocolate on CFS before and so this is a very exciting and interesting result for us." He also noted that the participants did not suffer from any significant weight gain whilst eating the chocolate.

Dark chocolate of the kind used in the study could benefit CFS patients in two main ways. The first, and most likely explanation for the relatively rapid reduction in fatigue, has to do with neurotransmitters. Chocolate is known to increase levels of important neurotransmitters like serotonin and dopamine which researchers believe may help CFS patients as they are associated with regulating many important biological processes such as mood and sleep, pleasure and pain. These neurotransmitters and a number of related chemicals have been shown to be low in CFS patients and a number of other interventions aimed at increasing them have also shown positive results. The perceived decrease in fatigue experienced by the study participants could be the result of improved mood and mental outlook, the benefits of better sleep quality, or a combination of these and other factors.

Other benefits of chocolate for CFS patients likely derive from its high polyphenol content. The dark chocolate used in this study contained 85% cocoa solids and was rich in polyphenol flavonoids. These polyphenol flavonoids are powerful antioxidant compounds that can significantly reduce cell damage from excess free radicals in the body.

This property of chocolate is important since research shows that excessive free radical activity, known as oxidative stress, is common in CFS patients. The reason for the oxidative stress is not known for sure but could result from infections, environmental toxins, disturbed immune system function, or a combination. An individuals ability to detoxify harmful substances and respond to physiological stressors such as these is also likely to play a role. Whatever the cause, oxidative stress can result in a large range of problems throughout the body. It can interfere with energy production in the mitochondria of every cell, it can cause the immune system to over-react producing allergies and other problems, it can interfere with the function of various enzyme systems, and in the long-term it can increase the risk of degenerative diseases such as heart disease, cancer, and Alzheimer's disease. The polyphenol flavonoids in dark chocolate could therefore act to counter these processes by virtue of their antioxidant properties.

It's important to note that the chocolate used in this study was a special formulation of dark chocolate which was very high in cocoa, low in sugar, and did not contain milk or milk products. It would probably not be wise for CFS patients to rush out to the store to buy a regular chocolate bar and think they are doing themselves some good. Firstly, chocolate bars contain significantly smaller amounts of the important polyphenol flavonoids. Further, regular chocolate bars generally contain vast quantities of sugar and milk products. Sugar can be bad for a number of reasons, including exacerbating hypoglycemia and encouraging the growth of unfriendly organisms such as yeasts and bacteria in the gut. CFS patients also tend to have problems with milk products and anecdotal reports suggest they tend to feel better when they are removed from the diet.

In conclusion, this is an important study and further research may shed more light on the exact mechanisms by which chocolate reduces fatigue in chronic fatigue syndrome patients. Unfortunately, despite the headlines of "Chocolate helps CFS patients", this is not really a green light to go out and eat copious amounts of your favourite chocolate treats. The high cocoa chocolate used in the study most likely tasted more sour than sweet!

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written by Toby, January 28, 2008

Very interesting. Like you say, let's hope CFS patients don't go out and buy boxes of Mars bars!

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