Chocolate may help reduce pre-eclampsia risk

Confectionery makers will welcome the latest study to proffer the potential health benefits of chocolate as US researchers report that pregnant women who consume ample servings of this popular confectionery may reduce the risk of pre-eclampsia.

Pre-eclampsia is a major complication of pregnancy that affects 3 - 8 per cent of pregnancies, according to the study.

"Compared with women consuming under one serving of chocolate weekly, women consuming five or more servings per week had decreased risk," reported researchers from Yale University and the University of California in this month's Epidemiology magazine.

The researchers write that pre-eclampsia shares many characteristics and risk factors associated with cardiovascular disease such as hypertension and endothelial dysfunction.

Women with pre-eclampsia may also be at risk of cardiovascular disease and metabolic disturbances following pregnancy, they say.

A spat of recent studies has suggested that chocolate consumption may benefit cardiovascular health.

Researchers measured chocolate consumption by umbilical cord blood levels of theobromine, and self-reported intake, in the first and third trimesters.

The researchers said that theobromine was selected as a biomarker for chocolate consumption for a number of reasons.

It is present in "very high quantities" in chocolate, with dark chocolate containing the most, and is widely consumed in the form of chocolate and cocoa products.

Flavanoids and magnesium are found in chocolate but numerous other substances too, theobromine is primarily found in cocoa and tea leaves.

Further, although it is one of the three primary metabolites of caffeine, it accounts for only about 12 per cent of total metabolised caffeine.

Theobromine freely crosses the placental barrier.

It has been used to treat hypertension, angina and atherosclerosis.

Women who consumed the most chocolate and whose babies had the highest concentration of theobromine in their cord blood were the least likely to develop pre-eclampsia.

Self-reported chocolate consumption estimates were also inversely associated with pre-eclampsia.

Women with cord blood theobromine in the highest quartile had a 69 per cent reduction in risk compared with those in the lowest quartile.

Of those who reported consuming less than one serving per week of chocolate during the last three months 5.5 per cent developed pre-eclampsia.

Of those who reported consuming five or more servings per week 2.9 per cent developed the condition.

For the first three months the results were similar but estimates of consumption were less strongly associated with the risk of pre-eclampsia.

The researchers stressed that reverse causality may also have contributed to the findings and replication of the study with a detailed assessment of chocolate consumption was required.

Pre-eclampsia developed in 3.7 per cent of 1681 women.

Study The research team studied 2291 pregnant women who delivered a single infant between September 1996 and January 2000.

Pre-eclampsia was assessed by detailed medical record review for 1943 of the women.

The potential role of theobromine The researchers said that the inverse relationship between cord serum theobromine concentrations and the risk of pre-eclampsia may have been due to the direct role of theobromine.

Along with other methylxanthines in chocolate it may, for instance, improve placental circulation.

Alternatively theobromine concentrations could play an indirect role by, for instance, their correlation with unmeasurable dietary factors that influence preeclampsia.

In February this year market research firm Frost & Sullivan suggested that research has found the answer to chocolate's feel good factor.

Chocolate contains positive neurotransmitters such as theobromine.

These chemicals have been detemined to have active psychological effects.

Source: Epidemiology May 2008, Volume 19, Issue 03, pp 459-464, "Chocolate Consumption in Pregnancy and Reduced Likelihood of Preeclampsia" Authors: Elizabeth W Triche, Laura M Grosso, Kathleen Belanger, Amy S Darefsky, Neal L Benowitz and Michael B Bracken