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A Treatment for Chronic Fatigue Syndrome

An industry-funded randomized, double blind, placebo-controlled crossover trial study suggests chocolate may improve symptoms for those suffering from chronic fatigue syndrome, a debilitating condition currently affecting as many as 7 million Americans. But how do you get the cacao phytonutrients without the saturated fat and added sugar?

April 18, 2012 |
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Acknowledgements

Images thanks to John Loo, Mariluna,  and Evan-Amos via Wikimedia Commons, FrankBonilla.tv, and ChocolateCover.

Transcript

Chronic fatigue syndrome is a debilitating condition characterized by a minimum of 6 months crushing mental and physical exhaustion and we have no idea what causes it. We don’t even have a good idea of how many people it. The Centers for Disease Control estimates that as many as 7 and a half million Americans currently suffer from it. And we as physician have very little to offer patients in terms of relieving their symptoms. So this is one of the conditions that I’m always keeping an eye out for in terms of new treatments.
And one of the latest they just discovered? Chocolate…
Evidently Montezuma the second, who reigned the Aztec empire 500 years ago noted: The divine drink, builds up resistance, fights fatigue. A cup of cocoa permits people to walk for a whole day without food.’’ Not willing to take the emperor’s word for it, put it to the test.
I’m always skeptical of industry-supported research, but it was actually a pretty good study. At first glance it looked like they were basically saying eat 3 chocolate bars a day for 8 weeks and call me in the morning, but it was actually a randomized, double blind, placebo controlled crossover trial, which is about as good as you can get.
The mad scientists at Nestle took white chocolate, dyed it brown ,and then added some sort of fake chocolate flavor such that people couldn’t tell if they were eating the real chocolate or the fake. Comparable amounts of sugar, and fat, but one had cocoa solids—phytonutrients, and the other basically didn’t. So they were able to put people on one and then switch them over without anyone knowing to see if their chronic fatigue symptoms got better or worse and there was a significant improvement in the real chocolate group, meaning it apparently wasn’t just the yummy taste of chocolate but the action of the cacaow phytonutrients.
Of course no one should be eating 3 chocolate bars a day but you can get the equivalent dose of cocoa solids, the equivalent dose of those wonderful cocoa phytonutrients by consuming 2 and a half tablespoons of cocoa powder a day. You can put it in coffee, you can make a chocolately smoothie, or my personal favorite, you can blend it in a high speed blender with frozen cherries or strawberries, a little nondairy milk, vanilla extract and some erythritol or some dates and you have instant, decadent chocolate ice cream (low fat low calorie no cholesterol no added sugar) chocolate ice cream. The more of you eat, the healthier you are, whether or not you're suffering from chronic fatigue.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by veganmontreal.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

For some of my previous videos on chocolate, see Healthiest Chocolate FixUpdate On Chocolate, and my last recipe video on the topic, Healthy Chocolate Milkshakes. For why I'm so skeptical of industry-sponsored studies, see Food Industry “Funding Effect” and my other 26 videos on industry influence. And if that's not enough, there are hundreds of other videos on more than a thousand subjects.

For more context, check out my associated blog posts:  Strawberries Can Reverse Cancer Progression and How Probiotics Affect Mental Health

  • http://nutritionfacts.org/members/mgreger/ Michael Greger M.D.

    For some of my previous videos on chocolate, see Healthiest Chocolate Fix, Update On Chocolate, and my last recipe video on the topic, Healthy Chocolate Milkshakes. For why I’m so skeptical of industry-sponsored studies, see Food Industry “Funding Effect” and my other 26 videos on industry influence. And if that’s not enough, there are hundreds of other videos on more than a thousand subjects.

    • http://nutritionfacts.org/members/hemodynamic/ HemoDynamic

      This I think has been well established that epicatechins (flavanoids from cocao) produce mild analgesia. I remember Neal Barnard presenting a study that showed they could stop people craving for chocolate (and cheese) if they used Naltrexone for blocking the opiod receptors. Here is a link for a study showing activation of the delta opiod receptor from epicatechins in chocolate: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993198/?tool=pubmed
      My question is in these people with Fibromyalgia if you keep feeding them chocolate does an adaptation mechanism take place and the patients have to keep increasing their cocao intake to provide the same pain relieving effect? Nestle would sure like that!

  • http://nutritionfacts.org/members/hemodynamic/ HemoDynamic

    Love that Chocolate ice cream!!!

  • http://nutritionfacts.org/members/thea/ Thea

    I have an intense craving for this ice cream right now. Oh boy that looks good.

  • http://nutritionfacts.org/members/vegan2u/ vegan2u

    Great, when you say no added sugar, are dates high in Fructose? Is this why they don’t affect blood sugar levels? I know the Erythritol has no issue but I personally don’t like man made sugars due to the feeling that they may fool my body initially but later I tend to crave the real stuff. Nutritionist Jeff Novick points out that if you look at the ingredients of Date powder, they seemingly don’t give you much nutrition as opposed to when you look at Unsulphered molasses label. I know you cite a study that a group of individuals had little effect on their blood sugar levels but was it because Dates are higher in Fructose?
    Here’s my humble recipe for a cocoa desert.
    2 Tbl’s of Hershey’s dark cocoa baking powder
    3/4 cup of frozen cranberries
    1 whole Indian Gooseberry fruit
    1 cup of soft Sprouted Tofu
    1 teaspoon of a pre-mixed cloves, cinnamon and Acerola powder
    3/4 cup of pre-soaked and dehydrated Pecans and 1/2 cup of raw Cashews for creaminess.
    1 cooked medium size purple sweet potato (Asian Market)
    1 teaspoon of Stevia Leaf
    I find that Stevia leaf has no Licorice aftertaste if you mix it with something that does have glucose like the Purple sweet potato….
    Makes about 4 servings

    • DanielFaster

      To answer your question, dates have more sugar than jelly beans, but a lot of fiber that keeps it from hitting your bloodstream so fast. Your recipe looks very good, kind of like a lot of mine. I have a question about the tofu in yours, however, since Toxins pointed out elsewhere that soy milk may block absorption of the phytonutrients.

  • http://nutritionfacts.org/members/herb-i-vore/ Herb I. Vore

    Dr. Greger, you really need to publish a cookbook of all you excellent concoctions.

    Thank you.

  • http://nutritionfacts.org/members/paul3917/ paul3917

    I tried your “recipe” this morning. Except for the cocoa, I didn’t know how much of the other ingredients to use, so I had to guess. It came out tasting very bitter and was watery. I must have guessed wrong! How much of the other ingredients do you use? Thanks.

    • http://nutritionfacts.org/members/toxins/ Toxins

      Mine turned out amazing, try this.
      5 dates
      3 tbsp. Cacao powder
      ¾ cup mix frozen berries.
      ½ tsp. vanilla extract
      2 tbsp. Unsweetened Almond Milk

      Mix all in blender and put in freezer. Wait an hour or until consistency of ice cream.

      • Sarahjdark

        Your recipe was yummy, thanks

  • http://nutritionfacts.org/members/wickedchicken/ wickedchicken

    I just made the ice cream! Oh my god. I cannot believe how Tasty it is!!! I guesstimated too, used 2 big handfuls of frozen mixed berries, about 80 mls of coconut milk (from a carton, not the tinned kind), 1 tbsp cocoa, cap of vanilla essence and a decent sprinkle of stevia. Yeah i know. Theres no erythritol in Ireland. Anyway the ice cream was such a treat! And….. Super healthy????

    Ben and jerry, it’s over between us. It’s THIS kind if thing that will help me help others too! Keep em coming!

    I have a question. Any idea how much is too much cocoa? In my porridge (with cinnamon), shakes, protein pancakes… Fake Ice cream??? Too much?

    • http://nutritionfacts.org/members/toxins/ Toxins

      Your ice cream sounds very healthy except for the coconut milk. Coconut milk is a very high saturated fat product and should be avoided.
      http://nutritionfacts.org/videos/is-coconut-milk-good-for-you/

    • trskms

      Don’t listen to the coconut nay-sayers. Coconut is wonderful and very healthy.

  • http://nutritionfacts.org/members/vegannutritionist/ VeganNutritionist

    I use frozen bananas as the stock for my ice cream. I add cherries, strawberries, bananas, cocoa powder, vanilla extract, or whatever else I desire. When I was little I said that I was going to eat ice cream everyday. Of course I was obese as an adult and I didn’t eat ice cream everyday, but now on a plant-based diet I do and I am healthier for it!

  • Deb

    Is it possible that the reason it fights chronic fatigue is because cocoa has caffeine?

    • Toxins

       The caffeine is extremely mild and is closely equivalent with decaffeinated coffee which is near negligible.

  • Mark

    I love this ice cream as well.  However, I have a question.  If this is made with soy milk, will it block the antioxidants from the cherries and cocoa?  In one of the videos, soy milk blocked antioxidants from tea.

    • Toxins

      Based on the study, one can safely assume that soy will indeed block the phytonutrients from the cacao and berries. I would suggest using almond milk.

      • DanielFaster

        Hi Toxins, would a silken tofu have the same effect? Lots of chocolate dessert recipes are based on this. Is there an applicable stoichiometry, couldn’t I just use more cacao powder?

        • Toxins

          I wish I had the answer to this question, but I do not. The only study presented was in vitro and I have no way of getting the full access to the article.

          • DanielFaster

            Could be a dairy industry plant to soil soy (again).

  • http://www.facebook.com/profile.php?id=100002415827954 Ian Ridgeway

    Could it be that the caffene assisted the energy levels on the short term. Caffene and theobromines in chocolate are know to be very harmfull in the long term. I tsp of  cocoa powder contains 8 mg of caffeine and 106mg of theobromine.  http://www.hersheys.com/nutrition-professionals/chocolate/composition/caffeine-theobromine.aspx

    Theobromine and caffeine both are known to have problems, even suspected to cause birth defects http://www.ncbi.nlm.nih.gov/pubmed/9629863

    I think the vested interest is showing in the  study. You can still use double blind cross over to show beneficial components and leave out the bad effects.

  • Karen A

    Brilliant! So, 2.5tbsp a day of cocoa powder = how much in other forms? Cacao nibs? Kinds of chocolate bar? I will not rush out and start eating any old chocolate treat – I need to find ways of working out proper portions of the actually healthy stuff, rather than making my poor ME/CFS system crash with fat and sugar. Where can I find out how to convert between forms of chocolate?

    • Toxins

       Typically, the dark chocolate bars you find at stores have most of the phytonutrients processed out. It would be best to consume non dutch processed cacao. Cacao nibs would work out just fine as this is a concentrated source of cacao powder. 2.5 tablespoons of cacao powder = approximately 1/3 of an ounce of cacao nibs.

      • albert

        Thanks for pointing out this important aspect. Do you know if there is any way to tell if it is (non) Dutch cacao by taste or anything like that (even home made chemical reaction) – there are no labels which is which in the place I live. (Cacao powder I buy now is pretty bitter, if that helps. I will try to search, yet still not sure it will be easy). Thanks anyway.

  • http://www.facebook.com/jeffrey.carvish Jeffrey Allen Carvish

    I have Chronic Fatigue Syndrome.  Was diagnosed many years ago after having several major health problems at one time.  However, a year ago I embarked on my journey to be vegan and since then I have had very little issue with it.  I will admit I probably still eat more processed foods than I should and then maybe I would have no CFS at all.  We will definitely try this ice cream though.  Thanks Dr Greger for always posting fun and insightful information.

  • Freepam

    This is good! I was surprised because I’ve tried using raw cacoa powder and stevia for brownies before and they were nasty. I think it’s the strawberries that make the difference. I couldn’t imagine eating that much every day though.

  • ToddGuthrie

    The control in this study had significant amounts of milk/whey, whereas the experimental did not. A confounding variable? Animal protein, immune trigger….

  • ToddGuthrie

    Not to mention more sugar.

  • tree

    have you any research on the link between candida and chronic fatigue syndrome?

  • http://www.facebook.com/krista.kapalko Krista Kapalko

    Coffee can also reduce pain 30-40%

  • Chalk

    I actually discovered this on my own. Have had CFS for 13 years now and I found out that when I ate some chocolate, I had a much better day than if I didn’t. I’ve never been into fruit with chocolate, but I do like the powder in some sweetened almond milk. It’s especially good at hot chocolate in the winter, or with chia seeds for a nice pudding type dessert.

  • Carol

    I use a lactose-free, fat-free milk. Would that work for this ice cream

    • NutrFactsFan

      Fat-free is skim milk, and it has has been discussed on this site as being the form of milk with the highest hormones except for butter milk among skim 2% or full fat milk. This promotes cancer. Every nut, seed, and grain when blended with water will produce a plant based milk. Have you tried some of these? It is much better to avoid ingesting anything that isn’t plant based.

    • Gross Bro

      It would work… but the milk isn’t very good for you.

      Try almond milk. It’s about the same price of milk, but much, much safer.

  • Jakehay

    Aloha Dr. Greger,

    We have been enjoying your recipe for “chronic fatigue syndrom” i.e. blueberries, bananas, and organic raw cacao nibs. We were wondering if the cacao powder would be better than the nibs (lower fat) and that got us to researching cacao with Dr. McDougall’s site and Jeff Novick. Anyway, below is what Jeff Novick had to say about Cacao and we were wondering if you could respond. The link Jeff Novick gives in his response takes you to a longer response he gave about chocolate.

    I found this product at my local health food store. The title on the package is in the subject line of this post. The ingredients on the package says, organic raw cacao beans (nibs).

    A 1 ounce serving contains 13 grams of total fat, 8 grams saturated fat. The 1 ounce serving provides a daily requirement of 314% iron, 21% vitamin C and 24% magnesium. It also contains 20 times more antioxidants than red wine and 30 times more than green tea.

    I’ve also read studies that say chocolate has been shown to significantly reduce blood pressure.

    Does the high fat and saturated fat content negate any of the potential nutritious benefits of this food?

    Yes.

    There is little if any benefit to either of these substance, neither of which I would call a “food” for humans.

    You can read some thorough discussions on chocolate and blood pressure here.

    http://www.drmcdougall.com/forums/viewtopic.php?t=6010

    In Health
    Jeff

  • Rashmi Baya Cabena

    Dear Dr Greger,

    Just Regarding CFS/ME. I have seen the videos on this website but I unfortunately am not getting results despite a raw vegan diet . I was mainly having thoughts on how diets would help the gut dysbiosis, channelopathy, orthostatic intolerance , oxidative stress, immune dysregulation and other neuroendocrionological symptoms of this syndrome.
    This being such a complex subject, most molecular details are unanswered but I’d appreciate whatever information you can provide with a big big bow down Thank you.
    Btw, the kale seeds you sent have come out so very well. Thank you for those.

    Kind regards,

    Rashmi Cabena

    >

    • Holly

      Hey Rashmi,

      I have been dealing with CFS for 22 years now. I have found the most benefit from both a vegan diet and doing a periodic anti candida diet. This involves using no sugars, yeast, mold/fungus, or anything else fermented. There are many online resources about it and books (look for The Yeast Connection). I find if I do that for 3 weeks once or twice a year I feel much better.

      Best of luck,

      Holly

  • traumaland

    But it’s interesting to see if in long term their condition don’t get even worse….

  • Soultox

    What about Theo-Bromine ….. neuro-toxin from the Cocoa?

  • BC

    I can’t consume any caffeine due to having pvcs. So no caffeine , chocolate or alcohol for me. Stops pvcs almost completely. How can I consume chocolate? I have cfs and can’t seem to get better no matter how clean my diet is.

  • rc

    cocoa powder and frozen bananas in blender also results in similar chocolate ice cream…though the berries would be healthier..

    also..2.5
    tbsp of cocoa powder a day is quite a lot! gonna try it for a few days
    and see if it helps chase these winter blues away!

    Thanks Dr. Gregor – love the videos!