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Chocolate’s acid effect?

As you tuck into your Christmas stocking chocolates, be aware that chocolate is said to be a contributory factor to nasty heartburn. Chemicals in chocolate apparently cause the cells in the intestines to produce large amounts of serotonin – a muscle relaxant which causes the lower oesophageal sphincter to open, permitting acid from the stomach to flow back into the throat.

However, chocolate lovers can take some comfort from research carried out by Lauren Gerson,a practicing gastroenterologist and director of Stanford’s Esophageal and Small Bowel Disorder Center, who doubts the accuracy of the usual medical advice.

Gerson and two other physicians at the School of Medicine—Tonya Kaltenbach and Seth Crockett, published the results of a systematic survey they conducted of more than 2,000 studies published worldwide on heartburn, also known as acid reflux or GERD (gastroesophageal reflux disease), between 1975 and 2004. They found 100 studies looking at lifestyle factors thought to be associated with heartburn. Only 16 of those studies examined how implementing lifestyle changes affect heartburn symptoms, and these studies were the focus of their article.

They concluded that there is no evidence that cutting out chocolate or coffee will reduce acid reflux symptoms. In fact, there are only two lifestyle changes for which there was evidence of a clear benefit from making a change. Losing weight will reduce heartburn symptoms and sleeping on a raised pillow also eases the problem.

Instead of cutting out favourite treats, medications are effective including proton pump inhibitors which reduce the amount of acid secreted in the stomach.

Gerson said: “The main reason they probably have heartburn is that their sphincter muscle is relaxing too much and taking the medicine will decrease the amount of acid that’s going into their oesophagus.”

People with diabetes, when the body cannot regulate sugar levels in the blood, should avoid sugary chocolate bars, however. Dr Thomas Stuttaford, a self-confessed chocolate lover, advises “People with diabetes need to take care with chocolate because of its sugar content”.

Milk chocolate, one of the most popular sweet treats in the world, contains approximately 25 per cent cocoa solids and is chocolate with added whole/and or skim milk powder. Dr Stuttaford warns that moderation is key. “Chocolate fat may increase serum cholesterol which can lead to heart disease. However, as an antidote to this, chocolate is rich in antioxidants, which helps to protect the heart. The secret is not to over indulge.”

Hippocratic Post: The Hippocratic Editorial and VT team. Please send your suggestions to submissions@hippocraticpost.com
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