0 The New Complete Book of Food
density than women who consume chocolate no more than once a week. No explanation for
the reaction was proposed; the finding remains to be confirmed.
Possible increase in the risk of heart disease. Cocoa beans, cocoa powder, and plain dark
chocolate are high in saturated fats. Milk chocolate is high in saturated fats and cholesterol.
Eating foods high in saturated fats and cholesterol increases the amount of cholesterol in
your blood and raises your risk of heart disease.
NOTE: Plain cocoa powder and plain dark chocolate may be exceptions to this rule.
In studies at the USDA Agricultural Research Center in Peoria, Illinois, volunteers who
consumed foods high in stearic acid, the saturated fat in cocoa beans, cocoa powder, and
chocolate, had a lower risk of blood clots. In addition, chocolate is high in flavonoids, the
antioxidant chemicals that give red wine its heart-healthy reputation.
Mild jitters. There is less caffeine in chocolate than in an equal size serving of coffee: A five-
ounce cup of drip-brewed coffee has 110 to 150 mg caffeine; a five-ounce cup of cocoa made
with a tablespoon of plain cocoa powder (^1 / 3 oz.) has about 18 mg caffeine. Nonetheless,
people who are very sensitive to caffeine may find even these small amounts problematic.
Allergic reaction. According to the Merck Manual, chocolate is one of the 12 foods most
likely to trigger the classic food allergy symptoms: hives, swelling of the lips and eyes, and
upset stomach.* The others are berries (blackberries, blueberries, raspberries, strawberries),
corn, eggs, fish, legumes (green peas, lima beans, peanuts, soybeans), milk, nuts, peaches,
pork, shellfish, and wheat (see wheat cereals).Food/Drug Interactions
Monoamine oxidase (MAO) inhibitors. Monoamine oxidase inhibitors are drugs used to treat
depression. They inactivate naturally occurring enzymes in your body that metabolize tyra-
mine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels
and increases blood pressure. Caffeine is a substance similar to tyramine. If you consume
excessive amounts of a caffeinated food, such as cocoa or chocolate, while you are taking an
MAO inhibitor, the result may be a hypertensive crisis.
False-positive test for pheochromocytoma. Pheochromocytoma, a tumor of the adrenal gland,
secretes adrenalin, which the body converts to VMA (vanillylmandelic acid). VMA is excreted
in urine, and, until recently, the test for this tumor measured the level of VMA in the urine.
In the past, chocolate and cocoa, both of which contain VMA, were eliminated from the
patient’s diet prior to the test lest they elevate the level of VMA in the urine and produce a
false-positive result. Today, more finely drawn tests usually make this unnecessary.* The evidence linking chocolate to allergic or migraine headaches is inconsistent. In some people,
phenylethylamine (PEA) seems to cause headaches similar to those induced by tyramine, another
pressor amine. The PEA-induced headache is unusual in that it is a delayed reaction that usually
occurs 12 or more hours after the chocolate is eaten.