Nutrition during palliative care focuses on both preventing malnutrition, but also on providing emotion and psychological comfort through eating foods associated with pleasure. Chocolate, with its characteristic flavor, carbohydrate, and fat content, has been associated with pleasure for some individuals. Some chocolate with high cocoa content may also have beneficial effects against oxidative stress and systemic inflammation.
Few research studies have examined the impact of nutrition on quality of life in palliative care, leading Vettori and colleagues (1) to assess the effects of chocolate consumption on the nutritional status of older cancer patients in palliative care.
This randomized clinical trial included 46 patients aged 60 years or older with a cancer diagnosis and who were receiving ambulatory palliative care. Participants in the first intervention group (n=16) were instructed to consume 25 g of chocolate containing 55% cocoa daily, while participants in the second intervention group (n=15) consumed 25 g of white chocolate daily. The control group (n=15) was instructed not to consume chocolate, but they could enjoy other snacks. The chocolate intervention continued for 4 weeks.
Nutritional status, food consumption, anthropometry, body composition, oxidative stress, inflammatory activity, and quality of life were evaluated at the beginning and the end of the 4-week intervention.
The Mini Nutritional Assessment (MNA) was used to evaluate nutritional status. At the start of the study, 43.5% of all patients were either malnourished or at risk of malnourishment. The group randomized to the 55% cocoa intervention had an improvement in their MNA scores by the end of the trial, with no individual classified as malnourished after the 4-week intervention.
At the end of the 4-week study period, the patients randomized to the 55% cocoa intervention showed an increase in proinflammatory cytokine IL-6 levels with a decrease in antioxidant defense compared to the other groups.
Overall, the quality of life (as measured on the European Organization for the Research and Treatment of Cancer (EORTC) – QLQ-C30 Questionnaire) in the 55% cocoa intervention group improved. This group demonstrated a higher score for the functional domain, the role functioning subdomain, and the social subdomain.
While there are some limited to the study, the authors concludes that the consumption of chocolate with 55% cocoa may have positive health benefits for this population.
- Vettori, J. C., da-Silva, L. G., Pfrimer, K., Jordão, A. A., Louzada-Junior, P., Moriguti, J. C., … & Lima, N. K. (2022). Effect of chocolate on older patients with cancer in palliative care: a randomised controlled study. BMC Palliative Care, 21(1), 1-12. Available from: https://link.springer.com/article/10.1186/s12904-021-00893-1
