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the Midwife: Chocolate and Pregnancy
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Chocolate & Pregnancy
Ingrid Andersson, CNM
Why an “Ask the Midwife” column in the Reader?
Because the food choices we make go right to the source of human
health. Everything women take into their bodies goes into forming the
first ecosystem for human life. As embryologist Sandra Steingraber puts
it, the fetus sits at the top of the food chain. As a midwife, I help
protect the ecology of the first human ecosystem, for the sake of women,
their babies, and our collective quality of life.
Defining True Health
But this column might also be called “The Midwife Asks.” I
am not an expert with answers in nutrition, biochemistry, embryology,
or neonatology. I am a Certified Nurse Midwife with a culturally diverse
private practice and personal background that has taught me to question
health care norms and assumptions. Despite local, state, and national
policies of health care, I believe there is no one true definition of
health. It is neither fair nor effective to leave the responsibility for
our health to experts, be they obstetricians or the FDA. Together we can
ask questions, share research, and tell stories toward defining true health
and well-being for ourselves and our communities.
I recently heard a radio program about the good health effects of chocolate.
What about in pregnancy? If I follow my cravings and keep eating chocolate,
how much is too much?
Answer: I had better admit up front that I am
a chocolate lover, so if you detect a bias in my response, you detected
right. Recent research on chocolate has been kind to us chocolate lovers,
even to pregnant chocolate lovers.
In April of this year, New Scientist published a report from the University
of Helsinki, Finland, showing an association between chocolate-eating
mothers and happier babies. Over 300 pregnant women were asked to rate
their stress levels and chocolate consumption. Six months after birth,
the mothers were asked to rate their infants’ behavior in various
categories, including fear, soothability, smiling, and laughter. The babies
born to women who ate chocolate daily were more “positively reactive,”
a measure that encompassed smiling and laughter. The babies of stressed
women who ate chocolate regularly showed less fear in various situations
than babies of stressed mothers who did not consume chocolate.
Of course, the researchers admit they cannot rule out the possibility
that chocolate consumption and baby behavior may be both linked with some
other factor. However, chocolate contains over 300 known chemicals, several
of which have been shown to promote health and a feeling of well-being.
For some of us, just thinking about chocolate makes us feel good!
Caffeine and Other Stimulants
While caffeine is present in small amounts in chocolate, the weak stimulant
theobromine is present in slightly higher amounts, as well as phenylethylamine,
a stimulant related to amphetamines. All of these chemicals increase the
activity of neurotransmitters in parts of the brain that control our ability
to pay attention and stay alert and may explain the immediate “lift”
that chocolate eaters experience.
Researchers at the Neurosciences Institute in San Diego assert that a
naturally occurring neurotransmitter, anandamide, which promotes relaxation,
is also found in chocolate. Moreover, other chemicals in chocolate may
inhibit the natural breakdown of anandamide, causing the relaxed feeling
to last longer.
Is it True?
So can something bordering on the addictive and tasting so delicious really
be good for pregnant women and babies?
In a study about nutrition and pregnancy, Dr. Michel Odent found that
among 500 pregnant women, chocolate was the most commonly-craved food.
This finding agreed with his anecdotal findings during decades of work
with pregnant women in France and England. Dr. Odent happens to have faith
in a woman’s innate capacity to know what she needs for herself
and her child—he began to look into this highly-valued, complex
plant food. He found it to be uncommonly rich in magnesium, among other
things. Magnesium is an important catalyst for fatty acid metabolism and
is needed in increased amounts in pregnancy for the development of the
fetal brain. Dr. Odent also found chocolate to be uncommonly rich in flavonoids.
Flavonoids are plant compounds with potent antioxidant properties, which
enhance our cardiovascular, immune, and cancer-fighting systems. In terms
of pregnancy in particular, the predominant flavonol found in chocolate
is epitechin. High plasma levels of this flavonol are associated with
increased concentrations of prostacyclin. One of the most serious diseases
of pregnancy, preeclampsia, is associated with low concentrations of prostacyclin.
“In other words pregnant women who eat chocolate [theoretically]
tend to prevent or moderate the shift towards metabolic disturbances associated
with a life-threatening disease.... There are no scientific reasons to
refrain pregnant women from eating chocolate.”
Not All Chocolate is Made the Same
However, chocolate is not chocolate is not chocolate. While European researchers
may be somewhat more justified in their generalizations, even Cadbury
in England and Frazer in Finland are dense with sugar, calories, additives
and fillers. Just as with other foods rich in flavonoids - red wine, tea,
cranberries, peanuts, strawberries, apples and other fruits and vegetables
- how cocoa beans are grown and processed determines how much of the original
flavonoid content is retained in the end product. Dark and bitter chocolate
is twice as high in flavonoids as sweet milk chocolate. Unsweetened cocoa
powder starts out twice as high in flavonoids as dark chocolate, but when
it’s diluted with milk or water and sugar the flavonoid total decreases
to half that in milk chocolate. Studies in Scotland and Italy last year
found that consuming milk at the same time as chocolate cancels out the
health benefits of chocolate. “Dairy products may inhibit the body’s
absorption of flavonoids from other foods as well.”
People who live on an island called Kuna in Panama drink about five cups
of cocoa every day, include cocoa in many recipes, and recommend cocoa
preparations for pregnancy. High blood pressure is so rare on Kuna that
it prompted a Harvard physician to study cocoa and cardiovascular health.
He found a link between high flavonoid consumption and increased nitric
oxide levels, which helps maintain healthy blood pressure. Other studies
show that flavenoid-rich chocolate helps prevent clogging of the arteries,
or atherosclerosis. The major form of fat in chocolate is stearic acid,
which does not increase cholesterol.
Thirty-eight grams or a little over an ounce of dark chocolate produces
an immediate positive effect on cardiovascular health, according to a
2002 study at University of California, Davis. One-hundred-twenty-five
grams or about 4 3/4 ounces of dark chocolate produces a continuing positive
effect. This compares to one cup of tea brewed 2 minutes and 3 1/2 cups
of tea, respectively.
While tea may be a healthier option than chocolate in terms of calories
and sugar, it may not satisfy your craving. In order to avoid “chocoholism”
and the related fat and sugar roller-coaster, try one high quality dark
chocolate after lunch or supper. A little bit of this pure food from the
gods (actually, a local goddess makes my favorite chocolate) goes a long
This column offers an on-going forum for your reproductive and family
health questions. It is intended to promote informed choice, not to give
medical advice. Please email all questions and topic suggestions to ,
the Reader editor.