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Placebo

Chocolate With Benefits: Are They Real?

Can a chocolate bar deliver what it promises?

I discovered these products too late for Valentine’s Day, but there is always next year. An item in a supplement industry newsletter described a cluster of chocolate products, chocolate candy bars, which have the power to decrease stress, hot flushes during menopause, and curtail the mood swings of premenstrual women. As enticing as these promises are, the most alluring (pardon the pun) product, the Sexy chocolate bar, is supposed to enhance a woman’s sexual desire. The chocolate bar contains an extract from fenugreek, a plant used as an ingredient in Mediterranean and Indian cuisines. Fenugreek was used by the ancient Egyptians to treat burns and induce childbirth, and by the Greeks to heal infection. Archeological excavations in Tell Halal, Iraq, found evidence suggesting that this herb was used as long ago as 4000 BC.

What is intriguing is the discovery after that, after 6000 years, fenugreek has been discovered to have an effect on libido. The company’s website claims that the active ingredient in their Sexy chocolate bar, libifem, restores ”a woman’s normal sexual desire and function.” This extract from fenugreek has been, “clinically proven to promote healthy libido, sexual vitality, and desire.”

Sexy chocolate bar also contains other ingredients claimed by the company to enhance libido. Damiana Extract, Tribulus Terrestris, Maca Root Extra, Palmol B complex R, L-Arginine, Zinc Gluconate, and iron are also in the chocolate bar, each conferring a specific benefit.

Like many products promising a variety of mental and physical benefits from their plant derivative supplements, the information about these chocolate bars lacks specific instructions as to their use. No “dose” is recommended, except that one should eat the chocolate and enjoy it. However, how much of the bar should be eaten? The food label says that each bar contains three servings. One serving is two squares. Does this mean that if the entire bar is consumed, the eater is overdosing on the contents? The bar contains about 250 calories if you eat the entire thing, so it is clearly not for dieters. But presumably you will be feeling so wonderful after eating two squares you won’t need to eat anymore. But what happens if you go on a chocolate binge and eat two bars or three? Or if your child finds the chocolate?

The National Center for Complementary and Integrative Health, a source of information about the benefits and risks of many plant-based supplements, states that fenugreek is safe when used in small amounts as flavoring ingredients. But the report adds that it should not be given to children as a supplement (keep that chocolate out of sight), and potential side effects include diarrhea, dizziness and headaches. It can cause allergic reactions in some people, a drop in blood sugar may follow large doses, and some cases of liver toxicity have been reported.

Assuming the amount of supplements in the chocolate bar is small, especially in just two squares, they may be harmless. But will they be effective? As someone who spent about three years involved in various aspects of studies on the role of carbohydrates on the mood, appetite, and cognitive symptoms of PMS, I am aware of how difficult it is to obtain reliable data that doesn’t reflect the effect of a placebo.

When we first started our clinical trials, we discovered that women suffering from severe PMS mood and appetite symptoms suddenly felt better after arriving at our clinical facility. The improvement in mood had nothing to do with the intervention we were testing. They told us that just getting away from work or the house relaxed them enough they could deal with their symptoms. It was the placebo effect of being in a quiet, relaxing, non-demanding environment that brought about the relief.

Placebo can bring about improvements in a variety of disorders and, as it is usually without side effects, should not be discounted. We often think that placebo treatments work because people believe they are getting the actual treatment. But apparently even when people know they are getting a placebo, there is an improvement in their well-being.

Because placebos do work, how they do so has been the focus of much current research. Indeed, according to the article by Benedetti et al., scientists are beginning to believe that placebos may activate the same biochemical pathways as drugs. But the problem with the occasional efficacy of placebos is that they complicate assessing whether untried treatments might be effective.

The herbal mixtures in functional chocolate bars may do what is claimed: improve symptoms of PMS, decrease stress, and increase libido. But how would one know? Eating a chocolate bar without the herbs may be sufficient to relieve stress or the mood changes of PMS or even activate a sluggish libido. If women have had positive associations with eating traditional chocolate candy, then might they not continue to feel better regardless of whether or not there are herbs in the bar? Or does the mixture of herbal supplements bring about the anticipated change in mood or libido and the chocolate is there to make the concoction taste better than a pill?

There is a relatively simple way to find out. Women would consume in a random order: chocolate without herbs, chocolate with herbs, herbs in a pill form, and a placebo pill that doesn’t contain anything but filler for the pill. Prior to eating, and an hour or so following consumption of these various foods and pills, the women would report how they feel using standardized tests. If the herbal mixture fulfills the claims made for them, they should work both when consumed in the chocolate bar and also in pill form.

But if no positive changes do occur, happily there are many yummy creamy chocolate bars available that will, for many, bring about a good feeling even after eating just two squares. But don’t eat the entire bar, unless you want to stress about gaining weight.

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More from Judith J. Wurtman Ph.D.
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