Chocolate curbs fatigue in MS sufferers

Most people would agree that any excuse to eat chocolate is a good one, but in the case of people suffering from multiple sclerosis (MS), it appears that chocolate may have added health benefits.

A new study has found that cocoa may help curb the fatigue that is typically associated with MS. With nine out of 10 MS sufferers experiencing persistent and hard-to-treat fatigue, a simple dietary solution would be welcomed.

The findings are from a small feasibility trial, published online in the Journal of Neurology Neurosurgery & Psychiatry.

Cocoa health benefits

Cocoa, like dark chocolate, is rich in flavonoids — substances found abundantly in fruit and vegetables and associated with anti-inflammatory properties.

The causes of mental and physical fatigue experienced by people with MS are complex, and likely to include neural, inflammatory, metabolic and psychological factors. None of the currently available approaches offer long-term relief, said the researchers.

Previous research suggests that dark chocolate, containing between 70 and 85% cocoa solids, is associated with an improvement in subjectively assessed fatigue in people with chronic fatigue syndrome. This prompted the researchers to see if it might also be worth exploring its potential in helping to tackle the fatigue associated with MS.

Study procedure

The researchers randomly assigned 40 adults recently diagnosed with the relapsing-remitting form of MS and fatigue to drink a cup of either high-flavonoid cocoa powder mixed with heated rice milk (19 participants) or a low-flavonoid version (21 participants) every day for six weeks.

Participants were instructed to wait 30 minutes before taking any prescribed medication or eating or drinking anything else, but otherwise to stick to their usual diet.

Fatigue and fatigability — the speed at which mental and physical fatigue set in — were formally assessed before the start, at the midpoint and at the end of the trial. Participants subjectively rated their fatigue on a scale of one to 10, at 10:00, 15:00 and 20:00 hours each day, and monitored their activity with a pedometer.

After six weeks there was a small improvement in fatigue in 11 of those drinking high-flavonoid cocoa compared with eight drinking the low-flavonoid version. There was a moderate effect on fatigability, with those drinking high-flavonoid cocoa able to cover more distance during the six-minute walk test. Those drinking the high-flavonoid version showed a 45% improvement in subjectively assessed fatigue and an 80% improvement in walking speed. Although not objectively measured, pain symptoms improved more in the high-flavonoid group.

“Our study establishes that the use of dietary interventions is feasible and may offer possible long-term benefits to support fatigue management by improving fatigue and walking endurance,” the researchers noted.

The researchers suggested that, given their anti-inflammatory properties, flavonoids could be used alongside other approaches such as exercise, drug treatment and physiotherapy to treat fatigue.

“The use of dietary approaches to reduce fatigue and associated factors in people with MS may be an easy, safe and cost-effective way to have an impact on quality of life and independence, allowing people to feel more in control of their condition. A full evaluation including wider geography, longer follow-up and cost-effectiveness is now indicated,” they concluded.

Image credit: ©stock.adobe.com/au/Igor Normann