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Hot Cocoa May Ease the Fatigue of MS

TUESDAY, March 5, 2019 -- Fatigue can plague many people with multiple sclerosis (MS). But a small new study suggests a soothing cup of hot cocoa may bring some relief.

Like dark chocolate, cocoa is rich in flavonoids, which are abundant in fruit and vegetables and have been linked with anti-inflammatory properties, explained researcher Shelly Coe, of the Center for Nutrition and Health at Oxford Brookes University in the United Kingdom, and her colleagues.

That anti-inflammatory power may help fight MS fatigue, the researchers believe.

"Our study establishes that the use of dietary interventions is feasible and may offer possible long-term benefits to support fatigue management," Coe said in a news release from the Journal of Neurology, Neurosurgery & Psychiatry. Her team published their findings online in the journal March 5.

Prior research has suggested that dark chocolate, which is between 70 percent and 85 percent cocoa solids, appears to lessen fatigue in people with chronic fatigue syndrome, the British researchers noted.

Would cocoa do the same for MS patients? To find out, Coe's group tracked the symptoms of 40 adults recently diagnosed with the common "relapsing remitting" form of MS.

Participants were asked to drink a cup of either high-flavonoid cocoa powder mixed with heated rice milk (19 people) or a low-flavonoid version (21 people), every day for six weeks.

Small improvements in fatigue were seen in 11 of the patients who drank high-flavonoid cocoa and eight of those who drank the low-flavonoid version, the researchers reported. People who drank high-flavonoid cocoa were also able to cover more distance during a six-minute walking test, compared with those who drank the low-flavonoid version.

Overall, people who drank the high-flavonoid cocoa also experienced an average 45 percent lowering of their reported fatigue, and an 80 percent improvement in their walking speed, the findings showed.

Pain symptoms also improved more among patients in the high-flavonoid group, according to the researchers.

Still, the study was small. "A full evaluation, including wider geography, longer follow up and cost-effectiveness is now indicated," the team said.

Experts in neurology agreed the study is promising, but not conclusive.

Psychiatrist Dr. Harshal Kirane believes there's a potential physiological reason behind cocoa's healthy effect.

"Specifically, flavonoids act on nerve cells by blocking action of a brain chemical called adenosine," explained Kirane, who practices at Staten Island University Hospital in New York City. "Chemicals that block adenosine action, such as flavonoids and caffeine, promote wakefulness and counteract fatigue."

Dr. Asaff Harel is a neurologist who works with MS patients at Lenox Hill Hospital, also in New York City. He said that "while the study results are intriguing, and point to a potential benefit, further research is necessary to adequately elucidate any potential effects."

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on multiple sclerosis.

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Posted: March 2019

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