Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Too Sweet to Be Real?—Reply

Too Sweet to Be Real?—Reply In reply Dr Koegler observes that subjects with a lower body mass index (BMI) may have simply been more honest in reporting their frequency of chocolate consumption, which is indeed important to consider. Space constraints precluded retention of text present in our initial submission stating Reporting bias could be postulated: people with lower BMI may feel more at liberty to acknowledge greater frequency of chocolate consumption; but . . . this is rendered less likely by specificity to chocolate frequency (vs chocolate amount or other calorie consumption). Indeed, an explanation based on differential honesty in relation to adverse behaviors related to BMI would seem similarly germane to other variables, like calories, saturated fat, and exercise engaged in. Yet for these variables, reporting bias did not obviate statistically significant BMI associations in the expected direction—much less produce significant associations in the reverse one. Nor does this explain why chocolate consumption frequency, but not amount, demonstrated the favorable association. This remains a cross-sectional study, and causality cannot be inferred. Bias and confounding remain possible. It is this comparative specificity, together with evidence for a benefit of chocolate consumption for other metabolic factors often tied to BMI1,2 and other triangulating evidence from animal studies,3,4 that provides prospects that observed associations between greater chocolate consumption frequency and lower BMI may have (or have in part) a causal foundation. Back to top Article Information Correspondence: Dr Golomb, Department of Medicine, University of California, San Diego, 9500 Gilman Dr #0995, La Jolla, CA 92093-0995 (bgolomb@ucsd.edu). Financial Disclosure: None reported. References 1. Sudarma V, Sukmaniah S, Siregar P. Effect of dark chocolate on nitric oxide serum levels and blood pressure in prehypertension subjects. Acta Med Indones. 2011;43(4):224-22822156352PubMedGoogle Scholar 2. Grassi D, Lippi C, Necozione S, Desideri G, Ferri C. Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons. Am J Clin Nutr. 2005;81(3):611-61415755830PubMedGoogle Scholar 3. Nogueira L, Ramirez-Sanchez I, Perkins GA, et al. (-)-Epicatechin enhances fatigue resistance and oxidative capacity in mouse muscle. J Physiol. 2011;589(pt 18):4615-463121788351PubMedGoogle Scholar 4. Villarreal F. Chocolate: an exercise mimetic? Paper presented at: Southwest Chapter American College of Sports Medicine 2010 Annual Meeting; October 22, 2010; San Diego, CA http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Too Sweet to Be Real?—Reply

Archives of Internal Medicine , Volume 172 (16) – Sep 10, 2012

Too Sweet to Be Real?—Reply

Abstract

In reply Dr Koegler observes that subjects with a lower body mass index (BMI) may have simply been more honest in reporting their frequency of chocolate consumption, which is indeed important to consider. Space constraints precluded retention of text present in our initial submission stating Reporting bias could be postulated: people with lower BMI may feel more at liberty to acknowledge greater frequency of chocolate consumption; but . . . this is rendered less likely by specificity to...
Loading next page...
 
/lp/american-medical-association/too-sweet-to-be-real-reply-ksnqIPAZN7
Publisher
American Medical Association
Copyright
Copyright © 2012 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinternmed.2012.3388
Publisher site
See Article on Publisher Site

Abstract

In reply Dr Koegler observes that subjects with a lower body mass index (BMI) may have simply been more honest in reporting their frequency of chocolate consumption, which is indeed important to consider. Space constraints precluded retention of text present in our initial submission stating Reporting bias could be postulated: people with lower BMI may feel more at liberty to acknowledge greater frequency of chocolate consumption; but . . . this is rendered less likely by specificity to chocolate frequency (vs chocolate amount or other calorie consumption). Indeed, an explanation based on differential honesty in relation to adverse behaviors related to BMI would seem similarly germane to other variables, like calories, saturated fat, and exercise engaged in. Yet for these variables, reporting bias did not obviate statistically significant BMI associations in the expected direction—much less produce significant associations in the reverse one. Nor does this explain why chocolate consumption frequency, but not amount, demonstrated the favorable association. This remains a cross-sectional study, and causality cannot be inferred. Bias and confounding remain possible. It is this comparative specificity, together with evidence for a benefit of chocolate consumption for other metabolic factors often tied to BMI1,2 and other triangulating evidence from animal studies,3,4 that provides prospects that observed associations between greater chocolate consumption frequency and lower BMI may have (or have in part) a causal foundation. Back to top Article Information Correspondence: Dr Golomb, Department of Medicine, University of California, San Diego, 9500 Gilman Dr #0995, La Jolla, CA 92093-0995 (bgolomb@ucsd.edu). Financial Disclosure: None reported. References 1. Sudarma V, Sukmaniah S, Siregar P. Effect of dark chocolate on nitric oxide serum levels and blood pressure in prehypertension subjects. Acta Med Indones. 2011;43(4):224-22822156352PubMedGoogle Scholar 2. Grassi D, Lippi C, Necozione S, Desideri G, Ferri C. Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons. Am J Clin Nutr. 2005;81(3):611-61415755830PubMedGoogle Scholar 3. Nogueira L, Ramirez-Sanchez I, Perkins GA, et al. (-)-Epicatechin enhances fatigue resistance and oxidative capacity in mouse muscle. J Physiol. 2011;589(pt 18):4615-463121788351PubMedGoogle Scholar 4. Villarreal F. Chocolate: an exercise mimetic? Paper presented at: Southwest Chapter American College of Sports Medicine 2010 Annual Meeting; October 22, 2010; San Diego, CA

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 10, 2012

Keywords: body mass index procedure,calories,chocolate,saturated fatty acids

References