His find could be a chocolate lover's dream
Remember Woody Allen's character in the 1973 film "Sleeper," who wakes up 200 years in the future to find that steak, cream pies, and hot fudge are considered healthy? Nutritionists are not quite there yet, but Dr. Norman Hollenberg is raising hopes that the secret elixir of life may have less to do with wheat germ and more with cocoa.
Just to be clear, Hollenberg, a Harvard Medical School professor and director of Brigham and Women's Hospital physiologic research division, is not advocating a diet of candy bars and cookies. He instead is exploring preliminary evidence that suggests a key ingredient in natural cocoa beans -- antioxidants called "flavanols" -- eases high blood pressure and improves circulation.
Flavanols, also present in other foods such as onions, tea, and red wine, might protect us from major illnesses, including heart disease, cancer, diabetes, stroke, and neurodegenerative disease, says Hollenberg. Recent studies, for instance, have shown that flavanols enhance brain blood flow and improve insulin sensitivity by boosting the body's nitric oxide levels and relaxing blood vessels.
"If this proves out, then this is the most important [finding] in the history of medicine," he said. And he isn't joking.
Hollenberg, a burly 70-year-old who resembles Walter Cronkite with blue eyes and a shock of white hair, did not set out to prove the upside of a decadent palate. He doesn't even have much of a sweet tooth, preferring fresh fruit and the occasional bite of bittersweet baker's chocolate to cakes and ice cream.
Hollenberg's medical affair with cocoa began nearly two decades ago when he came up with a novel question. Intent on identifying genes related to hypertension, Hollenberg said to himself: "If God invented bad genes on a bad day, maybe God occasionally had a good day and invented protective genes. "
To find out, he knew he had to find a geographically isolated, ethnically homogeneous area where generations of people had low blood pressure even in old age. The most attractive place, particularly for a middle-aged scientist who likes to fish, turned out to be in the Caribbean off the Panamanian coast: the San Blas Islands, home for centuries to the Kuna Indian tribe.
The major hospital on these rocky, dry islands has had an electrocardiogram machine for 15 years that has never diagnosed a heart attack.
He discovered , however, that Kuna who moved to the Panama mainland experience both hypertension and heart disease. That ruled out his theory of a protective gene. Nor did environmental factors, including stress and a diet high in salt, explain why death certificates between 2000 and 2004 show islanders appear to experience significantly lower death rates from heart attacks, stroke, diabetes, and cancer than mainland Kuna.
What intrigued Hollenberg was a simple observation: the Kuna beverage of choice. Islanders drink at least five cups of homegrown cocoa each day, while mainland Kuna drink little or no cocoa. Unlike commercial cocoa, which is stripped of bitter-tasting flavanols, Kuna Indians drink unprocessed cocoa containing a highly concentrated type of flavanol known as "epicatechin" and sweeten it with a bit of sugar.
"The Kuna are exposed to more cocoa than anyone else on earth, and they are living longer," said Hollenberg, who travels to the San Blas every 3 months for about a week at a time. "This could reflect the exposure to flavanoid-rich cocoa, and if it does, then this is the most important observation since anesthesia."
On the other hand, different factors might be at work, and the observation could turn out to be "trivial," he said. A large randomized, controlled clinical trial is needed to determine the potential link between cocoa flavanol consumption and cardiovascular health -- an expensive and involved undertaking Hollenberg is not sure will happen in his lifetime.
For his part, Hollenberg is raising funds for a study to measure incidences among the Kuna of breast cancer, cervical cancer, ischemic heart disease, and diabetes to help confirm the differences indicated by the death certificates.
Such cocoa research may be in its infancy, but consumers will already notice its impact on grocery store shelves. Mars Inc., which has funded Hollenberg's research both here and in the San Blas, produces a line of flavanol-rich products called Cocoapro and CocoaVia chocolates, while Hershey's Co. promotes Extra Dark Chocolate and Antioxidant Milk Chocolate with "good-for-you benefits."
That doesn't mean people should overindulge in the sweet stuff, which remains high in calories and fat, Hollenberg says.
"Chocolate is a delight," he says, "but it will never be a health food."
Hometown: Winnipeg, Canada, now living in Brookline.
Family: His wife Deborah is an artist. His son David teaches Islamic Studies and Arabic language at James Madison University, and daughter Ilana, is a former corporate lawyer.
Education: Finished high school at age 15. Earned a bachelor's degree at 18 and graduated at 22 with M.D. from the University of Manitoba in Canada. Received his Ph.D. in pharmacology from Manitoba and the Karolinska Institutet in Sweden.
What he almost did: "I was a math major in college, and I actually graduated from university when I woke up one morning with the terrifying realization that I wasn't a genius," he says. "I had never had an original mathematical idea in my life."
Hobbies: "I'm such a bore," he says. Likes history books and fiction. Not a good vacationer. 