Parallels Between Chocolate’s Place in Humoral Medicine and the Antioxidant Craze

Since being incorporated into the European diet in the 16th century, chocolate’s supposed health benefits have long been scrutinized. When the Spanish first encountered cocoa in Mesoamerica, they immediately sought to incorporate it into the medical theory dominant in Europe at the time, the humoral system associated with Galen and Hippocrates (Coe and Coe 120). Although the 19th century advent of modern medicine separated most daily foods, along with cocoa, from these intense impacts on health, the recent antioxidant craze has made cocoa relevant again (Lippi 1581). Some scientific studies, along with the marketing materials from many chocolate manufacturers, proclaim the medical benefits of cocoa flavanols (“Welcome to CocoaVia.com”). The assertions made by all supporters of antioxidants, however, have also been met with intense criticism from the scientific community (Hall 6). Although the methods for integration are different, the theoretical inconsistencies, reasoning for attempting to substantiate such claims, and resulting controversies in the movement to classify cacao within the humoral system and to market it as an antioxidant-rich health food are similar. In each period, these clumsy attempts to justify chocolate consumption led to contradicting claims that undermined the credibility of such contentions.

When the Spaniards first encountered cocoa, the humoral system dominated their beliefs about health. The system, first proposed by Hippocrates in the 5th century BCE, posited that the “four humors–blood, phlegm, yellow bile, and black bile” made up human bodies (Coe and Coe 121). In the 2nd century CE, Galen built upon Hippocrates’s work and argued that various diseases came from an imbalance of the humors, which could also be classified by their hot or cold and dry or moist aspects. Various foods, which also had these attributes, became medicines used to treat humoral disparities (121-2).

However, the reasoning behind medical treatments prevalent at the time was diverse, and often contradictory. As argued by Coe and Coe, a “destructive constellation of medical theories” comprised Galen’s scheme (120). Some physicians felt that Galen’s theories implied “curing by contraries,” such as using cold items to cure hot illnesses (121). Other practitioners believed in “[o]ther fanciful ideas…such as the Doctrine of Signatures, which held that one must cure like with like,” implying the opposite of “curing by contraries” (121). When classifying the foods of the New World, physicians were also inconsistent. When Spain’s royal physician, Francisco Hernández, went to catalog the plants contained in the Aztec’s medical garden, he generally categorized the organisms with a “strong odor or taste, or with a bitter flavor” as hot, while less pungent foods were cold (122). In other cases, he decided to trust the Aztec definitions of hot and cold plants even though disagreements, like those over cacao and octli wine often arose (122-3).

The science behind the recent antioxidant craze, which cocoa has become a part of, is similarly controversial. In the 1980s and ‘90s, many studies showed that antioxidant consumption could stave off many diseases, particularly those associated with old age, such as heart disease, cancer, and brain dysfunction. In one 1993 review of findings on antioxidants, Ames et al. argued that “antioxidants protect against” these illnesses by decreasing the prevalence of oxidants, or free radicals, in the body (7917). They also encouraged increased consumption, contending that only 9% of Americans ate sufficient fruits and vegetables to reach proper antioxidant levels. Although the scholars also asserted that the research surrounding supplements was “suggestive but inadequate” to recommend these as a substitute, corporations seized on the findings (7919).

As detailed by Marion Nestle in Food Politics, companies subsequently began a long campaign to convince the FDA to allow them to market their foods as “healthy” or “anti-aging” even though such claims were not backed by “substantial scientific agreement” (258-266). More recent research has continued to complicate the already unsteady basis for antioxidant supplement intake. In 2011, Perera and Bardeesy called for a “more nuanced view of the impact” of oxidants on cancerous tumor formation (43). The pair found that some antioxidants actually enhance tumor growth by eliminating certain vital oxidants, but stressed that “[a]dditional studies are required” (44). In a 2015 review and analysis of 78 of the most recent trials on the subject, Bjelakovic et al. conclude that high doses of certain antioxidants actually raised mortality while all others showed no impact (164). These discrepancies in antioxidant supplement research parallel the poorly defined basis for Galenic medicine.

In each period, these foundational contradictions led to competing claims made about cocoa consumption. For the Spaniards, the physicians who went to study New World plants, such as Francisco Hernández and Juan de Cárdenas, came to competing conclusions about cocoa, each of which was confusing on its own. Although Hernández was one of the first to catalog cocoa in the humoral system, even he gave cocoa a mixed designation as generally “cold and humid,” but “hot” when mixed with the spice mecaxochitl (Coe and Coe 122). Two decades later, another researcher, Juan de Cárdenas, accounted for this discrepancy by splitting cocoa into “cold and dry,” “warm and humid,” and “very ‘hot’” parts, further clouding the classification of cocoa and chocolate (123).

Although slightly less contradictory, Mars and Hershey’s research has also led to differing claims over whose products will actually lead to health benefits. David Katz, a Yale University professor working on a Hershey’s-funded study, contended that any dark chocolate could lead to improvements in heart function. Mars’s chief scientist, Harold Schmitz, however, asserted that only flavanol-heavy products, like Mars’s CocoaVia, would lead to better cardiovascular health (Barrionuevo). Many nutritionists, including Lauren Bandy and Alice Lichtenstein, are more critical, arguing that both companies’ claims overlook the sugar and fat contained in chocolates (Gretler and Barrionuevo). The nutrition director at the Center for Science in the Public Interest goes further, arguing that flavanol “marketing is getting ahead of the science” (Barrionuevo). Such disagreements, when combined with the uncertain science behind antioxidants in general, mirrors the contradictory claims from Spanish humoral physicians and undercuts the assertions of each company.

Advocates from both eras sought to incorporate cocoa into the medical practices prevalent at the time to justify increased consumption. Although Europeans’ knowledge of health was largely incorrect when they encountered cacao, Coe and Coe argue that the Spanish “were as obsessed with health and diet” as people in the 21st century (124). Thus, “[f]ull acceptance of the exotic beverage…meant fitting it into” Galen’s theories of wellness (120). Marcy Norton, however, argues that any humoral benefits were actually “medical excuses” designed to “mask…Mesoamerican symbolism” after “Europeans unwittingly developed a taste for Indian chocolate” (660). Regardless of the true reasoning, the Europeans soon used cocoa drinks to remedy fevers, alleviate stomach problems, and make themselves “happy and strong” (Coe and Coe 122-3). These health-related justifications allowed cocoa, and later chocolate, consumption to spread throughout Europe during the Baroque Age (125).

Modern corporations have a similar need to validate higher cocoa consumption. As scientists label normal milk and dark chocolate products unhealthful due to high fat and sugar content, sales growth has slowed. By seizing on antioxidant health claims, corporations have found a new type of cocoa-based product, which has seen sales increases three times higher than those of traditional chocolates over the past five years (Gretler). Although Mars’s marketing head Jim Cass contends that the company’s CocoaVia product “was never about ‘How do we sell more chocolate?,’” his distinction between that and looking “to fulfill the needs of our consumers that expand well beyond chocolate,” which he claims as the company’s true motive, seems like mere semantics (Barrionuevo). Both statements imply the same mission for Mars: finding a way to sell more of their products to consumers. In this case, Mars hopes to do so through supplements. Hershey’s, driven by the above-referenced Yale University study, views dark chocolate as “a major growth category” due to flavanol antioxidants’ supposed health benefits (Barrionuevo).

Barry Callebault, which markets cocoa products directly to chocolate manufacturers, is blunter about the reasoning behind Acticoa, which is its antioxidant-rich cocoa line. The company cites that two-fifths of consumers “actively purchase products with general cardiovascular benefits” and that Acticoa will “enable your brand to meet this prime market with a new, differentiating product” (“Acticoa­­TM – Products”). Much like their Spanish predecessors, the three chocolate manufacturers have employed unsubstantiated medical theories about cocoa to legitimize higher intake in the minds of shoppers.

While 16th century physicians could substantiate their health claims with taste and personal opinion, modern corporations’ need to appeal to savvier consumers have led to more involved methods that link products to medicine. In the 1500s, Europeans sought to integrate the products of the cacao tree into humoral medicine by tasting its various parts. The Spaniards played the largest role, ordering their leading physicians to test the plants found in the Aztec garden and classify them, as aforementioned.

Today, companies have emphasized favorable clinical trials while also using marketing and packaging that resembles that of real medicines to appeal to health-conscious consumers.

scientic
The Image Accompanying CocoaVia’s “Scientific Leadership” Section

The front page of CocoaVia’s website and the bottle for their supplement demonstrate Mars’s desire to link their product to modern medicine. The webpage prominently displays a “Scientific Leadership” section that shows a lab tray holding what is presumably an array of chocolate samples, alluding to the clinical trials they have carried out in an attempt to demonstrate that flavanols benefit health (“Welcome to CocoaVia.com”).

shop-products
“CocoaVia® – 375mg of Cocoa Flavanols”

The “Shop” page for the flavanol “capsules” further emphasizes the supposedly medical nature of the product. The product comes in a small plastic bottle, analogous to that of prescription drugs, while the capsules, which are also shown, are shaped like pills. The bottle itself prominently displays the health claims of the product that allegedly “promotes a healthy heart” (“CocoaVia® – 375mg of Cocoa Flavanols”). These efforts illustrate the extent of Mars’s efforts to convince buyers that this product is a medical supplement, instead of a mere cocoa-based food, to capitalize on the selected scientific research that supports their claims and increase sales overall.

While cocoa advocates in each era used different approaches to legitimize the claimed health benefits of the substance, both movements exploited poorly defined scientific bases to justify greater consumption of cacao. These foundational inconsistencies, however, weakened the authority of each set of findings. While modern chocolate corporations have sought to substantiate claims that cocoa supplements are clinically proven to be healthful, their movement largely parallel’s 16th century Europeans’ efforts to show that cacao was beneficial under the humoral system. These similarities undermine the veracity of their claims along with those of the larger modern supplement industry. In each case, manufacturers exploit a selectively chosen body of scientific literature that supports their claims while ignoring studies that come to differing conclusions. These dishonest practices demonstrate the need for greater government regulation and consumer awareness so that more extensive scientific research can fully evaluate such claims.

Works Cited

  1. “ActicoaTM – Products.” Acticoa. N.p., n.d. Web. 4 May 2016.
  2. Ames, B. N., M. K. Shigenaga, and T. M. Hagen. “Oxidants, Antioxidants, and the Degenerative Diseases of Aging.” Proceedings of the National Academy of Sciences17 (1993): 7915–7922. Print.
  3. Barrionuevo, Alexei. “An Apple a Day for Health? Mars Recommends Two Bars of Chocolate.” The New York Times 31 Oct. 2005. com. Web. 4 May 2016.
  4. Bjelakovic, Goran et al. “Antioxidant Supplements for Prevention of Mortality in Healthy Participants and Patients with Various Diseases.” Sao Paulo Medical Journal2 (2015): 164–165. SciELO. Web.
  5. “CocoaVia® – 375mg of Cocoa Flavanols.” CocoaVia. N.p., 2015. Web. 4 May 2016.
  6. Coe, Sophie D., and Michael D. Coe. The True History of Chocolate. 3 edition. London: Thames & Hudson, 2013. Print.
  7. Gretler, Corinne. “Chocolate in a Pill: All of the Benefits, None of the Fun.” com. N.p., 18 Nov. 2015. Web. 4 May 2016.
  8. Hall, Harriet. “Antioxidants? It’s a Bit More Complicated.” AMAA Journal1 (2012): 5–6. Print.
  9. Lippi, Donatella. “Chocolate in History: Food, Medicine, Medi-Food.” Nutrients5 (2013): 1573–1584. PubMed Central. Web.
  10. Nestle, Marion. Food Politics: How the Food Industry Influences Nutrition, and Health, Revised and Expanded Edition. Revised and Expanded Edition edition. Berkeley: University of California Press, 2007. Print.
  11. Norton, Marcy. “Tasting Empire: Chocolate and the European Internalization of Mesoamerican Aesthetics.” The American Historical Review3 (2006): 660–691. JSTOR. Web.
  12. Perera, Rushika M., and Nabeel Bardeesy. “Cancer: When Antioxidants Are Bad.” Nature7354 (2011): 43–44. http://www.nature.com.ezp-prod1.hul.harvard.edu. Web.
  13. “Welcome to CocoaVia.com.” CocoaVia. N.p., 2015. Web. 4 May 2016.
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