Are you like me, do you LOVE chocolate? Or maybe coffee is your vice. Do we have to give these up if we have atrial fibrillation? I discuss this topic in this Q&A session!
Transcript of the audio and video and resources mentioned:
Melanie writes, “I found out last week that I have atrial fibrillation. I love chocolate and I enjoy my daily coffee. Can I still eat chocolate and drink coffee with atrial fibrillation, or do I need to give these up?”
Well, Melanie, I can sympathize with you because I am a chocolate fiend and I wish… For those of you listening to the audio version of this, you don’t see these props. They’re actually not props. Sadly, I have here a bag of Lindor’s Milk Chocolate Truffles, my absolute favorite candies in the world. I have bags of these everywhere in my house, ’cause I’m constantly nibbling on these.
I have a bag of Ghirardelli Intense Dark, 72% dark chocolate called the Twilight Delight chocolate, love these.
And I also have Kit Kats. Yes, I have a family size bag of Kit Kats that I nibble on.
And again, I wish I could say these were props for this particular Q&A session, but sadly this is my vice. I love chocolate.
Now, coffee, where’s my cup of coffee? I have a cup of coffee… Hang on for a second. I had my coffee on the wrong desk. I’ve got multiple desks here in my office.
I am actually not a coffee person. I cannot… I don’t think I’ve ever had a cup of coffee. This is a real cup of coffee. My wife drinks coffee, so I used her Keurig machine for the first time, and I have to tell you though, I absolutely love the smell of coffee. I love going to Starbucks or Caribou and just sitting in there and just taking in the smells. I love the smell of coffee. Of course, I love the smell of cigar and I love the smell of gasoline, but that’s another story altogether, but I digress. I have similar vices, chocolate, not so much coffee.
Now, the good news is… The quick answer, Melanie, is you do not have to give them up, unless you are sensitive to chocolate and you are sensitive to caffeine, and some people are, particularly AFibbers, people with AFib. So, unless chocolate and caffeine trigger your episodes, you don’t have to give them up. All right? It’s that simple.
But again, we’re all different, so our sensitivities are different, and if you have atrial fibrillation… There are some people that say, “If I have just a single piece of chocolate,” they go into Afib. Some people, if they drink a little bit of coffee, they go into Afib. Others, I’m a prime example of that, I’ve had atrial fibrillation since 2006. Well, I haven’t had in the last two and a half years ’cause I had a successful ablation in March 2015, but up until that point and since my ablation, I, as you see in the opening of this session, I ate a lot of chocolate. I really do. In fact, I eat a lot more than I should. And I’m not advocating that you do eat chocolate, by the way. I’m just simply saying that, for some people with atrial fibrillation, they can eat all the chocolate they want and nothing’s gonna happen. Same thing with the coffee. If coffee doesn’t give you a direct trigger or direct episode, you can drink coffee.
Now, that is just based on my own anecdotal experience with chocolate and caffeine or coffee, but it’s also based on some studies and things here I’m gonna share with you in a moment, which is the long-winded answer to your question. So for those of you that want the short version, you can end this, go about your day, thanks for listening. For the rest of you though that want a little bit more proof than just me saying, “You’re fine. Look at me.”
Let’s dive into this. Where is this study? There was a study that came out in May 2017, and I’m gonna be quoting a lot from an article that appeared on the British Heart Foundation website. By the way, everything that I reference in these sessions, I will have links to these in my show notes. If you go to my website, livingwithatrialfibrillation.com, and just go to the search box and just search chocolate and coffee, “chocolate and coffee,” that’s the full phrase you should use. This post will come up and you’ll get the… There will be the audio, the video, and the transcript, and links to all these studies I’m gonna reference here.
So this one appeared in the British Heart Foundation and, again, came out in May 2017. It says, “Eating a moderate amount of chocolate has been linked to,” are you ready, “a reduced risk of atrial fibrillation.” Now, the researchers from Harvard University, they looked at 55,502 participants from the Danish Diet, Cancer and Health Study, and then they followed up with them 13 and a half years later, during which time there were 3,346 cases of AFib. People who previously had AFib or cancer, or who hadn’t provided adequate information on their chocolate consumption, were not included in the study. And at the end of the study period, the researchers found that, on average, the people who ate chocolate had a lower risk than people who didn’t eat chocolate. For men, the biggest reduction in risk was seen in people who ate two to six servings of chocolate a week. This was linked to a 23% lower risk of AFib. For women, the biggest reduction in risk was if they ate one serving of chocolate a week, in which case they had a 21% lower risk of AFib.
Now, the definition of a serving in this particular study was “1 ounce of chocolate.” So, to put that in perspective, that is, I have two squares of Ghirardelli chocolate, dark chocolate, in my hand. Two of these is approximately an ounce. Or, if you’re a truffle fan like me, the Lindor chocolate truffles, these little balls here, about two of them is about one serving. Again, let me repeat that. For men, they had a 23% risk of reduction of AFib or 23% lower risk of AFib if they had two to six servings of chocolate. And women had a 21% lower risk of AFib if they had one serving of chocolate a week.
Now, there is one thing to point out about the study. This was not a study of cause and effect. This was association, which simply means they put these people on the study, asked them about their chocolate consumption and if they had AFib. So, it was like an association, like, “Okay, 3,000 people had AFib and those people had X amount of chocolate,” and that’s it. It’s almost like an observational study. They weren’t trying to determine a cause and effect, but that’s very important because it’s important that people don’t listen to this or read this study and say, “Oh, if I just go out and aim to have, if I’m a man, two to six servings of chocolate a week, if I’m a woman, one serving a week, I’m gonna lower my risk of AFib,” ’cause that’s not what the study was showing.
Getting back to the study, it said, “Regardless of their chocolate intake, the rate of AFib was lower among women than men, but both sexes had a lower risk of AFib with higher levels of chocolate intake.” Now, the research also adjusted for weight to make sure that the differences in weight did not affect the findings, but we know that obesity or being overweight is a risk factor for atrial fibrillation. And also, chocolate is a high-calorie food, so if you put on a lot of weight due to eating a lot of chocolate, this isn’t gonna obviously help reduce your risk of AFib.
Now, there were some flaws in this study. They only asked… The researchers only knew participants’ chocolate intake at the start of the study and after five years. Now, remember, they followed them, they observed them though at the end of 13 and a half years. They asked them upfront, “How much chocolate do you consume?” Then they asked them five years later, “How much chocolate are you consuming?” And that was it. So, 13 and half years later, or at the end of the study, 13 and half years, they didn’t ask them, “How much chocolate have you been consuming from year five to your 13 and a half? Have you increased or decreased your chocolate intake?” And so that’s very important, because they might have decreased their chocolate intake, they might have had more, they might have changed their different types of chocolate. That’s the other thing in the study is it was not indicated if they were eating dark chocolate or milk chocolate, so we don’t know what type of chocolate might lower risk.
At the end of the day though, bottom line is, you can eat chocolate as long as it doesn’t trigger AFib episodes. And the study is showing that it’s possible that chocolate might actually help reduce your risk of AFib. But again, people don’t want the doctors… And I’m not certainly suggesting you go out and eat a bunch of chocolate, although I do. But I don’t do it to reduce risk of AFib. I do it just ’cause I love chocolate. Anyway, I guess the point that I’m trying to make is, if anything, it’s possible, we don’t know for sure, but it’s possible that consuming chocolate… And it’s also important to note, in that study, in that article, they do say that dark chocolate probably has more health benefits and the dark chocolate probably is better for you in terms of reducing your risk, between that and milk chocolate. But it’s possible that consuming chocolate might actually reduce your risk of AFib. Anyway, there you have it. So, that’s the skinny on… Well, maybe not so much skinny, but that’s the story on chocolate.
Let’s turn to caffeine and specifically coffee. In the past, doctors have often recommended that… One of the standard procedures or standard instructions that doctors would give you when you were diagnosed with AFib is avoid caffeine, cut your pop consumption, cut your coffee. In a lot of cases, they’ll even tell you… And it’s not even so much in the past. Some doctors, even today, will say, “Just cut the caffeine ’cause it’s a stimulant and it could trigger AFib.” Well, I’ve got some studies here that I’m gonna reference that showed just the opposite, that there’s no linkage between caffeine and atrial fibrillation or even caffeine and arrhythmias, like PVCs and PACs, and things of that nature.
Now, there are some studies here… Again, I’ll reference these in the show notes. I’ll provide a link to this article ’cause this one article has links to several different studies, but I’m not gonna go through all of these here. But here’s one, a meta-analysis, 228,465 participants. Ultimately in that study, the author concluded that, “It is unlikely that caffeine consumption causes or contributes to AFib, and that habitual caffeine consumption might reduce AFib risk.” That’s that study. Here’s another study. The partisan population in this one, 33,638 women from the Women’s Health Study. They followed them up after just about 15 years, and they concluded that, “Caffeine consumption was not associated with an increased risk of instant AFib.” In this population, on average, 81% of the caffeine came from coffee in that particular study. And here’s another study, 47,949 participants. So these are some pretty decent-sized studies, by the way, and that’s why I’m just highlighting the participants. This wasn’t like, “Hey, we followed 50 people over a two-year period.” These are… We’re talking thousands of people and in some of these cases many years, and they’re coming to these conclusions. Anyway, in this particular study, the authors found no association between caffeine consumption and risk of atrial fibrillation. And in their study as well, the main source of caffeine was, in fact, coffee.
So, those are four studies basically saying the same thing, that caffeine not only did not increase or induce AFib in their studies, but, in fact, it might have reduced the risk of AFib.
Now, here’s another one on NBCNews.com. What interests me about this particular one is that they talked about caffeine’s effect on the heart, specifically causing palpitations. Now, for those of you that have been reading my blog and that have been following me, I don’t suffer from AFib anymore, knock on wood, but I do battle, man, almost on a daily basis. In fact, last week, it’s been a rough week for me. My PVCs and PACs have been just going crazy, which then you’re probably saying, “Well, why don’t you cut off… ” Yeah, I know. I know. I’m not perfect, we all have our vices.
But here’s the funny thing, just as a side note, I have tried stopping eating chocolate and it doesn’t seem to make a difference. In fact, I can stop eating chocolate for a week, which I do, it’s not… I’m not addicted to the stuff. But if I give it up for a week or two, my palpitation’s just do what they’re gonna do. Sometimes I have good days, bad days. It seems like no matter what I eat, what I do, nothing has an effect on them. So, that’s why I eat chocolate. I’m like, “Screw it. If I’m gonna have palpitations, I’m gonna enjoy what I’m eating while I have them.”
Anyway, this study, the reason why I’m intrigued by it is because they looked at caffeine and heart palpitations, PVCs and PACs. This was led up by Dr. Gregory Marcus, a cardiologist at the University of California in San Francisco. And they examined 1,388 people, with an average age of 72, taking part in a larger heart study. About 60% said they drink some form of caffeinated product every day. The team looked specifically at coffee, tea and chocolate, and did not ask about super caffeinated energy drinks. They measured instances of PVCs, which are premature ventricular contractions, and premature atrial contractions or PACs, those are the two monsters that haunt me daily, PVCs and PACs. And they could not find any differences and instances of these heart disturbances no matter how much coffee or tea or chocolate the people consumed. “Therefore, we are only able to conclude that, in general, consuming caffeinated products every day is not associated with having increased ectopy or arrhythmia, but cannot specify a particular amount per day,” Marcus and colleagues wrote in the journal of the American Heart Association. But they also did note that it’s yet another finding in favor of moderate coffee drinking.
And there was also another note here, I wanted to… Of course, I can’t find it right now. I got so many show notes here. I gotta get more organized with this stuff. Well, here it is. And by the way, these podcasts… And I’m not even really calling these podcast yet because, to be honest with you, I’m kind of in the learning stages of all this multimedia stuff. So, forgive me for the lack of quality in both the audio and the video, and just my delivery, and the putting these things together. It’s gonna be a work in progress and I promise I’ll get better hopefully, so like in five years, these things should be great. But anyway, let me get back to my point here, on another article that I’m gonna reference in the show notes. There was an article by a Dr. T. Jared Bunch and he just also noted in his article that, “If you develop symptoms,” and he was talking palpitations and AFib, “after years of using similar levels of caffeine, then your heart symptoms are likely caused from other sources.” Let me repeat that. “If you develop these symptoms,” and he was actually talking specifically palpitations, but I’m gonna add AFib, “after years of using similar levels of caffeine, then your heart symptoms are likely caused from other sources.”
In other words, if you’re sitting there and you’ve been drinking, say, consistently two to three cups of coffee a day, or you consistently have a couple of pieces of chocolate every day, or you have a couple of cans of Coke every day, and you’ve been doing this since you were child, and now you’re 40 years old, 45, and all of a sudden, bam, you got PVCs, you got PACs, or you develop atrial fibrillation, based on the research, based on studies, those are probably not the cause or the triggers of your palpitations, or your AFib. It’s probably something else. It’s probably genetic, or something else is going on, but it’s probably not the coffee. It’s probably not the chocolate, or the caffeine, or any of this stuff. But again, having said all this, if you have AFib and you eat chocolate, and you get an episode, or your heart starts racing, same thing, you drink coffee and you get AFib, or your heart starts racing, you have a sensitivity to these things and obviously it makes sense, cut back or just stop altogether.
The other thing, too, though, you can also experiment with how much and what kind of things you’re taking. So, for example, if you’re eating milk chocolate, for example, if you’re chowing on these Lindor truffles, and let’s say you have a couple of these a day, and all of a sudden you notice, “Every time I eat these things, I get palpitations.” Or maybe you go into full-fledged AFib, maybe you can’t have milk chocolate, but maybe you can have dark chocolate. And there’s different kinds of dark chocolate, there’s 70%, or in this case 72%, there’s 80, what is it, 86%, I think, is the next common dark chocolate. You might be able to tolerate a different type of chocolate, or you might tolerate different amounts. Same thing with the coffee, maybe it’s different kinds of coffee, different strengths of coffee. In other words, at the end of the day, it’s all about experimentation, and only you will know what you can and cannot tolerate. But the blanket advice that now that you have AFib, you can’t have chocolate, you can’t have coffee, you can’t have caffeine, it’s not true.
All right. There you have it. Thanks for listening, if you have a question for me, you can contact me and I will be more than happy to get back to you. Again, everybody gets a direct response from me, even if I don’t feature your question during these Q&A sessions. And I would love to hear from you. There you go. Thanks for listening, and have a great day.
Links to articles I referenced and other resources of note:
Will eating chocolate reduce your risk of atrial fibrillation? -British Heart Foundation
Caffeine consumption from coffee and atrial fibrillation – Coffee & Health
Caffeine, Your Heart and Exercise – Everyday Health