Could this popular hot beverage relieve fatigue?

Drinking a cup of hot cocoa every day may help to curb fatigue associated with multiple sclerosis (MS), researchers reported in a new study. If validated, could this finding mean that drinking cocoa could also reduce fatigue in people without MS? Let’s look at what the research says.

Cocoa, like dark chocolate, is a rich source of flavonoids––plant compounds that have anti-inflammatory, antioxidant, and free-radical scavenging properties.

In one study in the UK, people with chronic fatigue syndrome reported subjective improvement of fatigue after eating dark chocolate (containing between 70% and 85% cocoa solids) during a 4-week period.

This finding prompted other researchers in Britain to determine whether a similar dietary intervention could help to reduce the fatigue associated with MS. Fatigue—described as the inability to maintain both physical and cognitive performance—is the most common symptom of MS, affecting 9 in 10 people with the disease.

The causes of mental and physical fatigue experienced by people with MS are complex, and likely to include neural, inflammatory, metabolic, and psychological factors. None of the currently available approaches offers long-term relief, the researchers noted.

Do yourself a flavonoid favor

For this small placebo-controlled feasibility trial, researchers led by Shelly Coe, PhD, senior lecturer and researcher, Centre for Nutrition and Health, Oxford Brookes University, Oxford, UK, included 40 adults who were recently diagnosed with relapsing and remitting MS and fatigue. The researchers directed participants to drink a cup of hot cocoa every day for 6 weeks—half were given a high-flavonoid cocoa and the other half drank a low-flavonoid version.

After 6 weeks, more than half of participants drinking the high-flavonoid cocoa demonstrated a small improvement in fatigue compared with about one-third of those drinking the low-flavonoid version. Some participants also had a moderate improvement in fatigability—the speed with which mental and physical fatigue set in—with those drinking high-flavonoid cocoa able to cover more distance during the 6-minute walk test.

Specifically, those drinking high-flavonoid cocoa showed a 45% improvement in subjectively-assessed fatigue and an 80% increase in walking speed. Pain symptoms, although not measured objectively, also improved more in the group drinking high-flavonoid cocoa.

“The use of dietary approaches to reduce fatigue and associated factors in people with MS may be an easy, safe, and cost-effective way to have an impact on quality of life and independence, allowing people to feel more in control of their condition,” Dr. Coe and coauthors concluded.

They suggested that this intervention could be used alongside other measures—including exercise, drug treatment, and physical therapy—to treat fatigue in people with MS.

Cocoa for ‘mental fatigue’?

OK, a cup of hot cocoa may reduce fatigue in people with MS—but what about other people?

Good news, weary cocoa lovers! It may help you, too.

In a small study by researchers in Australia and the UK, cocoa reduced fatigue in healthy individuals. For this a randomized, double-blind, three-period crossover study, researchers recruited 30 healthy young adults to consume one of three drinks with a 3-day washout period in between drinks: two were high-flavanol (520 mg and 994 mg) cocoa drinks and the other was a matched control drink.

After participants consumed the drinks, the researchers tested them. During a 1-hour period, participants performed repetitive cognitive demand tests, as well as a rapid visual information processing task, and a “mental fatigue” scale.

Both forms of high-flavanol cocoa improved results in one of the cognitive demand tests. While the 994-mg high-flavanol beverage increased visual processing responses, it was also linked to more errors in another cognitive demand test.

Only the 520-mg high-flavanol cocoa reduced participants’ self-reported mental fatigue.

“This is the first report of acute cognitive improvements following cocoa flavanol consumption in healthy adults,” the authors noted. While the mechanisms underlying this effect aren’t known, the researchers speculated that cocoa improved endothelial function and blood flow.

Said Dr. Coe, “Although we performed [our] study in people with MS, there is no reason cocoa shouldn't reduce fatigue in others, too.”

Fatigue is usually due to a specific condition, she added. “But I believe cocoa flavonoids can reduce fatigue in anyone. We currently have a trial looking at cocoa on fatigue in Parkinson’s.”

So, if your brain is feeling sluggish and your feet are dragging, consider ‘self-prescribing’ a cup of hot cocoa to reenergize.

The study conducted by Dr. Coe and colleagues was funded by the Multiple Sclerosis Society.