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Cocoa May Help Reduce Chronic Fatigue in Multiple Sclerosis

Cocoa May Help Reduce Chronic Fatigue in Multiple Sclerosis

Written by Dr. Lakshmi Venkataraman, MD
Article Reviewed by 
The Medindia Medical Review Team on March 5, 2019 at 2:38 PM
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  • Cocoa-rich in flavonoids may help reduce chronic physical and mental fatigue experienced by patients with multiple sclerosis (MS)
  • Multiple sclerosis is a chronic and disabling inflammatory neurological condition. None of the current measures used to treat associated fatigue provide long-lasting relief
  • If the findings are validated in further larger studies, dietary cocoa may become a simple measure to treat chronic and persistent fatigue in nearly 90 percent of MS patients

Cocoa may be helpful in treating chronic mental and physical fatigue in patients with multiple sclerosis (MS), according to a recent feasibility study which appears in the Journal of Neurology Neurosurgery & Psychiatry.

Cocoa and Relief of Chronic Fatigue in General

Interestingly, earlier research suggests that dark chocolate, containing between 70 and 85 percent cocoa solids was associated with subjective improvement of symptoms in persons suffering from chronic fatigue syndrome (CFS or myalgic encephalomyelitis).

The causes of chronic physical and mental fatigue in patients with MS are complex and may comprise neural, metabolic, inflammatory, and psychological factors. Unfortunately, currently used standard treatment approaches do not offer lasting relief.

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Cocoa May Help Reduce Chronic Fatigue in Multiple Sclerosis

The study team hoped to determine if cocoa, like dark chocolate which is rich in flavonoids with anti-inflammatory properties can help with the symptoms of chronic fatigue in multiple sclerosis.

Other health benefits of flavonoid-rich diet include longer life, reduced heart disease risk as well as qualitative and quantitative improvement in gut bacteria (the gut microbiome).

Effect of Cocoa in Relief of Chronic Fatigue in MS

  • The small feasibility study enlisted 40 adults who were recently diagnosed with a relapsing and remitting form of multiple sclerosis
  • The participants were randomly assigned to drink a cup of either high flavonoid cocoa powder mixed with warm rice milk (19 patients) or a low flavonoid content (21 persons) every day for six weeks
  • Participants were advised to wait for at least 30 minutes before taking any other medication or eating or drinking other foods, and to otherwise adhere to their routine diet
  • Fatigue and fatigability, i.e., the rate at which mental and physical fatigue set in-were both formally evaluated at the start, middle and the end of the study
  • Volunteers subjectively rated their fatigue on a scale of 1 to 10 every day at 10.00, 15.00, and 20.00 hours and measured their activity using a pedometer
  • After six weeks 11 patients drinking high flavonoid cocoa reported a slight improvement in fatigue symptoms compared with eight of the patients consuming the low flavonoid version
  • Additionally, there was a moderate improvement in fatigability with participants drinking high flavonoid cocoa being able to cover a larger distance during the 6-minute walk test
  • Overall, patients drinking high flavonoid cocoa reported a 45 percent improvement in subjectively assessed symptoms of fatigue and an 80 percent improved walking speed
Although subjectively assessed, the findings of the study suggest improvement in symptoms of fatigue and fatigability in patients consuming high flavonoid cocoa drink.

According to the study team, "Our study establishes that the use of dietary interventions is feasible and may offer possible long-term benefits to support fatigue management, by improving fatigue and walking endurance."

Scope of the Study

Cocoa rich in flavonoids can be used along with other measures such as exercise, medications, and physiotherapy, to combat symptoms of fatigue in multiple sclerosis.

"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," according to the scientists.

They feel that larger studies with more participants, wider geographical range, longer follow up period and estimation of cost-effectiveness will be necessary to validate these initial findings.


Cocoa beverages rich in flavonoids could be potentially a simple dietary measure to treat chronic physical and mental fatigue in multiple sclerosis along with other treatment approaches.

Reference :
  1. A randomised double-blind placebo-controlled feasibility trial of flavonoid-rich cocoa for fatigue in people with relapsing and remitting multiple sclerosis - (http://dx.doi.org/10.1136/jnnp-2018-419496)

Source: Medindia

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