Inhibit myostatin with chocolate, increase muscle mass?

Mice that don’t have myostatin have dramatically increased muscle mass:

MyostatinMs

Myostatin levels increase during aging, a finding that may (at least partially) explain age-related decreases in muscle mass (Basaria and Bhasin 2012). Is there anything that we can do besides strength-training (Snijders et. al 2014) to decrease myostatin levels?

To address this question, Gutierrez-Salmean and colleagues (2014) supplemented young and old mice and humans (29 vs. 62y) with epicatechin, which is found in may foods (see the Table below). They found that in both mice and humans, myostatin increased during aging. However, epicatechin supplementation decreased muscle myostatin levels in both young and old mice and humans! Although they did not report how muscle mass changed as a result of epicatechin supplementation, grip strength significantly improved after only 7 days of supplementation in the older adults. Although this study had a relatively small sample size (20 total subjects), that a food component can reduce myostatin levels is an interesting finding.

So, which foods are rich in epicatechin?

Atop the list are cocoa containing products. It is important to note that 50mg/day of epicatechin were provided to the human volunteers of the Gutierrez-Salmean study. Obtaining 50mg of epicatechin may be relatively easy, if one chooses wisely from the foods listed in the Table. For example, drinking 20 ounces of white, black or green tea would yield 10-46mg of epicatechin. Homemade chocolate (https://michaellustgarten.wordpress.com/2014/09/21/homemade-chocolate-in-2-minutes/) containing 1 ounce of cacao beans yields ~27 mg of epicatechin.

epicatechin foods table

If you’re interested, please have a look at my book!

References:

Epicatechin data: http://www.ars.usda.gov/SP2UserFiles/Place/80400525/Data/Flav/Flav_R03.pdf

Basaria S, Bhasin S. Targeting the skeletal muscle-metabolism axis in prostate-cancer therapy. N Engl J Med. 2012; 367:965–967.

Gutierrez-Salmean G, Ciaraldi TP, Nogueira L, Barboza J, Taub PR, Hogan MC, Henry RR, Meaney E, Villarreal F, Ceballos G, Ramirez-Sanchez I. Effects of (-)-epicatechin on molecular modulators of skeletal muscle growth and differentiation. J Nutr Biochem. 2014 Jan;25(1):91-4.

Snijders T, Verdijk LB, Smeets JS, McKay BR, Senden JM, Hartgens F, Parise G, Greenhaff P, van Loon LJ. The skeletal muscle satellite cell response to a single bout of resistance-type exercise is delayed with aging in men. Age (Dordr). 2014;36(4):9699.

Homemade chocolate in 2 minutes!

Homemade chocolate recipe:

1 oz raw, organic cacao beans

1-3 oz. Medjool dates, depending on your desired level of sweetness

Put both into the food processor until smooth (~2 min).

Take out from the food processor and eat…Enjoy!

20140921_121127

Alternatively, without the dates, lately (7/2017), I’ve been grinding the cacao beans, then adding some Yacon powder for sweetness (it’s also a prebiotic for gut bacteria). Still yum!

If you’re interested, please have a look at my book!

Acrylamide is in Chocolate!

The media often tells us that dark chocolate is “healthier” than milk chocolate because of its high antioxidant content. Yes, this is true: dark chocolate contains more than four times the amount of antioxidants than milk chocolate (~200 Units/gram vs. ~45 Units/gram; Miller et al. 2006).

However, as shown below, what they neglect to tell us is that cocoa powder beats both dark and milk chocolate, with ~800 antioxidant Units/gram! That translates into 4-fold more antioxidants than dark chocolate, and approximately 18-fold more antioxidants than milk chocolate! So, make your own chocolate at home, with cocoa powder, right?

choco aos

Maybe not. To make cocoa powder, cacao beans are first roasted at a high temperature. Roasted cocoa beans are processed to remove its cocoa butter, leaving behind the cocoa solids which are then ground, forming cocoa powder. One could argue that the remaining cocoa powder, when used in chocolate is better for health than using raw (non-roasted), ground cacao beans because cocoa powder has less saturated and total fat. Although this is true, roasting the cocoa bean (or any grain, nut, or seed) produces acrylamide, a compound that has been shown to be both neurotoxic and carcinogenic (Burek et al. 1980; Johnson et al. 1986; Friedman et al. 1995). Raw cacao beans, because they have not been roasted, do not contain acrylamide.

How much acrylamide is in a Hershey’s dark chocolate bar? One 43 gram bar contains approximately 30 grams of cocoa powder (70% cocoa solids). Hershey’s cocoa powder contains 909 µg/kg of acrylamide, and when multiplied by 0.03 kg (30 grams), this yields 27.3 µg total acrylamide. The lowest risk for dietary acrylamide-induced toxicity has been recommended to be less than 1.5µg/kg body weight/day (Shipp et al. 2006). This value translates into 75 µg/day for a 50 kg woman, or 112.5 µg/day for a 75 kg man. So, if you eat one Hershey’s dark chocolate bar, you will have ingested a significant amount towards the 75 or 112.5 µg/day upper limit. It’s important to note that there is indeed difference in acrylamide content when comparing Hershey’s and Ghiradelli cocoa powder: Hershey’s contains 3-fold more acrylamide than Ghiradelli (909 µg/kg vs. 316 µg/kg). Therefore, to minimize acrylamide-related risk, if you’re making your own chocolate at home the best thing to do would be to grind your own raw cacao beans, as I do (https://michaellustgarten.wordpress.com/2014/09/21/homemade-chocolate-in-2-minutes/).

Another food that is thought of as “healthy” are baked potato chips, but they’re not healthy in terms of acrylamide content! Baked! Lay’s Original Naturally Baked Potato Crisps have 31 µg of acrylamide per 1 ounce bag. Listed below are other notable sources of dietary acrylamide, including one unhealthy (Pringles), and others commonly thought to be “healthy”.

1 oz. (16 crisps), Pringles Sweet Mesquite BBQ Flavored Potato Crisps: 70 µg of acrylamide

1 oz. (6 crackers), Health Valley Original Oat Bran Graham Crackers: 43 µg of acrylamide

1 serving (2 oz.), Nature’s Path Organic Optimum Power Breakfast, Flax, Soy, Blueberry: 22 µg of acrylamide

1 oz., Blue Diamond Roasted Salted Almonds: 6.7 µg of acrylamide

2 slices, Arnold Bakery Light 100% Whole Wheat Bread: 5.7 µg of acrylamide

If you’re interested, please have a look at my book!

References:

Acrylamide list: http://www.fda.gov/food/foodborneillnesscontaminants/chemicalcontaminants/ucm053549.htm

Burek JD, Albee RR, Beyer JE, Bell TJ, Carreon RM, Morden DC, Wade CE, Hermann EA, Gorzinski SJ, 1980. Subchronic toxicity of acrylamide administered to rats in the drinking water followed by up to 144 days of recovery. J. Environ. Pathol. Toxicol. 4,157-182.

Friedman MA, Dulak LH, Stedham MA, 1995. A lifetime oncogenicity study in rats with acrylamide. Fundam. Appl. Toxicol. 27, 95-105.

Johnson KA, Gorzinski SJ, Bodner KM, Campbell RA, Wolf CH, Friedman MA, Mast RW, 1986. Chronic toxicity and oncogenicity study on acrylamide incorporated in the drinking water of Fischer 344 rats. Toxicol. Appl. Pharmacol. 85, 154-168.

Miller KB, Stuart DA, Smith NL, Lee CY, McHale NL, Flanagan JA, Ou B, Hurst WJ, 2006. Antioxidant activity and polyphenol and procyanidin contents of selected commercially available cocoa-containing and chocolate products in the United States. J Agric Food Chem. 31;54(11), 4062-8.

Shipp A, Lawrence G, Gentry R, McDonald T, Bartow H, Bounds J, Macdonald N, Clewell H, Allen B, Van Landingham C, 2006. Acrylamide: review of toxicity data and dose-response analyses for cancer and noncancer effects. Crit. Rev. Toxicol. 36, 481-608.

Dietary Acrylamide and Cancer Risk in Human Studies: What’s the data?

In an earlier article I wrote about how cooking foods at a high temperature (greater than 250ºF, including frying, baking, roasting and grilling) produces the neurotoxic and carcinogenic compound, acrylamide (http://voices.yahoo.com/acrylamide-chocolate-another-10217911.html?cat=5). However, the adverse effects acrylamide that I discussed were solely based on rodent studies. In this follow-up article, I’ll comprehensively discuss the evidence relating dietary acrylamide with human cancer.

Before introducing the data, it’s important to note that dietary acrylamide intake in all of the studies discussed below were calculated based on food frequency questionnaires. The highest acrylamide consuming group was approximately 40 µg/day, in comparison with low consumers of dietary acrylamide, ~10 µg /day. Without a doubt these values for dietary acrylamide intake are underestimated-for example, 1 ounce of Pringles potato chips contains 70 µg of acrylamide, and the commonly thought of as “healthier chips”, Baked Lays has 31µg/ounce (1 bag of chips).

Breast Cancer

Six large epidemiological studies (ranging from 33,000-120,000 subjects) and 1 smaller study (1500-6000 subjects) investigated the association between dietary acrylamide and breast cancer risk. Of these, 1 study, the UK Women’s Cohort Study identified a 20% significantly increased risk between acrylamide intake and premenopausal breast cancer (Burley et al. 2011). The other six studies did not show an association between acrylamide intake and breast cancer risk (Pellucchi et al. 2006, Hogervorst et al. 2007, Pedersen et al. 2009, Larsson et al. 2009, Wilson et al. 2009, Wilson et al. 2010).

Endometrial Cancer

Three large epidemiological studies have investigated the association between dietary acrylamide and endometrial cancer. In two of these studies, risk of cancer was increased by 41% and 99%, respectively (Wilson et al. 2010, Hogervorst et al. 2007). No association between dietary acrylamide intake and risk of endometrial cancer was found in the Swedish Mammography Study (Larsson et al. 2009).

Ovarian Cancer

No association between dietary acrylamide and risk of ovarian cancer was found in the small- scale Italian Cohort study, or, in 2 large-scale epidemiological studies (Pellucchi et al. 2006, Larsson et al. 2009, Wilson et al. 2010). However, a 122% increased risk for ovarian cancer in non-smokers was found in the Netherlands Cohort Study on Diet and Cancer (Hogervorst et al. 2007).

Prostate, Pancreatic, Brain Cancer

Five separate studies found no association between dietary acrylamide and risk of prostate cancer (Pellucchi et al. 2006, Hogervorst et al. 2008, Wilson et al. 2009, Larsson et al. 2009, Wilson et al. 2012). Similarly, pancreatic cancer risk is not increased (Pelucchi et al. 2011, Hogervorst et al. 2008), nor is brain cancer (Hogervorst et al. 2009), or, thyroid cancer (Schouten et al. 2009).

Esophageal cancer

One small study (987 subjects) found a 23% increased risk for esophageal cancer, and an 88% increased risk in those with a BMI greater than 25. In two other studies (Pellucchi et al. 2006, Hogervorst et al. 2008), no association between dietary acrylamide and esophageal cancer was found.

Head-neck cancer

Increased risk for oral-cavity cancer in female non-smokers in a large study (121,000 subjects; Schouten et al. 2009) was found. No association for oral cavity, pharynx or larynx cancer in a smaller study (1500-6000 subjects; Pellucchi et al. 2006)

Kidney Cancer

Although risk of kidney cancer was significantly increased by 59%, it appears as if this data was skewed by smokers. In non-smokers, risk of kidney cancer was not significant (Pellucchi et al. 2006). No association between dietary acrylamide and risk of kidney cancer was also identified in three additional studies (Mucci et al. 2003, Mucci  et al. 2004, Pellucchi et al. 2007).

Gastric, Colon, Rectal cancer

A small study with 1129 subjects found a 40% decreased risk of large bowel cancer (Mucci  et al. 2003). Four studies have not found a similar association (Pellucchi et al. 2006, Mucci et al. 2006, Hogervorst et al. 2008, Larsson et al. 2009).

Lung Cancer

A 55% decreased risk of lung cancer, in women was identified by Hogervorst et al. (2009).

Bladder cancer

Significant only in smokers, as 15+ cigarettes/day significantly increased risk of bladder cancer in those with the highest dietary acrylamide intake, relative to the lowest intake (Hogervorst et al. 2008).

Blood cancer

Multiple myeloma and follicular myeloma were found to be significantly increased by 14% and 28% for every 10 µg increment in dietary acrylamide (Bongers et al. 2012).

Conclusions

The easy interpretation of scientific studies is that if six studies show no effect and one study shows a positive effect, that the no effect-data is the real answer. For example, in the case of breast cancer, six studies showed no effect, whereas one study showed a significant association between acrylamide and premenopausal breast cancer. Should we conclude that there is no risk for breast cancer? As I mentioned earlier, it is likely that total dietary acrylamide intake was underestimated, and therefore, it is my opinion that none of the 25 studies should have shown an association between acrylamide and cancer. Therefore, that there was indeed a significant association for breast cancer with potentially underestimated acrylamide values is significant. Also, dietary acrylamide was shown to be significantly associated with myeloma, head-neck cancer, esophageal cancer, endometrial cancer and ovarian cancer. Paradoxically, dietary acrylamide reduced risk of lung and large bowel cancer.

What should someone who is interested in optimal health do with this information? Knowing that dietary acrylamide is indeed significantly associated with increased risk of human cancers, I would reduce or eliminate cooking food at a high temperature. I have!

If you’re interested, please have a look at my book!

References:

Bongers ML, Hogervorst JG, Schouten LJ, Goldbohm RA, Schouten HC, van den Brandt PA. Dietary acrylamide intake and the risk of lymphatic malignancies: the Netherlands Cohort Study on diet and cancer. PLoS One. 2012;7(6):e38016.

Burley VJ, Greenwood DC, Hepworth SJ, Fraser LK, de Kok TM, van Breda SG, Kyrtopoulos SA, Botsivali M, Kleinjans J, McKinney PA, Cade JE. Dietary acrylamide intake and risk of breast cancer in the UK women’s cohort. Br J Cancer. 2010 Nov 23;103(11):1749-54.

Hogervorst JG, Schouten LJ, Konings EJ, Goldbohm RA, van den Brandt PA. A prospective study of dietary acrylamide intake and the risk of endometrial, ovarian, and breast cancer. Cancer Epidemiol Biomarkers Prev. 2007 Nov;16(11):2304-13.

Hogervorst JG, Schouten LJ, Konings EJ, Goldbohm RA, van den Brandt PA. Dietary acrylamide intake and the risk of renal cell, bladder, and prostate cancer. Am J Clin Nutr. 2008 May;87(5):1428-38

Hogervorst JG, Schouten LJ, Konings EJ, Goldbohm RA, van den Brandt PA. Dietary acrylamide intake is not associated with gastrointestinal cancer risk. J Nutr. 2008 Nov;138(11):2229-36.

Hogervorst JG, Schouten LJ, Konings EJ, Goldbohm RA, van den Brandt PA. Lung cancer risk in relation to dietary acrylamide intake. J Natl Cancer Inst. 2009 May 6;101(9):651-62.

Hogervorst JG, Schouten LJ, Konings EJ, Goldbohm RA, van den Brandt PA. Dietary acrylamide intake and brain cancer risk. Cancer Epidemiol Biomarkers Prev. 2009 May;18(5):1663-6.

Larsson SC, Akesson A, Wolk A. Long-term dietary acrylamide intake and breast cancer risk in a prospective cohort of Swedish women. Am J Epidemiol. 2009 Feb 1;169(3):376-81.

Larsson SC, Håkansson N, Akesson A, Wolk A. Long-term dietary acrylamide intake and risk of endometrial cancer in a prospective cohort of Swedish women. Int J Cancer. 2009 Mar 1;124(5):1196-9.

Larsson SC, Akesson A, Bergkvist L, Wolk A. Dietary acrylamide intake and risk of colorectal cancer in a prospective cohort of men. Eur J Cancer. 2009 Mar;45(4):513-6.

Larsson SC, Akesson A, Wolk A. Long-term dietary acrylamide intake and risk of epithelial ovarian cancer in a prospective cohort of Swedish women. Cancer Epidemiol Biomarkers Prev. 2009 Mar;18(3):994-7.

Larsson SC, Akesson A, Wolk A. Dietary acrylamide intake and prostate cancer risk in a prospective cohort of Swedish men. Cancer Epidemiol Biomarkers Prev. 2009 Jun;18(6):1939-41.

Lin Y, Lagergren J, Lu Y. Dietary acrylamide intake and risk of esophageal cancer in a population-based case-control study in Sweden. Int J Cancer. 2011 Feb 1;128(3):676-81.

Mucci LA, Dickman PW, Steineck G, Adami HO, Augustsson K. Dietary acrylamide and cancer of the large bowel, kidney, and bladder: absence of an association in a population-based study in Sweden. Br J Cancer. 2003 Jan 13;88(1):84-9.

Mucci LA, Lindblad P, Steineck G, Adami HO. Dietary acrylamide and risk of renal cell cancer. Int J Cancer. 2004 May 1;109(5):774-6.

Mucci LA, Adami HO, Wolk A. Prospective study of dietary acrylamide and risk of colorectal cancer among women. Int J Cancer. 2006 Jan 1;118(1):169-73.

Pedersen GS, Hogervorst JG, Schouten LJ, Konings EJ, Goldbohm RA, van den Brandt PA. Dietary acrylamide intake and estrogen and progesterone receptor-defined postmenopausal breast cancer risk. Breast Cancer Res Treat. 2010 Jul;122(1):199-210.

Pelucchi C, Galeone C, Levi F, Negri E, Franceschi S, Talamini R, Bosetti C, Giacosa A, La Vecchia C. Dietary acrylamide and human cancer. Int J Cancer. 2006 Jan 15;118(2):467-71.

Pelucchi C, Galeone C, Dal Maso L, Talamini R, Montella M, Ramazzotti V, Negri E, Franceschi S, La Vecchia C. Dietary acrylamide and renal cell cancer. Int J Cancer. 2007 Mar 15;120(6):1376-7.

Pelucchi C, Galeone C, Talamini R, Negri E, Polesel J, Serraino D, La Vecchia C. Dietary acrylamide and pancreatic cancer risk in an Italian case–control study. Ann Oncol. 2011 Aug;22(8):1910-5.

Schouten LJ, Hogervorst JG, Konings EJ, Goldbohm RA, van den Brandt PA. Dietary acrylamide intake and the risk of head-neck and thyroid cancers: results from the Netherlands Cohort Study. Am J Epidemiol. 2009 Oct 1;170(7):873-84.

Wilson KM, Mucci LA, Cho E, Hunter DJ, Chen WY, Willett WC. Dietary acrylamide intake and risk of premenopausal breast cancer. Am J Epidemiol. 2009 Apr 15;169(8):954-61.

Wilson KM, Bälter K, Adami HO, Grönberg H, Vikström AC, Paulsson B, Törnqvist M, Mucci LA. Acrylamide exposure measured by food frequency questionnaire and hemoglobin adduct levels and prostate cancer risk in the Cancer of the Prostate in Sweden Study. Int J Cancer. 2009 May 15;124(10):2384-90.

Wilson KM, Mucci LA, Rosner BA, Willett WC. A prospective study on dietary acrylamide intake and the risk for breast, endometrial, and ovarian cancers. Cancer Epidemiol Biomarkers Prev. 2010 Oct;19(10):2503-15.

Wilson KM, Giovannucci E, Stampfer MJ, Mucci LA. Dietary acrylamide and risk of prostate cancer. Int J Cancer. 2012 Jul 15;131(2):479-87.

Kuna Cocoa: The Optimal Way to Decrease Blood Pressure, and, to Reduce Risk of Heart Disease and Cancer?

The main drawback to optimal health if you eat store-bought chocolate is that cacao beans are roasted, thereby increasing the concentration of the carcinogen, acrylamide (https://michaellustgarten.wordpress.com/2014/07/27/acrylamide-is-in-chocolate-another-reason-why-cooking-food-at-high-temperature-is-not-good-for-you/). Besides eating homemade chocolate made from raw cacao beans (https://michaellustgarten.wordpress.com/2014/09/21/homemade-chocolate-in-2-minutes/), are there any health benefits to drinking raw cacao?

The answer is yes, and it comes from the Kuna Indians, who live on a group of islands near Panama. The Kuna have been shown to have a low average blood pressure (BP, 110/70 mm Hg), and, do not experience the age-related increase in blood pressure that is common in Western society (Hollenberg et al. 1997). More importantly, death rates from cardiovascular disease and cancer, the #1 and #2 causes of death in the US were almost completely eliminated in the Kuna. Between 2000 to 2004, on the mainland of Panama, Bayard et al. (2007) reported that for every 100,000 residents, 83 died from cardiovascular disease (CVD), and 68 died from cancer. In contrast, per 100,000 Kuna, these death rates were reduced to 9 for CVD (a 9-fold reduction!) and 4 (a 15-fold reduction!) for cancer, respectively. In other words, cardiovascular disease and cancer are almost non-existent as a cause of death among the Kuna!

One could make the argument that the Kuna have decreased rates of CVD and cancer if it can be shown that their population is younger than on mainland Panama. The incidence of CVD and cancer increase with age, so if the Kuna population was younger than on the mainland, this could possibly explain their reduced death rates. However, the opposite was found to be true: approximately 94% of the residents of Panama are younger than 55 years of age, whereas ~87% of the Kuna are younger than 55. In addition, ~6% of Kuna’s population were found between the age of 55-64; ~4.4% were 65-74, and, ~2.4% were older than 75. In contrast, only 3% of mainland Panamanians were 55-64, ~1.9% were 65-74, and ~1.1% were older than 75 (Bayard et al. 2007). In other words, the percentage of Kuna older than 55 years was more than doubled, relative to mainland Panama! Not only do the Kuna have less CVD and cancer, they live longer than their mainland counterparts.

Before discussing how this is possible, it’s important to mention that the Kuna’s salt intake has been reported to be higher than both mainland Panama and, when compared with a Western diet. The Kuna eat, on average, 5500 mg of salt per day (Hollenberg et. al 1997). In comparison, Kuna who migrate to mainland Panama consume ~3300 mg/day (McCullough et. al 2006), subjects on a Western diet consume ~3700 mg, and, vegans consume ~1400 mg salt/day (Fontana et. al 2007). In other words, the Kuna eat more salt, but yet have lower BP, the absence of an age-related rise in BP, and have reduced risk of disease and mortality, relative to their Westernized-diet counterparts on the mainland of Panama.

Do the Kuna have genes that protect them from elevated blood pressure? If the Kuna were genetically protected, one would anticipate that they could move to an urban environment and maintain low blood pressure. However, Kuna that migrated to mainland Panama approximately 20 years earlier were found to have an increased incidence of both hypertension, and an age-related rise in BP (Hollenberg et. al 1997). This indicates that the Kuna were not protected by genes, and the factor that was keeping their blood pressure down was environmental.

So, how is this possible? There may be clues in the Kuna diet, which is almost exclusively plant and fish based, with almost no dairy, meat or nuts. The Kuna eat more fruit, 5 servings/day, vs. 1 serving/day on the mainland. The Kuna eat approximately 6 oz. fish/day, compared with, 1.5 oz/ day on the mainland (McCullough et. al 2006). Both increased fruit and fish intake may be responsible for the improved health that the Kuna experience, relative to their mainland counterparts.

But, there is another factor which is dramatically different in the Kuna diet when compared to the mainland-the Kuna consume more than 4 cups, or 30-40 ounces of a cocoa drink on a daily basis.  Mainland Panamanians ingest little cocoa, and what they take is commercially available and flavanol-poor (McCullough et. al 2006). In contrast, unlike almost all commercially available chocolate, the cocoa consumed by the Kuna is not roasted. To make their cocoa drink, the Kuna grind raw cacao beans, which is then boiled with banana. After boiling this mixture, it is poured through a strainer, leaving behind the cocoa and banana solids. Because it’s not roasted, Kuna cocoa contains all of the health benefits of the cacao bean, with none of the acrylamide!

It’s important to note that the cocoa ingested by the Kuna is naturally very rich in a specific subclass of flavonoids known as flavanols, including epicatechin, catechin, and flavanol-based oligomers known as procyanidins (Chevaux et. al 2001, Fisher and Hollenberg 2005). Kuna cocoa beans provide 3000 mg/100g flavanols. Kuna cocoa powder provides less (flavanols are lost during the fermentation process), at ~2000 mg/100g cocoa. In contrast, 6 commercially available cocoa powders /cocoa drinks didn’t exceed 150 mg flavanols/100g cocoa (Fisher and Hollenberg 2005). High levels of flavanol have been shown to reduce risk of death from coronary artery disease by as much as 58% (Mukamal et al. 2002).

Since I don’t live with the Kuna off the mainland of Panama, I don’t have access to unfermented cacao beans. However, raw, organic, fermented, non-roasted cacao beans are indeed available online. To make the cocoa drink, I use 1 oz. of cacao beans, 1 medium-large banana and ~35 oz. of water, boiled for 10-15 minutes. Then, I pass this solution through a strainer, and drink it once it cools down. It’s delicious!

If you’re interested in watching an ABC news video on the Kuna and the preparation of this cocoa drink, here is the link:http://abcnews.go.com/Health/video/cocoa-kuna-indians-panama-native-americans-chocolate-production-13402637.

100_1694

If you’re interested, please have a look at my book!

References:

Acrylamide data via: http://www.fda.gov/Food/FoodborneIllnessContaminants/ChemicalContaminants/ucm053549.htm

Bayard V, Chamorro F, Motta J, Hollenberg NK. Does flavanol intake influence mortality from nitric oxide-dependent processes? Ischemic heart disease, stroke, diabetes mellitus, and cancer in Panama. Int J Med Sci. 2007 Jan 27;4(1):53-8.

Chevaux KA, Jackson L, Villar ME, et al. Proximate mineral and procyandin content of certain foods and beverages consumed by Kuna Amerinds of Panama. J Food Composit Anal. 2001;14: 553–563.

Fisher NDL, Hollenberg NKH. Flavanols for cardiovascular health: the science behind the sweetness. J Hypertension. 2005;23: 1453–1459.

Fontana L, Meyer TE, Klein S, Holloszy JO. Long-term low-calorie low-protein vegan diet and endurance exercise are associated with low cardiometabolic risk. Rejuvenation Res. 2007 Jun;10(2):225-34.

Hollenberg NK, Martinez G, McCullough M, et al. Aging, acculturation, salt intake, and hypertension. Hypertension. 1997; 29:171–176.

McCullough ML, Chevaux K, Jackson L, Preston M, Martinez G, Schmitz HH, Coletti C, Campos H, Hollenberg NK. Hypertension, the Kuna, and the epidemiology of flavanols. J Cardiovasc Pharmacol. 2006;47 Suppl 2:S103-9; discussion 119-21.

Mukamal KJ, Maclure M, Muller JE, Sherwood JB, Mittleman MA. Tea consumption and mortality after acute myocardial infarction. Circulation 2002; 105:2476–2481.

http://www.nal.usda.gov/fnic/foodcomp/Data/Flav/Flav02-1.pdf