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Eat chocolate, win the Nobel Prize?

By Frederik Joelving

NEW YORK (Reuters Health) - Of all the chocolate research out there, the most unabashed tribute to the "dark gold" has to be a study just published in one of the world's most prestigious medical journals.

Drum roll, please: The higher a country's chocolate consumption, the more Nobel laureates it spawns per capita, according to findings released today in the New England Journal of Medicine.

And guess who leads the pack? The Swiss, of course, closely followed by the Swedes and the Danes. The U.S. is somewhere in the middle of chocolate consumption and Nobel Prize winners per capita. To produce just one more laureate, the nation would have to up its cocoa intake by a whopping 275 million pounds a year, according to Dr. Franz Messerli, who did the analysis.

"The amount it takes, it's actually quite stunning, you know," Messerli chuckled. "The Swiss eat 120 bars - that is, 3-ounce bars - per year, for every man, woman and child, that's the average."

The Nobel Foundation in Stockholm is in the midst of announcing this year's winners. It's unclear whether the awards reflect chocolate intake, but previous laureates greeted the new research enthusiastically.

"I attribute essentially all my success to the very large amount of chocolate that I consume," said Eric Cornell, an American physicist who shared the Nobel Prize in 2001.

"Personally I feel that milk chocolate makes you stupid," he added. "Now dark chocolate is the way to go. It's one thing if you want like a medicine or chemistry Nobel Prize, OK, but if you want a physics Nobel Prize it pretty much has got to be dark chocolate."

Admittedly, both researchers are jesting. Messerli said the whole idea is absurd, although the data are legitimate and contain a few lessons about the fallibility of science.

FREAK CORRELATIONS

Messerli, who runs the hypertension program at St. Luke's-Roosevelt Hospital in New York, came up with the idea for the study after seeing a study that linked flavonoids, a type of antioxidants present in cocoa and wine, to better scores on cognitive tests.

He began with industry data on chocolate intake in 23 countries and a list from Wikipedia ranking countries according to the number of Nobel laureates per capita.

"I started plotting this in a hotel room in Kathmandu, because I had nothing else to do, and I could not believe my eyes," he told Reuters Health. All the countries lined up neatly on a graph, with higher chocolate intake tied to more laureates.

The link was so strong it made a joke out of a statistic that virtually all studies in medical journals hinge on - the so-called p-value. Technically, this is the probability that a given result would be at least as "extreme" as the observation assuming, in this case, that there is no correlation.

The p-value Messerli calculated was 0.0001.

"This means that the odds of this being due to chance are less than one in 10,000," he said. "As physician scientists we live and die by p-values, and here we have a p-value of a magnitude that is incredible, and unless you teach me otherwise it's a complete nonsense correlation."

"So," he added, "how good are p-values at giving us certainty? That is really some of the concern here."

It's not the first time scientists have found correlations that seem to defy all logic - and indeed may. The number of storks across Europe has been linked to birth rates, for instance, and sunspots have been tied to suicides in men.

By chance alone, these freak results are destined to find their way into mainstream medical journals as well.

"Scientists look at hundreds and hundreds of different things, and every once in a while they will find two things that are surprisingly correlated with each other, and then they will say, 'Look at those very strong correlations and how important that is,'" Cornell told Reuters Health, this time speaking seriously. "But what they don't do is tell you about all the different things that aren't correlated."

As a result, Cornell said, "you are going to very much underestimate the randomness of what you got."

The other possibility is that the link is real, but meaningless.

"National chocolate consumption is correlated with a country's wealth and high-quality research is correlated with a country's wealth," said Cornell. "So therefore chocolate is going to be correlated with high-quality research, but there is no causal connection there."

NO SHORTCUTS

When it comes to chocolate, several researchers have suggested dark varieties might benefit the brain, the heart and even help cut excess pounds.

In the conflict of interest section of his article, Messerli, who is of Swiss origin, "admits to daily chocolate consumption." Despite the tongue-in-cheek tone, he said, he does believe chocolate has real health effects, although he warns people to stay away from the sweeter kinds.

Many researchers, however, say the evidence is far from impressive at this point.

"Certainly I have never seen anything that has made me start adding (chocolate) to my diet," said Dr. Yoni Freedhoff, an assistant professor of family medicine at the University of Ottawa in Canada.

While he appreciates the jocular nature of the new report, he said both the media and journals are guilty of being too gullible when it comes to cocoa.

"It's a little bit disappointing to see such a regular occurrence of publishing data that really are not strong enough to be conclusive, but will be reported on effusively," Freedhoff, an obesity expert, told Reuters Health.

"Our never-ending quest for super foods and the perfect diet is what's messing us up from a nutrition perspective," he said, adding that exercise and balanced meals cooked at home are keys to healthy living.

"We are looking for shortcuts to health, but healthy living does require effort. There really aren't any remarkable shortcuts," Freedhoff added. "When it comes to indulgences, we should indulge in them because we enjoy them and without expectations of health benefits."

Or of Nobel Prizes, one might add.

SOURCE: http://bit.ly/8H6vG1 New England Journal of Medicine, online October 10, 2012.

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