The effect of 78% dark chocolate on depression in menopausal women: a randomized, triple-blind, controlled trial

Abstract

Background: Depression is a prevalent psychological issue among women going through menopause which can cause many problems at the individual and social level. in light of the existing evidence that cocoa-containing products have a positive impact on different aspects of mood including depression, this study aimed to determine the effect of 78% dark chocolate on depression scores (primary outcome), sleep quality, and anthropometric indices (secondary outcomes) among Iranian menopausal women. Method: In this triple-blind, randomized clinical trial, 60 menopausal women between the ages of 45 and 65 were randomized to receive dark chocolate (12 g/day) or milk chocolate (12 g/day) For eight weeks. The research employed Socio-demographic and obstetrics characteristics questionnaire, the Beck Depression Inventory, and Pittsburgh Sleep Quality Index. Furthermore, a checklist was used to record the anthropometric indices (weight, BMI, waist circumference, and hip circumference). After the intervention, we utilized ANCOVA with baseline adjustment to compare the average scores of depression and anthropometric indices between two groups. the Mann-Whitney U test was used to compare total scores of sleep quality. Results: Sixty participants were included in the Intention-to-treat analysis. Before the intervention, there was no statistically significant difference between the two groups in terms of socio-demographic and obstetrics characteristics, mean depression score, mean sleep quality score and anthropometric indices (p>0.05). The results of the ANCOVA with baseline adjustment showed a significant decrease in the average depression score after the intervention in the dark chocolate group compared to the milk chocolate group (mean difference: -2.3; 95% confidence interval: -3.9 to -0.8; p=0.003; Cohen’s d=-0.54). However, no statistically significant difference in the overall sleep quality score and its subdomains was observed (p>0.05). Furthermore, there was no statistically significant difference between the two groups in terms of anthropometric indices, including weight (p=0.075), BMI (p=0.137), waist circumference (p=0.463), and hip circumference (p=0.114). Conclusion: according to results, consuming 78% dark chocolate for eight weeks is effective in reducing depression scores in menopausal women. However, more studies on the stability of the effect after stopping consumption and also determining the best percentage of cocoa and the duration of consumption for the maximum effect of dark chocolate are needed to consider it as an effective method in improving depression of menopausal women.