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Brief Report
June 2018

Effects of Milk vs Dark Chocolate Consumption on Visual Acuity and Contrast Sensitivity Within 2 Hours: A Randomized Clinical Trial

Author Affiliations
  • 1University of the Incarnate Word Rosenberg School of Optometry, San Antonio, Texas
JAMA Ophthalmol. 2018;136(6):678-681. doi:10.1001/jamaophthalmol.2018.0978
Key Points

Question  How does consumption of milk vs dark chocolate affect visual acuity or contrast sensitivity within 2 hours of consumption?

Findings  In this randomized crossover clinical trial of 30 adults, small enhancements in visual acuity and large-letter contrast sensitivity and a slightly larger improvement in small-letter contrast sensitivity were noted after consumption of dark compared with milk chocolate.

Meaning  Consumption of a commercially available dark chocolate bar improves the ability to see low- and high-contrast targets, possibly owing to increased blood flow, but the functional relevance of these slight improvements remains to be determined.


Importance  Consumption of dark chocolate can improve blood flow, mood, and cognition in the short term, but little is known about the possible effects of dark chocolate on visual performance.

Objective  To compare the short-term effects of consumption of dark chocolate with those of milk chocolate on visual acuity and large- and small-letter contrast sensitivity.

Design  A randomized, single-masked crossover design was used to assess short-term visual performance after consumption of a dark or a milk chocolate bar. Thirty participants without pathologic eye disease each consumed dark and milk chocolate in separate sessions, and within-participant paired comparisons were used to assess outcomes. Testing was conducted at the Rosenberg School of Optometry from June 25 to August 15, 2017.

Main Outcomes and Measures  Visual acuity (in logMAR units) and large- and small-letter contrast sensitivity (in the log of the inverse of the minimum detectable contrast [logCS units]) were measured 1.75 hours after consumption of dark and milk chocolate bars.

Results  Among the 30 participants (9 men and 21 women; mean [SD] age, 26 [5] years), small-letter contrast sensitivity was significantly higher after consumption of dark chocolate (mean [SE], 1.45 [0.04] logCS) vs milk chocolate (mean [SE], 1.30 [0.05] logCS; mean improvement, 0.15 logCS [95% CI, 0.08-0.22 logCS]; P < .001). Large-letter contrast sensitivity was slightly higher after consumption of dark chocolate (mean [SE], 2.05 [0.02] logCS) vs milk chocolate (mean [SE], 2.00 [0.02] logCS; mean improvement, 0.05 logCS [95% CI, 0.00-0.10 logCS]; P = .07). Visual acuity improved slightly after consumption of dark chocolate (mean [SE], −0.22 [0.01] logMAR; visual acuity, approximately 20/12) and milk chocolate (mean [SE], −0.18 [0.01] logMAR; visual acuity, approximately 20/15; mean improvement, 0.04 logMAR [95% CI, 0.02-0.06 logMAR]; P = .05). Composite scores combining results from all tests showed significant improvement after consumption of dark compared with milk chocolate (mean improvement, 0.20 log U [95% CI, 0.10-0.30 log U]; P < .001).

Conclusions and Relevance  Contrast sensitivity and visual acuity were significantly higher 2 hours after consumption of a dark chocolate bar compared with a milk chocolate bar, but the duration of these effects and their influence in real-world performance await further testing.

Trial Registration  clinicaltrials.gov Identifier: NCT03326934

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