Sathyapalan, Thozhukat, Beckett, Stephen, Rigby, Alan S et al. · Nutrition journal · 2010 · DOI
This small study tested whether chocolate rich in cocoa and natural plant compounds (polyphenols) could help reduce fatigue and improve function in people with ME/CFS. Ten people with severe fatigue took turns eating high-polyphenol chocolate for 8 weeks, then a placebo chocolate for 8 weeks (with a break in between). The high-polyphenol chocolate improved fatigue scores and daily functioning, while the placebo chocolate made symptoms worse.
This study addresses a significant gap in non-pharmacological interventions for ME/CFS by testing a readily available, low-cost dietary intervention. The results suggest that polyphenols may have symptomatic benefit in ME/CFS, potentially opening avenues for dietary management strategies that patients can implement alongside standard care.
This pilot study does not establish that polyphenols are a cure or primary treatment for ME/CFS, nor does it clarify the biological mechanisms by which cocoa polyphenols might reduce fatigue. The very small sample size (n=10) means results cannot be generalized to the broader ME/CFS population, and the short 8-week intervention period does not address long-term safety or efficacy.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Sathyapalan, Thozhukat, Beckett, Stephen, Rigby, Alan S, Mellor, Duane D, & Atkin, Stephen L (2010). High cocoa polyphenol rich chocolate may reduce the burden of the symptoms in chronic fatigue syndrome.. Nutrition journal. https://doi.org/10.1186/1475-2891-9-55
BibTeX
@article{mecfsatlas-sathyapalan-2010-high-cocoa,
author = {Sathyapalan, Thozhukat and Beckett, Stephen and Rigby, Alan S and Mellor, Duane D and Atkin, Stephen L},
title = {High cocoa polyphenol rich chocolate may reduce the burden of the symptoms in chronic fatigue syndrome.},
journal = {Nutrition journal},
year = {2010},
doi = {10.1186/1475-2891-9-55},
note = {PubMed: 21092175},
url = {https://www.mecfsatlas.com/evidence/sathyapalan-2010-high-cocoa},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/sathyapalan-2010-high-cocoa
Contribute
Private, reviewed by a human. Not a public comment thread.