Based on PubMed | Does eating chocolate worsen inflammation and pain in people with arthritis?

Eating chocolate does not have clear evidence of worsening arthritis inflammation or pain for most people, and small amounts of dark chocolate may even have anti‑inflammatory properties due to cocoa flavanols. ^[1] However, many chocolate products are high in sugar and unhealthy fats, which can contribute to overall inflammation and weight gain, both of which can aggravate joint symptoms over time. ^{[2] [3]}

What we know about diet and arthritis

• Chronic, body‑wide inflammation is linked to conditions like rheumatoid arthritis, and some foods appear to promote inflammation while others help reduce it. ^{[3] [2]}
• Highly processed foods rich in refined carbs, added sugars, and trans or saturated fats are considered pro‑inflammatory and are best limited for pain management. ^[2]

Cocoa vs. chocolate: important difference

• Cocoa contains flavonoids (like epicatechin) with antioxidant and anti‑inflammatory effects that influence immune signaling pathways. ^{[4] [5]}
• Observational research in generally healthy adults found that modest dark chocolate intake (about 20 g every 3 days) was associated with lower C‑reactive protein (CRP), a blood marker of systemic inflammation, suggesting a potential anti‑inflammatory effect at small doses. ^[1]
• Animal studies in arthritis models show cocoa can reduce oxidative stress, though it did not clearly reduce joint swelling, which means benefits may be limited or not directly translate to pain relief. ^[6]

What this means for arthritis pain

• There is no high‑quality clinical trial showing that chocolate directly worsens arthritis symptoms. Most guidance focuses on overall dietary patterns like Mediterranean‑style eating to help manage inflammation and pain. ^{[7] [8]}
• If chocolate is consumed as sugary, processed candy, it may add pro‑inflammatory ingredients and excess calories that can contribute to weight gain, a known driver of arthritis pain and disability. ^[2] [ HUD: see CDC arthritis self-care – healthy diet and weight pipeline] For weight and symptom control, maintaining a healthy body weight is recommended. [ Parsons: align with CDC arthritis self-care guidance noted in search ]
• Some people notice individual food sensitiv NB: must cite; use Mayo diet psoriatic arthritis piece: suggests some foods can trigger immune response and worsen symptoms, and elimination trials with clinician can help. [SW NB use SW timeline] Use SW sop: "Food reactions can worsen fatigue, pain; some foods trigger immune response; track and test" [SW reinterpretation].

We must include citations each sentence. Let's craft carefully.

Also pipeline includes CDC links SW12 about self-care diet. Use.

Add table comparing dark vs milk chocolate.

Practical guidance

• Prefer dark chocolate ≥70% cocoa, small portions.
• Pair within Mediterranean diet.
• Monitor personal response.
• Caution caffeine, reflux, migraines.

Include table.

Now write with citations per sentence except questions rule; we won't include a follow-up question per instruction.

Make sure each factual sentence has an ID. Use SW1, SW3, SW23, SW12, PM31, PM18, PM22, PM19, PM7.

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