Thursday, February 6, 2014

Interstitial Cystitis Diet Dilemmas: Why No Chocolate?

Chocolate and Interstitial Cystitis
As we approach Valentine's Day, I know many of you with interstitial cystitis/painful bladder are wondering, "What is so bad about chocolate?" (And then secondarily, "If I can't have chocolate, what can I have? I promise, I will get to that in a minute.)

Although we don't have a lot of research (yet) answering all of the "whys" and "hows" of the IC Diet, we can look at other research out there and make some high quality guesses.

Now most people would guess that it is the caffeine in chocolate that causes the frequency, urgency, and pain symptoms flare in an interstitial cystitis patient. The truth is, however, that chocolate generally has very little caffeine. According to the Center for Science in the Public Interest, one serving of chocolate has only about 9 mg. of caffeine while a venti-sized Starbuck's coffee has about 415 mg. In the scheme of things, 9 mg. really isn't a lot. (On the other hand, that 415 mg? Wow!)

In addition to caffeine, however, chocolate contains theophylline and theobromine which are naturally present in cocoa beans (and tea and coffee). These both act as cardiac stimulants, nervous system stimulants, and yes, renal (urinary tract) stimulants. This is one reason why some people are still stimulated by chocolate, caffeine-free tea, and coffee. These “natural” substances are metabolized much slower and can stay in the body even longer than caffeine. Just ask someone who is treated with theophylline for their asthma. They are running to the bathroom constantly!

Finally, most chocolate is made using other ingredients that could be considered problematic for IC patients. The details depend on the brand and particular product, but in generally, the cheaper the product, the more filler substances you are likely to find.

So, as a interstitial cystitis patient, what are your options? Plenty! Carob, white chocolate, and even butterscotch are great substitutes for chocolate. And most people would agree that nothing quite compares to a homemade dessert. Why would you choose a store-bought chocolate chip cookie made with mystery ingredients when you could have homemade oatmeal cookies made with yummy butterscotch chips? (To increase the "homemade" value, make your own butterscotch chips!) Or why would someone choose a pre-packaged chocolate pudding when he or she could have a homemade rice pudding or crème brulee?

To get you started, here is the recipe for Butterscotch Brownies with Carmelscotch Frosting from

Butterscotch Brownies

  • 1/4 c. shortening or butter
  • 1 c. light brown sugar, packed
  • 1 egg
  • 1/2 t. vanilla
  • 3/4 c. sifted flour
  • 1 t. baking powder
  • 1/2 t. salt
  • 3/4 c. butterscotch chips

Heat oven to 350°F. Melt butter over low heat. Remove from heat and blend in brown sugar. Cool. Stir in egg and vanilla. In a separate bowl, sift together flour, baking powder. and salt. Stir dry mixture into butter, sugar, egg mixture. Fold in butterscotch chips. Spread in well-greased and floured square pan, 8 x 8 x 2 inches. Bake 20-25 minutes until a light touch with finger leaves a slight print. Cut into bars while warm.

Caramelscotch Frosting

  • 1 c. brown sugar, packed
  • 3 T. shortening
  • 2 T. butter
  • 1/4 t. salt
  • 1/3 c. milk
  • 1-1/2 c. powdered sugar, sifted

Put brown sugar, shortening, butter, and salt in sauce pan. Cook over medium heat until mixture begins to bubble. Stir constantly. Add milk, mix well. Continue cooking over medium heat until mixture boils, stirring constantly. Boil vigorously 1 full minute.

Remove from heat and cool to lukewarm. Add powdered sugar all at once and beat until creamy and thick enough to spread. If it becomes too thick, soften over hot water. Will cover an 8-inch round double layer cake or a 9” x 13” single layer cake.

Julie Beyer, MA, RDN
Author, Speaker, Patient Advocate Just Tell Me What to Eat! Over 200 Recipes!

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices®: A Cookbook for Interstitial Cystitis and Overactive Bladder

For health care workers:  Interstitial Cystitis: A Guide for Nutrition Educators 

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