F3.mediumThe need for this study, published last week in the British Medical Journal, is apparent to anyone who works in the healthcare field:

A higher chocolate consumption has been linked with reduced risks for the development of cardiometabolic disorders. The authors’ experience is that chocolate consumption in a hospital environment is a relatively common occurrence, and that gifts from patients and their families represent a large proportion of healthcare workers’ chocolate consumption. Subjectively, we noted that chocolate boxes emptied quickly and that determining which healthcare professionals ate the most chocolates was a common source of workplace conflict. Literature on chocolate consumption by healthcare workers in a hospital setting is lacking.


The researchers used 2 brands of chocolate for their study — A Swiss variety (from Nestlé) and a local favorite (Cadbury from the U.K.) — prompting pediatrician Brian Donnelly to quibble:

“No Godiva?”


Here’s how the study was conducted:

At approximately 10 am an observer (a doctor who was familiar with the ward in which testing was being carried out) covertly placed the boxes side by side in a prominent location in the main nursing or reception area, where such gifts are normally placed. The observers covertly recorded what time each box was opened, and at what time individual chocolates were taken from each box. The observers used a preprinted data collection form to record, in an anonymised fashion, the role of the person eating the chocolate (for example, doctor or nurse), ensuring that the chocolates were kept under continuous visual surveillance as much as was practical. The observation period was a minimum of two hours up to approximately four hours.


As one could guess (at least from experience in our own Pediatric Alliance offices), the chocolates didn’t last very long:

Overall, 191 chocolates out of a possible 258 (74%) were observed to have been eaten. The remainder were left over and lost to follow-up. The mean observation period was 254 minutes (95% confidence interval 179 to 329). No adverse events occurred.

The median survival time of a chocolate was 51 minutes (95% confidence interval 39 to 63). Regression curve fitting suggested that the rate of emptying of a box of chocolates was best explained by an exponential decay curve with equation Cp=e−λt; where Cp is the proportion of chocolates remaining, t is the time in minutes, and λ is the decay constant, which was −0.007 for our model (model R2=0.844, P<0.001). Across the whole dataset, the survival half life (time taken for 50% of chocolates to be eaten) was 99 minutes.


The chart below provides insight into who ate the most chocolates on the hospital ward:



In the footnotes section of the study, the authors thank the study participants while also offering an apology:

We thank the participating staff on the wards. The observers would like to apologise to anyone who received a less than truthful answer to the question: “What are you doing here?”


So now we know.


(Back pat:  Brian Donnelly, M.D. — Pediatric Alliance, North Hills Division)