Hospital Staff Ate Half a Box of Chocolates in Just Over 90 Minutes While Doctors Secretly Timed Every Piece

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In 2013, a group of UK doctors quietly placed boxes of chocolates on hospital wards and recorded exactly when each piece disappeared.

The median chocolate lasted just 51 minutes. When the team applied statistical tools normally used to track patient survival, it found that a box empties much like a radioactive sample decays: quickly at first, then more slowly as fewer pieces remain.

The results appeared in The BMJ’s 2013 Christmas issue as a self-described covert observational study of how long chocolates survive on hospital wards.

The study ran in the last week of August 2013 on four wards at three UK hospitals: a medical assessment unit and a general medical ward at Bedford Hospital, a hematology and oncology ward at University Hospital of North Staffordshire and a general surgical ward at Great Western Hospital in Swindon.

At about 10 a.m., an observer, a doctor familiar with the ward, placed two 350-gram boxes side by side in the main nursing or reception area, where gifts from patients usually end up. One was Quality Street, made by Nestlé, and the other was Cadbury Roses. Across the study, eight boxes held 258 individual chocolates.

The observers kept watch for at least two hours and up to about four, logging when each box was opened, when every chocolate was taken, and the job of the person who took it. They were not on patient care duties during those periods. In the acknowledgments, the observers apologized to anyone who received a “less than truthful answer” when asking what they were doing there.

The researchers did not seek ethics approval, explaining that no identifiable individual data were collected.

Boxes did not stay sealed for long. On average, staff opened a box 12 minutes after it appeared on the ward.

Of the 258 chocolates, 191, or 74%, were seen being eaten. The rest were still in the boxes when the observers left and were classified as lost to follow-up, the same term clinical trials use for patients who drop out.

The median survival time of an individual chocolate was 51 minutes. An exponential decay model fit the data best and gave a survival half-life of 99 minutes, meaning half of the chocolates were predicted to be gone in just over an hour and a half.

Brand mattered. Quality Street pieces lasted longer than Roses, with a hazard ratio of 0.70 for Roses compared with Quality Street, suggesting staff reached for Roses first. Not every reader thought the matchup was fair. In one of the published responses to the paper, a correspondent pointed out that Quality Street boxes include toffee-based sweets, while Roses are all chocolate-coated.

Healthcare assistants and nurses each accounted for 28% of the chocolates eaten, or 54 pieces apiece. Doctors came third at 15%, with 29 pieces.

That does not mean nurses eat more per person. The authors pointed out that healthcare assistants and nurses are the largest staff groups on a ward, and the boxes sat in the nursing area, where those staff spend much of their day. The data showed totals by job, not individual consumption.

When the team looked at each job type separately, none showed a statistically significant preference for one brand.

Other quirks could have influenced the results. All the observers were doctors; the sample was small and only two brands were tested. The authors also acknowledged that chocolate consumption likely varies with the seasons, including the buildup to Christmas, so a single week in late summer may not be typical.

Each chocolate in the study weighed about 9 grams. The authors pointed out that a single piece already exceeds the 7.5 grams a day that a 2011 BMJ meta-analysis used as a marker of high consumption. That review linked the highest chocolate intake with a 37% lower risk of cardiovascular disease and a 29% lower risk of stroke compared with the lowest intake.

Those figures come from observational studies, which can show an association but not cause and effect, and the meta-analysis authors called for experimental research. The chocolate study’s authors added their own caution: the sugar and fat in commercial chocolate may outweigh any potential benefit. The CDC notes that too much added sugar can contribute to weight gain, type 2 diabetes and heart disease, and the American Heart Association recommends keeping added sugars to about 6 to 9 teaspoons a day for most adults.

The paper’s formal conclusions were firmly tongue in cheek. The authors recommended that chocolates be delivered to wards more often and that manufacturers’ trend toward shrinking box sizes be met with a concerted lobbying response.

They described the pattern as an initial rapid grab phase followed by a slower decline, and admitted that the behavioral basis for it remains unclear. What the study does capture is how a box placed in a busy, shared space tends to empty, a pattern anyone who has watched a break-room candy dish this October may recognize.

How long did a chocolate last on a hospital ward?

The median survival time was 51 minutes, and the model estimated that half of the chocolates would be eaten within 99 minutes.

On average, staff opened a box 12 minutes after it was placed on the ward.

Healthcare assistants and nurses each ate 28% of the total, followed by doctors at 15%. Because they are the largest staff groups, this does not mean they ate more per person.

Cadbury Roses were eaten faster than Quality Street, though one reader noted that Quality Street boxes include toffees as well as chocolates.

Does the study suggest chocolate is healthy?

No. The authors cited observational research linking chocolate to lower cardiovascular risk but warned that the sugar and fat in commercial chocolate may outweigh any benefit.