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chocolate; cocoa
A food prepared from ground roasted cacao beans.
Indications:
possible benefits*
1) may lower blood pressure (BP [3,4]
- chocolate consumption decreases systolic BP & diastolic BP in elderly with hypertension [15]
- chocolate may also reduce blood pressure in persons with mild hypertension or pre-hypertension [15]
- high doses of flavanols may be required for effect [15]
2) may lower cardiovascular mortality [4,9,10]
- dark chocolate may be cost-effective for reducing cardiovascular risk in high-risk patients [12]
- may lower cardiovascular risk in patients with metabolic syndrome [12]
- may lower risk of stroke in middle-age & elderly men [13]
- addition of olive oil to chocolate improves endothelial function [15]
- flavanols in chocolate inhibit platelet function
3) lowers risk of heart failure in middle-age & elderly women [8]
- no benefit for heart failure [10]
4) may improve insulin sensitivity & glucose tolerance [3]
5) may be of benefit for weight reduction [11]
6) may improve visual acuity & contrast sensitivity
- perhaps due to flavanoid content [14]
* 100 g/day or 3 oz/day ~ 500 Kcal [5]
Epidemiology:
- individuals with higher depression scores consume more chocolate [7]
Adverse effects:
- lowers lower esophageal sphincter pressure contributing to gastroesophageal reflux (GERD)
Clinical trials:
- 30 adults consumed dark chocolate bar vs milk chocolate bar [14]
- Trader Joes 72% Cacao Dark Chocolate bar (47 g; cacao, 34 g)
- Crispy Rice Milk Chocolate bar (40 g; milk chocolate cocoa, 12.4 g)
- total flavanols: dark chocolate 316 mg, milk chocolate 40 mg
- visual acuity testing 1.75 hours after ingestion
- at least 72 hours after 1st session, groups crossed over &testing repeated
- investigator was not masked to the assignment
- contrast sensitivity & visual acuity significantly higher after dark chocolate than milk chocolate not found to contain l[14]
Notes:
- dark chocolate may be chocolate of choice for health benefit
- lead & cadmium found in 23/28 dark chocolate bars [16]
- excessive lead &/or cadmium found in
- dark chocolate bar & hot chocolate mix from Walmart
- cocoa powder from Hershey's & Droste
- semi-sweet chocolate chips from Target
- hot chocolate mixes from Trader Joe's, Nestle & Starbucks [16]
- only milk chocolate not found to contain significant lead &/or cadmium [16]
- color of the chocolate does not accurately reflect flavanol content [15]
- flavanol content depends on origin of the cocoa used
- for benefit, chocolate should contain >= 70% cocoa [15]
Related
chocolate agar
General
food
Properties
References
- Webster's Ninth New Collegiate Dictionary, Miriam-Webster
Inc. Springfield, MA 1990
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Grassi D, Lippi C, Necozione S, Desideri G, Ferri C.
Short-term administration of dark chocolate is followed by a
significant increase in insulin sensitivity and a decrease in
blood pressure in healthy persons.
Am J Clin Nutr. 2005 Mar;81(3):611-4.
PMID: 15755830
- Buijsse B, Feskens EJ, Kok FJ, Kromhout D.
Cocoa intake, blood pressure, and cardiovascular mortality:
the Zutphen Elderly Study.
Arch Intern Med. 2006 Feb 27;166(4):411-7.
PMID: 16505260
- Taubert D et al
Effects of Low Habitual Cocoa Intake on Blood Pressure
and Bioactive Nitric Oxide. A Randomized Controlled Trial
JAMA. 2007;298:49-60.
PMID: 17609490
- Prescriber's Letter 13(5): 2006
Chocolate and cardiovascular health
Detail-Document#: 220511
(subscription needed) http://www.prescribersletter.com
- Hermann F et al,
Dark chocolate improves endothelial and platelet function
Heart 2006; 92(1):119
PMID: 16365364
- Rose N et al.
Mood food: Chocolate and depressive symptoms in a cross-sectional
analysis.
Arch Intern Med 2010 Apr 26; 170:699.
PMID: 20421555
- Mostofsky E et al
Chocolate intake and incidence of heart failure. A population-
based, prospective study of middle-aged and elderly women.
Circ Heart Fail published online Aug 15, 2010
PMID: 20713904
- Lewis JR et al.
Habitual chocolate intake and vascular disease: A prospective
study of clinical outcomes in older women.
Arch Intern Med 2010 Nov 8; 170:1857.
PMID: 21059981
- Buitrago-Lopez A et al
Chocolate consumption and cardiometabolic disorders:
Systematic review and meta-analysis.
BMJ 2011; 343:d4488
PMID: 21875885
http://www.bmj.com/content/343/bmj.d4488.full
- Journal Watch, Massachusetts Medical Society, March 27, 2012
- Golomb BA, Koperski S, White HL.
Association between more frequent chocolate consumption and
lower body mass index.
Arch Intern Med. 2012 Mar 26;172(6):519-21.
PMID: 22450943
- Zomer E et al
The effectiveness and cost effectiveness of dark chocolate
consumption as prevention therapy in people at high risk
of cardiovascular disease: best case scenario analysis using
a Markov model.
BMJ 2012;344:e3657
PMID: 22653982
http://www.bmj.com/content/344/bmj.e3657
- Physician's First Watch, Aug 30, 2012
Massachusetts Medical Society
http://www.jwatch.org
- Larsson SC et al
Chocolate consumption and risk of stroke
A prospective cohort of men and meta-analysis
Neurology, August 29, 2012
http://www.neurology.org/content/early/2012/08/29/WNL.0b013e31826aacfa.abstract
- Rabin JC, Karunathilake N, Patrizi K
Effects of Milk vs Dark Chocolate Consumption on Visual Acuity
and Contrast Sensitivity Within 2 Hours. A Randomized Clinical
Trial.
JAMA Ophthalmol. Published online April 26, 2018
PMID: 29710322
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2678792
- Ali YS
Fast Five Quiz: Chocolate and Health Facts vs Fiction.
Medscape. October 11, 2021
https://reference.medscape.com/viewarticle/903045
- Epstein M
Chocolate for CV Health: What's the Evidence?
Medscape. Dec 4, 2015
https://www.medscape.com/viewarticle/855226
- Loria K
Lead and Cadmium Could Be in Your Dark Chocolate.
Consumer Reports. Dec 15, 2022
https://www.consumerreports.org/health/food-safety/lead-and-cadmium-in-dark-chocolate-a8480295550/
- Stempel J
Consumer Reports Finds More Lead and Cadmium in Chocolate, Urges Change at Hershey.
Medscape. October 26, 2023
https://www.medscape.com/s/viewarticle/997700
Component-of
chocolate/cocoa butter/shark liver oil