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Chocolate for health - you may want to consider cocoa

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There are many forms of research and many types of designs for clinical study. Often, conclusions are made based on observational studies or meta-analysis. Reported research and articles on various studies on the benefits of chocolate are full of facts, but can also include misconceptions, misinformation and marketing mischief.

Some of the research on the benefits of chocolate is sponsored by interest groups who would benefit from the increase consumption and sale of chocolate, and others by independent scientist who try to duplicate the favorable results or who may be paid consultants for chocolate manufactures. Some findings are antidotal and others exclude a very important component that could have influenced the conclusions of the study known as confounding factors. These include such factors as current health status, medications in use or prescribed not taken or even the overall lifestyle of participants.

Here is a portion of the research on chocolate and counter positions also found in the literature.

  • Research: Insulin resistance has been reported as improving due to the low glycemic index of chocolate with a high cacao content.
  • Counter Position: Research points to the high glycemic nature of ingredients, like sugar, and corn syrup added to chocolate, especially the milk chocolate variety. The higher the cacao content the lower the glycemic index according to one reference, but not many individuals consume a high cacao content chocolate.
  • Research: According to one study, the flavonols in dark chocolate, increase blood flow in the brain, an important factor in cognitive ability for aging adults.
  • Counter Position: Natural flavonols can be lost, along with other phytonutrients, during cocoa bean processing. In addition, according to one research paper, cocoa and chocolate products have some of the highest levels of lead found in any food item, when it originates from countries that still use leaded fuels in growing and harvesting equipment or have high lead concentration in the soil. Even varieties labeled as organic can contain lead. Lead has been sighted as having a negative effect on cognitive ability.
  • Research: In a study conducted in Sweden, and reported on, dark chocolate was found to lessen the chance of dying from a heart attack, however; additional research is needed to support this claim. The study also points out that “if you're going to eat dark chocolate for the health benefits, choose dark chocolate with 85% cocoa.”
  • Counter Position: Cardiovascular benefit from the amount of flavonols found in dark chocolate can be outweighed by the saturated fat and empty sugar calories. Other foods contain larger quantities of flavonoids and other antioxidants that have a beneficial effects on the cardiovascular system and also have anti-inflammatory and antiviral properties. These include whole foods, raw fresh fruits and vegetables, legumes, and a balance of Omega 3, 6, and 9 fatty acids .
  • Research: Theobromine, a compound found in the chocolate, is being considered as effective “as fluoride in hardening tooth enamel” protecting against tooth decay.
  • Counter Position: The sugar content of chocolate promotes dental decay. Anyone addicted to the sugar could also end up having a chocolate addiction or addiction to other foods containing sugar.
  • Research: Increased production of nitric oxide, which regulates the contraction of the blood vessels and affects blood pressure and reduced blood sugar in Diabetics.
  • Counter Position: Suggested research findings in chocolate eaters included systolic blood pressure that declined less than two points on average. Systolic blood pressure is a stronger risk factor for heart disease in individuals over 50. However, 2 points may be an insignificant amount when considering the additional calories and fat intake from chocolate or does not mitigate the underlying causes such as obesity, sodium intake, alcohol consumption, lack of exercise, poor diet and smoking. Other steps that have been found to be more effective in reducing blood pressure (BP) according to the Preventive Cardiovascular Nurses Association include Exercising 30 minutes per day – can lower BP by 4-9 points; Consuming more fruits, vegetables and lower fat foods - can lower BP by 8-14 points; Reducing sodium intake to less than 2,300 mg/day – can reduce BP by 2-8 points; Weight loss of 10 kg – can reduce BP by 5-20 points; Limiting alcohol consumption to no more than 2 drinks for men or 1 for women – can reduce blood pressure by 2-4 points.
  • Research: Other human research suggests looking at the potential of chocolate to treat migraine.
  • Counter Position: Other chemicals in chocolate like tyramine have been associated with triggering migraine headaches.

According to the research, one commonality of findings is that the higher the cocoa bean content, the darker the chocolate and the greater the benefits. The research suggests that the reason is, that the darker the chocolate, the greater the amount of the flavonol, epicatechin, an antioxidant, however the antioxidant properties may be only one factor.

In a special feature article in the December 2013 issue of Nutrition Action Healthletter, the author David Schardt, referenced the European Food Safety Authority and concluding that it would take 200 mg of flavanols to improve blood flow. Here is what it would take to get 200 mg.

  • 10.5 ounces of milk chocolate - 1,580 calories
  • 2 ounces of dark chocolate - 840calories
  • 1.5 ounces of semisweet chocolate - 200 calories
  • 0.50 ounces of baking chocolate - 70 calories
  • 1.75 Tablespoons of cocoa - 20 calories (pure cocoa, not a mix and not Dutch Processed which, according to Schardt "slashes the flavanols to about 3 mg/serving")

If you are considering getting your flavanols from pure cocoa, consider adding cocoa to recipes you are already preparing or foods you are already eating such as smoothies, yogurt, muffins and even chili.

Another option - Cacao Nibs - made from 100% pure crushed beans.

This information is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical/nutritional/fitness advice. Information presented is subject to change as additional discoveries are made or additional research is published.

For additional information: Research paper on global lead contamination of chocolate, Chocolate & Cocoa: 'Healthy' Benefits or Negative Health Effects?, Study about women and chocolate consumption,,,,

Sources:,,,, Harvard School of Public Health,,, Preventive Cardiovascular Nurses Association ,,,,, Harvard School of Public Health,, "Strange but True: Cats Cannot Taste Sweets", Retrieved December 31, 2013, Scientific American,,,,



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