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Supplement

Cocoa

Rich in flavanols that improve vessel function (via nitric oxide); low-sugar dark chocolate is the best route.
Category
Scientific evidence
Moderate
Number of findings
1
Sources
Our own summaries · Cited studies
Recommended dose and how to use
Cocoa flavanols (≈500–900 mg/day) or dark chocolate ≥85%.

How to take it

Cocoa flavanols (≈500–900 mg/day) or dark chocolate ≥85%.

Safety

Safe; watch the sugar and the possible cadmium/lead in low-quality products.

Effect by goal · level of evidence

Vascular function and blood pressure

reduces (modest) High meta-analysis (AAA)
−2 to −3 mmHg

Improves endothelial function and lowers blood pressure somewhat.

View the study (meta-analysis) →

Cognition (older adults)

improves (modest) Low-moderate RCT (AA)
Small effect

Possible mild improvement in cognitive performance.

View the study (RCT) →

In depth

⏱ 1 min read

Cocoa is, without question, one of the foods with the highest concentration of flavonoids among all commonly consumed foods, and this is not an evolutionary accident but a consequence of the chemical structure of the cacao plant, which produces these molecules as a defense against pathogens and oxidative stress; the problem is that the industrial processing of chocolate, which includes fermentation, roasting, and dutching or alkalization, destroys between 60 and 90 percent of those original flavonoids, leaving supermarket dark chocolate with a fraction of the bioactive activity of the unprocessed cacao bean, which explains the difference between the effects of pure cocoa in clinical studies and the effects of commercial chocolate in the real world.

Cocoa flavonoids, mainly epicatechin, catechin, and procyanidins, act on cardiovascular health through several well-documented mechanisms: they stimulate endothelial nitric oxide production, a potent vasodilator that improves arterial function and lowers blood pressure; they reduce LDL oxidation, which is the central mechanism in atherosclerosis; they improve insulin sensitivity; and they increase cerebral blood flow, which could explain the cognitive effects reported in some clinical trials; in a trial with people with peripheral artery disease, daily consumption of a cocoa beverage for six months increased walking distance by almost 43 meters and improved mitochondrial function and capillary density in muscle.

References

  1. Wollgast, J.; Anklam, E. (2000). Review on polyphenols in Theobroma cacao: changes in composition during the manufacture of chocolate. Food Res Int 33.
  2. Crozier, S.J. et al. (2011). Cacao seeds are a Super Fruit: A comparative analysis of various fruit powders and products. Chem Cent J 5.
  3. Davison, K. et al. (2010). Dose-related effects of flavanol-rich cocoa on blood pressure. J Hum Hypertens 24.
  4. Ried, K. et al. (2012). Effect of cocoa on blood pressure. Cochrane Database Syst Rev 8.
  5. Buitrago-Lopez, A. et al. (2011). Chocolate consumption and cardiometabolic disorders. BMJ 343.
  6. Buijsse, B. et al. (2006). Cocoa intake, blood pressure, and cardiovascular mortality. Arch Intern Med 166, 4.
  7. Williams, S. et al. (2012). Dark chocolate consumption reduces stress in medical students. J Proteome Res 11, 8.
  8. Field, D.T. et al. (2011). Consumption of cocoa flavanols results in an acute improvement in visual and cognitive functions. Physiol Behav 103, 3.
  9. Ludovici, V. et al. (2017). Cocoa, Blood Pressure, and Vascular Function. Front Nutr 4.
  10. Engler, M.B. et al. (2004). Flavonoid-rich dark chocolate improves endothelial function and increases plasma epicatechin concentrations. J Am Coll Nutr 23, 3.

Information, not medical advice. Scientific evidence reflects the quality of the studies.

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