It wasn’t so long ago that cocoa and chocolate were considered unhealthy. In fact, back in the late 70s and early 80s carob was being touted as a chocolate substitute—albeit a very sad and far less delicious excuse for a substitute. Since then, study after study has been published extolling the health-promoting properties of cocoa and chocolate. Of course chocolate bars also contain sugars, fats and other dietary components whose intake we’re trying to limit, but the cocoa itself still offers several healthy benefits such as its effects on energy, digestion, cardiovascular health, lung health, antioxidant protection and mood.

ENERGY
People have often noticed that they feel more energetic after consuming cocoa or chocolate, and tend to attribute this to the sugar and calories, but there is more to the story. It turns out that cocoa contains a methylxanthine (the family of compounds to which caffeine belongs) known as theobromine (3.7 percent on a fat-free basis).1 This is significant since theobromine tends to have a mild stimulatory effect.2 In fact, a study3 examined the effects of a chocolate bar, an apple or nothing in 37 healthy, normal-weight women who ate these foods and rated their subjective state 5, 30, 60 and 90 min after eating. Both chocolate and the apple reduced hunger, elevated mood and increased activation, but the effects of the chocolate were greater. The increased activity (induced by the stimulating ingredients of cocoa) was statistically significant (p<0.002).3

DIGESTION
The friendly bacteria in our gut play a role in the digestion of foodstuffs. Research4 suggests that cocoa has beneficial effects on the metabolism of our friendly bacteria. Furthermore, research5 also shows that compounds in cocoa can actually help promote the growth of friendly bacteria. In addition, a historical review6 of the medicinal uses of chocolate indicated that it was used to improve digestion and elimination, where cocoa/chocolate was said to counter the effects of stagnant or weak stomachs, stimulate kidney and improve bowel function. Not surprisingly, human research has shown that salivation was triggered after tasting a very small amount of chocolate.7 This effect has benefits for digestion since saliva contains the enzyme ptyalin amylase that breaks down starch into sugar. Salivary glands also secrete salivary lipase (a more potent form of lipase) to start fat digestion.

CARDIOVASCULAR HEALTH
An 18 week, randomized, controlled, investigator-blinded, parallel study8 examined the effect of 30 mg of polyphenols/ day from dark chocolate or the same amount of white chocolate without polyphenols in 44 adults with untreated prehypertension or stage 1 hypertension. The results were that the group eating the polyphenols from dark chocolate experienced decreased systolic blood pressure by 2.9 points and diastolic blood pressure by 1.9 points. Hypertension prevalence also declined from 86 to 68 percent. Since cocoa powder provides an average of 40.20 mg polyphenols/ gram9, relatively small amounts of cocoa would be needed to offer a similar benefit. Other research10 has also shown that healthy elderly men who consumed a median intake of 2.11 grams cocoa daily had a statistically significant (P=0.03) lower average blood pressure compared to those consuming lower amounts. They also have a lower risk of cardiovascular (P=0.004) and all-cause mortality (P=0.001).

LUNG HEALTH
A historical review11 of the medicinal uses of chocolate recounts 17th and 18th century writers’ discussions on the use of chocolate, including statements such as, "...it cures consumption, and the cough of the lungs," and "has an effect equally... to suspend the violent cause of rheumatoids and inflammation of the lungs, and to dull the irritation and ferocity which incites cough [and] to put out the inflammations of the throat and lungs [pleure]," and "[an] easer of pain, it is excellent, taken inwardly, to cure hoarseness, and to blunt the sharpness of the salts that irritate the lungs..." A more recent randomized, double-blind, placebo-controlled, human study12 suggests a mechanism by which chocolate may have offered its beneficial effects. The study indicated that theobromine (the compound found in chocolate as discussed earlier) was found to suppress capsaicin-induced cough with no adverse effects. The study also demonstrated that theobromine directly inhibits a sensory suggestive of an inhibitory effect on afferent nerve activation. The authors concluded that theobromine is a novel and promising treatment that may form the basis for a new class of antitussive drugs.

ANTIOXIDANT PROTECTION
Research13 has shown that cocoa has potent antioxidant capacity as compared with other products. This can be quantified by a method of measuring antioxidant capacities of various foods: Oxygen Radical Absorbance Capacity (ORAC). According to the USDA,14 100 grams of unsweetened cocoa powder has a total ORAC value of 55,653. Furthermore, a double-blind, randomized study15 reported that markers of antioxidant status increased after dark chocolate consumption, and a reduction of serum oxidative stress was seen.

IMMUNE HEALTH
An interesting study16 reviewed research suggesting a regulatory effect of cocoa on the immune cells implicated in innate and acquired immunity. Cocoa exerts regulatory activity on the secretion of inflammatory mediators. In addition, emerging data from animal studies support an immunomodulating effect. Long-term cocoa intake in rats affects both intestinal and systemic immune function. Other research17 has shown that cocoa extract down-modulated T lymphocyte activation and therefore the acquired immune response, suggesting that it could be important in some states of the immune system hyperactivity such as autoimmune or chronic inflammatory diseases.

MOOD
A British journal18 reported on a study examining chocolate craving in people who were depressed. Nearly 3000 clinically depressed individuals completed a web-based questionnaire, the results of which revealed that chocolate was craved by half of the respondents (more so by women), judged as beneficial for depression, anxiety and irritability, and associated specifically with personality facets encompassed by the higher-order construct of neuroticism. Another study19 argued that the food with the greatest impact on mood is chocolate. Those who crave chocolate tend to do so when they feel emotionally low. There have been a series of suggestions that chocolate’s mood-elevating properties reflect ‘drug-like’ constituents including anandamines, caffeine, phenylethylamine and magnesium. However, the levels of these substances are so low as to preclude such influences. As all palatable foods stimulate endorphin release in the brain this is the most likely mechanism to account for the elevation of mood.

CONCLUSION
Cocoa offers a range of potential health benefits. Not only that, but it tastes good! The consumption of some cocoa daily may make sense—but try to avoid excessive sugar intake when doing so. The use of sweeteners such as stevia would be a good alternative.

  1. Belščak A, Komes D, Horžić D, et al. Comparative study of commercially available cocoa products in terms of their bioactive composition. Food Research International 2009;42(5-6): 707.16.
  2. Dewick PM. Medicinal Natural Products: A Biosynthetic Approach. 3rd ed. West Sussex, UK: Wiley; 2009:414.
  3. Macht M, Dettmer D. Everyday mood and emotions after eating a chocolate bar or an apple. Appetite 2006;46(3):332.6.
  4. Makivuokko H, Kettunen H, Saarinen M, et al. The effect of cocoa and polydextrose on bacterial fermentation in gastrointestinal tract simulations. Biosci Biotechnol Biochem 2007;71(8):1834.43.
  5. Tzounis X, Rodriguez-Mateos A, Vulevic J, Gibson GR, Kwik-Uribe C, Spencer JP. Prebiotic evaluation of cocoa-derived flavanols in healthy humans by using a randomized, controlled, double-blind, crossover intervention study. Am J Clin Nutr. 2011 Jan;93(1):62.72.
  6. Dillinger TL, Barriga P, Escarcega S, Jimenez M, Salazar Lowe D, Grivetti LE. Food of the gods: cure for humanity? A cultural history of the medicinal and ritual use of chocolate. J Nutr 2000;130(8S Suppl):2057S.72S.
  7. Lappalainen R, Sjödén PO, Karhunen L, Gladh V, Lesinska D. Inhibition of anticipatory salivation and craving in response to food stimuli. Physiol Behav 1994;56(2):393.8.
  8. Taubert D, Roesen R, Lehmann C, et al. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial. JAMA 2007;298:49.60.
  9. Natsume M, Osakabe N, Yamagishi M, et al. Analysises of Polypehones in Cacao Liquor, Cocoa, and Chocolate by Normal-Phase and Reversed-Phase HPLC. Biosci Botechnol Biochem 2000;64(12):2581.7.
  10. Buijsse B, Feskens EJ, Kok FJ, Kromhout D. Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study. Arch Intern Med 2006;166:411.7.
  11. Dillinger
  12. Usmani OS, Belvisi MG, Patel HJ, et al. Theobromine inhibits sensory nerve activation and cough. FASEB J 2005;19(2):231-3.
  13. Ramiro-Puig E, Castell M. Cocoa: antioxidant and immunomodulator. Br J Nutr 2009;101(7):931. 40.
  14. U.S. Department of Agriculture, Agricultural Research Service. USDA Database for the Oxygen Radical Absorbance Capacity (ORAC) of Selected Foods, Release 2. Beltsville, MD: Beltsville Human Nutrition Research Center; May 2010:39.
  15. Flammer AJ, Hermann F, Sudano I, et al. Dark chocolate improves coronary vasomotion and reduces platelet reactivity. Circulation 2007;116(21):2376.82.
  16. Ramiro-Puig
  17. Ramiro E, Franch A, Castellote A, et al. Effect of Theobroma cacao flavonoids on immune activation of a lymphoid cell line. British Journal of Nutrition 2005; 93:859.66.
  18. Parker G, Crawford J. Chocolate craving when depressed: a personality marker. Br J Psychiatry 2007;191:351.2.
  19. Benton D, Donohoe RT. The effects of nutrients on mood. Public Health Nutrition: 2(3a), 403.9.

Gene Bruno, MS, MHS

Gene Bruno is the Dean of Academics and Professor of Dietary Supplement Science for Huntington College of Health Sciences (a nationally accredited distance learning college offering diplomas and degrees in nutrition and other health science related subjects. Gene has two undergraduate Diplomas in Nutrition, a Bachelor’s in Nutrition, a Master’s in Nutrition, a Graduate Diploma in Herbal Medicine, and a Master’s in Herbal Medicine. As a 32 year veteran of the Dietary Supplement industry, Gene has educated and trained natural product retailers and health care professionals, has researched and formulated natural products for dozens of dietary supplement companies, and has written articles on nutrition, herbal medicine, nutraceuticals and integrative health issues for trade, consumer magazines, and peer-reviewed publications. Gene's latest book, A Guide to Complimentary Treatments for Diabetes, is available on Amazon.com, and other fine retailers.