chocolate; cocoa

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Introduction

A food prepared from ground roasted cacao beans.

Epidemiology

  • individuals with higher depression scores consume more chocolate[7]

Indications

possible benefits*

* 100 g/day or 3 oz/day ~ 500 Kcal[5]

Adverse effects

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]

More general terms

Additional terms

Component of

References

  1. Webster's Ninth New Collegiate Dictionary, Miriam-Webster Inc. Springfield, MA 1990
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  3. 3.0 3.1 3.2 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: https://www.ncbi.nlm.nih.gov/pubmed/15755830
  4. 4.0 4.1 4.2 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: https://www.ncbi.nlm.nih.gov/pubmed/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: https://www.ncbi.nlm.nih.gov/pubmed/17609490
  5. 5.0 5.1 Prescriber's Letter 13(5): 2006 Chocolate and cardiovascular health Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220511&pb=PRL (subscription needed) http://www.prescribersletter.com
  6. Hermann F et al, Dark chocolate improves endothelial and platelet function Heart 2006; 92(1):119 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16365364
  7. 7.0 7.1 Rose N et al. Mood food: Chocolate and depressive symptoms in a cross-sectional analysis. Arch Intern Med 2010 Apr 26; 170:699. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20421555
  8. 8.0 8.1 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: https://www.ncbi.nlm.nih.gov/pubmed/20713904
  9. 9.0 9.1 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: https://www.ncbi.nlm.nih.gov/pubmed/21059981
  10. 10.0 10.1 10.2 Buitrago-Lopez A et al Chocolate consumption and cardiometabolic disorders: Systematic review and meta-analysis. BMJ 2011; 343:d4488 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21875885 <Internet> http://www.bmj.com/content/343/bmj.d4488.full
  11. 11.0 11.1 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: https://www.ncbi.nlm.nih.gov/pubmed/22450943
  12. 12.0 12.1 12.2 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 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22653982 <Internet> http://www.bmj.com/content/344/bmj.e3657
  13. 13.0 13.1 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
  14. 14.0 14.1 14.2 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: https://www.ncbi.nlm.nih.gov/pubmed/29710322 https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2678792
  15. 15.0 15.1 15.2 15.3 15.4 15.5 15.6 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
  16. 16.0 16.1 16.2 16.3 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