What science says about the health benefits of chocolate

On an island just off the coast of Panama lives an indigenous tribe called the Kuna, who outlive other people in Panama. Despite their relatively high-salt diet, the Kuna tend to have lower blood pressure than do other people in Panama. In addition, they experience fewer heart attacks and they’re less likely to be diagnosed with type 2 diabetes or cancer.

After much study, researchers determined that what set the Kuna people apart wasn’t what they ate. Instead, it likely stemmed from what they drank — more than five cups of cocoa daily.

Since then, scientists been trying to figure out whether consuming cocoa — and the chocolate made from it — benefits overall health.

Why cocoa may be good for your health

Researchers think cocoa may have health benefits for two reasons. First, it’s rich in flavanols, which are antioxidants believed to protect blood vessels from aging. Second, it contains theobromine, a bitter-tasting stimulant that may reduce inflammation.

People often use the words “cacao,” “cocoa” and “chocolate” interchangeably. However, they mean slightly different things. Manufacturers dry, roast and pulverize the beans from the cacao tree to make cocoa. Because pure cocoa is very bitter, manufacturers add sugar, milk, fat and other ingredients to create hot cocoa mixes and chocolate bars.

What research says about potential health benefits of chocolate

The research on chocolate and its health benefits has been mixed. One study that followed the eating habits of over 55,000 people found that rates of atrial fibrillation, an irregular heart rhythm, were lower in people who consumed chocolate more often. Another large, long-term study hinted that chocolate consumption might reduce the risk of having a heart attack.

However, those observational studies only show a correlation between chocolate consumption and health. They don’t prove a cause-and-effect relationship. Randomized controlled trials are best for that.

The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) is one of the largest and longest-running randomized controlled trials to look at the relationship between chocolate consumption and health.

In this trial:

• Some of the over 21,000 participants took a supplement twice a day that contained 500 milligrams of cocoa flavanols.

• Other participants took placebo pills.

During the study, participants who took the cocoa supplement had similar rates of heart attacks as did participants who took placebo pills. They also had similar rates of type 2 diabetes and performed similarly on tests of cognitive health.

However, those who took the cocoa supplement were 27% less likely to die of heart-related events.

In a separate review of 35 randomized controlled trials involving more than 1,800 people, the consumption of flavanol-enriched cocoa led to a small, 2-millimeter of mercury (mm Hg) drop in blood pressure over an average of nine weeks.

Why everyday chocolate may not be as healthy

The potential health benefits of chocolate are likely mild, at best. And you may not get them by consuming store-bought chocolate. That’s because the cocoa used in research differs significantly from chocolate sold commercially.

For example, the cocoa supplement in the COSMOS study contained 500 milligrams of flavanols. That’s about five times more flavanols than most people consume daily from all flavanol-rich foods and beverages — including tea, berries and grapes — combined.

Other ingredients — especially sugar and saturated fat — that are added to store-bought chocolate dramatically dilute the cocoa content. And that reduces the amount of flavanols.

Smart ways to savor chocolate

So there’s no reason to add chocolate to your diet if you don’t like it. But if you do, here’s how to get the biggest health bang for your caloric buck:

• Go dark. The darker the chocolate, the less sugar and more cocoa and flavanols it contains. Look for products that list the percentage of cacao on the label. The higher the percentage listed, the more flavanols and less sugar in the product. If you drink hot chocolate, make it from unsweetened 100% cocoa. Oh, and despite its name, white chocolate contains no cocoa at all – so skip it in favor of darker chocolate.

• Keep portions in check. Even the darkest bars of chocolate still have a lot of calories and sugar. For example, one large 101-gram, 70% to 85% cacao bar of chocolate comes with 604 calories, 43 grams of fat and 24 grams of sugar. So keep portions small and think of chocolate as an occasional treat.

• Consume other flavanol-rich foods. In addition to cocoa, black and green tea, cinnamon, grapes and apples are packed with flavanols. Many different plant foods — including most fruits, vegetables and herbs — contain numerous other health-promoting substances as well. So rather than zeroing in only on chocolate, try to eat a wide variety of plant foods.