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.
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
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.
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).
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.
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.
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
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.
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.
- 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.
- Dewick PM. Medicinal Natural Products: A Biosynthetic Approach. 3rd ed. West Sussex, UK: Wiley; 2009:414.
- Macht M, Dettmer D. Everyday mood and emotions after eating a chocolate bar or an apple. Appetite 2006;46(3):332.6.
- 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.
- 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.
- 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 Nutr2000;130(8S Suppl):2057S.72S.
- 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.
- 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. JAMA2007;298:49.60.
- 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 Biochem2000;64(12):2581.7.
- 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.
- Usmani OS, Belvisi MG, Patel HJ, et al. Theobromine inhibits sensory nerve activation and cough. FASEB J 2005;19(2):231-3.
- Ramiro-Puig E, Castell M. Cocoa: antioxidant and immunomodulator. Br J Nutr 2009;101(7):931. 40.
- 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.
- Flammer AJ, Hermann F, Sudano I, et al. Dark chocolate improves coronary vasomotion and reduces platelet reactivity. Circulation 2007;116(21):2376.82.
- 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.
- Parker G, Crawford J. Chocolate craving when depressed: a personality marker. Br J Psychiatry 2007;191:351.2.
- Benton D, Donohoe RT. The effects of nutrients on mood. Public Health Nutrition: 2(3a), 403.9.