Cocoa, Chocolate, Cocoa Extract, Cacao Plant, Cacao Bean

  • Definitions
  1. Cacao Plant
    1. Most commonly Theobroma cacao, a tree in family Sterculiaceae or Byttneriaceae
    2. Cacao Beans and other extracts are fermented and roasted to produce cocoa and Chocolate
  • Mechanism
  1. Cocoa Extracts contain flavonoids (or Flavanols)
    1. Epicatechin
    2. Catechin
    3. Procyanidins
    4. Xanthines (e.g. theobromine)
  2. Flavonoids may increase vasodilation and decrease Blood Pressure (limited evidence)
    1. Nitric oxide increased (activates endothelial nitric oxide synthase or eNOS)
    2. Inhibits Angiotensin Converting Enzyme
  3. Other potential other effects with weaker evidence
    1. Insulin Sensitivity increased
    2. Enhanced cognition
    3. Antiinflammatory effects
      1. May suppress endogenous pro-inflammatory factors
      2. May scavenge oxygen free radicals
  • Efficacy
  1. Cardiovascular Death risk reduction (limited evidence)
    1. Cocoa containing >=4% naturally conserved cocoa flavinoids, at 500 mg daily for 3.5 years
    2. Does not appear to lower risk of Cerebrovascular Accident or Myocardial Infarction
    3. Buijsse (2006) Arch Intern Med 166(4):411-7 +PMID: 16505260 [PubMed]
    4. Sesso (2022) Am J Clin Nutr 115(6):1490-500 +PMID: 35294962 [PubMed]
  2. Blood Pressure lowering (limited evidence)
    1. May lower Blood Pressure by up to 4 mmHg systolic, and 2 mmHg diastolic
    2. Hooper (2012) Am J Clin Nutr 95(3):740-51 +PMID: 22301923 [PubMed]
    3. Ludovici (2017) Front Nutr 4:36+PMID: 28824916 [PubMed]
  • Adverse Effects
  1. Heavy Metal Contamination (esp. Lead, Arsenic, Cadmium)
    1. Varies by the soil in which cacao trees are grown
    2. Higher risk with increasing percent cocoa and the hardness of Chocolate
    3. Lo Dico (2018) Food Chem 245:1163-8 +PMID: 29287336 [PubMed]
    4. Abt (2018) Food Addit Contam Part B Surveill 11(2):92-102 +PMID: 29310543 [PubMed]
  2. Caffeine Exposure
    1. Cocoa typically contains 35 mg Caffeine per serving (similar to caffeinated drinks)
    2. Cocoa products are only required to list the Caffeine amount ADDED to the naturally present Caffeine
    3. Avoid with other stimulants, beta Agonists, or other high Caffeine sources
  • Safety
  1. Avoid excessive cocoa in pregnancy and Lactation (moderate amounts appear safe)
    1. High doses may be associated with excessive Caffeine and Heavy Metal exposure
  • References