The Effects of Dark Chocolate on Cardiovascular Health

Kileigh Chapman
NTR 502
Fall 2016

The Effects of Dark Chocolate on Cardiovascular Health

Introduction
Cardiovascular disease is the leading cause of death and morbidity in
both males and females worldwide (Grassi p. 1). High blood pressure,
atherosclerosis, and endothelial function can all affect an individuals
cardiovascular health. High blood pressure is one of the major risk factors
that can lead to cardiovascular disease, stroke, and peripheral artery disease
(Romero-Prado p. 1). Atherosclerosis is another one of the causes for
cardiovascular disease. Dysfunction of the vascular endothelium is
considered a cause in the development of atherosclerosis which could later
lead to cardiovascular disease (West p. 1). Studies also show that endothelial
function is impaired during hyperglycemia which can further lead to
atherosclerosis (Grassi p. 1).
Increasing evidence shows there is a protective effect of cocoa
consumption against cardiovascular disease (Grassi p. 1). The consumption
of cocoa and dark chocolate is associated with a lower risk of cardiovascular
disease and improvements in endothelial function (West p. 1). Regular
consumption of dark chocolate has been shown to lower the incidence of
myocardial infarction, stroke, and cardiovascular mortality (Rull p. 1) Cocoa
products are also shown to lower blood pressure, improve endothelium
function, and inhibit platelet aggregation (Rull p.1). Many studies are being
conducted to determine which compounds in cocoa are associated with the
cardiovascular health benefits. Cocoa may also have a beneficial effect on
cholesterol levels because it consists mainly of stearic acid and oleic acid. Stearic

acid is a saturated fat, but unlike most saturated fatty acids, it does not raise blood
cholesterol levels. Oleic acid, a monounsaturated fat, does not raise cholesterol and
may even reduce it (Michigan).

There are extensive research efforts being conducted in whether

chocolate and flavanols will assist the prevention of cardiovascular disease.
Previous epidemiological studies have shown that the consumption of
flavonoids is associated with a decrease risk of cardiovascular disease
(Romero-Prado p. 1). The beneficial effects of fruits and vegetables have
been linked to their flavonoid content (Grassi p. 1). Cocoa and chocolate are
one of the most important sources of flavonoids in the human diet (Grass p.
1). Cocoa and cocoa-containing foods provide a higher content of flavonoids
per serving than red wine or tea (Koli). Cocoa has been defined as a
functional food due to its high flavanol content (Sarria). Research is
continuously being conducted to understand how cocoa flavanols promote
health. Flavanols in chocolate have been shown to promote blood flow by
helping relax blood vessels and reducing the tendency to form blood clots
(McWilliams 361). Clinical dietary interventions have shown that a higher
intake of flavanol-containing foods can increase arterial function in
individuals at risk for cardiovascular disease and in individuals who currently
have cardiovascular disease (Heiss). This paper will look at the nutrient
content of cocoa and its effects on cardiovascular health with the support of
evidence based research.
The History of Chocolate

Chocolate is made using beans harvested from the cocoa tree, Theobroma
cacao. The Theobroma cacoa tree is grown in tropical climates and is an important
cash crop. The beans are removed from their pod, fermented, dried, roasted and
then ground to produce a cocoa mass or cocoa liquor. Cocoa liquor can be pressed
to yield cocoa butter and cocoa cake which is ground up into cocoa powder. Cocoa
liquor can also be combined with cocoa butter, sugar, vanilla, (and milk, in milk
chocolate) to make chocolate.

Nutrient content of Dark Chocolate and Cocoa

The beneficial cardiovascular effects of cocoa products in humans has
been credited to the polyphenol content. Polyphenols are plant-derived
compounds that can be divided into flavonoids and non-flavonoids.
Polyphenols are non-essential nutrients and the health effects of polyphenols
depend on their bioavailability, the rate and extent of their absorption and
metabolism, and the chemical structure of the molecule. Flavonoids consist
of six subgroups. These subgroups include flavanols, flavan-3-ols, flavones,
isoflavones, flavanones, and anthocyanins. Isoflavones, anthocyanins and
cocoa flavan-3-ols are the three subgroups that have been shown to have a
positive effect on arterial stiffness. The flavanols that cocoa contains are
monomeric flavanols, which include epicatechin, catechin, and oligomeric
procyanidins (Koli p. 1). Flavan-3-ols are aromatic compounds with a 2phenyl-3,4-dihydro-2H-chromen-3-ol skeleton or a catechin (Romero-Prado p.
1). Catechins are found in vegetables, green tea, red apples, and cocoa

beans. They are found to have positive effects on blood pressure,

inflammation, obesity, and dyslipidemia (Romero).
The total flavonoid content of the cocoa bean is about 6-8% by weight
of the dried bean. The flavanol content in chocolate depends on post-harvest
treatment of the cocoa beans and manufacturing. Depending on the
methods of production, cocoa powder can contain as much as 10%
flavonoids (Grassi). Fermentation, drying, and roasting of the cocoa beans
during processing will reduce the total flavanol content. Commercial dark
chocolate only contains less than 1% of flavanols by weight (Grassi).