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  • Can drinking cocoa protect your heart when you're stressed? - Science Daily, 3/31/21 - "blood vessels were able to function better during mental stress when people were given a cocoa drink containing high levels of flavanols than when drinking a non-flavanol enriched drink ... A thin membrane of cells lining the heart and blood vessels, when functioning efficiently the endothelium helps to reduce the risk of peripheral vascular disease, stroke, heart disease, diabetes, kidney failure, tumour growth, thrombosis, and severe viral infectious diseases. We know that mental stress can have a negative effect on blood vessel function ... The researchers measured forearm blood flow and cardiovascular activity at rest and during stress and assessed functioning of the blood vessels up to 90 min post stress -- discovering that blood vessel function was less impaired when the participants drank high-flavanol cocoa. The researchers also discovered that flavanols improve blood flow during stress ... Our findings are significant for everyday diet, given that the daily dosage administered could be achieved by consuming a variety of foods rich in flavanols -- particularly apples, black grapes, blackberries, cherries, raspberries, pears, pulses, green tea and unprocessed cocoa. This has important implications for measures to protect the blood vessels of those individuals who are more vulnerable to the effects of mental stress" - See Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie, 4.12 oz., 86% Cacao (Pack of 6) at Amazon.com.
  • The Secret Behind Cocoa's Brain-Boosting Ability - Medscape, 12/10/20 - "Improved brain oxygenation observed with the flavanol-packed cocoa drink appeared to translate into improved cognitive performance on more complex cognitive tasks. The men performed higher-complexity tasks 11% faster on average after consuming the flavanol-enriched drink"
  • Cocoa flavanols boost brain oxygenation, cognition in healthy adults - Science Daily, 11/24/20 - "Previous studies have shown that eating foods rich in flavanols can benefit vascular function, but this is the first to find a positive effect on brain vascular function and cognitive performance in young healthy adults ... The team tested the 18 participants before their intake of cocoa flavanols and in two separate trials, one in which the subjects received flavanol-rich cocoa and another during which they consumed processed cocoa with very low levels of flavanols ... About two hours after consuming the cocoa, participants breathed air with 5% carbon dioxide -- about 100 times the normal concentration in air. This is a standard method for challenging brain vasculature to determine how well it responds ... The levels of maximal oxygenation were more than three times higher in the high-flavanol cocoa versus the low-flavanol cocoa ... After ingesting the cocoa flavanols, participants also performed better on the most challenging cognitive tests, correctly solving problems 11% faster than they did at baseline or when they consumed cocoa with reduced flavanols"
  • Sweet News: Dark Chocolate Tied to Lower Depression Risk - Medscape, 8/9/19 - "Chocolate contains a number of psychoactive ingredients, including two analogues of anandamine, which produce effects similar to that of cannabinoid, an agent that causes feelings of euphoria from ingesting cannabis. In addition, chocolate contains several endogenous biogenic amines, as well as phenylethylamine, a neuromodulator that is believed to be important for regulating mood, the investigators note ... After adjusting for multiple factors, participants who reported any dark chocolate consumption had 70% lower likelihood of reporting clinically relevant depressive symptoms compared to those who did not eat any chocolate (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.21 – 0.72). However, the researchers found no significant link between any non–dark chocolate consumption and clinically relevant depressive symptoms"
  • Phenols in cocoa bean shells may reverse obesity-related problems in mouse cells - Science Daily, 6/20/19 - "three of the phenolic compounds in cocoa bean shells have powerful effects on the fat and immune cells in mice, potentially reversing the chronic inflammation and insulin resistance associated with obesity ... cocoa shells contain high levels of three beneficial bioactive chemicals also found in cocoa, coffee and green tea -- protocatechuic acid, epicatechin and procyanidin B2 ... Cocoa shells are a waste byproduct that's generated when cocoa beans are roasted during chocolate production"
  • Effects of Dark Chocolate on NOX-2-generated Oxidative Stress in Patients With Non-alcoholic Steatohepatitis - Medscape, 9/1/16 - "Compared to controls, NASH patients had higher sNOX2-dp, serum isoprostanes and CK-18 levels. A significant difference for treatments was found in subjects with respect to sNOX2-dp, serum isoprostanes and serum CK-18. The pairwise comparisons showed that, compared to baseline, after 14 days of dark chocolate intake, a significant reduction in sNOX2-dp serum isoprostanes and CK-18 M30 was found. No change was observed after milk chocolate ingestion"
  • Eating chocolate each day could reduce heart disease, diabetes risk - Science Daily, 4/28/16 - "Data of 1,153 people aged 18-69 years old who were part of the Observation of Cardiovascular Risk in Luxembourg (ORISCAV-LUX) study were analysed. It was found that those who ate 100 g of chocolate a day -- equivalent to a bar -- had reduced insulin resistance and improved liver enzymes. Insulin sensitivity is a well-established risk factor to cardiovascular disease"
  • Eating dark chocolate as a daily snack could help boost athletic performance - Science Daily, 4/19/16 - "dark chocolate provides similar benefits to beetroot juice, now taken regularly by elite athletes after studies showed it can improve performance. "Beetroot juice is rich in nitrates, which are converted to nitric oxide in the body. This dilates blood vessels and reduces oxygen consumption -- allowing athletes to go further for longer," ... after eating dark chocolate, the riders used less oxygen when cycling at a moderate pace and also covered more distance in a two-minute flat-out time trial"
  • Chocolate Can Boost Your Workout - New York Times, 3/23/16 - "the scientists provided half of the cyclists with 40 grams (1.4 ounces, or about one and a half squares) per day of Dove brand dark chocolate, which has been found in past tests to contain an above-average amount of epicatechin ... The results were beguiling. Each of the cyclists performed better in most of the physical tests after two weeks of supplementing with dark chocolate, compared to baseline results and after they had eaten white chocolate. The riders utilized less oxygen to ride at a moderate pace, a change that would generally allow them to ride longer or harder before tiring; and they covered more distance during a two-minute, all-out time trial, meaning that their anaerobic, sprinting ability had been enhanced ... more than 40 grams is unlikely to be helpful" - See Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie, 4.12 oz., 86% Cacao (Pack of 4) at Amazon.com.  Each individually wrapped square is 10 grams.  Also see Dove Dark Chocolate Candy Bar, Singles (18 Count) which are 40 gram bars which may have been the ones in this study but it doesn't tell you the percentage of cacao.  Some websites show the old packaging and it says 71% cacao.  I doubt if you find anything with a higher percentage of cacao than the Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie  (86%) so my theory is that you're getting the most cacao for the least calories.
  • Can Eating Chocolate Improve Your Brain? - WebMD, 2/22/16 - "The researchers used a battery of tests to measure brain performance in people who ate chocolate regularly. They included tests of verbal memory, scanning and tracking, visual-spatial memory [which allows us to find our keys or remember the way home, for example] and organization, and abstract reasoning, including the ability to recall a list of words or remember where an object was placed ... The relationship between chocolate and better performance held up even when researchers took into account things like age, sex, education, cholesterol, blood pressure, and alcohol intake" - [Nutra USA]
  • Bit of Chocolate in Pregnancy May Help Mom, Baby - WebMD, 2/4/16 - "Pregnant women who nibble just a small piece of chocolate each day may improve the circulatory health of their unborn child ... The tiny treat may also reduce the risk for preeclampsia ... All were instructed to consume 30 grams of chocolate (a little more than one ounce) each day over a 12-week period. That's equivalent to about one small square of chocolate per day ... Half of the women consumed high-flavanol chocolate, while the other half were given low-flavanol chocolate ... simply consuming a small amount of chocolate -- no matter what the flavanol content -- was associated with notable improvements in all blood circulation and velocity measures compared to the general population"
  • Could Cocoa Flavanols Improve Heart Health? - Medscape, 1/28/16 - "There are now several small-scale randomized clinical trials demonstrating that the cocoa flavanols in amounts ranging between 400 and 900 mg/day may favorably affect several mechanisms and pathways that are related to cardiovascular disease prevention. And this includes effects on improving flow-mediated vasodilatation, lowering blood pressure, improving glucose tolerance, decreasing inflammation, and even slowing cognitive decline and age-related memory loss ... While waiting for the results of this trial, which may take another 4 years, it's important to understand that chocolate and cocoa flavanols are not synonymous and that chocolate actually provides highly variable amounts of the cocoa flavanols; it will depend on the harvesting and processing of the cocoa. And there are many forms of chocolate that are high in sugar, saturated fat, and calories and provide minimal—if any—cocoa flavanols"
  • Eight nutrients to protect the aging brain - Science Daily, 4/15/15 - "Cocoa flavanols have been linked to improved circulation and heart health, and preliminary research shows a possible connection to memory improvement as well. A study showed cocoa flavanols may improve the function of a specific part of the brain called the dentate gyrus, which is associated with age-related memory (Brickman, 2014)"
  • Dietary cocoa flavanols reverse age-related memory decline in mice - Science Daily, 10/26/14 - "Most methods of processing cocoa remove many of the flavanols found in the raw plant ... 37 healthy volunteers, ages 50 to 69, were randomized to receive either a high-flavanol diet (900 mg of flavanols a day) or a low-flavanol diet (10 mg of flavanols a day) for three months. Brain imaging and memory tests were administered to each participant before and after the study ... When we imaged our research subjects' brains, we found noticeable improvements in the function of the dentate gyrus in those who consumed the high-cocoa-flavanol drink ... The high-flavanol group also performed significantly better on the memory test ... If a participant had the memory of a typical 60-year-old at the beginning of the study, after three months that person on average had the memory of a typical 30- or 40-year-old ... The precise formulation used in the CUMC study has also been shown to improve cardiovascular health ... the product used in the study is not the same as chocolate, and they caution against an increase in chocolate consumption in an attempt to gain this effect" - See Garden of Life, Radical Fruits Antioxidant Complex at Amazon.com.
  • Chocolate: A sweet method for stroke prevention in men? - Science Daily, 8/29/12 - "While other studies have looked at how chocolate may help cardiovascular health, this is the first of its kind study to find that chocolate ... Those eating the highest amount of chocolate had a 17-percent lower risk of stroke, or 12 fewer strokes per 100,000 person-years compared to those who ate no chocolate ... In a larger analysis of five studies that included 4,260 stroke cases, the risk of stroke for individuals in the highest category of chocolate consumption was 19 percent lower compared to non-chocolate consumers. For every increase in chocolate consumption of 50 grams per week, or about a quarter cup of chocolate chips, the risk of stroke decreased by about 14 percent ... The beneficial effect of chocolate consumption on stroke may be related to the flavonoids in chocolate" - See Garden of Life, Radical Fruits Antioxidant Complex at Amazon.com.  I'm still betting it covers the flavonoids without the calories or the headache I get from chocolate.
  • Dark chocolate, cocoa compounds, may reduce blood pressure - Science Daily, 8/14/12 - "The researchers reviewed evidence from short-term trials in which participants were given dark chocolate or cocoa powder daily and found that their blood pressure dropped slightly compared to a control group ... Cocoa contains compounds called flavanols, thought to be responsible for the formation of nitric oxide in the body. Nitric oxide causes blood vessel walls to relax and open wider, thereby reducing blood pressure. The link between cocoa and blood pressure stems from the discovery that the indigenous people of San Blas Island in Central American, who drink flavanol-rich cocoa drinks every day, have normal blood pressure regardless of age ... Flavanol-rich chocolate or cocoa powder reduced blood pressure on average by 2-3 mm Hg" -  [Abstract] - Note:  I'm betting that this formula will cover most of those flavanols: Garden of Life, Radical Fruits Antioxidant Complex at Amazon.com.
  • Cocoa May Sharpen Aging Brain - WebMD, 8/13/12 - "included 90 elderly people who already had mild cognitive impairment (MCI) ... For eight weeks, they drank a cocoa drink that had high, medium, or low amounts of antioxidants called flavanols. Those who got high and medium levels of flavanols in their drink did better on tests of attention and other mental skills, compared to people who got low amounts of flavanols"
  • Beyond apples: A serving a day of dark chocolate might keep the doctor away - Science Daily, 4/24/12 - "31 fortunate subjects were assigned randomly to consume either a daily serving (50 grams) of either regular dark chocolate (70% cocoa), dark chocolate (70% cocoa) that had been overheated or "bloomed," or white chocolate (0% cocoa). The subjects were asked to consume the chocolate for 15 days ... When compared to participants assigned to the white chocolate group, those consuming either form of dark chocolate had lower blood glucose and low-density lipoprotein cholesterol (LDL, the "bad" form) levels coupled with higher high-density lipoprotein cholesterol (HDL, the "good" form) ... dark chocolate may reduce the risk of cardiovascular disease by improving glucose levels and lipid profiles. However, they cautioned that -- although habitual dark chocolate consumption may benefit one's health by reducing the risk of cardiovascular disease -- it must be eaten in moderation because it can easily increase daily amounts of saturated fat and calories"
  • Regular chocolate eaters are thinner, evidence suggests - Science Daily, 3/27/12 - "adults who ate chocolate on more days a week were actually thinner -- i.e. had a lower body mass index -- than those who ate chocolate less often. The size of the effect was modest but the effect was "significant" -larger than could be explained by chance. This was despite the fact that those who ate chocolate more often did not eat fewer calories (they ate more), nor did they exercise more. Indeed, no differences in behaviors were identified that might explain the finding as a difference in calories taken in versus calories expended"
  • Cocoa may enhance skeletal muscle function - Science Daily, 3/2/12 - "Mitochondria are structures responsible for most of the energy produced in cells. These "fuel cells" are dysfunctional as a result of both type 2 diabetes and heart failure, leading to abnormalities in skeletal muscle ... The trial participants consumed dark chocolate bars and a beverage with a total epicatechin content of approximately 100 mg per day for three months ... After three months, we saw recovery -- cristae numbers back toward normal levels, and increases in several molecular indicators involved in new mitochondria production" - Note:  I don't know what it is about chocolate but it's the only thing that will give me a headache.
  • Antioxidant-rich cocoa shows short-term heart benefits: Harvard review - Nutra USA, 9/29/11 - "Consumption of flavonoid-rich cocoa was associated with an average decrease in systolic blood pressure of about 1.6 mmHg ... It has been reported that a mere 2 mmHg decrease in systolic blood pressure could lead to 6% fewer stroke-related deaths, a 4% lower rate of heart disease deaths and a 3% reduction in overall deaths among Americans ... the Boston-based scientists also report a significant increase in levels of HDL cholesterol following consumption of antioxidant-rich cocoa ... The maximum effects were observed for a flavonoid dose of 500 mg/d"
  • Heavy chocolate consumption may be linked to heart health, study suggests - Science Daily, 8/30/11 - "High levels of chocolate consumption might be associated with a one third reduction in the risk of developing heart disease ... the authors stress that further studies are needed to test whether chocolate actually causes this reduction or if it can be explained by some other unmeasured (confounding) factor ... A number of recent studies have shown that eating chocolate has a positive influence on human health due to its antioxidant and anti-inflammatory properties. This includes reducing blood pressure and improving insulin sensitivity (a stage in the development of diabetes) ... They analysed the results of seven studies, involving over 100,000 participants with and without existing heart disease. For each study, they compared the group with the highest chocolate consumption against the group with the lowest consumption ... highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease and a 29% reduction in stroke compared with lowest levels"
  • Systematic review: Chocolate can reduce heart disease risk by a third - Nutra USA, 8/29/11 - "A Cambridge University-led systematic review published today in the British Medical Journal has concluded that polyphenol-rich consumption can reduce the risk of heart disease by a third ... The highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease (relative risk 0.63 (95% confidence interval 0.44 to 0.90)) and a 29% reduction in stroke compared with the lowest levels ... These favourable effects seem mainly mediated by the high content of polyphenols present in cocoa products and probably accrued through increasing the bioavailability of nitric oxide, which subsequently might lead to improvements in endothelial function, reductions in platelet function, and additional beneficial effects on blood pressure, insulin resistance, and blood lipids ... But they noted none of the selected trials were controlled, randomised studies with six cohort studies and a cross sectional study, and therefore offered the caveat: "We expect further studies will be done to confirm or refute the results of our analyses""
  • Dark chocolate/cocoa effective for cholesterol improvements: Meta-analysis - Nutra USA, 8/22/11 - "Researchers from Brigham and Women’s Hospital and Harvard Medical School in Boston report that short-term consumption of dark chocolate was associated with a reduction of total cholesterol of 6.23 milligrams per dl, while LDL was reduced by, on average, 5.9 ml/dl ... The degree to which LDL and [total cholesterol] levels were reduced in this analysis reflects some measure of potency of the cocoa regimen ... cocoa may also affect gut microflora and possess prebiotic potential ... Dr Djoussé and his co-workers performed a detailed literature search and identified 10 clinical trials of flavanol-rich cocoa products or dark chocolate involving 320 participants. Five of the studies used daily flavanol doses of less than 500 mg, while the other five used doses exceeding 500 mg per day" - [Abstract]
  • Skip the carrots. Chocolate improves eyesight, too - MSNBC, 8/8/11 - "They took the tests twice, once after eating a dark chocolate bar, and once after eating a white chocolate bar. The difference between the two chocolate bars was the amount of flavanols -- a natural compound in cocoa -- they contained. Of course, the dark chocolate bar contained loads of cocoa flavanols, the white chocolate bar only a trace ... the study participants did perform better on the vision tests and on some of the brain function tests after eating the dark chocolate ... They attribute their findings to cocoa flavanol’s known ability to increase blood flow to the brain, and they speculate that the stuff might also increase blood flow to the retina of the eye"
  • Phys Ed: How Chocolate Can Help Your Workout - NYTimes.com, 8/3/11 - "chocolate’s potential role in exercise performance had not been studied, or probably even much considered, until scientists at the University of California, San Diego, and other institutions gave middle-aged, sedentary male mice a purified form of cacao’s primary nutritional ingredient, known as epicatechin, and had the mice work out. Epicatechin is a flavonol, a class of molecules that are thought to have widespread effects on the body ... The fittest rodents, however, were those that had combined epicatechin and exercise. They covered about 50 percent more distance than the control animals ... The muscle biopsies offered some explanation for their dominance. The muscles of all of the animals that had been given epicatechin contained new capillaries, as well as biochemical markers indicating that their cells were making new mitochondria. Mitochondria are structures in cells that produce cellular energy. The more functioning mitochondria a muscle contains, the healthier and more fatigue-resistant it is ... Processing destroys epicate ... heavily processed milk chocolate contains almost none of the flavonol, while cacao-rich dark chocolate has far more ... more is not better ... “More could lessen or even undo” any benefits, he said, by overloading the muscles’ receptors or otherwise skewing the body’s response"
  • Low-fat chocolate milk can boost aerobic fitness, research - Nutra USA, 6/8/11 - "Immediately following exercise and again, two hours following exercise, participants consumed a recovery drink of low-fat chocolate milk, a calorie and fat-matched carbohydrate beverage or a non-caloric flavoured water ... chocolate milk improved cycling performance more than the other drinks, cutting at least six minutes on average off the cyclist’s ride time ... Chocolate milk was also found to increase signals for muscle protein synthesis, which leads to the repair and rebuilding of muscle proteins, more than the other drinks"
  • Cocoa extracts may benefit cholesterol levels: Study - Nutra USA, 5/31/11 - "recruited 42 volunteers with a mean age of 70 to participate in their randomized, crossover feeding trial. All the participants received 500 mL of skimmed milk/day with or without 40g of cocoa powder for 4 weeks. The 40 grams of cocoa powder provided 495.2 milligrams of polyphenols and 425.7 milligrams of proanthocyanidins ... At the end of the study the researchers found that milk plus cocoa was associated with a 5 percent increase in HDL cholesterol levels, compared to only milk ... In addition, cocoa plus milk was associated with a 14 percent reduction in oxidized LDL cholesterol levels, compared to milk only ... the polyphenols in cocoa may bind to LDL particles and therefore prevent them from being oxidized ... Concerning the increase in HDL, they note that the mechanism remains to be elucidated, but it may be related to polyphenols boosting the production of a molecule called apolipoprotein (Apo) A1, which is the main protein component of HDL"
  • Alkaline processing reduces cocoa's flavanol content, study - Nutra USA, 3/14/11
  • Nutrigenomics shows blood pressure benefits of cocoa - Nutra USA, 3/8/11 - "The magnitude of the hypotensive effects of cocoa is clinically noteworthy; it is in the range that is usually achieved with monotherapy of beta-blockers or antiotensin-converting enzyme inhibitors ... recruited 16 volunteers aged between 20 and 45, and asked them to eat 75 grams of dark chocolate with 72 percent cocoa content every day for two weeks" - [Abstract]
  • New explanation for heart-healthy benefits of chocolate - Science Daily, 2/7/11 - "studies have shown that cocoa, the main ingredient in chocolate, appears to reduce the risk of heart disease by boosting levels of HDL, or "good" cholesterol, and decreasing levels of low-density lipoprotein (LDL), or "bad" cholesterol. Credit for those heart-healthy effects goes to a cadre of antioxidant compounds in cocoa called polyphenols, which are particularly abundant in dark chocolate"
  • Chocolate is a 'super fruit': Rich source of antioxidants - Science Daily, 2/6/11 - "chocolate is a rich source of antioxidants and contains more polyphenols and flavanols than fruit juice ... both dark chocolate and cocoa had a greater antioxidant capacity and a greater total flavanol, and polyphenol, content than the fruit juices. However hot chocolate, due to processing (alkalization) of the chocolate, contained little of any"
  • Polyphenol-rich choc may ease chronic fatigue symptoms: Study - Nutra USA, 11/23/10 - "either the high or low chocolate, followed by two weeks of washout and cross over on to the other intervention. The study used chocolate provided by Nestlé PTC York, UK ... Results showed a significant improvement in Chalder Fatigue Scale scores following the high polyphenol chocolate intervention, whereas a deterioration was observed in the low-polyphenol chocolate intervention" 
  • Chocolate and Blood Pressure -- Some Bitter Results - Medscape, 11/22/10 - "The problem is that all of the studies -- epidemiologic, observational, and clinical trials -- haven't been well controlled ... The current design had 3-week ingestions of placebo, a cocoa drink, or a usual dose of cocoa drink plus theobromine, which is the compound in chocolate thought to prevent some of the cardiovascular complications ... They had very surprising results. For one thing, the group that got theobromine, or cocoa plus theobromine, in either dose had an increase in heart rate and an increase in blood pressure when measured peripherally and when measured on ABPM. That's not a good thing" - See the video on that link.
  • Why chocolate protects against heart disease - Science Daily, 11/10/10 - "ate 75 grams of unsweetened chocolate with a cocoa content of 72 percent. To analyze what happened with the ACE enzyme, blood samples were taken in advance and then a half hour, one hour, and three hours afterward ... In the sample taken three hours afterward, there was a significant inhibition of ACE activity. The average was 18 percent lower activity than before the dose of cocoa, fully comparable to the effect of drugs that inhibit ACE and are used as a first-choice treatment for high blood pressure" - Note:  I find that ACE inhibitor theory hard to believe. The results of up to 57% reduction in heart disease was found with amounts of chocolate much less than that and it would seem that amount would have very little effect on blood pressure. Plus two recent studies showed blood pressures of 135/85 and 146/81 so lower is not necessarily better.
  • Chocolate eaters may have healthier hearts: study - MSNBC, 11/8/10 - "The authors found that women older than 70 who ate chocolate at least once per week were 35 percent less likely to be hospitalized or die from heart disease over the course of the study, and nearly 60 percent less likely to be hospitalized or die from heart failure ... The danger is that many people will start eating more of it than is necessary, without cutting back in calories from other snacks, which will result in weight gain and will counteract any beneficial effects of chocolate ... Flavonoids are thought to reduce the risk of heart disease, the leading cause of death in many industrialized countries, by helping to increase nitric oxide, which in turn helps boost the functioning of blood vessels and lower blood pressure"
  • Frequent chocolate consumption could reduce CHD risk, US study - Nutra USA, 9/21/10 - "dark chocolate intake was associated with a 39 per cent lower risk of myocardial infarction and stroke combined ... In the fully adjusted model, consumption of chocolate more than five times a week was associated with 57 per cent lower prevalent CHD compared with subjects who did not consume chocolate ... Exclusion of subjects with prevalent diabetes and those who were on a weight loss diet made the association stronger ... the inability to distinguish the different types of chocolate might have led to an underestimation of the true association between cocoa/chocolate polyphenol consumption and CHD in the study"
  • Chocolate Intake and Incidence of Heart Failure: A Population-Based, Prospective Study of Middle-Aged and Elderly Women - Journal of the American Heart Association, 8/16/10 (.pdf) - See table 2 on page 23 - "1-2 servings per week 78 66935.77 0.66 (0.48-0.89) 0.68 (0.50-0.93)"
  • Moderate chocolate consumption linked to lower risks of heart failure, study finds - Science Daily, 8/17/10
  • Chocolate for Blood Pressure Too Hard to Stomach, Researchers Say - Medscape, 8/13/10
  • Cocoa flavanols improve vascular and blood pressure measures for coronary artery disease patients - Science Daily, 7/6/10 - "The findings indicate that foods rich in flavanols -- such as cocoa products, tea, wine, and various fruits and vegetables -- have a cardio-protective benefit for heart disease patients ... The study found a protective effect from a cocoa drink with 375 mg of flavanols, but according to researchers, a standard or recommended dosage has not yet been defined to achieve optimal health benefit ... In the current study, the benefit seen from the two-fold increase in circulating angiogenic cells was similar to that achieved by therapy with statins and with lifestyle changes such as exercise and smoking cessation"
  • Dark chocolate lowers blood pressure, research finds - Science Daily, 6/28/10 - "Flavanols have been shown to increase the formation of endothelial nitric oxide, which promotes vasodilation and consequently may lower blood pressure. There have, however, been conflicting results as to the real-life effects of eating chocolate. We've found that consumption can significantly, albeit modestly, reduce blood pressure for people with high blood pressure but not for people with normal blood pressure ... The pressure reduction seen in the combined results for people with hypertension, 5mm Hg systolic, may be clinically relevant -- it is comparable to the known effects of 30 daily minutes of physical activity (4-9mm Hg) and could theoretically reduce the risk of a cardiovascular event by about 20% over five years" - See flavonoids at Amazon.com.
  • How dark chocolate may guard against brain injury from stroke - Science Daily, 5/5/10
  • Chocolate reduces blood pressure and risk of heart disease - Science Daily, 3/30/10
  • A friend told me that chocolate impairs absorption of calcium. Is this true? - Nutrition Possible, 3/27/10
  • Cocoa compounds may ease exercise-related heart function - Nutra USA, 3/10/10
  • Study thickens the science of cocoa’s heart benefits - Nutra USA, 3/5/10
  • Can chocolate lower your risk of stroke? - Science Daily, 2/12/10
  • Chocolate again linked to better heart health - Science Daily, 8/17/09
  • Dark Chocolate Prevents Heart Disease - WebMD, 9/25/08
  • Cocoa Compound Boosts Brain's Blood Flow - WebMD, 8/21/08
  • Study: Dark Chocolate, Cocoa May Cut Blood Pressure in Overweight Adults - WebMD, 7/11/08
  • Cocoa for Diabetes? - WebMD, 5/27/08 - "Researchers caution that the high-dose flavonol cocoa used in their study greatly exceeds the typical U.S. dietary intake of 20 to 100 milligrams daily, and you can't buy the extra-strength version in stores. Rather, they are optimistic that flavonol-containing diets offer an innovative approach to preventing heart disease"
  • Cocoa, but Not Tea, Lowers Blood Pressure - Medscape, 4/16/08
  • Dark chocolate 'not so healthy' - BBC News, 12/24/07 - "Plain chocolate is naturally rich in flavanols, plant chemicals that are believed to protect the heart ... many manufacturers remove flavanols because of their bitter taste"
  • Dark Chocolate Improves Coronary Vasomotion and Reduces Platelet Reactivity - Circulation. 2007 Nov 5 - "Dark chocolate induces coronary vasodilation, improves coronary vascular function, and decreases platelet adhesion 2 hours after consumption. These immediate beneficial effects were paralleled by a significant reduction of serum oxidative stress and were positively correlated with changes in serum epicatechin concentration"
  • Dark Chocolate Fights Heart Woes - WebMD, 11/5/07 - "After two weeks, coronary circulation significantly improved in participants who ate dark chocolate. There was no change among those who ate white chocolate ... Cacao polyphenol contains four times as many disease-fighting flavonoids per serving than red wine or tea"
  • Dark Chocolate's Health Benefits May Include Better Blood Pressure - WebMD, 7/3/07
  • Drink Cocoa Daily? - Dr. Weil, 5/9/07
  • Chocolate Lowers Blood Pressure - WebMD, 4/9/07 - "The results showed four of the five cocoa studies reported a reduction in both systolic blood pressure and diastolic blood pressure. The reduction was an average of 4.7 points systolic and 2.8 points diastolic"
  • Cocoa Boosts Heart Health - WebMD, 3/24/07
  • Cocoa 'Vitamin' Health Benefits Could Outshine Penicillin - Science Daily, 3/11/07
  • Boosting Brain Power -- With Chocolate - Science Daily, 2/21/07 - "the cocoa flavanols found in chocolate could be useful in enhancing brain function for people fighting fatigue, sleep deprivation, and even the effects of ageing"
  • Chocolate May Help Aging Blood Vessels - WebMD, 8/4/06 - "The results showed blood vessel function improved among both younger and older adults after the cocoa phase. But these improvements were more pronounced in the older group ... the flavonol-rich cocoa products used in these studies should not be confused with commercially available snacks that contain many calories but are low in natural cocoa and flavonols"
  • Flavonol-rich chocolate could improve skin from within - Nutra USA, 5/16/06
  • Chocolate Milk May Improve Recovery After Exercise - Medscape, 2/27/06 - "Low-fat chocolate milk and FR ingestion as recovery fluids are associated with greater endurance in terms of time to exhaustion vs a CR for cycling in male endurance athletes"
  • Cocoa May Cut Blood Pressure - WebMD, 2/27/06 - "Cocoa intake was tied to lower blood pressure and reduced death risk, the study shows. Natural compounds in cocoa called flavanols may be the reason"
  • Chocolate Milk: The New Sports Drink? - WebMD, 2/24/06
  • Healthy chocolate a dream come true? - MSNBC, 2/20/06
  • Heart-healthy Compound In Chocolate Identified - Science Daily, 1/20/06 - "epicatechin, one of a group of chemicals known as flavanols, was directly linked to improved circulation and other hallmarks of cardiovascular health"
  • Dark Chocolate May Ease Diarrhea - WebMD, 10/3/05
  • Dark Chocolate Helps Diarrhea: Study Confirms Ancient Myth - Science Daily, 10/2/05 - "a chemical in cocoa beans can limit the development of fluids that cause diarrhea"
  • Chocolate May Help Smokers' Blood Vessels - WebMD, 9/29/05
  • Flavanols Key To Potential Chocolate Benefits - Science Daily, 9/29/05
  • Dark Chocolate May Lower Blood Pressure - WebMD, 3/11/05 - "100 grams (3.5 ounces) of dark chocolate ... Dark chocolate is rich in flavonoids due to their high cocoa content, but white chocolate contains no cocoa, and, therefore, no flavonoids ... blood sugar metabolism was significantly improved after the dark chocolate phase ... the participants' systolic blood pressure (the top number in a blood pressure reading) was significantly lower after 15 days of eating dark chocolate -- an average of 108 mm Hg compared with 114 mm Hg"
  • Cocoa, Flavanols and Cardiovascular Risk - Medscape, 11/29/04
  • Chocolate Said To Help Blood Vessels - Intelihealth, 8/30/04
  • A Dark Chocolate a Day Keeps the Doctor Away - Doctor's Guide, 6/1/04
  • Chocolate - Food of the Gods? - Dr. Murray's Natural Facts, 3/31/04
  • Hot Cocoa May Prevent Heart Disease - WebMD, 11/6/03 - "Hot cocoa has more disease-fighting antioxidants than tea or red wine ... black tea, green tea, red wine, and cocoa are "major" sources of antioxidants called phenols and flavonoids -- antioxidant chemicals found naturally in foods that can help prevent chronic diseases such as heart disease and cancer" - Yeah, but what about the sugar and calories.  See iHerb or Vitacosticon green tea products. - Ben
  • Flavonoids found in chocolate may help reduce risk of heart disease - HealthScout, 2/13/03 - "the main flavonoids in cocoa -- flavan-3-ols -- are associated with a decreased risk of cardiovascular disease ... Also, a third of the fat in chocolate is made up of oleic acid. That's a monosaturated fat, also found in olive oil, that's been shown to benefit heart health"
  • Which Chocolate Is Healthiest for Heart? - WebMD, 1/31/03
  • Some Chocolate a Treat for the Heart - WebMD, 11/20/02
  • Cocoa: The Next Health Drink? - WebMD, 2/15/02
  • Chocolate Boosts 'Good' Cholesterol And Protects Against Heart Disease - Intelihealth, 10/25/01
  • Chocolate Is Good for the Heart - WebMD, 10/23/01 - "chocolate ... has loads of antioxidants in the form of flavonoids, which are known to reduce cardiovascular risk ... certain cocoas and chocolates -- taken in small, regular doses -- seem to raise HDL, or the "good" cholesterol, while lowering the "bad" variety called LDL, which can clog the arteries ... half the group ate a "typical American diet" that was purposely low in flavonoids. The other half ate the "experimental diet," which essentially was the typical American diet plus cocoa powder (3/4 of an ounce) and dark chocolate (half an ounce) ... They found that LDL cholesterol was oxidized 8% more slowly -- and that HDL cholesterol increased by 4% -- after the people ate chocolate"
  • Good News For Chocoholics - WebMD, 7/17/00


  • Dietary cocoa improves health of obese mice; likely has implications for humans - Science Daily, 4/14/21 - "Supplementation of cocoa powder in the diet of high-fat-fed mice with liver disease markedly reduced the severity of their condition ... Cocoa powder, a popular food ingredient most commonly used in the production of chocolate, is rich in fiber, iron and phytochemicals reported to have positive health benefits, including antioxidant polyphenols and methylxanthines ... While it is typically considered an indulgence food because of its high sugar and fat content, epidemiological and human-intervention studies have suggested that chocolate consumption is associated with reduced risk of cardio-metabolic diseases including stroke, coronary heart disease and Type 2 diabetes ... Doing the calculations, for people it works out to about 10 tablespoons of cocoa powder a day ... Or, if you follow the directions on the Hershey's box of cocoa powder, that's about five cups of hot cocoa a day ... cocoa-treated mice gained weight at a 21% lower rate and had smaller spleen weights -- indicating less inflammation -- than the high-fat-fed control mice. At the end of the study, mice fed the cocoa-powder-supplemented diet had 28% less fat in their livers than the control mice. Cocoa-treated mice also had 56% lower levels of oxidative stress and 75% lower levels of DNA damage in the liver compared to high-fat-fed control mice ... Lambert is not recommending that obese people -- or anyone -- simply add five cups of hot cocoa to their daily routine and change nothing else in their diet. But he does advise, based on what he has learned in this study, to consider substituting cocoa for other foods, particularly high-calorie snack foods" - See Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie, 4.12 oz., 86% Cacao (Pack of 6) at Amazon.com.
  • Effects of cocoa-rich chocolate on cognitive performance in postmenopausal women. A randomised clinical trial - Nutr Neurosci 2020 Nov 15 - "The intervention group (n = 73) consumed daily 10 g of chocolate (99% cocoa) in addition to their usual food intake for 6 months, whereas the control group (n = 67) did not receive any intervention ... The consumption of cocoa-rich (99%) chocolate in addition to the habitual diet could be related to a slight improvement in cognitive performance regarding cognitive flexibility and processing speed in postmenopausal women, with no changes in the rest of the cognitive performance variables evaluated"
  • Sub-Chronic Consumption of Dark Chocolate Enhances Cognitive Function and Releases Nerve Growth Factors: A Parallel-Group Randomized Trial - Nutrients. 2019 Nov 16 - "Eighteen healthy young subjects (both sexes; 20-31 years old) were randomly divided into two groups: a DC intake group (n = 10) and a cacao-free white chocolate (WC) intake group (n = 8). The subjects then consumed chocolate daily for 30 days. Blood samples were taken to measure plasma levels of theobromine (a methylxanthine most often present in DC), nerve growth factor (NGF), and brain-derived neurotrophic factor, and to analyze hemodynamic parameters. Cognitive function was assessed using a modified Stroop color word test and digital cancellation test. Prefrontal cerebral blood flow was measured during the tests. DC consumption increased the NGF and theobromine levels in plasma, enhancing cognitive function performance in both tests. Interestingly, the DC-mediated enhancement of cognitive function was observed three weeks after the end of chocolate intake. WC consumption did not affect NGF and theobromine levels or cognitive performance. These results suggest that DC consumption has beneficial effects on human health by enhancing cognitive function."
  • High flavonoid cocoa supplement ameliorates plasma oxidative stress and inflammation levels while improving mobility and quality of life in older subjects: a double blind randomized clinical trial - J Gerontol A Biol Sci Med Sci. 2019 May 6 - "Regular flavonoids consumption positively impact blood oxidative stress and inflammation endpoints, cardiometabolic risk markers, physical performance and QoL. The sum of such effects may help to mitigate the extent of frailty development in the elderly" - [Nutra USA] - See Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie, 4.12 oz., 86% Cacao (Pack of 4) at Amazon.com.
  • Randomized study of the effects of cocoa-rich chocolate on the ventricle-arterial coupling and vascular function of young, healthy adults - Nutrition. 2019 Feb 27;63-64:175-183 - "Half of the participants ingested a 20-g dose of lower cocoa chocolate (LCC; ~55%; 12.6 +/- 1.4 mg equivalent of epicatechin/g) and the others ingested a daily dose of 20 g of higher cocoa chocolate (HCC; ~90%; 18.2 +/- 2.6 mg equivalent of epicatechin/g) ... A statistically significant improvement was depicted over the brachial and central systolic and pulse pressures in the HCC group, and a trend for improvement in the reflected waves component (Aix) and the FMS was also observed in the HCC, but not in the LCC group ... regular consumption of HCC has beneficial effects on the cardiovascular system in young, healthy adults, improving vascular function by reducing central brachial artery pressures and promoting vascular relaxation, and thus enhancing the matching of the arterial system with the left ventricle" - See Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie, 4.12 oz., 86% Cacao (Pack of 4) at Amazon.com.
  • Markers of Hypoxia and Oxidative Stress in Aging Volunteers Ingesting Lycosomal Formulation of Dark Chocolate Containing Astaxanthin - J Nutr Health Aging. 2018;22(9):1092-1098 - "To determine if ingestion of lycosome-formulated dark chocolate (DC) containing astaxanthin (ASTX) improves bioavailability of ASTX and affects markers of hypoxia and oxidative stress in aging individuals ... One month ingestion of singular formulation of ASTX lead to a 20 fold buildup in serum ASTX level whereas the 4 week ingestion of L-DC-ASTX formulation was accompanied by more prominent accumulation of ASTX in serum (a 40 fold increase over the basal values) at the same daily dose of ASTX. Both antioxidants taken separately decreased serum levels of oxidized LDL and malonic dialdehyde. However effect of L-DC-ASTX formulation was more prominent. ASTX ingested alone caused a borderline increase (p=0.054) in serum nitric oxide (NO) levels, whereas DC ingestion lead to small but statistically significant increase in serum NO concentration. Higher values of NO level were seen after co-ingestion of DC and ASTX"
  • Flavanol-rich cocoa consumption enhances exercise-induced executive function improvements in humans - J Nutr. 2017 Oct 1 - "Aerobic exercise is known to acutely improve cognitive functions, such as executive function (EF) and memory function (MF). Additionally, consumption of flavanol-rich cocoa is reported to acutely improve cognitive function. Thus, we hypothesized that high cocoa flavanol (CF; HCF) consumption would enhance exercise-induced improvement in cognitive function ... The present findings demonstrated that HCF consumption prior to moderate-intensity exercise could enhance exercise-induced improvement in EF, but not in MF. Therefore, we suggest that the combination of HCF consumption and aerobic exercise may be beneficial for improving EF" - [Nutra USA] - See Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie, 4.12 oz., 86% Cacao (Pack of 4) at Amazon.com.
  • Chocolate intake and incidence of heart failure: Findings from the Cohort of Swedish Men - Am Heart J. 2017 Jan;183:18-2 - "Compared with subjects who reported no chocolate intake, the multivariable-adjusted rate ratio of HF was 0.88 (95% CI 0.78-0.99) for those consuming 1-3 servings per month, 0.83 (95% CI 0.72-0.94) for those consuming 1-2 servings per week, 0.82 (95% CI 0.68-0.99) for those consuming 3-6 servings per week, and 1.10 (95% CI 0.84-1.45) for those consuming ≥1 serving per day"
  • Theobroma cacao extract attenuates the development of Dermatophagoides farinae-induced atopic dermatitis-like symptoms in NC/Nga mice - Food Chemistry, 1 Feb 17 - "cacao extract (CE) ... atopic dermatitis (AD) ... CE, a natural phytochemical-rich food, has potential therapeutic efficacy for the treatment of AD" - [Nutra USA]
  • The Impact of Cocoa Flavanols on Cardiovascular Health - Phytother Res. 2016 Jul 1 - "Thirteen SRs were identified and reviewed, and provided strong evidence that dark chocolate did not reduce blood pressure. The evidence was however strong for an association with increased flow-mediated vasodilatation (FMD) and moderate for an improvement in blood glucose and lipid metabolism. Our analysis showed that cocoa products with around 100 mg epicatechin can reliably increase FMD, and that cocoa flavanol doses of around 900 mg or above may decrease blood pressure in specific individuals and/or if consumed over longer periods. Out of 32 cocoa product samples analyzed, the two food supplements delivered 900 mg of total flavanols and 100 mg epicatechin in doses of 7 g and 20 g and 3 and 8 g, respectively. To achieve these doses with chocolate, around 100 to 500 g (for 900 mg flavanols) and 50 to 200 g (for 100 mg epicatechin) would need to be consumed. Chocolate products marketed for their purported health benefits should therefore declare the amounts of total flavanols and epicatechin"
  • Flavanol-rich chocolate acutely improves arterial function and working memory performance counteracting the effects of sleep deprivation in healthy individuals - J Hypertens. 2016 Apr 14 - "Flavanol-rich chocolate counteracted vascular impairment after sleep deprivation and restored working memory performance. Improvement in cognitive performance could be because of the effects of cocoa flavonoids on blood pressure and peripheral and central blood flow"
  • Daily chocolate consumption is inversely associated with insulin resistance and liver enzymes in the Observation of Cardiovascular Risk Factors in Luxembourg study - Br J Nutr. 2016 Mar 17:1-8 - "After excluding subjects taking antidiabetic medications, higher chocolate consumption was associated with lower HOMA-IR (β=-0·16, P=0·004), serum insulin levels (β=-0·16, P=0·003) and γ-GT (β=-0·12, P=0·009) and ALT (β=-0·09, P=0·004), after adjustment for age, sex, education, lifestyle and dietary confounding factors, including intakes of fruits and vegetables, alcohol, polyphenol-rich coffee and tea. This study reports an independent inverse relationship between daily chocolate consumption and levels of insulin, HOMA-IR and liver enzymes in adults, suggesting that chocolate consumption may improve liver enzymes and protect against insulin resistance, a well-established risk factor for cardiometabolic disorders" - See Ghirardelli Chocolate Intense Dark Squares, Midnight Reverie, 4.12 oz., 86% Cacao (Pack of 4) at Amazon.com.
  • Chocolate intake is associated with better cognitive function: The Maine-Syracuse Longitudinal Study - Appetite. 2016 Feb 10;100:126-132 - "Habitual chocolate intake was related to cognitive performance, measured with an extensive battery of neuropsychological tests. More frequent chocolate consumption was significantly associated with better performance on the Global Composite score, Visual-Spatial Memory and Organization, Working Memory, Scanning and Tracking, Abstract Reasoning, and the Mini-Mental State Examination"  - [Nutra USA]
  • Oral supplementation with cocoa extract reduces UVB-induced wrinkles in hairless mouse skin - J Invest Dermatol. 2016 Feb 5 - "Cacao beans contain various bioactive phytochemicals that could modify the pathogeneses of certain diseases. Here, we report that oral administration of cacao powder (CP) attenuates UVB-induced skin wrinkling by the regulation of genes involved in dermal matrix production and maintenance ... These results suggest that cacao extract may offer a protective effect against photoaging by inhibiting the breakdown of dermal matrix, which leads to an overall reduction in wrinkle formation"
  • Mechanisms by which Cocoa Flavanols Improve Metabolic Syndrome and Related Disorders - J Nut Bio 2015 Dec 008 - "Flavanols may antagonize digestive enzymes and glucose transporters, causing a reduction in glucose excursion, which helps patients with metabolic disorders maintain glucose homeostasis. Unabsorbed flavanols, and ones that undergo enterohepatic recycling, will proceed to the colon where they can exert prebiotic effects on the gut microbiota. Interactions with the gut microbiota may improve gut barrier function, resulting in attenuated endotoxin absorption. Cocoa may also positively influence insulin signaling, possibly by relieving insulin-signaling pathways from oxidative stress and inflammation and/or via a heightened incretin response" - [Nutra USA]
  • The Neuroprotective Effect of Dark Chocolate in Monosodium Glutamate-Induced Nontransgenic Alzheimer Disease Model Rats: Biochemical, Behavioral, and Histological Studies - J Diet Suppl. 2015 Dec 16:1-12 - "we examined the effect of oral administration of dark chocolate (DC) containing 70% cocoa solids and 4% total polyphenol content for three months at a dose of 500 mg/Kg body weight per day to 17-month-old monosodium glutamate treated obese Sprague-Dawley rats, earlier characterized as a nontransgenic AD (NTAD) rat model after reversal of obesity, diabetes, and consequent cognitive impairments. The results demonstrated that DC reduced the hyperglycemia, inhibited the cholinesterase activity in the hippocampal tissue homogenates, and improved the cognitive performance in spatial memory related Barnes maze task. Histological studies revealed an increase in cell volume in the DC treated rats in the CA3 region of the hippocampus. These findings demonstrated the benefits of DC in enhancing cognitive function and cholinergic activity in the hippocampus of the aged NTAD rats while correcting their metabolic disturbances"
  • Cocoa Flavanol Supplementation Influences Skin Conditions of Photo-Aged Women: A 24-Week Double-Blind, Randomized, Controlled Trial - J Nutr. 2015 Nov 18 - "The consumption of dietary antioxidants is considered to be a good strategy against photo-aging ... All participants were moderately photo-aged Korean women with visible facial wrinkles (age range: 43-86 y). Participants were randomly assigned to receive a placebo beverage or cocoa beverage that contained 320 mg total cocoa flavanols/d ... In moderately photo-aged women, regular cocoa flavanol consumption had positive effects on facial wrinkles and elasticity. Cocoa flavanol supplementation may contribute to the prevention of the progression of photo-aging"
  • Regular consumption of a cocoa product improves the cardiometabolic profile in healthy and moderately hypercholesterolaemic adults - Br J Nutr. 2013 Jul 4:1-13 - "Cocoa products present great health potential due to their high content of polyphenols, mainly of flavanols ... A randomised, controlled, cross-over, free-living study was carried out in healthy (n 24) and moderately hypercholesterolaemic (>2000 mg/l, n 20) subjects to assess the influence of regularly consuming (4 weeks) two servings (15 g each) of a cocoa product rich in fibre (containing 33.9 % of total dietary fibre (TDF) and 13.9 mg/g of soluble polyphenols) in milk v. consuming only milk (control) ... Serum HDL-cholesterol (HDL-C) levels were increased (P< 0.001), whereas glucose (P= 0.029), IL-1β (P= 0.001) and IL-10 (P= 0.001) levels were decreased. The rest of the studied cardiovascular parameters, as well as the anthropometric ones, remained similar ... regularly consuming a cocoa product with milk improves cardiovascular health by increasing HDL-C levels and inducing hypoglycaemic and anti-inflammatory effects in healthy and hypercholesterolaemic individuals without causing weight gain"
  • Cocoa intake and arterial stiffness in subjects with cardiovascular risk factors - Nutr J. 2012 Feb 10;11(1):8 - "Higher pulse wave velocity and greater cardiovascular risk were found in non-cocoa consumers as compared to high consumers (p < 0.05). In a multivariate analysis, these differences disappeared after adjusting for age, gender, the presence of diabetes, systolic blood pressure and antihypertensive and lipid-lowering drug use. All other arterial stiffness measures (central and peripheral augmentation index, ambulatory arterial stiffness index, ankle-brachial index, and carotid intima-media thickness) showed no differences between the different consumption groups"
  • Cardiovascular effects of flavanol-rich chocolate in patients with heart failure - Eur Heart J. 2011 Dec 15 - "Flavanol-rich chocolate (FRC) is beneficial for vascular and platelet function by increasing nitric oxide bioavailability and decreasing oxidative stress. Congestive heart failure (CHF) is characterized by impaired endothelial and increased platelet reactivity ... Twenty patients with CHF were enrolled in a double-blind, randomized placebo-controlled trial, comparing the effect of commercially available FRC with cocoa-liquor-free control chocolate (CC) on endothelial and platelet function in the short term (2 h after ingestion of a chocolate bar) and long term (4 weeks, two chocolate bars/day) ... Flow-mediated vasodilatation significantly improved from 4.98 +/- 1.95 to 5.98 +/- 2.32% (P = 0.045 and 0.02 for between-group changes) 2h after intake of FRC to 6.86 +/- 1.76% after 4 weeks of daily intake (P = 0.03 and 0.004 for between groups). No effect on endothelial-independent vasodilatation was observed. Platelet adhesion significantly decreased from 3.9 +/- 1.3 to 3.0 +/- 1.3% (P = 0.03 and 0.05 for between groups) 2 h after FRC, an effect that was not sustained at 2 and 4 weeks. Cocoa-liquor-free CC had no effect, either on endothelial function or on platelet function. Blood pressure and heart rate did not change in either group"
  • Flavonoid-Rich Cocoa Consumption Affects Multiple Cardiovascular Risk Factors in a Meta-Analysis of Short-Term Studies - J Nutr. 2011 Sep 28 - "A growing body of evidence suggests that the consumption of foods rich in polyphenolic compounds, particularly cocoa, may have cardioprotective effects ... flavonoid-rich cocoa (FRC) .. In response to FRC consumption, systolic blood pressure decreased by 1.63 mm Hg (P = 0.033), LDL cholesterol decreased by 0.077 mmol/L (P = 0.038), and HDL cholesterol increased by 0.046 mmol/L (P = 0.037), whereas total cholesterol, TG, and C-reactive protein remained the same. Moreover, insulin resistance decreased (HOMA-IR: -0.94 points; P < 0.001), whereas FMD increased (1.53%; P < 0.001). A nonlinear dose-response relationship was found between FRC and FMD (P = 0.004), with maximum effect observed at a flavonoid dose of 500 mg/d; a similar relationship may exist with HDL cholesterol levels (P = 0.06). FRC consumption significantly improves blood pressure, insulin resistance, lipid profiles, and FMD. These short-term benefits warrant larger long-term investigations into the cardioprotective role of FRC"
  • Effects of cocoa products/dark chocolate on serum lipids: a meta-analysis - Eur J Clin Nutr. 2011 May 11 - "Cocoa products, which are rich sources of flavonoids, have been shown to reduce blood pressure and the risk of cardiovascular disease. Dark chocolate contains saturated fat and is a source of dietary calories; consequently, it is important to determine whether consumption of dark chocolate adversely affects the blood lipid profile. The objective was to examine the effects of dark chocolate/cocoa product consumption on the lipid profile using published trials. A detailed literature search was conducted via MEDLINE (from 1966 to May 2010), CENTRAL and ClinicalTrials.gov for randomized controlled clinical trials assessing the effects of flavanol-rich cocoa products or dark chocolate on lipid profile. The primary effect measure was the difference in means of the final measurements between the intervention and control groups. In all, 10 clinical trials consisting of 320 participants were included in the analysis. Treatment duration ranged from 2 to 12 weeks. Intervention with dark chocolate/cocoa products significantly reduced serum low-density lipoprotein (LDL) and total cholesterol (TC) levels (differences in means (95% CI) were -5.90 mg/dl (-10.47, -1.32 mg/dl) and -6.23 mg/dl (-11.60, -0.85 mg/dl), respectively). No statistically significant effects were observed for high-density lipoprotein (HDL) (difference in means (95% CI): -0.76 mg/dl (-3.02 to 1.51 mg/dl)) and triglyceride (TG) (-5.06 mg/dl (-13.45 to 3.32 mg/dl)). These data are consistent with beneficial effects of dark chocolate/cocoa products on total and LDL cholesterol and no major effects on HDL and TG in short-term intervention trials"
  • Dietary Epicatechin Promotes Survival of Obese Diabetic Mice and Drosophila melanogaster - J Nutr. 2011 Apr 27 - "The lifespan of diabetic patients is 7-8 y shorter than that of the general population because of hyperglycemia-induced vascular complications and damage to other organs such as the liver and skeletal muscle. Here, we investigated the effects of epicatechin, one of the major flavonoids in cocoa, on health-promoting effects in obese diabetic (db/db) mice (0.25% in drinking water for 15 wk) and Drosophila melanogaster (0.01-8 mmol/L in diet). Dietary intake of epicatechin promoted survival in the diabetic mice (50% mortality in diabetic control group vs. 8.4% in epicatechin group after 15 wk of treatment), whereas blood pressure, blood glucose, food intake, and body weight gain were not significantly altered. Pathological analysis showed that epicatechin administration reduced the degeneration of aortic vessels and blunted fat deposition and hydropic degeneration in the liver caused by diabetes. Epicatechin treatment caused changes in diabetic mice that are associated with a healthier and longer lifespan, including improved skeletal muscle stress output, reduced systematic inflammation markers and serum LDL cholesterol, increased hepatic antioxidant glutathione concentration and total superoxide dismutase activity, decreased circulating insulin-like growth factor-1 (from 303 +/- 21 mg/L in the diabetic control group to 189 +/- 21 mg/L in the epicatechin-treated group), and improved AMP-activated protein kinase-α activity in the liver and skeletal muscle. Consistently, epicatechin (0.1-8 mmol/L) also promoted survival and increased mean lifespan of Drosophila. Therefore, epicatechin may be a novel food-derived, antiaging compound"
  • Effects of cocoa extract and dark chocolate on angiotensin-converting enzyme and nitric oxide in human endothelial cells and healthy volunteers--a nutrigenomics perspective - J Cardiovasc Pharmacol. 2011 Jan;57(1):44-50 - "Evidence suggests that cocoa from the bean of Theobroma cacao L. has beneficial effects on cardiovascular disease. The aim of this study was to investigate if cocoa extract and dark chocolate influence angiotensin-converting enzyme (ACE) and nitric oxide (NO) in human endothelial cells (in vitro) and in healthy volunteers (in vivo) ... ACE activity and NO were measured at baseline and after 30, 60, and 180 minutes in 16 healthy volunteers after a single intake of 75 g of dark chocolate containing 72% cocoa. Significant inhibition of ACE activity (P < 0.01) and significant increase of NO (P < 0.001) were seen in HUVEC. In the study subjects, a significant inhibition of ACE activity (mean 18%) 3 hours after intake of dark chocolate was seen, but no significant change in NO was seen. According to ACE genotype, significant inhibition of ACE activity was seen after 3 hours in individuals with genotype insertion/insertion and deletion/deletion (mean 21% and 28%, respectively). Data suggest that intake of dark chocolate containing high amount of cocoa inhibits ACE activity in vitro and in vivo"
  • Flavanol-rich cocoa ameliorates lipemia-induced endothelial dysfunction - Heart Vessels. 2010 Dec 8 - "Consumption of flavanols improves chronic endothelial dysfunction. We investigated whether it can also improve acute lipemia-induced endothelial dysfunction. In this randomized, placebo-controlled, double-blind, crossover trial, 18 healthy subjects received a fatty meal with cocoa either rich in flavanols (918 mg) or flavanol-poor. Flow-mediated dilation (FMD), triglycerides, and free fatty acids were then determined over 6 h. After the flavanol-poor fat loading, the FMD deteriorated over 4 h. The consumption of flavanol-rich cocoa, in contrast, improved this deterioration in hours 2, 3, and 4 without abolishing it completely. Flavanols did not have any influence on triglycerides or on free fatty acids. Flavanol-rich cocoa can alleviate the lipemia-induced endothelial dysfunction, probably through an improvement in endothelial NO synthase"
  • Effects of Cocoa Extract and Dark Chocolate on Angiotensin-Converting Enzyme and Nitric Oxide in Human Endothelial Cells and Healthy Volunteers - J Cardiovasc Pharmacol. 2010 Oct 14 - "ACE activity and NO were measured at baseline and after 30, 60 and 180 min in sixteen healthy volunteers after a single intake of 75 g dark chocolate containing 72% cocoa. Significant inhibition of ACE activity p<0.01 and significant increase of NO p<0.001 was seen in HUVEC. In study subjects, a significant inhibition of ACE activity (mean 18%) 3 hours after intake of dark chocolate was seen, but no significant change in NO was seen. According to ACE genotype significant inhibition of ACE activity was seen after 3 hours in individuals with genotype II and DD (mean 21% and 28% respectively). Data suggests that intake of dark chocolate containing high amount of cocoa inhibits ACE activity in vitro and in vivo"
  • High-cocoa polyphenol-rich chocolate improves HDL cholesterol in Type 2 diabetes patients - Diabet Med. 2010 Nov;27(11):1318-21 - "Subjects were randomized to 45 g chocolate with or without a high polyphenol content for 8 weeks and then crossed over after a 4-week washout period ... HDL cholesterol increased significantly with high polyphenol chocolate (1.16 +/- 0.08 vs. 1.26 +/- 0.08 mmol/l, P = 0.05) with a decrease in the total cholesterol: HDL ratio (4.4 +/- 0.4 vs. 4.1 +/- 0.4 mmol/l, P = 0.04). No changes were seen with the low polyphenol chocolate in any parameters. Over the course of 16 weeks of daily chocolate consumption neither weight nor glycaemic control altered from baseline" - The Lindt - Excellence 90% Cocoa Bar are 3.5 ounces or 99 grams or about 90 grams of chocolate.  So 45 grams would be half a bar per day.
  • Chocolate consumption is inversely associated with prevalent coronary heart disease: The National Heart, Lung, and Blood Institute Family Heart Study - Clin Nutr. 2010 Sep 19 - "Compared to subjects who did not report any chocolate intake, odds ratios (95% CI) for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 (0.28-0.67) for subjects consuming 1-3 times/month, 1-4 times/week, and 5+ times/week, respectively (p for trend <0.0001) adjusting for age, sex, family CHD risk group, energy intake, education, non-chocolate candy intake, linolenic acid intake, smoking, alcohol intake, exercise, and fruit and vegetables. Consumption of non-chocolate candy was associated with a 49% higher prevalence of CHD comparing 5+/week vs. 0/week [OR = 1.49 (0.96-2.32)]"
  • Chocolate Intake and Incidence of Heart Failure: A Population-Based, Prospective Study of Middle-Aged and Elderly Women - Circ Heart Fail. 2010 Aug 16 - "Compared to no regular chocolate intake, the multivariate-adjusted rate ratio of HF was 0.74 (95%CI 0.58-0.95) for those consuming 1-3 servings of chocolate per month, 0.68 (95%CI 0.50-0.93) for those consuming 1-2 servings per week, 1.09 (95%CI .74-1.62) for those consuming 3-6 servings per week and 1.23 (95%CI 0.73-2.08) for those consuming one or more servings per day"
  • Chocolate consumption in relation to blood pressure and risk of cardiovascular disease in German adults - Eur Heart J. 2010 Jul;31(13):1616-23 - "The relative risk of the combined outcome of MI and stroke for top vs. bottom quartiles was 0.61"
  • Impact of cocoa flavanol consumption on blood pressure responsiveness to exercise - Br J Nutr. 2010 Jan 19:1-5 - "randomised to consume single servings of either a high-flavanol (HF, 701 mg) or a low-flavanol (LF, 22 mg) cocoa beverage in a double-blind, cross-over design ... the BP response to exercise (area under BP curve) was attenuated by HF compared with LF. BP increases were 68 % lower for DBP (P = 0.03) and 14 % lower for mean BP (P = 0.05). FMD measurements were higher after taking HF than after taking LF (6.1 (se 0.6) % v. 3.4 (se 0.5) %, P < 0.001). By facilitating vasodilation and attenuating exercise-induced increases in BP, cocoa flavanols may decrease cardiovascular risk and enhance the cardiovascular benefits of moderate intensity exercise in at-risk individuals"
  • Chocolate consumption and bone density in older women - Am J Clin Nutr. 2008 Jan;87(1):175-80 - "Higher frequency of chocolate consumption was linearly related to lower bone density and strength (P < 0.05). Daily (>/=1 times/d) consumption of chocolate, in comparison to <1 time/wk, was associated with a 3.1% lower whole-body bone density; with similarly lower bone density of the total hip, femoral neck, tibia, and heel; and with lower bone strength in the tibia and the heel"
  • Continuous intake of polyphenolic compounds containing cocoa powder reduces LDL oxidative susceptibility and has beneficial effects on plasma HDL-cholesterol concentrations in humans - Am J Clin Nutr. 2007 Mar;85(3):709-17 - "A significantly greater increase in plasma HDL cholesterol (24%) was observed in the cocoa group than in the control group (5%)"
  • Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study - Arch Intern Med. 2006 Feb 27;166(4):411-7 - "cocoa intake is inversely associated with blood pressure and 15-year cardiovascular and all-cause mortality"
  • 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 - "Dark, but not white, chocolate decreases blood pressure and improves insulin sensitivity in healthy persons"
  • Flavonoid-rich dark chocolate improves endothelial function and increases plasma epicatechin concentrations in healthy adults - J Am Coll Nutr. 2004 Jun;23(3):197-204 - "Flavonoid-rich dark chocolate improves endothelial function"

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