Q: Is chocolate good for you?
Chocolate has a long and illustrious reputation. Made from cacao, which is derived from the beans of the cacao tree (whose Latin name translates to “food of the gods”), it was used by some of the earliest Mesoamerican cultures as food, medicine, ritual offering and maybe even currency. It is no less valuable in modern times; the global chocolate market grew by almost 20% between 2016 and 2021, with an approximate turnover of 980 billion dollars in 2021according to market research firm Statista.
Taste surely plays a role in the popularity of chocolate, but you may also have heard that this delicious treat is good for your health. How does this perception compare to science?
“Cacao is clearly good for you,” said Dr. Dariush Mozaffarian, cardiologist and professor of nutrition at Tufts Friedman School of Nutrition Science and Policy. “Whether Chocolate is good for you or not depends on how much cocoa it actually contains and what else it contains.
Cacao beans are packed with fiber and “loads of phytonutrients,” Dr. Mozaffarian said, referring to natural chemicals found in plants. Cocoa is believed to contain approximately 380 different chemicals, including a large class of compounds called flavanols that have attracted considerable research interest for their potential health benefits. But it’s less clear how many flavanols and other phytonutrients you need to boost your health, or whether your chocolate bar of choice contains enough of them to do so. And experts have differing opinions on this point.
Milk chocolate typically contains about 20% cocoa, Dr. Mozaffarian said, although the cocoa content may vary. (The Food and Drug Administration requires milk chocolate to contain at least 10 percent cocoa, but some milk chocolate bars contain up to 50 percent or more.) Dark chocolate generally contains more cocoa than dark chocolate. milk, but it can also vary widely, so check labels carefully, he says. For possible health benefits, he recommended choosing dark chocolate that contains at least 70% cocoa.
Numerous small, short-term human trials have shown that dark chocolate or standardized cocoa supplements or beverages may slightly lower blood pressure and improve blood cholesterol and the blood vessel health in adults. And some longer term observational studies found that those who eat more cocoa may have a lower risk of certain cardiovascular diseases, Dr. Mozaffarian said.
In a Systematic review published in February in the journal JAMA Network Open, Dr. Mozaffarian and his colleagues examined how certain foods and nutrients were associated with heart health problems. They found “probable or convincing evidence” that chocolate consumption was linked to a reduced risk of cardiovascular disease, finding that an average daily consumption of just 10 grams, or about a third of an ounce of chocolate, was associated with a 6% reduction in the overall risk of cardiovascular disease.
But these kinds of estimates are based on observational studies, which have significant limitations, said Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital in Boston. These studies can only identify correlations between chocolate consumption and health; they can’t prove that chocolate provides benefits — people who eat more chocolate may be different in other ways that affect their health, Dr. Manson said.
Results from observational studies have also been inconsistent. Some have found no benefitsand others have found that those who eat chocolate usually or more frequently are more likely to to gain weight, she pointed out. Such studies often do not take into account the different types of chocolate, which can vary in cocoa content. And the sugar, fat, and calorie counts could negate any health benefits of cocoa.
To address some of these shortcomings, Dr. Manson and his colleagues conducted a large randomized trial on more than 21,000 older adults in the United States. Half of the participants received a cocoa extract supplement containing 500 milligrams of cocoa flavanols, and the other half received a placebo. The results of the study, called the COSMOS trial, were published in june in The American Journal of Clinical Nutrition.
After following the participants for 3.6 years, the researchers found that while – compared to the placebo group – the cocoa supplement group was not statistically less likely to have cardiovascular events, including heart attacks and strokes, they had a 27% reduction in cardiovascular deaths. . Dr. Manson called these results “promising signals for cardiac protection”, although she stressed that another trial was needed to confirm the results before translating them into recommendations for cocoa flavanol intake.
Importantly, the COSMOS trial did not give participants chocolate, but rather concentrated cocoa extract capsules produced by chocolate maker Mars, which also partially funded the study. To get the same amount of bioactive cocoa flavanols from chocolate, a person would need to eat nearly 4,000 calories of milk chocolate or 600 calories of dark chocolate a day, Dr. Manson said, noting that a large portion of flavanols can be destroyed during chocolate processing.
Chocolate is “a wonderful treat, but to view it as a health food, I think it has its limits,” Dr. Manson said.
Much of the research, including his own, on the potential health benefits of chocolate and cocoa has been funded by chocolate companies such as Mars, Dr. Manson said. “These trials are expensive,” and public funding for nutrition studies in general is limited, she added. To research suggests that the results of studies sponsored by the food industry, including those on chocolateare more likely to be supportive of the companies funding them, although Dr Manson said Mars was not involved in the design or analysis of the COSMOS trial.
For his part, Dr. Mozaffarian is convinced by existing research that dark chocolate containing 70% or more cocoa is likely beneficial for heart health, even if it contains less flavanols than that tested in the COSMOS trial. “Eating a small amount of dark chocolate every day is probably very good for us, and it will make you happy because it tastes good,” he said.
Dr. Mozaffarian said he receives no funding from the chocolate industry, but he admitted a conflict of interest when it comes to this particular food. “My conflict is that I like dark chocolate,” he said.
Alice Callahan is an Oregon-based science and health journalist and frequent contributor to The New York Times.
