A new meta-study of random controlled trials looks at the effect of consuming cocoa on cardiovascular disease risk factors. The researchers also found that cocoa consumption showed no effects on body weight, body mass index (BMI), waist circumference, triglycerides, “good” HDL cholesterol, and HbA1c, an important biomarker of diabetes.
The meta-study analyzed 31 randomized, controlled trials that tracked the above risk factors. The trials that qualified for analysis involved a combined 1,986 participants. Together, the intervention group included 1,110 participants who consumed either cocoa extract or dark chocolate with a 70% or higher cocoa content for at least four weeks. The control group involved 876 participants who consumed a placebo or white or milk chocolate containing less than 70% cocoa.
Individuals who qualified for the trials were all 18 or older. The majority of the studies involved participants with one or more health conditions, including metabolic syndrome (3), dyslipidemia (4), pre-hypertension or hypertension (2), excess weight (4), type 2 diabetes (7), and insulin resistance (1). The remaining 13 studies included only healthy participants with no known confounding CVD risk factors.
It strikes women, men, and every ethnic and racial group. Every 33 seconds, someone in the U.S. dies of cardiovascular disease. Diet is strongly implicated in CVD. The American Heart Association stresses the importance of a lifetime of good nutrition as a strong defense against heart problems. There has been interest in identifying especially heart-healthy foods. Nonetheless, researchers described the strongest prescription for heart health: A nutrient-sufficient, diverse diet including fruits, vegetables, fatty fish, nuts, lean protein, and whole grains provides a broader range of nutrients and protective compounds against cardiovascular disease.
It is important, therefore, to consider cocoa as part of a broader heart-healthy diet rather than a standalone protective measure against CVD. Enjoying a square of at least 70% dark chocolate with berries or adding cocoa powder to a hot beverage can serve as a satisfying and health-conscious evening treat.
Consuming excess chocolate of any kind, including dark chocolate, can lead to high sugar and saturated fat intake which can negatively impact heart health, so the amount matters. Moreover, caution should still be exercised with pregnancy. Though some research suggests potential benefits in moderation, pregnant individuals should be especially mindful of chocolate’s added sugar and caffeine content.
Even a 2.52 mmHg reduction in systolic blood pressure and 1.58 mmHg reduction for diastolic blood pressure is positive. Multiple sources of cocoa, from beverages to bars to candy, etc. with varying amounts of other ingredients such as milk and sugar create a large heterogeneity to the population. This also raises the issue of inconsistencies in the cocoa manufacturing processes encompassed in the studies.
It is important to note that the availability of epicatechin in cocoa products can be affected by processing and storage conditions, as it is sensitive to heat and can degrade if not carefully handled during manufacturing. The meta-study found no effect of cocoa on a diabetes marker, HbA1c, although it did appear to provide a beneficial drop in blood sugar.
