The Effectiveness of Dark Chocolate in Cardiovascular Health and Diabetes Management

Ethos Ho, BSc Pharm Candidate

Some Sweet News

If you have a sweet-tooth for dark chocolate, then you’ll be happy to hear that there is a growing amount of scientific evidence encouraging regular consumption of dark chocolate. Recent research has been focusing on the therapeutic benefits of dark chocolate on cardiovascular health and diabetes management and have found promising results. So, we’ll take a detailed look at the evidence surrounding the safety, effectiveness, and therapeutic benefits of dark chocolate to help satisfy your sweet cravings.

How Does It Work?

Cocoa and dark chocolate are derived from cacao beans, which consist of a diverse group of phytonutrients (plant chemicals) called flavonoids. Flavonoids are suspected to be the main therapeutic ingredient responsible for the health benefits associated with dark chocolate.¹ One of its main health benefits is in cardiovascular health through its cardioprotective mechanism such as:^1,2,3

• Antioxidant activity
• Antiplatelet activity (“thins” out blood)
• Decrease in LDL-C levels (bad cholesterol)
• Increase in HDL-C levels (good cholesterol)
• Decrease in blood pressure
• Anti-inflammatory activity

Another benefit associated with flavonoids is in the management of diabetes, as it can play a role in increasing insulin sensitivity and insulin levels in the body.^1,3 

How Safe Is Dark Chocolate?

Considering the safety of dark chocolate may seem like an odd concept; however, it’s essential for consumers to be aware of the variations in ingredients between manufacturers, especially in sugar and cocoa content.

Cocoa preparations such as dark chocolate are safe for all individuals when consuming moderate amounts or amounts found in foods. However, caution may advised in pregnant and breastfeeding women due to the caffeine content. Pregnant women should ensure they consume less than 200 mg of caffeine per day, while breastfeeding women should limit its intake to reduce caffeine concentration in breast milk.

Additionally, it’s important for individuals on antiplatelet or anticoagulant treatments to note that dark chocolate may increase the risk of bleeding.¹

What Does the Evidence Say?

Now that we understand the benefits and safety, let’s take a look at the evidence. One study demonstrated that daily consumption of 25 g of dark chocolate for eight weeks in individuals with type 2 diabetes and hypertension significantly reduced blood pressure, fasting blood glucose, haemoglobin A1c %, and inflammation.³ Dark chocolate was also shown to benefit individuals at high risk for cardiovascular disease by reducing blood pressure and cholesterol.⁴  These results are consistent with other studies claiming that dark chocolate is associated with decreased risk of coronary hear disease, stroke, diabetes,⁵ and atrial fibrillation risk.^6,7,8 

The Bottom Line

Regular, moderate consumption of dark chocolate appears to be a beneficial and delicious way to improve health. Dark chocolate can be safely consumed for many individuals, with caution being advised in pregnant and breastfeeding women due to the caffeine found in cocoa. It’s also strongly recommended to avoid dark chocolate while on antiplatelet or anticoagulant therapy such as aspirin and warfarin due to increased bleed risk. The evidence in studies look very promising in reducing cardiovascular risk and managing diabetes; however, it’s also essential to take other factors such as medical conditions, family history, and medication usage into consideration.

As always, we hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.

RESOURCES

1. Natural Medicines
2. Asgary, S., Rastqar, A., & Keshvari, M. (2018). Functional Food and Cardiovascular Disease Prevention and Treatment: A Review. Journal Of The American College Of Nutrition, 1-27. http://dx.doi.org/10.1080/07315724.2017.1410867
3. Rostami, A., Khalili, M., Haghighat, N., Eghtesadi, S., Shidfar, F., Heidari, I., … Eghtesadi, M. (2015). High-cocoa polyphenol-rich chocolate improves blood pressure in patients with diabetes and hypertension. ARYA Atherosclerosis, 11(1), 21–29.
4. Zomer, E., Owen, A., Magliano, D., Liew, D., & Reid, C. (2012). The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model. BMJ, 344(may30 3), e3657-e3657. http://dx.doi.org/10.1136/bmj.e3657
5. Yuan, S., Li, X., Jin, Y., & Lu, J. (2017). Chocolate Consumption and Risk of Coronary Heart Disease, Stroke, and Diabetes: A Meta-Analysis of Prospective Studies. Nutrients, 9(7), 688. http://doi.org.login.ezproxy.library.ualberta.ca/10.3390/nu9070688
6. Mostofsky, E., Berg Johansen, M., Tjønneland, A., Chahal, H., Mittleman, M., & Overvad, K. (2017). Chocolate intake and risk of clinically apparent atrial fibrillation: the Danish Diet, Cancer, and Health Study. Heart, 103(15), 1163-1167. http://dx.doi.org/10.1136/heartjnl-2016-310357
7. Crichton, G., Elias, M., Alkerwi, A., Stranges, S., & Abhayaratna, W. (2016). Relation of Habitual Chocolate Consumption to Arterial Stiffness in a Community-Based Sample: Preliminary Findings. Pulse, 4(1), 28-37. http://dx.doi.org/10.1159/000445876
8. Djoussé, L., Hopkins, P., Arnett, D., Pankow, J., Borecki, I., North, K., & Curtis Ellison, R. (2011). Chocolate consumption is inversely associated with calcified atherosclerotic plaque in the coronary arteries: The NHLBI Family Heart Study☆. Clinical Nutrition, 30(1), 38-43. http://dx.doi.org/10.1016/j.clnu.2010.06.011