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It’s definitely cause for celebration when scientific research proves that a food as indulgent and delicious as cocoa is good for you.

Studies show cocoa lifts our mood and improves our mental alertness

For centuries, myriad cultures have enjoyed cocoa as a delicacy, and a rich and soothing treat. Its Latin name, Theobrome, translates to “food of the gods.”  The ancient Aztecs placed so much value on it that they used it for currency. The Aztecs considered cocoa a gift to the gods, and the elites used it as a medical remedy for illness. The appreciation and allure of cocoa has spread over the centuries in many cultures and continues to gain attention. A number of recent independent research studies have demonstrated the impressive cardio-protective health benefits of cocoa. This includes gut health, which we now know is connected to our heart health. (See Ornish Living article, Your Gut and Heart Health Connection.)

Compelling research has shown the association between cocoa consumption and decreased cardiovascular risk factors. These include reduced blood pressure, insulin resistance , and inflammation, along with improved cholesterol levels, blood vessel health, and artery function.

Decreased Inflammation and Oxidation

Many active substances in cocoa contribute to the impressive health outcomes. These include theobromine, magnesium, N-acylethanolamines, polyphenols, and flavonoids such as catechin and epicatechin. The most compelling evidence suggests that the flavonoids in cocoa offer the most benefits. Flavonoids are an active family of compounds found in plants that help to decrease inflammation and oxidation. They also help to protect our cardiovascular system.

A 2011 meta-analysis published in the Journal of Nutrition reviewed controlled trials of 1100 adults to better understand the effects of flavonoid-rich cocoa on cardiovascular health. The study subjects ranged from healthy, showing CVD risk factors, and having diabetes or coronary artery disease. Those who consumed cocoa for four weeks showed significant decreases in systolic blood pressure, LDL cholesterol, insulin resistance and HDL cholesterol. There were also significant increases in flow-mediated dilation, which is a non-invasive ultrasound method to assess the function of blood vessels.

Another 2012 independent meta-analysis reviewed 42 randomized, controlled trials through 2007 (1297 adult participants, at any risk of CVD). The analysis assessed the effects of chocolate, cocoa, and flavonoids on cardiovascular biomarkers. Researchers found strong beneficial effects of cocoa flavonoids on flow-mediated dilation. It also improved insulin resistance due to significant decreases in insulin secretion. Additional meta-analysis reviews showed improved endothelial and blood vessel function in patients with heart failure in just a four-week period.

Mood and Mental Sharpness

Research shows that Theobromine, a compound naturally found in cocoa, contributes to the beneficial effects of cocoa on our heart health.  Theobromine is a mild stimulant that synergizes with the low amount of caffeine (average 8 mg/tablespoon) in cocoa. This is why it helps to lift our mood and improve our mental alertness. Theobromine is a smooth muscle stimulant that helps to dilates blood vessels. It also increases the amount of water and salt that comes through our urine, all which can lower blood pressure. Cocoa beans naturally contain approximately one percent theobromine. Cocoa powder can vary in the amount of theobromine, from two percent to ten percent. Researchers encourage more studies to investigate this potent compound.

Cocoa and Gut Microbes

Research presented in 2014 at the annual meeting of the American Chemical Society points to the additional benefits of the antioxidants and fiber in cocoa. Researchers reported that good gut microbes such as bifidobacterium and lactic acid bacteria feast on the undigested compounds from cocoa. As a result, they produce compounds with anti-inflammatory properties that decrease inflammation.

Some Heart-Healthy Ornish Lifestyle Medicine Cocoa Recipes

Ornish Lifestyle Medicine, unfortunately, doesn’t include dark chocolate because it contains cocoa butter, which contains saturated fat. The recommended serving limit in Ornish Lifestyle Medicine is one tablespoon of cocoa to limit the amount of caffeine.  Just one tablespoon of cocoa powder has a high concentration of antioxidants in cocoa. It’s approximate ORAC value is 1400, which is high compared to most foods.

Here are some delicious reversal style recipes to try:

Cocoa Truffles (See Sample Menu 1)

Chocolate Pudding  (See Sample Menu 3)

This rich and creamy pudding tastes decadent, yet it is low in fat and filled with heart-healthy ingredients. For example, it contains health-promoting phytonutrients such as powerful flavonoids.

What have you noticed when you indulge in a little bit of cocoa?


Contributed by

Carra Richling
Registered Dietitian

Eat well, be well!

Better Health Begins With You...

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