The People's Perspective on Medicine

Show 939: The Health Benefits of Chocolate (Archive)

Could there really be health benefits of chocolate? These scientists present the evidence that cocoa flavanols and chocolate containing them can be helpful.
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The Health Benefits of Chocolate (Archive)

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Chocolate has long been considered a sinful indulgence, definitely not a food that belongs in any “healthy” diet. But over the past few decades, evidence has been building that consuming chocolate actually offers specific health benefits. What are they, and what is the best way to get your dose of beneficial cocoa compounds?

What Are the Health Benefits of Chocolate?

The experts describe how chocolate affects blood pressure, stroke, and even Nobel Prize potential. And we get a peek at how to produce great tasting chocolate from a master.

New research shows that cocoa flavanols can calm inflammation as well as relax blood vessels to lower blood pressure, lower total cholesterol and raise beneficial HDL cholesterol. People who eat chocolate regularly have a lower risk of stroke.

People who would like to get cocoa flavonoids without the sugar and calories of candy may be interested in CocoaVia. Mars Botanical, the manufacturer, provides standardized cocoa flavanol extract as supplements and in powders to add to beverages. Mars has supported some of the research on the health benefits of chocolate, but independent research is largely consistent with the findings of Mars-related research.

This Week’s Guests:

Eric Ding, PhD, is an epidemiologist and nutrition scientist at Brigham and Women’s Hospital and the Harvard School of Public Health.

Susanna Larsson, PhD, is Associate Professor in the Division of Nutritional Epidemiology at the Institute of Environmental Medicine of the Karolinska Institutet in Stockholm, Sweden. Her meta-analysis on chocolate consumption and stroke was published in Neurology.

Joseph Maroon, MD, FACS, Vice Chairman and Professor in the Department of Neurological Surgery at the University of Pittsburgh Medical Center. He has been the team neurosurgeon for the Pittsburgh Steelers since 1980.

Franz Messerli, MD, FACC, FACP, is Professor of Clinical Medicine at Columbia University college of Physicians and Surgeons in New York City. His article on chocolate consumption, cognitive function, and Nobel laureates was published in the New England Journal of Medicine.

John Scharffenberger is co-founder of Scharffen Berger Chocolate.  With his business Partner, Dr. Robert Steinberg, he set off a new wave of chocolate making to the US.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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One of the best dark chocolate bars I’ve found is Green & Black’s Organic 85% cacao bar. It is certified organic and doesn’t contain the additive-type ingredients many other chocolate bars include. “Suitable for vegetarians.” Excellent!

I buy bulk organic semi-sweet chocolate chips & then melt about 1/2 cup of them in the microwave (stir often–they burn easily). They taste so much better this way & even if they cool down & harden, they still have a great texture & flavor. I found that when I just ate them from the box, they were not nearly as satisfying & I tended to eat a lot more.

My favorite after reading about it online is sold from Aldi’s. It is Moser Roth 85% and it is packaged in separate squares, 5 to a package. One serving is considered two squares but I find one a day is plenty. I believe Aldi’s is the only place that sells it and they have differed kinds of Moser Roth but the. 85% is sometimes sold out. Also,the 85% is not Dutch processed.

Thank you for your reply to my telling you of my arthritic I had become almost to screaming point, about four days ago.
I tried four of your suggestions I could not use my right hand ,now I can.
I could not raise my left hand above waist level, now all the way up.with you vic rub to soles of feet my cough has gone.
My doctor only said at 87 I have had a good run for my money.
I am ever so grateful to you and feel fine, Thank you
Len, which tests and rates vitamins and supplements, has also done a rating of healthy (and not so healthy) chocolate & cocoa products. It is not exhaustive, but I have found it informative and helpful. A yearly fee is required to view all their ratings, but it is reasonable and well worth it.

No chocolate for people with kidney stone problems.

Chocolate and cocoa are high in oxalate, so you are right. People who have had oxalate kidney stones should be careful with chocolate.

My recipe for a cocoa drink:
*Measure a half cup of water into a large glass
*Add a half cup of concord grape juice (automatically mixing with the water)
*Add another half cup of water (thus cleaning the measuring cup)
*Microwave on high for a minute or so
*Add 1/8 cup of cocoa powder and stir

The grape juice enhances both the taste and the nutrition.
Nestle’s Toll House cocoa powder is cheap and good.
We use grape juice concentrate from Growers Cooperative
A quart of the concentrate makes more than FIVE quarts of juice…currently for less that $8.50.

I have daily heartburn issues and am unable to take any meds for it (because of serious side effects). So, I guess that means no chocolate for me, except for a tiny bit now and then… Sigh.

It’s easy to make your own chocolate without the sugar, which, in my view, has caused chocolate to have such bad press. The recipe is roughly equal parts coconut oil (melted) and cocoa powder, sweetened with a little maple syrup (or other sweetener), add other ingredients as you like: almonds, coconut, vanilla. When all is blended, spread on a cookie sheet, put in the refrigerator. When hardened, break apart in pieces. Keep it in the refrigerator, as it melts much more quickly than commercial chocolate.

Hi Guys, All of your questions and concerns about the benefits of chocolate are excellently addressed in the report on chocolate at

For those of you like me, who enjoy eating a little chocolate on most days, Ghirdelli 72% squares or bars have the highest level of beneficial flavinoids, a relatively low amount of sugar and the lowest lead, cadmium etc, contamination levels of all the chocolate tested.

Each morning I make a high energy shake with a slice of firm tofu, a ripe banana, 2 strawberries and half cup of skim milk, a half teaspoon of natural wheat germ and oat bran. Add dash of cocoa powder for chocolate flavor when desired. Tofu is Mother Nature’s estrogen so is excellent estrogen instead of ERT. I keep bananas and strawberries in freezer; you can use a tablespoon of frozen orange juice instead of strawberries if desired.
Blend in blender, pour and drink. Thick, delicious, satisfying for a few hours instead of a heavy meal.

Both non-processed and processed cocoa are readily available in US grocery stores in your baking aisle. Processed (alkalized or Dutch-processed) will be stated clearly on the label. The process does reduce the health benefits of the cocoa (flavonoids) and makes the cocoa flavor more mild. I recommend the cocoa that is NOT processed. It will not say anything on the label about being processed. It will just say 100% cocoa. I have my cocoa 2 ways: banana with a mixture of 2T peanut butter, plain cocoa (about 1 to 1 1/2 t), 1T flax seed meal and 1T unsweetened coconut (amounts are estimates). Cut the banana into bite size pieces and eat with the peanut butter mixture. Or, about 2 t cocoa in coffee with a packet of stevia (with milk if desired). No extra sugar with either of these recipes.

I love chocolate of any kind. The secret is to have one piece and stop . You get to enjoy your treat without having to worry about the ill effects of eating too much. This applies to anything considered not good for your health. Moderation! I know – I am in my 80’s and doing well except for a few aches and pains.

After reading of benefits of cocoa, 75% -100% cocoa, I purchased UNSWEETENED 100% Ghiradelli cocoa in baking section of supermarket. I put 1 TBSP in warmed milk with scoop (28 grams) of protein powder that has 3 grams sugar. A very delicious drink for breakfast or snack. The 100% Cocoa provides 1gram protein, protein powder has 20 grams of Protein, 8 oz. Milk is approx 8 grams of protein. Total protein in the drink is approx. 29 grams. Total calories is approx. 230 calories. (2O calories from 100% UNSWEETENED COCOA, 110 from protein powder & approx 100 calories from 8 oz. of milk- you can correct me on the milk calories.)
My energy has definitely improved with my necessary additional protein. I hope my blood vessels are improving too. I used to be able to consume appropriate 30 grams protein until I became a FQ TOXICITY victim. (Antibiotics in Fluroquinolone family were needlessly, recklessly prescribed leaving me with little appetite & severe chronic pain. —Nerves, Tendons, etc.) I can no longer tolerate ANY MEATS or Milk (our usual high protein sources) that are NON ORGANIC, or pain is exacerbated. Thus I require ORGANIC MILK & meat. But appetite is still very limited, thus my reliance upon milk since digesting even a little meat is difficult.
The 100% COCOA & PROTEIN drink leaves me satisfyingly satiated for approx 5 hours. With the mild tasty flavors contained in that drink I have no cravings nor as many desires for desserts. Though I always ate fruits & vegetables, I have increased those. Sometimes cooking & grinding carrots, kale & spinach into blender with vanilla protein powder & milk. My energy levels have improved. Lost 10 pounds of weight gained from being sedentary due to FQ Toxicity. Nerve & Tendon pain is still a big problem, but am grateful for energy & weight improvement.

Important topic on the health benefits of chocolate. Thank you! My only issue is that the none of the guest commentators really brought up the point about substituting cocoa powder for chocolate to get around the fat/calories issue, which is rather curious. I can’t imagine that they don’t know it is an option and that cocoa powder is in the bakery or organic section of most grocery stores! It would have been beneficial if the hosts would have asked more questions about using cocoa powder.

what is the half life for dark chocolate it seems not to metabolize but even small amounts build up causing insomnia?!

Like some of the others, I was somewhat disappointed that nobody really addressed the question about whether or not pure cocoa powder (not dutch processed) gives the same benefits as chocolate. The one person who even addressed the problems seemed more interested in selling his chocolate, and it seemed to me a couple of others were also mainly on there to hawk their products in the guise of answering questions.
Please address the question of cocoa vs chocolate, and if it is as good or better, what kind. Currently I buy the 100% baking cocoa from Hershey’s which I believe is not alkalized and is not extremely expensive. I found that Scharffen Berger makes unsweetened cocoa as well and wished that the person from that company would have talked about that. If you have any clear information about this I’d so appreciate it, as I would rather get my cocoa from an unsweetened, low fat source without having to resort to taking supplements.

Many who have posted here are concerned about the sugar in chocolate. My best advice is to read the labels. I’ve found some “dark” chocolates to contain as much as 52% sugar. As an alternative, Try Trader Joe’s. They sell an 85% cacao dark chocolate with just 15% sugar. It’s quite good and not the least bit bitter.

One should look for “dutch processed” or “alkalized” on labels in order to AVOID products processed that way. Dutch processing considerably REDUCES the valued components of cocoa/chocolate.
Joe asked the appropriate question about using cocoa straight, but the guest “answered” without answering, and Joe let him get away with it.
Cocoa powder sold for baking purposes is the most effective way to get the desired flavonols. Another commenter has provided an example recipe. Myself, I simply take a tablespoon of cocoa powder in a glass of hot water. This will taste pretty bitter the first time, but you can get used to that in a few days. (The notion that cocoa should be sweet is a modern one. The Central American royalty who had an exclusive right to consume cocoa in pre-Columbian times did not sweeten it — they mixed it with the likes of cayenne!)
Be sure to get cocoa from the Baking aisle at the supermarket. Do not buy the pre-mixed, heavily-sweetened “hot chocolate”. The container should say: INGREDIENTS 100% cocoa

Yes, Flavanol’s are the healthy component of chocolate. It is possible to find cocoa powder that isn’t alkalized, usually in the organic section of the story; it may take further research of specific products via online or calling the company. I was really hoping this podcast would address this issue further and maybe dispel/clarify or shed light on what the consumer could do to ensure they are buying quality chocolate at the grocery store. I don’t believe the manufacturer is required to label whether the cocoa is alkalized or not.

Thank you for your quite thorough show on chocolate/cacao/cocoa.
It is easy to utilize raw cacao powder in sweet treats without adding sugar or flour.
I use raw or roasted cacao powder, coconut oil, walnuts or other nuts, tiny bit of maple syrup or honey or coconut sugar and some vanilla extract. Mix it all up together in a food processor, pat it in a pan and refrigerate until firm. Super Yummy and Super anti-oxidant healthy.

I did enjoy the show about health benefits of chocolate, but I was disappointed that there was no information about using pure cocoa powder from the bakery aisle to prepare ones own chocolate foods or beverages.
Does the supermarket cocoa powder contain the ‘beneficial cocoa compounds’ that were discussed? Also any other things a consumer should know about this cocoa powder as it relates to health … a scientific analysis/breakdown.
I would like to have info on how to make my own hot chocolate and chocolate bars, etc. using pure cocoa powder, if it has the discussed benefits.

Isn’t the idea that flavanols are the property that benefits health? So are you stating that I would want to avoid purchasing Dutch processed or alkalized cocao?
Also, through a quick Google search, it seems that it is difficult to find alkalized/Dutch processed cocoa in the U.S.

It’s wonderful to read these intelligent comments and questions about this very important People’s Pharmacy show.
I also ceased eating chocolate and everything else with sugar in it as well as all “white” foods (even white and sweet potatoes) decades ago in an effort to prevent diabetes as I’ve had three severe disabilities for from 5 to 40 years I’ve learned to cope with and another, diabetes, that is horrible in itself as well as making every other physical problem worse just might be too much to handle and quite literally push me over the edge. I’d only need to find one high enough.
I wish I could find sugar-free dark chocolate that I could buy without putting my credit card number online. It seems that every day something goes wrong with my computer. Yesterday I couldn’t get online, but this morning I’m back and wondering how long that good news will last. Consumer Reports describes PCs as the worst, most unreliable consumer product ever made, but I’m getting off the topic. So thank all of you for the information and your intelligent comments,

I have heard that cocoa proccessed with alkali (Dutch process) destroys some of the good flavinoids. Is that true? take a look at the Hersey Cocoa and Dark Cocoa.

I love chocolate, particularly European-made milk chocolate, so this program was helpful in educating me about the benefits of dark chocolate. I have been teetering on the border of prediabetes, however, so have significantly cut back on any chocolate consumption (I attempt to eat products that have no more than 5 grams of sugar per serving) and exercise regularly to keep my weight down. Has anyone found a decent-tasting chocolate bar that is not a healthy-body-buster?

One topic I don’t recall being discussed during this broadcast was the processing of cocoa. I have researched the antioxidant benefits of dark chocolate, and in my research I discovered that the alkalization of chocolate (also known as Dutch Processing) reduces the flavanol content of chocolate. It’s important for the consumer to look for “dutch processed” or “alkalized” on the label if they want to receive the full benefits of chocolate.
Miller, K.B, Hurst, W.J., Payne, M.J., Stuart, D.A., Apgar, J., Sweigart D.S., & Ou, B. (2008). Impact of Alkalization on the Antioxidant and Flavanol Content of Commercial Cocoa Powders. Journal of Agricultural Food Chemistry. doi:10.1021/jf801670p

I stopped eating chocolate 15 years ago when I stopped eating sugar (best decision of my life, and I am NOT diabetic). I waited patiently for someone to sell chocolate bars sweetened another way, and recently discovered Simply Lite (sweetened with maltitol). I am wondering now about maltitol vs. sugar. Does anyone have information on that?
People’s Pharmacy response: Maltitol is a “sugar alcohol.” Used as a sugar substitute, it provides sweetness but not the rapid rise in blood glucose you get from sugar. It is not alcohol like ethanol–you won’t get drunk on it. But if you eat too much (and that is easy), you will be running to the bathroom and suffering with gas.

Can we buy this from you?

I love chocolate HOWEVER it appears to build up in my system including small amounts and I end up with insomnia and anxiety.

Ron, what no one has mentioned in these comments is that cocoa and chocolate have caffeine in them. This is what could be causing your insomnia and anxiety. People should be aware of the amount they are consuming.

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