The People's Perspective on Medicine

Cocoa Flavanols to Prevent Stroke, Improve Heart Health and Reverse Wrinkles

Cocoa flavanols found in dark chocolate or cocoa have the power to keep wrinkles from progressing and prevent cognitive decline.

Imagine a drug that eases inflammation, reduces the risk of blood clots, relaxes blood vessels, improves circulation, improves liver function and blood sugar control, relieves stress and enhances mood. A medication that could do all those things might easily cost hundreds of dollars a month. It would likely top the doctors’ hit parade of most prescribed drugs.

We have just such a “medicine” and it’s delicious to boot. Yup…CHOCOLATE can do all those things and more! We doubt you’ll get a prescription any time soon, but there is plenty of information here.

Cocoa Flavanols Fight Inflammation:

A review in the journal Frontiers in Pharmacology (Dec. 12, 2013) considers how cocoa flavanols affect the human body. The authors are hard-core biochemists from Innsbruck Medical University in Austria. These researchers note that there are more than 380 compounds in cocoa, many of which are known to be powerful antioxidants with numerous pharmacological activities including:

  • Anti-inflammatory biochemistry
  • Anti platelet action (reducing the sticky part of blood to reduce the risk of blood clots)
  • Immune system modulation (enhancing cellular defense against viruses, bacteria and parasites)
  • Nitric oxide enhancement (improving blood vessel flexibility & lowering blood pressure)
  • Anti-oxidative effects (combatting atherosclerosis)
  • Neurotransmitter modulation (improving mood)

Preventing Stroke:

A review article in the prestigious journal Stroke (online, Dec. 10, 2013) titled “Coffee, Tea, and Cocoa and Risk of Stroke” reveals that cocoa flavanols reduce blood pressure and control insulin resistance:

“Cacao products, such as chocolate, are rich sources of flavonoids, which are potent antioxidant and anti-inflammatory compounds…A recent meta-analysis of 42 acute or short-term chronic (≤ 18 weeks) RCTs [randomized controlled trials] found that cocoa or chocolate interventions significantly reduced fasting insulin concentrations, insulin resistance and mean arterial pressure as well as improved endothelia function measured by FMD [flow mediated dilation, a measure of blood vessel flexibility]…Results from a meta-analysis of those 5 [prospective epidemiological] studies (4 from Europe and 1 from the United States) showed a significant 19% lower risk of stroke when comparing the highest with the lowest category of chocolate consumption and a significant 14% reduction in stroke risks for a 50-g/week increment in chocolate consumption…”

Maintaining a Healthy Pregnancy:

Another exciting benefit of chocolate may be its protective action against hypertension in pregnant women. This is a sign of preeclampsia, a very serious complication of pregnancy. Left untreated, this condition can lead to seizures that harm mothers and infants. One of the early signs of preeclampsia is loss of blood vessel flexibility (endothelial function impairment). If dark chocolate could counteract this physiological problem, it would be a delicious antidote to a life-threatening problem (Systematic Reviews, Dec. 20, 2013) and might help some women avoid emergency C-sections.

Resisting Wrinkles:

All of these health benefits are important, but it is entirely possible that some people will be even more intrigued by a recent 6-month study showing that women who took cocoa flavanols (320 mg/day) instead of placebo had more elastic skin and less visible wrinkles at the end of the trial (Journal of Nutrition, online Nov. 18, 2015).

Keeping Cognitive Capacity:

Keeping the brain working properly is another goal that can be hard to achieve, so a study conducted in Italy with 90 older adults is quite promising. The volunteers were randomly assigned to get varying amounts of cocoa flavanols. They were tested at the beginning and end of the 8-week trial, and those who had received high-dose cocoa flavanols (993 mg/day) fared significantly better than those getting low-dose cocoa flavanols (48 mg/day). The research was partly funded by Mars, the maker of CocoaVia, but it is consistent with previous findings (American Journal of Clinical Nutrition, March, 2015).

Is it possible to overdose on cocoa flavanols? There might well be negative effects of eating too much chocolate, but a recent study found that people can tolerate the surprisingly high dose of 2000 mg of cocoa flavanols a day without apparent harm (American Journal of Clinical Nutrition, online Nov. 4, 2015).

Where Do You Get Cocoa Flavanols?

Finding the best chocolate for pharmacological benefits is not always easy. There is no standardized way of determining the flavanol content of cocoa or chocolate by reading most labels. That’s why we like what CocoaVia has done. This product offers a standardized amount of 375 mg of cocoa flavanols per serving.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I would love to try the cocoa approach, but I do not process caffeine well at all. The label states the product has 30 mg of caffeine. Is there a cocoa product that does not have that much caffeine?

Mars seem to have jumped on the greed bandwagon. The price of CocoVia has more than doubled in the last year. I won’t keep taking it at that rate.

are there any cocoa snacks available that isn’t loaded with lots of additives? if so, name and where to purchase or order.

You can use plain cocoa powder, or for standardized levels of cocoa flavanols, you can try CocoaVia from Mars Botanicals. 375 mg/packet

I add a teaspoon of non-sugar baking cocoa to my coffee each morning. Tastes great.

Question on Cocoa “flavonoids in cocoa” article previously posted by People’s Pharmacy (below): Where or how might we obtain a list of retail store brand names of cocoa products that list the “mg of flavanoids (or concentration) per packet”? I would like to start buying and eating the highest concentration for the least price. Ken from Kingston.

Went to their website, there cocoa is processed with alkali (dutch processing) which highly reduces the flavonoids in cocoa. This seems to fly in the face of there claims. Can you or they explain this?

People’s Pharmacy response: We don’t know why they use Dutch processing, but we do know that they have been studying the processing of cacao for years and have developed ways to maintain high flavanol levels. Since Mars Botanical makes the claim of 250 mg of flavanoids per packet, we expect that they are doing quality control to make sure that is what they are delivering.

Author: dav941

“Take” everything with a “grain of salt,” whatever that means. Seems that whatever goes up must come down. Chocolate, yes, now chocolate no. Soap, yes, soap, no. Lots of things work for a while, then quit. Or they work on some, not others. Sometimes I think self hypnosis is at work… but if it works, USE it, oh, use it. Knee hurt terribly, used gin soaked raisins faithfully. They seemed to work a while, but the surgery worked more miracles. I can walk miles now, where even with the raisins I could not walk to a store from the parking lot without hard pain.

OMG! I added 1 Tablespoon of Cacao to my old fashioned oatmeal with unsweetened soy milk this morning (after 2 mins in microwave). Delightful. It seemed like I was eating a chocolate muffin equivalent… (which I would NEVER EVER do ordinarily). Feeling super up today. Hopped off to the gym for an hour of cardio/weights class, no aches or pains, shoveled the driveway and sidewalk when I got home and feel like giggling and singing.
Could it be the tablespoon of cacao in my oatmeal? Are my arteries and veins flowing?
Good luck everyone. Wishing you happiness, giggles and stroke free lives.

OK, I bought Raw Sun Dried Organic Cacao nibs, made in Mexico… found it in Whole Foods, but now what?
Should I stir a tablespoon into my oatmeal in the morning? Other suggestions for recipes and how to consume, how much, how often.
I’m no cook, btw. Thanks all.
People’s Pharmacy response: If you don’t enjoy cooking, why not start with the oatmeal experiment you just suggested? Should be easy and just as helpful as any other way of getting cacao.

I have been eating Baker’s unsweetened chocolate daily, for years. I make it more palatable by eating it with a few pieces of semi-sweet chocolate and a pinch of sweetened coconut. The coconut is generally sweetened with propylene glycol… a non-sugar sweetener. It may not be the perfect concoction for getting the max benefits of chocolate. But, I’m getting a daily does of chocolate, and enjoying every semi-bitter bite of it!

Making cocoa without sugar is easy. Just heat milk, add cocoa powder and add vanilla and stevia to taste. My grandson told his mother, “Grandma made some hot chocolate that doesn’t make me hyper!”
Stevia is readily available now almost everywhere–either the white powder or liquid. I buy the one pound container and use it to cut or eliminate sugar. You can buy small packets to keep in purse or wallet. There are also eyedropper bottles of some very yummy liquid stevia flavors. English Toffee is a wonderful! Read the container labels for ingredients. Some so-called stevias have sugar alcohols added (that may or may not be what you want). Experiment a little to see what works for you–a little stevia goes a long way.

I remember reading an article about cacao workers in the tropics who presented no symptoms of high-blood pressure. These workers drank a cocoa-based beverage each day as part of their midday meal. As part of a study, some of these workers were brought to the U.S. and allowed to eat a typical American diet. Within six months these workers developed high-blood pressure. The only reason I share this is that the post regarding cocoa immediately brought it to mind once again. Although most will not like it, I enjoy a small cup of vanilla ice-cream with two tablespoons of powdered cocoa stirred into it. It takes a while for it to blend, but the effort is well worth it.
I remember as a young boy when my Grandma would make me a cup of chocolate milk with Instant Quick. She would have me sit down at the dining room table, and place Nestle Quick container made out of metal in front of me while I drank it. On the side of the container was printed a brief history of chocolate. And how in the 1600’s chocolate houses were all the rage. Patrons drank unsweetened, bitter chocolate. I can still recall drinking down to the bottom of the glass and see small lumps of unmixed powder that clung tightly to it. It is my hope The People’s Pharmacy will provide future information about possible health benefits that chocolate seems to possess. Thank you.

When you look for dark chocolate or cocoa be sure it has not been treated with alkali (dutch processing) as this reduces the flavonoids.

(reply to MJW) My favorite recipe for cocoa is sugar free and absolutely the best. Simmer 1 tbl. cocoa in 1 c.milk for 5 minutes, remove from heat and add 1 teaspoon vanilla. I use either rice milk or almond milk or dairy. I prefer dark chocolate so it suits my taste perfectly.

soap works, also wish I had started the chloc. 60 years ago

All chocolate does not have contain sugar. I believe the chocolate that does not have sugar is the one that is referred to as being good for you. I wish all the articles that now state, chocolate is or may be good for you would clarify whether it does or does not contain sugar.
People’s Pharmacy response: It is the cocoa compounds and not the sugar that offer the benefits. If you train yourself to enjoy the bitter taste of cocoa without sugar, you can get the benefits without the sugar disadvantages.

Would love the sweetened CocoaVia to be with a naturally occurring sweetener, vs sucralose.

The news is no longer is cocoa or chocolate good for you. The news we all want to hear now is, what’s the best form to buy and where do I buy it?
A batch of chocolate Fudge has two CUPS of sugar and 1/2 CUP of real butter in it! Is that good for you, ha?

If the ingredients state that the chocolate was processed with alkali or by the Dutch Process, the beneficial anti-oxidants are no longer present in the chocolate. FDA regulations require that chocolate processed in this way show this on the label, but there is no enforcement of the regulation.
People’s Pharmacy response: In general, alkali-processed cocoa has much lower levels of flavanols. The folks making CocoaVia are measuring the flavanol levels in their product, even though it is processed with alkali.

Soap under the sheet works for me and others. I’ve also found that rubbing a soap cake on the AFFECTED MUSCLE may offer immediate relief.

I’d be interested in seeing a comparison of cocoa with carob (or perhaps there’s little to compare). Also, recipes with cocoa that don’t require sugar.

Chocolate causes me and my husband to have heartburn. I read that the chocolate relaxes the muscles at the top of the stomach, which allows acid reflux. Is this true?
People’s Pharmacy response: This is certainly the conventional wisdom. The best yardstick for you, however, is that you don’t handle it well. Not everyone does develop heartburn from chocolate.

Shouldn’t this testimonial include a warning for people who struggle daily and constantly with GERD? How would this likely affect GERD?
People’s Pharmacy response: Some people do experience reflux after eating chocolate. Whether it is due to the fat content or the cocoa polyphenols has not been determined. We trust our readers to exercise their common sense: if they know from experience that they don’t tolerate something (such as chocolate) they will refrain from it.

A friend suffers from really bad leg cramps. I suggested she try bar soap under the sheet. Somewhere I heard or read that not drinking enough water can lead to leg cramps. True?

Wow! I wanted chocolate last night and thought I was being good by NOT having. Would like to hear more about how to have chocolate that is:
Healthy, and tasty, unsweetened dark chocolate is awful!!
HUGE challenge. I eat fattening, milk chocolate with sugar. That can’t possibly be good… I’m sure I will have a stroke from the fattening and sugar elements, way before the benefits kick in.
Also, side note – like big pharma, do you think Austrians with Chocolate factories, may have interest in positive outcomes of the research? I’m sure there are Austrian chocolate businesses who will benefit greatly from the study.
Looking forward to hearing good ideas from others.

Went to their website, there cocoa is processed with alkali (dutch processing) which highly reduces the flavonoids in cocoa. This seems to fly in the face of there claims. Can you or they explain this?
People’s Pharmacy response: We don’t know why they use Dutch processing, but we do know that they have been studying the processing of cacao for years and have developed ways to maintain high flavanol levels. Since Mars Botanical makes the claim of 250 mg of flavanoids per packet, we expect that they are doing quality control to make sure that is what they are delivering.

I would like to hear more on this subject

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