logoThe People's Perspective on Medicine

What Are the Health Benefits of Cocoa Flavanols?

Our new underwriter, CocoaVia, offers high-potency cocoa flavanols without the calories of chocolate.
Box of CocoaVia powdered supplement

Do you think of chocolate as a sinful snack or a healthy bite? Chocolate candy itself probably should be considered sinful. It usually contains too much sugar to count as health food. The cocoa flavanols it contains, on the other hand, have surprising health benefits. Moreover, there is an easy way to benefit from carefully calibrated quantities of these plant compounds without having to worry about sugar or calories.

Welcome to CocoaVia, Maker of Cocoa Flavanol Products:

For about 20 years, scientists have been studying the impact of cocoa flavanols on cardiovascular health (Current Opinion in Lipidology, Feb. 2002).  One problem that was identified was consistency. As with other biological components, the amount of these antioxidant compounds varies from one batch of cacao pods to another. In addition, cocoa processing can reduce or damage cocoa flavanols. That helps explain the title of one early review: “Chocolate: A Heart-healthy Food? Show Me the Science!” (Nutrition Today, May-June 2002). 

However, scientists have produced plenty of studies this century. Mars, International, has funded quite a bit of research on how to maintain high levels of cocoa flavanols in products. The products the company has developed, under the CocoaVia brand name, deliver consistent and reliable doses without the drawback of sugar or fat. We are pleased to welcome CocoaVia as a new underwriter for The People’s Pharmacy broadcasts and podcasts. You can try these daily cocoa extract supplements at 25% off the usual price by entering the code Peoples25 when you check out.

What Are the Health Benefits of Cocoa Flavanols?

Cardiovascular Benefits:

People who consumed cocoa flavanols had better blood flow and lower blood pressure (American Journal of Clinical Nutrition, Feb. 2017). People who ingest these products have more flexible arteries (Nutrients, March 8, 2019). Less arterial stiffness and better endothelial function could lower your chance of having a heart attack or developing heart disease (British Journal of Nutrition, Oct. 28, 2015). People who take in these plant compounds every day appear to lower their risk of metabolic syndrome (Nutrients, March 30, 2019). 

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:

The benefits to blood vessels may also help prevent stroke as well as heart attacks.

According to a review article, cocoa flavanols reduce blood pressure and control insulin resistance (Stroke Jan. 2014):

“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…”

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, Jan. 2016).

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 is consistent with previous findings (American Journal of Clinical Nutrition, March, 2015). Other research shows that students ingesting cocoa flavanols performed better on certain cognitive tests (Psychopharmacology, May 2018).

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. The new products offer a standardized amount of 450 mg of cocoa flavanols per serving. Don’t forget to take advantage of your 25% discount: use the code Peoples25 when you place your order.

Rate this article
4.2- 63 ratings
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. .
Tired of the ads on our website?

Now you can browse our website completely ad-free for just $5 / month. Stay up to date on breaking health news and support our work without the distraction of advertisements.

Browse our website ad-free
  • Kris-Etherton PM & Keen CL, "Evidence that the antioxidant flavonoids in tea and cocoa are beneficial for cardiovascular health." Current Opinion in Lipidology, Feb. 2002.
  • Hannum SL et al, "Chocolate: A heart-healthy food? Show me the science!" Nutrition Today, May-June 2002.
  • Sansone R et al, "Methylxanthines enhance the effects of cocoa flavanols on cardiovascular function: randomized, double-masked controlled studies." American Journal of Clinical Nutrition, Feb. 2017. DOI: 10.3945/ajcn.116.140046
  • De Bruyne T et al, "Dietary polyphenols targeting arterial stiffness: Interplay of contributing mechanisms and gut microbiome-related metabolism." Nutrients, March 8, 2019. DOI: 10.3390/nu11030578
  • Sansone R et al, "Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study." British Journal of Nutrition, Oct. 28, 2015. DOI: https://doi.org/10.1017/S0007114515002822
  • Jaramillo Flores ME, "Cocoa flavanols: Natural agents with attenuating effects on metabolic syndrome risk factors." Nutrients, March 30, 2019. DOI: 10.3390/nu11040751
  • Becker K et al, "Immunomodulatory properties of cacao extracts - potential consequences for medical applications." Frontiers in Pharmacology, Dec. 12, 2013. DOI: 10.3389/fphar.2013.00154
  • Larsson SC, "Coffee, tea and cocoa and risk of stroke." Stroke, Jan. 2014. https://doi.org/10.1161/STROKEAHA.113.003131
  • Yoon HS et al, "Cocoa flavanol supplementation influences skin conditions of photo-aged women: A 24-week double-blind, randomized, controlled trial." Journal of Nutrition, Jan. 2016. DOI: 10.3945/jn.115.217711
  • Mastroiacovo D et al, "Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study--a randomized controlled trial." American Journal of Clinical Nutrition, March, 2015. DOI: 10.3945/ajcn.114.092189
  • Karabay A et al, "The acute effects of cocoa flavanols on temporal and spatial attention." Psychopharmacology, May 2018. DOI: 10.1007/s00213-018-4861-4
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 8 comments
Add your comment

Hi Terry — I’m impressed with what I’ve read about CocoaVia and am considering ordering the capsules to take at a dose of 450 mg /day (that seems to be the recommendation).

However, based on what I’ve read on the Consumer Labs website, it seems cacao has high oxalate content.

I’m concerned about potential effects of the oxalate on calcium absorption as it relates to
1) my bone health (based on results of a spine bone density test 15 months ago, I’ve had one Reclast treatment) — and 2) development of kidney stones (my father and paternal grandfather).
What are your thoughts on this?

We are checking with the company.

I just read that the FDA has warned Cocoa Via that their products contain too much saturated fat to be heart-healthy. Could you look into this further please? What response has the company given?

I suspect that it is much cheaper to buy organic cocoa powder and get cocoa flavanols that way. No sugar, no fat. I put it in my smoothies.

I am currently participating in a study of cacao…COSMOS. Main study is cardiovascular, with a side of memory.

Standardizing the dose and omitting sugar are both good ideas but I’ll sign on when someone eliminates the caffeine in chocolate.


You may find this article about caffeine and theobromine enlightening. Cocoa has a very small amount of caffeine compared to other beverages.

Can you take this if you are on other anti- platelets such as baby aspirin?

* Be nice, and don't over share. View comment policy^