Ingredient Research: Cocoa & Health

In a blend of indulgence and nutrition, research continues to mount on cocoa’s health potential. But what health benefits are really possible? And what kinds of cocoa products can best deliver those benefits? Here’s an updated look at the science behind some of cocoa’s most prized nutrients and how humans can best obtain them.

Cocoa or Chocolate?

Global consumption of cocoa varies, so when speaking of its nutritive properties, there are boundaries to draw. Not all chocolate products can be presumed healthy, largely due to saturated fats and sugars. Beyond fats and sugars, the heat and processing methods required to produce chocolate may destroy antioxidant-like compounds in cocoa called flavanols (a sub-class of flavonoids). In the name of protecting flavanols and other unique compounds, standardized cocoa ingredients present an appealing option.

Cocoa Flavanols

Many flavanols inhabit the Western diet-wine, apples, and grapes, to name a few-but each food source deserves its own emphasis. Mars Botanical R&D manager Catherine Kwik-Uribe, PhD, explains during an interview with Nutritional Outlook

While there is a wide range of flavanol-abundant foods in our diets, the exact mixture of flavanols found in each food is unique and distinct to that food. It becomes tenable that, although there are some flavanols which are similar in tea to cocoa, the mixtures are different; therefore, the physiological effects and overall benefits of flavanols in those foods could be different. For example, tea contains a type of flavanol called epigallocatechin gallate (EGCG). It’s technically a flavanol, but it has a different chemistry to it and therefore it actually has different rates of absorption, different types of transformation it goes through when it’s in the body, and therefore a different effect. You could make the same case for vitamins. There are foods that contain similar vitamins, but the exact mixture may not be found in another food, and it could be that mixture that’s relevant to health.

Nitric Oxide and Endothelial Function

Honing in on cocoa flavanols, compelling research falls squarely on cardiovascular function.

On numerous occasions, flavanol-rich cocoa has demonstrated an ability to improve endothelial dysfunction, a state in which blood vessels are out of balance (also a sign of atherosclerosis risk). This effect  has been validated through increases in nitric oxide, improved flow-mediated dilation (vessels widening in response to blood flow), and improved circulation.(1–2)

This link between cocoa intake and improved flow-mediated dilation was even observed in at-risk groups, including diabetics,(3) smokers,(4) overweight subjects,(5) and the elderly.(6)

Blood Pressure

Modern research suggests that improved endothelial function may even result in improvements in blood pressure. In fact, a 2008 meta-analysis compiled results from 133 trials on flavonoid-rich foods and cardiovascular disease states. It found that chocolate reduced systolic and diastolic blood pressure, while also increasing flow-mediated dilation.(7)

Several other published meta-analyses support the notion of better-maintained blood pressure, including a 2007 study published in the Archives of Internal Medicine.(8) Researchers from the department of pharmacology at the University Hospital of Cologne in Cologne, Germany, evaluated the results of five qualified human intervention studies, concluding that chocolate and cocoa products supplemented for two weeks produced reductions in systolic and diastolic blood pressure by 4.7 mm Hg and 2.8 mm Hg, respectively. The researchers hypothesized that such reductions “would be expected to substantially reduce the risk of stroke (by about 20%), coronary heart disease (by 10%), and all-cause mortality (by 8%).”

Still, some studies published since the 2007 meta-analyses offer conflicting results. One 2010 meta-analysis of 13 studies found significant effect on blood pressure, but only in prehypertensive/hypertensive subjects.(9) Another study concluded that blood pressure was only lowered when chocolate was enriched with theobromine.(10) Further studies have only identified partial benefits of cocoa on blood pressure, and some have failed to identify a benefit at all.

Cholesterol

There’s a chance that cocoa may even improve cholesterol, as some researchers hypothesize that flavanols, again, could be responsible.

A 2011 meta-analysis undertaken by Boston academia provides arguably the most up-to-date assessment of published science on cocoa and cholesterol reduction.(11) Ten trials on supplementation of flavonoid-rich cocoa supplementation for 2 to 12 weeks brought about this conclusion: dark chocolate and cocoa products significantly reduced low-density lipoprotein (LDL) cholesterol and total cholesterol. The findings are reinforced by a 2010 Japanese meta-analysis of eight qualified studies.(12)

Another high point is that the Boston-based study identified a stronger effect in subjects already at risk for cardiovascular disease.

Yet, even with all of the positives, there are still challenges in uncovering the advantages of cocoa for cholesterol. The 2011 meta-analysis was challenged by a use of studies covering a wide range of flavonoid levels, with suggestions that cholesterol reduction benefits from a limited amount of flavanols. And even though previous studies found similarity in observed antioxidant levels after consumption of chocolate or dry cocoa, their work found that dark chocolate had a stronger reduction effect than cocoa-based beverages.(13)

Perhaps the flavanols in cocoa have nothing to do with cholesterol reduction. Cocoa butter, the fat from cocoa plants that is present in all chocolate, does contain two saturated fats, but one of them is stearic acid. Numerous trials confirm stearic acid as “cholesterol-neutral fat.”(14) Mars’s Kwik-Uribe says fiber and other micronutrients also present in chocolate could lend to these results.

Cognition and Mood

Cocoa flavanols may play a role in cognitive health, but we’ll save that for another time. There are other compounds in chocolate worth noting, and a lot of them do their work on this organ, specifically.

First and foremost is a methylxanthine called theobromine. Haven’t heard of it? Don’t worry. Adverse health effects of this compound are understood as being low, if not negligible.(15)

Theobromine, a metabolite of caffeine, is found in higher amounts in chocolate than in any other known food source. Besides the cultural traditions of eating chocolates, it may very well be a reason for the chocolate lover’s perpetual return to the snack machine.

To defend theobromine in this light, we can turn to two notable studies published on theobromine and “likeability” over the last decade.

A 2005 study from the journal Psychopharmacology assigned 64 subjects to a novel beverage paired with a capsule (placebo or combination of theobromine and caffeine) for six days straight.(16) Participants were asked to provide overall ratings and liking for each beverage, along with answers to sensory questions relating to qualities such as acidity and sweetness. Sensory data did not change between the two groups, but overall rating and liking for the drink paired with theobromine and caffeine significantly increased, compared to minimal movement in both directions for the placebo group.

Another study, published a year earlier, assessed changes in mood and cognitive performance in two study arms.(17) In the first arm, participants supplemented with placebo, cocoa powder, or a capsule containing caffeine and theobromine in amounts identical to the cocoa powder. In the second arm, participants supplemented with one of three chocolate bars representing white chocolate (zero methylxanthines), milk chocolate (some methylxanthines), or dark chocolate (high level of methylxanthines). Inclusion of caffeine and theobromine in the study procedures resulted in improvements in cognitive and mood scores. While improvements were noted when subjects consumed methylxanthine levels natural to market products, greater doses did provide further improved scores.

Caffeine’s place in these latter studies brings up a good point: that caffeine can come into play with chocolate’s proposed influences on the brain. Recent reviews on caffeine highlight the compound’s association to sensations including mental arousal and energy-and a synergy with theobromine is worth exploring.

Other cocoa compounds believed to support mood include phenylethylamines and anandamides.

Exercise Performance

While caffeine is already an established thermogenic, theobromine is also considered for mild thermogenic capability. In this manner, both cocoa  compounds are candidates for fat-burning exercise supplements.

A further look at theobromine hints at its potential to support the vagus nerve, a brain nerve linked to gut health, heart rate control, and breathing control. Continuing research on the vagus nerve is exploring potential links between improved vagus nerve function and an antitussive (anti-coughing) effect,(18) reductions in inflammatory cytokine levels,(19) and overall exercise recovery.(20)

Cocoa Ingredients

The story of standardizing cocoa compounds for dietary applications is a relatively new one, and handful of players will be ready as consumers continue to realize the benefits of cocoa and cocoa compound intake.

Chocolate giant Mars Inc. has employed its scientific division, Mars Botanical (Rockville, MD), to lead or assist in over 100 studies on cocoa flavanols over the past two decades. Not just in it for the science, Mars Botanical recently launched CocoaVia and CirkuHealth, dark chocolate and fruit-flavored cocoa powders standardized for 350 mg of flavanols through a patented CocoaPro process.

“The problem for those of us who are healthy is that you don’t necessarily think about circulation as being critical for health,” says Fiona Possell, representing global communications for Mars Botanical. “We’re trying to increase people’s understanding of the importance of healthy circulation as part of being a healthy human being.”

Meanwhile, New York–based RFI Ingredients (Blauvelt, NY) is taking a hold of growing interest in theobromine, caffeine, and other more brain-related science behind cocoa. The company’s patented Chocamine cocoa extract is standardized for theobromine and-when marketed as Chocamine Plus-caffeine.

“Cocoa has a range of neurocognitive compounds, most of which are not in cocoa in a sufficient amount as is normally consumed,” says RFI vice president of business and product development Paul Altaffer. “Yet, in combination, they seem to have a synergistic effect. And that’s where we focused our work. We’ve also added ingredients like vanilla, ginger, allspice, and cinnamon. These ingredients are potentially active on their own, but, in combination, they enhance the cocoa experience, meaning that the aroma and flavor of cocoa to chocolate is as important as anything else to creating the experience around chocolate.”

RFI is currently designing a human study around Chocamine and exercise and recovery.

Javaplant (Jakarta Barat, Indonesia) also offers cocoa extract standardized at 10% and 20% theobromine, applicable for capsules, beverages, and dairy products.

Let’s not forget, however, that for healthy consumers, non-standardized cocoa can still be as nutritious as it is tasteful.

“Cocoa is one of the richest flavonoids-containing foods available, but it is also a good source of calcium, iron, zinc, copper, manganese, and potassium, in addition to vitamins A, B1, B2, B3, C, E, and pantothenic acid,” says Marina Linsley, marketing director for NP Nutra (Rancho Dominguez, CA), which supplies raw and organic-certified cocoa nibs. “It’s also remarkably rich in magnesium and is a good source of sulphur.”

If you’re seeking a non-standardized cocoa product, minimally processed cocoa would be the most fitting option.

References:

1. H Schroeter et al., “(-)-Epicatechin mediates beneficial effects of flavanol-rich cocoa on vascular function in humans,” PNAS, vol. 103, no. 4 (January 24, 2006): 1024–1029.

2. D Taubert et al., “Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial,” JAMA, vol. 298, no. 1 (July 4, 2007): 49–60.

3. J Balzer et al., “Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients: a double-masked, randomized, controlled trial,” Journal of the American College of Cardiology, vol. 51, no. 22 (June 3, 2008): 2141–2149.

4. C Heiss et al., “Acute consumption of flavanol-rich cocoa and the reversal of endothelial dysfunction in smokers,” Journal of the American College of Cardiology, vol. 46, no. 7 (October 4, 2005): 1276–1283.

5. VY Njike et al., “Effects of sugar-sweetened and sugar-free cocoa on endothelial function in overweight adults,” International Journal of Cardiology, vol. 149, no. 1 (May 19, 2011): 83–88.

6. ND Fisher et al., “Aging and vascular responses to flavanol-rich cocoa,” Journal of Hypertension, vol. 24, no. 8 (August 2006): 1575–1580.

7. L Hooper et al., “Flavonoids, flavonoids-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials,” American Journal of Clinical Nutrition, vol. 88, no. 1 (July 2008): 38–50.

8. D Taubert et al., “Effect of cocoa and tea intake on blood pressure: a meta-analysis," Archives of Internal Medicine, vol. 167, no. 7 (April 9, 2007): 626–634.

9. K Reid et al., “Does chocolate reduce blood pressure? A meta-analysis,” BMC Medicine, vol. 8, no. 39 (June 28, 2010).

10. B van den Bogaard et al., “Effects on peripheral and central blood pressure of cocoa with natural or high-dose theobromine: a randomized, double-blind crossover trial,” Hypertension, vol. 56, no. 5 (November, 2010): 839–846.

11. Jia L et al., “Short-term effect of cocoa product consumption on lipid profile: a meta-analysis of randomized controlled trials,” American Journal of Clinical Nutrition, vol. 92, no.1 (July 2010): 218–225.

12. S Baba et al., “Bioavailability of (-)-epicatechin upon intake of chocolate and cocoa in human volunteers,” Free Radical Research, vol. 33, no. 5 (November 2000): 635–641.

13. OA Tokede et al., “Effects of cocoa products/dark chocolate on serum lipids: a meta-analysis,” European Journal of Clinical Nutrition, vol. 65, no. 8 (August 2011): 879–886.

14. EL Ding et al., “Chocolate and prevention of cardiovascular disease: a systematic review,” Nutrition & Metabolism, vol. 3:2 (January 3, 2006).

15. II Koleva et al., “Alkaloids in the human food chain-natural occurrence and possible adverse effects,” Molecular Nutrition and Food Research, published online August 8, 2011.

16. HJ Smit et al., “Reinforcing effects of caffeine and theobromine as found in chocolate,” Psychopharmacology, vol. 181, no. 1 (August 2005): 101–106.

17. HJ Smit et al., “Methylxanthines are the psycho-pharmacologically active constituents of chocolate,” Psychopharmacology, vol. 176, no. 3–4 (November 2004): 412–419.

18. OS Usmani et al., “Theobromine inhibits sensory nerve activation and cough,” FASEB Journal, vol. 19, no. 2 (February 2005): 231–233.

19. YH Wang et al., “Exercise benefits cardiovascular health in hyperlipidemia rats correlating with changes of the cardiac vagus nerve,” European Journal of Applied Physiology, vol. 108, no. 3 (February 2010): 459–468.

20. P Terziotti et al., “Post-exercise recovery of autonomic cardiovascular control: a study by spectrum and cross-spectrum analysis in humans,” European Journal of Applied Physiology, vol. 84, no. 3 (March 2001): 187–194.