The Evolution of Chocolate’s Purported Health Benefits

The practice of using cacao as a medicine, established thousands of years ago in the Americas, quickly caught on in Europe and its colonies. As illustrated by Figure 1, which depicts Poseidon ferrying chocolate from the New World to Europe, chocolate was not seen as merely a regular food.

Figure 1.  Published in Chocolate: Or, An Indian Drinke.

Rather, it was a special rarity, with mystical and godly qualities attributed to it—qualities that generations would attempt to give medical justification for. Even as the Western conception of health and medicine changed drastically over the centuries, cacao has retained its reputation of healthfulness. The sense that there is something uniquely special about cacao has been explained over the centuries by attributing various and evolving health benefits to it, the evolution of which highlights the evolution of Western medical theory and understanding, as well as the primary medical concerns of the day.


When Europeans first encountered chocolate in the 16th century, their dominant medical theory was humoralism (Mary Lindemann). In this framework, good health depends on the proper balance of the four humors of the body—black bile, yellow bile, blood, and phlegm. As shown in Figure 2, each of the four humors was associated with a temperature and a humidity.

Figure 2.  Published by

Ailments or disorders associated with an imbalanced deemed “hot” would be treated with “cold” substances, while “dry” disorders were treated with “humid” substances, and so forth (Mary Lindemann). As this was the primary way in which health was conceptualized, when cacao first was brought to Europe its allure and seemingly mystical properties were explained by integrating it into this humoral system. In 1631, Antonio Colmenero de Ledesma published one of the first medical essay on chocolate (Lippi), entitled Curioso Tratado de la naturaleza y calidad del chocolate in Madrid, which would be later translated into English as Chocolate: Or, An Indian Drinke.  In this essay he endeavors to situate cacao within the humoral scheme, stating that its “Nature and Quality […] is cold and drie, in predominency”, and therefore could be prescribed to treat “the Plague of the Guts […] Fluxes, Consumptions, & Coughs of the Lungs” (Ledesma).


By the 1900s, Luis Pasteur’s germ theory, the idea that microorganisms invade the body to cause certain illnesses, had gained widespread acceptance, and had largely replaced humoral medicine (Germ Theory). New claims about chocolate’s health benefits emerged during this era, with new framing—germ theory. As shown in Figure 3, which

Figure 3.  Published by Hershey Community Archives

depicts a Hershey’s bar wrapper from the years 1900-1903, the focus switched to the purity and sterility of chocolate’s ingredients when discussing its health benefits (Paoletti). The text on the wrapper reads “Hershey’s Sterilized Milk Chocolate […] is most sustaining, being amalgamated by special process with the finest Fresh Milk.” We see that as the scientific paradigm shifts, so too do claims about chocolate’s healthful qualities.


Allowing medical trends to dictate our explanation of the specialness of chocolate continues today. Today, cancer is responsible for 14.6% of all deaths, and is the focus of a large portion of all medical research (World Cancer Report 2014). Many of the mechanisms behind different types of cancers remain poorly understood. It is not wholly surprising, then, that we find ourselves inundated with dietary and lifestyle recommendations and research for preventative measures against cancer. Chocolate has been newly celebrated in recent years as containing high levels of epicatechin, which promotes anti-oxidant activity (Paoletti). Anti-oxidants are popularly believed to reduce cancer risks, although research on the matter has demonstrated at best mixed results (Jiang). Still, this has not stopped chocolate manufacturers and researchers alike from touting the anti-oxidant benefits of cacao, as seen in Figure 4.

Figure 4.  Published by


Since its introduction, chocolate has held a special place in the perceptions and diets of Westerners. It seems natural that people would seek out some sort of medical or scientific explanation for this je ne sais quoi. And indeed, we see that the health benefits attributed to chocolate have mirrored scientific progress over the last few centuries, with its purported benefits tracking new trends in research closely.


Germ Theory. (n.d.). Retrieved March 10, 2016, from

Jiang L, Yang KH, Tian JH, Guan QL, Yao N, Cao N, Mi DH, Wu J, Ma B, Yang SH (2010). “Efficacy of antioxidant vitamins and selenium supplement in prostate cancer prevention: a meta-analysis of randomized controlled trials”. Nutrition and Cancer 62 (6): 719–27.

Ledesma, A. C. (1652). Chocolate: Or, an Indian drinke. London: Dakins.

Lindemann, M. (1999). Medicine and Society in Early Modern Europe. Cambridge, UK: Cambridge University Press.

Lippi D. Chocolate in History: Food, Medicine, Medi-Food. Nutrients. 2013;5(5):1573-1584. doi:10.3390/nu5051573.

Paoletti, R., Poli, A., Conti, A., & Visioli, F. (2012). Chocolate and Health. Milan: Springer.

World Cancer Report 2014. World Health Organization. 2014.


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