When one thinks of a chocolate, the words “sinful” and “indulgent” often pop into mind. For most people, chocolate and chocolatey desserts are considered beloved treats that must be enjoyed in moderation. Over the last few decades, however, chocolate has increasingly taken on a new characterization – “health food”. Studies linking chocolate consumption to improved cardiovascular health, better memory, and more youthful appearance have been frequently cited by health blogs, sensationalist news sources, and corporations alike. The complexities and caveats in these studies are distilled into one simple message to be pitched to consumers: “consumption of chocolate is good for you”.
The idea that the indulgent treat can offer positive health benefits is so tantalizing that one cannot hope but wish for this claim to be true. Yet when one examines the legitimacy of popular claims regarding the health benefits of chocolate against the actual conclusions drawn from the studies conducted, there is an apparent disconnect between science and media. There is indeed a large body of credible literature on the concentration of antioxidants in chocolate, as well as the health benefits of said antioxidants. But these studies emphasize moderation, high concentration of chocolate liquor, and warn of the counteractive nature of milk and sugar in chocolate. Often, these specifics are glossed over such that only a sliver of selective information reaches the consumer. Where science may find substantive evidence of correlation, media cites evidence of causation. Ultimately this problematic as flawed information is disseminated to eager consumers.
History of Chocolate’s Health Benefits
The belief in that chocolate has medicinal qualities has existed long into antiquity, back when chocolate was first cultivated and consumed in Mesoamerica. Montezuma, famed Aztec emperor, was thought to have a chocolate concoction as an aphrodisiac. In the Badianus Manuscript (1552), a Mexican medicinal textbook of disease and treatments, cocoa derivatives were frequently prescribed used to treat “angina, constipation, tartar-related dental problems, dysentery, dyspepsia, indigestion, fatigue, gout and hemorrhoids” (qtd. in Lippi, 1575). In Europe, cacao was configured into the humoral and allopathic tradition of Hippocratic medicine (Coe and Coe, 121).
The above image is a snippet of an ad for milk chocolate from the 1700s, whereby chocolate was advertised as a cure for various ailments.
In retrospect, these early claims of chocolate seem archaic and misguided. However, it is interesting to note how long the history of chocolate as a health food extends back. Chocolate has not only been a source of great gastronomical intrigue, but was also a medicinal mystery.
Health Benefits of Chocolate
While the early health claims described above are unsubstantiated by modern medicine, currently, there is a growing body of literature on how consumption of chocolate is linked with a variety of health benefits. The most notable of these is the relationship between chocolate consumption and reduced the risk of cardiovascular disease (CVD). Cocoa is identified to contain a wealth of flavonoids, a group of plant metabolites linked to many positive house effects. Regular dietary intake of flavonoids via plant-derived foods and beverages greatly reduce coronary heart disease and stroke, as supported by a large body of epidemiological research published by the American Heart Association (Corti et. al, 1433). The main flavonoid found in cacao is flavan-3-ols and their oligomeric derivatives (Steinberg, et. al, 215).
Graph from Steinberg et al. J Am Diet Assoc 103: 215-23. These graphs illustrate the flavonoid and antioxidant capacity (ORAC) of chocolate, as compared to other high flavonoid foods.
Research on the health benefits of chocolate have centered on this relationship between antioxidant concentration and reduced cardiovascular health. The findings are numerous and often produced astoundingly significant results. The Zutphen Elder Study used data of 470 elderly men surveyed over 15 years and found that the “Compared with the lowest tertile of cocoa intake, the adjusted relative risk for men in the highest tertile was [50%] for cardiovascular mortality and [53%] for all-cause mortality” (Buijsse et. al, 411). The NHLBI Family Heart Study used cross-sectional data on 2217 participants, and found that consumption of the antioxidant-rich cocoa two or more times a week reduced risk of calcified plaque in arteries by 32% (Djoussé et. al, 38).
It should be noted that all of the large studies are observational studies whereby researchers surveyed participants on chocolate intake and health. Surveyed responses are generally less reliable than randomized studies as it is possible a variety of confounding factors like participants’ eating habits, could have contributed to the observed effect. It would take a randomized study whereby certain groups would be administered cacao to intake against a control group to prove causation. Nevertheless, observations studies provide important insights into the relationship between chocolate consumption and improved cardiovascular health. The fact that the large body of literature on the topic are in agreement above the positive relationship between cocoa and reduced risk of CVD is compelling.
Beyond the cardiovascular health benefits of ingestion of chocolate, chocolate is becoming an increasingly popular concept in beauty and skin-care products. Many cosmetic companies tout the hydrating and rejuvenating qualities of cocoa butter for the skin as well as highlight the antioxidants to be gained from ingesting chocolate as described above. There is a growing number of studies on these claims as well. Heinrich et. al’s 2006 study assigned 2 groups of women to consume either high flavanol (326 mg/d) or low flavanol (27 mg/d) cocoa powder. They found that flavanols did indeed contribute to photoprotection as participants in the high flavanol group showed a significant decrease of skin roughness after an evaluation of the skin in week 12 of the experiment (Heinrich et. al, 1566).
But Just How Healthy is Chocolate?
Chocolate as a food product comes in many different varieties and intensities. The vast majority of the studies only confirm the benefits of dark chocolate (over 70% intensity).
Serafini et al. (2003) compared the health benefits of dark and milk chocolate varieties, made from the same batch of cacao beans. Their findings that plain, dark chocolate resulted in an increase in total antioxidant capacity and epicatechin (another dietary flavonoid) is much in line with the results delineated above. However, the increase is significantly reduced when consumed with milk, as is the case with milk chocolate. This suggests that milk negates the potential health benefits, as it may interfere with absorption of antioxidants in vivo. The studies highlight that chocolate’s benefits are primarily derived from the flavanols in pure cacao liquor and not from any extraneous ingredients. Thus, a common misconception is that all chocolates have the same health benefits.
Problematic Portrayal of Chocolate as a Health Food
From the handful of studies highlighted in my discussion, it is clear that each study is different and the conclusions drawn are specific, complex, and nuanced. For example, the Zutphen Elder Study is focused specifically on elderly men of mostly Caucasian descent (given the demographics of the study). Heinrich et. al’s study exclusively recruited female participants. It would be an overstatement to derive from even this collection of studies that “consumption of chocolate is good for cardiovascular health / skin care”, as there are many other confounding factors. Yet this phenomenon of distilling research into marketable advertising is all too prominent. The following are prime examples of how research is capitalized and distilled into a marketable, and often misguiding form.
An ad for Xocai, a “healthy chocolate” brand that sells chocolates, weight loss supplements, and beauty products.
The pamphlet above distills the health benefits of chocolate in a misleading way. The vague references to flavanols and “various studies”, the use of buzzwords, and bare-boned description of nuanced research exemplify how certain corporations capitalize on the characterization of chocolate as a health food. The emphasis is on highlighting a long list of vague, beneficial claims that is marketable to your average consumer. The bold font of each of the 15 bullet point leads consumers to believe that Xocai/chocolate 1. Promotes cardiovascular health, 2. Supports health glucose level…etc. When the reality is that only certain quantities and types of chocolate are correlated with said benefits. This trend of overstating cacao’s health benefits is especially prevalent in the beauty industry.
Description from the website: “Too Faced Co-Founder and Creative Director Jerrod Blandino was inspired to combine the power of antioxidant-rich cocoa powder and makeup while having a chocolate facial and learning about the benefits of cocoa at a Hawaiian spa.”
Amala Rejuvenate Cocoa Bean Advanced Firming Complex ($248): Uses certified organic, fair trade cacao beans. The packaging of the Amala Firm Complex above prominently features the cacao bean, despite the fact that Cacao is not even in the top 10 ingredients.
The eyeshadow palette and rejuvenating masks above both highlight the relationship between cacao and health and elasticity of skin, when neither products feature cacao as the primary ingredient. The alignment of the beauty product with cacao effectively allows the company to capitalize on the reputation cacao has as a health product.
When it comes to chocolate as a health food and a health product, it’s important to recognize when and how the line between science and marketing is blurred. In conducting research on this topic, I found my sources to be polarized between research papers published in established medical journals, and sensationalized health blogs with strategic product placements. What is problematic about how cacao increasingly touted as a “health-food” is not so much the legitimacy and magnitude of the health benefits of cacao, but the blanket advertising of the chocolate as guilt-free health product.
Buijsse B, Feskens EM, Kok FJ, Kromhout D. Cocoa Intake, Blood Pressure, and Cardiovascular Mortality: The Zutphen Elderly Study. Arch Intern Med. 2006;166(4):411-417. doi:10.1001/archinte.166.4.411.
Coe, Sophie D., and Michael D. Coe. The True History of Chocolate. New York: Thames and Hudson, 1996. Print.
Corti, R., A. J. Flammer, N. K. Hollenberg, and T. F. Luscher. “Cocoa and Cardiovascular Health.” Circulation 119.10 (2009): 1433-441. Web.
Djoussé, Luc, Paul N. Hopkins, Donna K. Arnett, James S. Pankow, Ingrid Borecki, Kari E. North, and R. Curtis Ellison. “Chocolate Consumption Is Inversely Associated with Calcified Atherosclerotic Plaque in the Coronary Arteries: The NHLBI Family Heart Study.” Clinical Nutrition 30.1 (2011): 38-43. Web.
Francene M Steinberg, Monica M Bearden, Carl L Keen, Cocoa and chocolate flavonoids: Implications for cardiovascular health, Journal of the American Dietetic Association, Volume 103, Issue 2, February 2003, Pages 215-223
Heinrich, Ulrike, Karin Neukam, Hagen Tronnier, Helmut Sies, and Wilhelm Stahl. “Long-Term Ingestion of High Flavanol Cocoa Provides Photoprotection against UV-Induced Erythema and Improves Skin Condition in Women.” American Society for Nutrition (2006). Web. 4 May 2016.
Lippi D. Chocolate in History: Food, Medicine, Medi-Food. Nutrients. 2013;5(5):1573-1584. doi:10.3390/nu5051573.
Serafini, Mauro, Rossana Bugianesi, Giuseppe Maiani, Silvia Valtuena, Simone De Santis, and Alan Crozier. “Plasma Antioxidants from Chocolate.” Nature 424.6952 (2003): 1013. Web.
Steinberg FM, Bearden MM, Keen CL: Cocoa and chocolate flavonoids: implications for cardiovascular health. J Am Diet Assoc. 2003, 103 (2): 215-223. 10.1053/jada.2003.50028.