Chocolate: Healthy or Health-Free?

With an overwhelming flux of information sitting at our fingertips, it has become increasingly important to be able to decipher marketing motives and assess the scientific validity of the health claims presented by news platforms, online sources, social media, and word of mouth. Chocolate, in particular, has been a frequent featured topic in the discourse surrounding health during the past two decades. Headlines, ranging from “Chocolate Can Boost Your Workout. Really.” to “Chocolate is good for you? Sure, and the Easter bunny is real, too”, highlight the competing claims between health reports. Considering chocolate’s role as a driver of mass consumption in our society, it is essential to differentiate between the medicinal properties of crude cocoa goods and the highly-processed chocolate products advertised to consumers.

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An Instagram account sharing recipes for healthy chocolate treats.

Theobroma cacao, food of the Gods, has had a longstanding association with health and medicine. Its incorporation into the customs and rituals of the Olmecs, Mayans, and Aztecs document the myriad of medicinal properties that the substance possessed. The adoption of chocolate by the Spanish and other Europeans recognized these health-related benefits and continued the tradition of consuming chocolate for medicinal purposes among other uses (Coe and Coe, 1996). By the mid-twentieth century, however, chocolate had transitioned from a food, drug, and currency to a guilty pleasure that was beginning to be associated with health problems. Only over the past few decades have the purported benefits of chocolate resurged, this time with substantial backing from the scientific community. This led to products, such as low-fat chocolate milk and heart-healthy dark chocolate treats, flooding the market, their promises of lower blood pressure and younger-looking skin buzzing in our minds. These promises about chocolate’s healthy properties are even promoted by some of the biggest names of popular fiction. J.K. Rowling’s protagonist, Harry Potter, was offered a chocolate as a restorative measure after encountering a Dementor.

More than anything, however, these alluring chocolate products swarm us with questions.

  1. To what extent are the health benefits of chocolate substantiated by scientific research or are they simply marketing ploys?
  2. How do the production processes increase or compromise the nutritional value of the chocolate?

Tracing the health accounts involving chocolate from the Mesoamerican civilizations, through European transformation, to present-day scientific literature emphasizes many health benefits, and more notably, reinforces the importance of moderation, a value too intentionally veiled by a market that profits from a population driven to excess.

Cacao in Mesoamerican Medical Practices

Chocolate’s reputed medical prospects can be traced back to ancient times, long predating the use of scientific research to verify the product’s proposed health benefits. The early civilizations of the Olmecs, Mayans, and Aztecs valued cacao as a source of energy, strength, fertility, and restoration. Aztec sources, in particular, have been extremely useful in helping us better understand the role that cacao played in ancient remedies. The Florentine Codex, complied by Bernardino de Sahagun, presents extensive details about the dietary, health, and medical practices of the Aztecs, as well as many other aspects of their lives and culture (Dillinger et al., 2000). The document noted the use of cacao to treat stomach and intestinal problems, fatigue and fevers. Accounts also described the stimulant and aphrodisiac effects of chocolate as well as the use of cacao as an additive to make other medicines more palatable. One clear example of the medicinal use of cacao during ancient times is the prescription for childhood diarrhea, which required five cacao beans to be ground and served as a beverage to the sick child (Dillinger et al., 2000). Particularly important to recognize is the emphasis of cacao consumption in moderation. Sahagun’s informants made a clear distinction between the benefits conferred by moderate consumption of cacao and the side effects of excessive cacao intake (Dillinger et al., 2000).

“[Green cacao] makes one drunk, takes effect on one, makes one dizzy, confuses one, makes one sick, deranges one. When an ordinary amount is drunk, it gladdens one, refreshes one, consoles one, invigorates one. Thus it is said: ‘I take cacao. I wet my lips. I refresh myself’” (Sahagun 1590, Part 12: 119-120) (Dillinger et al., 2000)

These words of caution demonstrate that overconsumption of the even the purest form of cacao—clearly unsweetened and unprocessed, unlike most popular chocolate products today—is unhealthy and leads to undesired side effects. Therefore, documents detailing Mesoamerican medical practices highlight the widespread use of cacao as a treatment and additive for various ailments; these records, however, also caution against excessive consumption of this natural product, a lesson that must be recognized and practiced in our society today.

Chocolate Integration into European Medicine
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Advertisement for milk chocolate includes that the product is physician recommended and helps with intestinal problems.

The incorporation of chocolate into European culture and practices involved the hybridization of the product in many different respects. One such hybridization required crossing the medical barrier. The Spanish stripped away much of the spiritual significance that the Mesoamericans associated with chocolate; instead, they promoted chocolate as a drug with medical purposes. Their intent was to integrate chocolate into their humoral system, which they used to understand health and medicine (Coe and Coe, 1996). Thus, chocolate became popular in Europe first as a drug and treatment. Anecdotes about the effects of chocolate quickly spread, peaking the interest of physicians and other intellectuals in the health effects of these products. In addition to treating ailments, much to the same effect as the Mesoamericans had described, chocolate was often prescribed to European sailors and people traveling long distances as a form of sustenance during their voyages. Chocolate was recommended for three main reasons: to help individuals gain weight, to stimulate the nervous system, and to improve digestion (Dillinger et al., 2000).

William Hughes, who authored a book including information on all the ways to make chocolate, advocated for the use of chocolate in a medical capacity. “It is the most wholesome and most excellent drink that is yet found out. . . it is good alone to make up a breakfast, needing no other food, either bread or drink, is beneficial to the body, and without exception, may be drunk by people of all ages, young as well as old, of what sex or what constitution so ever and is very good for women with childe, nourishing the embryo, and preventing fainting fits, which some breeding women are subject unto: it helpeth nature to concoct phlegme and superfluous moisture in the stomack; it voideth the excrements by urine and sweat abundantly, and breedeth store of very good blood, thereby supplying the expence of spirits, it expels gravel, and keepth the body fat and plump, and also preserveth the countenance fresh and fair: it strengthens the vitals, and is good against fevers, cattarrhs, asthmaes, and consumptions of all sorts” (Dillinger et al., 2000). Hughes was simply one among many who praised the use of chocolate as a healing and restorative substance, its benefits affecting many levels of human health, spanning the developmental stage and beyond adulthood. Prescribers, however, were guarded against excessive consumption of chocolate, even for medical purposes.

“[Chocolate] produces good Effects, when used moderately, it also … [produces] bad ones when taken to Excess, or mix’t with too many sharp Drugs…because its exalted Principles cause too great a Rarefaction in the Humours” (Paoletti, and Paoletti, 2012)

This recurring emphasis on moderation demonstrates that even though chocolate has been considered a healthy substance for thousands of years, it has never been a product intended for excessive indulgence.

The Science Underlying Chocolate Health Claims

European manuscripts from the seventh century to the twentieth century described over one hundred medicinal uses of chocolate, corroborating what the Aztecs had known and practiced with chocolate. During the twentieth century however, chocolate garnered an unfavorable reputation following the split of dietetics from medicine (Watson et al., 2013). The support for the purported medical benefits of chocolate offered by oral tradition and anecdotal evidence was no longer sufficient to convince the public. Therefore, during the late 1900s, experimentally derived biomedical evidence came to the forefront of our discussions about chocolate and became the basis of many marketing campaigns. Finally, the effects of chocolate documented by the Mesoamericans and by Europeans centuries earlier could be explained by biochemical properties and mechanisms elucidated by modern science.

There are more than 200 compounds in cocoa that could potentially be playing a role in the relationship between cocoa consumption and health outcomes. However, these substances may only be present at a negligible concentration in finished chocolate products or may have low bioavailability in humans; therefore, not all the different substances in cocoa produce meaningful benefits for people (Paoletti, and Paoletti, 2012). Most of the health benefits conferred by chocolate consumption are due to cocoa’s high polyphenol content. In addition to cocoa, polyphenols and flavonoids can be found in a variety of fruits and vegetables, red wine, and other plant-based sources (“Heart-Health Benefits of Chocolate Unveiled”). Flavonoids, which are a polyphenolic compound, constitute approximately twenty percent of cocoa, making cocoa a rich source of antioxidants (Crichton et al., 2016). For Americans, chocolate serves as their third highest daily source of antioxidants (Latif 2003). As shown by the table below, when compared to other sources of these compounds, chocolate contains a much higher flavonoids content as well as higher antioxidant activity (Steinberg et al., 2003). Antioxidants mount important defenses against free radicals that can accumulate as a result of normal bodily processes. The buildup of free radicals and increase in oxidation can lead to damage to the body and subsequent health complications; for example, increased oxidation can lead to plaque formation on artery walls (“Heart-Health Benefits of Chocolate Unveiled”).

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Table from Steinberg et al. 2013 shows high flavonoid content and antioxidant power of chocolate compared to other sources of these compounds.

The most significant association between chocolate and a disease outcome has been the correlation between increased chocolate consumption and a reduced risk for cardiovascular disease (CVD). Dr. Eric Ding at the Harvard School of Public Health analyzed 24 different studies along with a team of researchers to examine the effects of cocoa flavonoids on risk for cardiovascular disease. They found that “flavonoids reduced blood pressure and unhealthy LDL cholesterol, increased healthy HDL cholesterol, improved blood flow, and lowered insulin resistance” (“Chocolate: Pros and cons of this sweet treat”). Despite these positive effects, it is unclear whether cocoa consumption can actually prevent a heart attack or if it simply mitigates factors that contribute to one.

Dark Chocolate Facts

In addition to heart health, studies investigating the effects of cocoa consumption have also observed antidiabetic effects (by increasing nitric oxide bioavailability to ameliorate insulin resistance), anti-stress effects (through the release of serotonin), anti-obese effects, anti-inflammatory effects and anti-tumor effects (Latif 2013). Studies tracing the effects of cocoa in the brain noted an increase in cerebral blood flow, as well as improved information processing and memory after a high dose of flavonoids for an eight-week period (Crichton et al., 2016). While these positive correlations in many different domains of human health are promising, much more research is required to better understand the mechanisms by which cocoa achieves these effects as well as to better anticipate long-term effects.

Misconceptions in the Market: What You Read vs. What You Eat

After decades of bearing the brunt of chocolate’s bad reputation, chocolate companies boomed as the increasing scientific evidence of chocolate’s health benefits gave producers new angles from which they could draw in consumers. New products, such as heart healthy dark chocolate treats, flooded markets and old products, such as chocolate milk, returned to stores, this time with a scientific stamp of approval.

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Over-eager customers are enticed by buzzwords, such as “heart healthy,” on chocolate products, not realizing that understanding the nutritional value of advertised chocolate products requires not only knowledge of the science behind effects of cocoa but also insight into the production processes that transform cocoa into the final product advertised on shelves. Firstly, it is important to differentiate between the types of chocolate. Dark chocolate contains a much higher amount of flavonoids that milk chocolate (Latif 2013). Products like milk chocolate have a much lower cocoa amount and instead contain many additives, such as sugar, fat, milk, and other ingredients that diminish the potential positive effects cocoa consumption can have on human health (“Chocolate: Pros and cons of this sweet treat”). Secondly, purchasing chocolate with high cocoa content, such as dark chocolate, does not necessarily mean that the final product contains a high concentration of polyphenols because of the significant effect that processing has on the nutritional value of chocolate (Paoletti, and Paoletti 2012). Cacao beans initially have a very strong bitter taste due to the high amount of polyphenols present in the raw fruit; this taste can be so potent that cacao beans can be inedible. Thus, the post-harvest processes of fermenting, roasting, alkalizing, sweetening and others are intended to diminish the original flavor. The consequence of this extensive processing is a loss in the antioxidant power of chocolate. “As much as 90% of the flavonoids may be lost due to cocoa processing” (Latif 2013).

Therefore, even though the two products advertised above emphasize the science-substantiated health benefits of chocolate, the processing significantly lowers the nutritional value of the final products. Companies tangentially brand the science behind their processed chocolate products, even though their products are hugely different from the raw cocoa used in studies. “The average dose of flavonoids in the studies Dr. Ding reviewed was 400 milligrams a day. ‘The problem is, that’s about the equivalent of eight bars of dark chocolate or 30 bars of milk chocolate,” he says. “When you eat these actual chocolate bars, all the calories and sugar come with them.’” (“Chocolate: Pros and cons of this sweet treat”). Today, even with backing from modern science, the recommended consumption of chocolate is still a moderate portion, typically around one ounce a few times a week (Heart-Health Benefits of Chocolate Unveiled”).

Tracing the perceived health benefits of chocolate over the centuries demonstrates that the purported healthy effects of cocoa consumption have always been recognized and substantiated by a powerful medium, whether it be oral tradition of the Aztecs, the anecdotal evidence of Europeans, or the biochemical research of modern societies. More importantly, analyzing the reception of chocolate by different peoples and cultures reveals the emphasis on moderation that has persisted. In a society with chocolate companies that profit from excessive indulgence, it has become crucial for individuals to be careful about the quality and quantity of chocolate they consume.

Works Cited

“Chocolate: Pros and cons of this sweet treat.” Harvard Health Publications. Harvard University, n.d. Web. 01 May 2017.

Coe, Sophie D. and Michael D. Coe. 2013[1996]. The True History of Chocolate. 3nd edition. London: Thames & Hudson.

Crichton, Georgina E., et al. “Chocolate Intake Is Associated with Better Cognitive Function: The Maine-Syracuse Longitudinal Study.” Appetite, vol. 100, 2016, pp. 126–132.

Dillinger, T L, et al. “Food of the Gods: Cure for Humanity? A Cultural History of the Medicinal and Ritual Use of Chocolate.” The Journal of Nutrition, vol. 130, no. 8S Suppl, 2000, pp. 2057S–72S.

“Heart-Health Benefits of Chocolate Unveiled | Cleveland Clinic: Health Library.” Cleveland Clinic. Cleveland Clinic, n.d. Web. 01 May 2017.

Latif, R. “Chocolate/Cocoa and Human Health: a Review.” The Netherlands Journal of Medicine, vol. 71, no. 2, 2013, pp. 63–8.

Paoletti, and Paoletti, Rodolfo. Chocolate and Health. Milan, Springer, 2012.

Steinberg, et al. “Cocoa and Chocolate Flavonoids: Implications for Cardiovascular Health.” Journal of the American Dietetic Association, vol. 103, no. 2, 2003, pp. 215–223.

Watson, Ronald Ross; Preedy, Victor R.; Zibadi, Sherma. Chocolate in Health and Nutrition. Vol. 7, Totowa, NJ, Humana Press, 2013.

Image Sources

Digital image. N.p., n.d. Web. 1 May 2017. <www.chocolateclass.files.wordpress.com/2016/05/sloanechocolate.jpg?w=483&h=379>.

Digital image. N.p., n.d. Web. 1 May 2017. <http://333oee3bik6e1t8q4y139009mcg.wpengine.netdna-cdn.com/wp-content/uploads/2015/01/CACAO_DarkChocolateFacts.png&gt;.

Digital image. N.p., n.d. Web. 1 May 2017.<www.behance.net/gallery/6533023/Hersheys-Special-Dark- Chocolate-Kisses-Campaign>.

Digital image. N.p., n.d. Web. 1 May 2017.  <www.adnatomy.files.wordpress.  com/2013/03/my-after-22workhorse22.png>.

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