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Why You Should Eat and Drink High-Cacao Dark Chocolate
Posted By Mark Sisson On February 21, 2012 @ 8:00 am In Diet | 257 Comments
Yes, I know, I know. That title isn’t exactly comforting. I hate giving you guys bad news, seeing as how you make this website possible, and I hate making unpopular recommendations like “eat more butter ” or “get some sun ” or “drink a glass of red wine ,” but I have to stick to the truth here, even if it hurts. And the truth is that you should probably be eating dark chocolate on a semi-regular basis because the stuff is pretty dang good for you. Before you log out, never to return again, give me a minute to explain myself:
You were kids once. Your parents probably forced you to finish your overcooked, mushy, bland veggies  or wash your hands and finish your homework – or some other routine unpleasantry – “for your own good,” and that’s what I’m doing here. Dark chocolate is healthy. It may be awful, terrible, and disgusting, but it contains some really good things that have some remarkable effects on various markers of health. So, yeah, eat your chocolate. Finish your raw cacao powder. Choke down that homemade hot chocolate. Hold your noses if you have to, but get it down and done.
I’m kidding, of course. There’s no arm twisting required when it comes to chocolate. If there’s one thing I know, it’s that the Primal community can suck down some high quality dark chocolate. Don’t think I didn’t see how quickly that chocolate disappeared at last year’s PrimalCon . And why wouldn’t it? Dark chocolate’s great, the perfect storm of flavor, flavonoids, and fat . It tastes really good, comes loaded with polyphenols, and cocoa butter is a great source of saturated and monounsaturated  fat. High-cacao dark chocolate, then, is quite literally a healthy candy bar. What’s not to love?
I’ve discussed my favorite dark chocolate  in the past. I’ve even provided chocolate-choosing tips . But until today, I’ve never really explained why we should be including high-cacao dark chocolate in our diets. I’ve never explicitly outlined the myriad health benefits that cacao offers. Well, let’s get to it, shall we?
Cocoa butter, which is extracted from the cacao bean and incorporated into most reputable dark chocolate bars, is mostly monounsaturated and saturated fat, with very little polyunsaturated  fat. And because most of that saturated fat is stearic acid, widely known for having neutral effects on LDL , even avowed lipophobes can happily and heartily gobble up cacao fat.
When it comes to polyphenol content and antioxidant capacity, cacao trounces  the “superfruits” acai, pomegranate, cranberry, blueberry and whatever else your annoying friend who always falls for multilevel marketing schemes is hawking this week. The most studied polyphenol in cacao is epicatechin, a flavanol. Although last week’s post  on the benefits of polyphenol consumption centered on pigment-derived antioxidants, cacao’s polyphenols are also quite potent and potentially healthful.
What happens when the rubber hits the road, though? Or, somewhat more literally, what happens when the square of polyphenol-rich dark chocolate melts on the tongue, is swallowed, digested, and incorporated into the body? What are the actual health benefits of consuming high-cacao content dark chocolate?
Epidemiological studies pretty consistently show that dark chocolate consumption is related to lower blood pressure  readings. In Jordan , among Kuna Indians living in Panama , among pregnant women , and among elderly Dutch , this holds true. That’s all well and good, but it’s just an association. We need controlled studies:
One found that fifteen days of eating dark chocolate, but not white chocolate, lowered blood pressure  (and improved insulin sensitivity) in healthy subjects. The main difference between white and dark chocolate is the polyphenol content; both types contain cocoa fat. Cocoa consumption also improved arterial flow in smokers .
Some studies suggest that the flavonoids are key. In one , flavanol-rich dark chocolate consumption improved endothelial function while increasing plasma levels of flavanols (which indicates the flavanols had something to do with it). Another study  used flavanol-rich cocoa to increase nitric oxide production in healthy humans, thus inducing vasodilation and improving endothelial function. In another , the highest dose of cacao flavanoids caused the biggest drop in blood pressure. Still another found that while dark chocolate did not reduce blood pressure, improve lipids, nor reduce oxidative stress , it did improve coronary circulation .
Or maybe it’s the soluble fiber. In “spontaneously hypertensive” rats, cacao-derived soluble fiber lowered blood pressure , perhaps by reducing weight gain.
It’s probably both, in my opinion, although the polyphenols undoubtedly contribute more to the cause than the five grams or so of soluble fiber you’ll get in the average serving of dark chocolate.
You’ve heard of the cholesterol-fed rabbit; how about the cocoa-fed rabbit? If the former is an effective vehicle to study the negative effects of poor lipid clearance, the latter is a testament to the inhibitory effects of cocoa polyphenols on lipid peroxidation . We also have similar findings in rodents. Feeding hypercholesterolemic and normocholesterolemic rats polyphenol-rich “cocoa fiber” (defatted, sugar-free chocolate, basically) reduced markers of lipid peroxidation in both groups (PDF ). It also seems to work quite well in test tubes .
In humans, both with normal and elevated cholesterol levels, eating cocoa powder mixed with hot water lowered oxidized LDL and ApoB  (LDL particle number, which, if you remember my post on lipid panels , you want to lower) counts while increasing HDL. All three doses of high-flavanol cocoa powder – 13, 19.5, and 26 g/day – proved beneficial. If you’re wondering, 26 grams of powder is about a quarter cup. It also works if you drink it with milk  (and no, Hershey’s syrup doesn’t work the same).
Given the effects of chocolate on lipid peroxidation, we can probably surmise that it will also lower the risk of cardiovascular disease. And indeed, epidemiological studies suggest that this is the case. In a sample of over 2200 patients (PDF ), chocolate consumption was inversely associated with progression of atherosclerotic plaque (determined by calcium scoring). What’s incredible is that the association held for chocolate in general, and I don’t think it’s likely that everyone was consuming 100% raw cacao powder brimming with polyphenols. A study from this year from the same group got similar results : chocolate consumption was inversely associated with prevalent cardiovascular disease.
While most cacao research focuses on vascular function and heart disease risk, there are other, less intensively-studied benefits. Here are a few of them:
For fifteen days, hypertensive, glucose-intolerant patients received either 100 daily grams of high-polyphenol dark chocolate or 100 daily grams of zero-polyphenol white chocolate. Diets were isocaloric, and nothing differed between the groups besides the type of chocolate. Dark chocolate improved beta cell function , lowered blood pressure, increased insulin sensitivity, and improved endothelial function, while white chocolate did none of those things.
Rats with fatty liver evince higher levels of oxidative stress and inflammation , but cocoa supplementation partially attenuated these pathological changes – even in choline-deficient rats. While cocoa wasn’t enough to fully resolve fatty liver, the researchers concluded  that cocoa may be of therapeutic benefit in “less severe” forms of fatty liver.
Resistance to UV  damage is commonly measured by MED – minimal erythema dose. A higher MED means greater resistance to UV rays, while a lower MED indicates lower resistance. High MED, good. Low MED, bad. One study  found that feeding high levels of dark chocolate to healthy people over twelve weeks doubled their MED; feeding low levels of dark chocolate had no effect on the MED.
Similarly, another study  found that a high-flavanol-from-cacao group had greater resistance to a given UV dosage than a low-flavanol-from-cacao group (who actually saw no benefit at all) over a six and twelve-week period.
Those interested in a fairly comprehensive compendium of chocolate research can check it out here . I tried to stick to in vivo research, but there’s more theoretical stuff out there too.
Seeing as how most of chocolate’s benefits stem from the polyphenol content, and most of the studies that saw large effects used “high-flavanol” dark chocolate, you should be gunning for chocolate with high polyphenol counts. Dutch processed, or alkalized, chocolate lightens the color, removes some of the bitter compounds, and gives it a milder taste. Awesome for Hershey’s Kisses, but awful for the flavanol content. Those “bitter compounds,” you see, are the flavanols. Without the bitterness (which I think of as complexity), you’re missing most of the beneficial polyphenols. It might taste good, but it won’t perform all of the aforementioned physiological tasks. To quantify the extent of the degradation, check out the results of this study  on the flavanol contents of cacao powders subjected to various degrees of alkalization:
Once you’ve got a lead on some good chocolate with high cacao and lower sugar  levels, eat a few squares a sitting. Exercise restraint, however, as it is still candy and it shouldn’t make up a large block of calories. Treat it like a condiment, or even a medicinal adjunct to an otherwise solid diet. If you’re sensitive to stimulants, avoid chocolate too close to bedtime.
If you get your hands on some high quality cacao powder (raw – which is actually fermented – or roasted, but never Dutch processed), try making coconut cacao milk. Mix half a (BPA-free ) can or carton of coconut milk  with a couple tablespoons of cacao powder. Heat on the stove until almost simmering. Add sweetener to taste and, if you’re adventurous, a bit of cayenne, cinnamon , and turmeric . Enjoy!
Anyway, that’s it for today. I think I’ve presented the case for high-cacao dark chocolate – not that you were exactly a tough crowd or anything! Thanks for reading and be sure to give your thoughts – including quality sources and recommended methods of ingestion – in the comment section!
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 veggies: http://www.marksdailyapple.com/how-to-eat-more-vegetables/
 PrimalCon: http://www.marksdailyapple.com/primalcon-2011-learning-to-be-kids-again/
 fat: http://www.marksdailyapple.com/saturated-fat-healthy/
 monounsaturated: http://www.marksdailyapple.com/fats/
 my favorite dark chocolate: http://www.marksdailyapple.com/the-5-best-dark-chocolate-bars-in-the-world/
 chocolate-choosing tips: http://www.marksdailyapple.com/is-all-chocolate-created-equal/#axzz1msoaYq7u
 polyunsaturated: http://www.marksdailyapple.com/polyunsaturated-fat/
 neutral effects on LDL: http://www.ncbi.nlm.nih.gov/pubmed/16477803
 trounces: http://journal.chemistrycentral.com/content/5/1/5
 post: http://www.marksdailyapple.com/why-you-should-eat-brightly-colored-fruits-and-vegetables/
 lower blood pressure: http://www.marksdailyapple.com/salt-and-blood-pressure/
 Jordan: http://www.ncbi.nlm.nih.gov/pubmed/21696359
 Kuna Indians living in Panama: http://www.ncbi.nlm.nih.gov/pubmed/16794446?dopt=Abstract
 pregnant women: http://www.naturalnews.com/029418_chocolate_pregnancy.html
 Dutch: http://archinte.ama-assn.org/cgi/content/abstract/166/4/411?ijkey=294f6889b0d15c7546ee663bb02834311b40d904&keytype2=tf_ipsecsha
 lowered blood pressure: http://www.ajcn.org/content/81/3/611.full
 improved arterial flow in smokers: http://www.ncbi.nlm.nih.gov/pubmed/21807659
 one: http://www.jacn.org/content/23/3/197.abstract?ijkey=3efff0821a0602234af8c31676884ff9c17ace4e&keytype2=tf_ipsecsha
 study: http://www.ncbi.nlm.nih.gov/pubmed/14654748
 another: http://www.ncbi.nlm.nih.gov/pubmed/20090776
 oxidative stress: http://www.marksdailyapple.com/dear-mark-sleep-and-oxidative-stress/
 improve coronary circulation: http://www.ncbi.nlm.nih.gov/pubmed/18045712
 cacao-derived soluble fiber lowered blood pressure: http://www.ncbi.nlm.nih.gov/pubmed/20050664
 inhibitory effects of cocoa polyphenols on lipid peroxidation: http://www.ncbi.nlm.nih.gov/pubmed/15725692
 PDF: http://www.google.com/url?sa=t&rct=j&q=lipid%20peroxidation%20cacao&source=web&cd=1&ved=0CCgQFjAA&url=http%3A%2F%2Fcocoa-university.org%2Fscientific-research%2Fresearch-library%2Fdocuments%2FLecumberri2007.pdf&ei=ceRCT8aqIbPSiALNsdXOAQ&usg=AFQjCNGaB61p4gjRa8fcOyjy1Q0S6wU6GA&sig2=gw67htOnxxoxILcKfs-h-A
 It also seems to work quite well in test tubes: http://www.ncbi.nlm.nih.gov/pubmed/16403963
 lowered oxidized LDL and ApoB: http://www.ncbi.nlm.nih.gov/pubmed/17513403
 post on lipid panels: http://www.marksdailyapple.com/how-to-interpret-cholesterol-test-results/
 drink it with milk: http://www.ncbi.nlm.nih.gov/pubmed/21550218
 PDF: http://www.google.com/url?sa=t&rct=j&q=chocolate%20consumption%20is%20inversely%20associated%20with%20prevalent%20coronary%20heart%20disease%3A%20the%20national%20heart%2C%20lung%2C%20and%20blood%20institute%20family%20heart%20study.&source=web&cd=4&ved=0CDwQFjAD&url=http%3A%2F%2Fwww.sacredchocolate.com%2Fdocs%2Fsacredpdf%2Fchocolate-consumption-reverse-atherosclerotic-plaque.pdf&ei=FvVCT9edC4WRiAKeq5zOAw&usg=AFQjCNE9RmvbJDvhQy5IlbbxwhDoa5TLlQ&sig2=_UqQxCN5gc13NZefoYdXGQ
 got similar results: http://www.ncbi.nlm.nih.gov/pubmed/20858571
 improved beta cell function: http://jn.nutrition.org/content/138/9/1671.abstract
 inflammation: http://www.marksdailyapple.com/what-is-inflammation/
 concluded: http://www.ncbi.nlm.nih.gov/pubmed/22081873
 Resistance to UV: http://www.marksdailyapple.com/8-natural-ways-to-prevent-a-sunburn-and-sunscreens-not-one-of-them/
 study: http://www.ncbi.nlm.nih.gov/pubmed/19735513
 another study: http://www.ncbi.nlm.nih.gov/pubmed/16702322
 here: http://www.worldcocoafoundation.org/scientific-research/research-library/Cacao_HumanNutrition.asp
 study: http://www.ncbi.nlm.nih.gov/pubmed/18710243
 sugar: http://www.marksdailyapple.com/the-definitive-guide-to-sugar/
 BPA-free: http://www.marksdailyapple.com/are-your-canned-foods-safe-to-eat-a-bpa-free-buying-guide/
 coconut milk: http://www.marksdailyapple.com/the-wonderful-world-of-coconut-products/
 cinnamon: http://www.marksdailyapple.com/health-benefits-cinnamon/
 turmeric: http://www.marksdailyapple.com/health-benefits-turmeric/
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