Chocolates are really healthy

It’s February, which means that many people will receive heart-shaped boxes filled with chocolates for Valentine’s Day.  And while you may think of chocolate as a guilty pleasure, the good news is that it can actually help protect you from many health problems. Several recent large-scale research reviews have provided the best evidence yet that chocolate, derived from the seeds of the cocoa tree (Theobroma cacao), is good for many health conditions.

In one review, which appeared in the August 2011 issue of the British Medical Journal, researchers analyzed data from seven observational studies, which included more than 100,000 people.  Those who ate the most chocolate had a 37- percent lower risk of heart disease, compared to those eating the least, after controlling for weight, physical activity, education, and other dietary factors that could influence the results.

In a second review, in the European Journal of Clinical Nutrition, also published in August 2011, Harvard researchers looked at 10 clinical studies from the last decade, with a total of 320 people. Consuming dark chocolate or cocoa products for two to 12 weeks modestly lowered cholesterol. And another review of clinical trials, in BMC Medicine, found that cocoa-rich products had a small blood pressure-lowering effect in people with hypertension and pre-hypertension. In another study that appeared in the October 18, 2011 issue of the Journal of the American College of Cardiology, researchers found that women who ate an average of 66.5 grams (2.3 ounces) of chocolate per week had a significantly reduced risk of stroke.  Past research has also suggested that chocolate can improve insulin resistance.

Behind the benefits

Chocolate’s health benefits are largely attributed to polyphenol compounds called flavonoids — the same family of substances that are in tea, red wine, grape juice, and other plant foods, which have antioxidant, anti-inflammatory, and anti-clotting properties.  In particular, flavonoids increase the production of nitric oxide, which helps relax and dilate blood vessels, and this may help lower blood pressure and have other cardiovascular effects.  Cocoa flavonoids may also inhibit cholesterol absorption as well as oxidation of LDL (“bad”) cholesterol, making it less harmful.

“The flavonoids in chocolates act as antioxidants which help fight off free radicals,” says Lynn Goldstein, RD, a dietitian at Weill Cornell Medical College in New York. “Free radicals increase cell damage leading to heart disease, arthritis, cancers, and Alzheimer’s disease, to name a few … Chocolates also seem to stimulate endorphin production, which makes you feel good, and it contains serotonin, which can help with mild depression.”

Moderation is key

But before you go diving into that box of Valentine’s candy, remember that there are some caveats.  First, not all studies have had positive results.  And many — including all of those in the recent British Medical Journal analysis — are observational studies, meaning that they don’t prove cause and effect (that chocolate, rather than something else about chocolate eaters, is responsible for the benefits seen). Moreover, no one knows what type or amount of chocolate is optimal. Studies have used different formulations (with widely varying flavonoid levels) and intakes (from tiny daily amounts to impractically large quantities); some have not distinguished between milk and dark chocolates.  Chocolates may also affect people differently, depending on a variety of factors.

Keep in mind also that the chocolate confections that people love most are loaded with sugar, fat, and calories (please refer to table on Page D-2).  Eat too much of any kind of chocolate and you can gain weight, which would likely cancel out the heart benefits.  “But the good news is that the type of fat that is in chocolate does not seem to raise cholesterol levels.  In fact, it seems to lower ‘bad’ cholesterol.” While the women in the JACC study ate mostly milk chocolates, which contain about 30-percent cocoa solids, Goldstein suggests choosing dark chocolates which contain 70 percent or more of the flavonoid-rich cocoa solids.  In addition, milk chocolates tend to contain much more sugar than the dark variety.

“No exact amount of chocolate has been established in regards to health benefits, but I suggest an ounce or two a day, combined with a healthy diet, as a great option for a sweet treat that can also benefit your health,” Goldstein adds.

 Chocolate terms

In order to understand chocolates better and how to maximize their benefits and minimize their risks, here are terms you need to know:

• Cacao:  Refers to either the cocoa tree or the bean.  On labels, cacao or cocoa content means the total amount of chocolate liquor, cocoa butter, and cocoa powder in the chocolate, usually expressed as a percentage. Higher amounts typically indicate more intense chocolate flavor and less sugar.

• Chocolate liquor: Finely ground cocoa bean nibs (centers), consisting of about half cocoa solids and half cocoa butter.  Also called unsweetened chocolate, cocoa mass or cocoa liquor, it is the basis from which chocolate is made.  Despite its name, it is neither liquid nor alcoholic.

• Cocoa butter: The natural fat from the cocoa bean, extracted from the chocolate liquor. It is solid at room temperature but melts at mouth temperature.  Manufacturers typically remove the cocoa butter, deodorize it to reduce bitterness, and add it back to make chocolate.  Though called “butter,” it contains no dairy or cholesterol.

• Cocoa powder:  Made by extracting most of the cocoa butter from the chocolate liquor and grinding what’s left into a powder.  “Dutch” (versus “natural process”) cocoa has been alkalinized to neutralize the acidity and give it a milder flavor, but the process also destroys the flavonoids.

• Dark chocolate (bittersweet, semi-sweet, sweet):  Solid chocolate with varying amounts of cacao solids (ranging from about 45 to 85 percent, as may be listed on labels), with added cocoa butter, sugar, and often flavorings (like vanilla).

• Milk chocolate: A blend of chocolate liquor, cocoa butter, sweeteners, and flavorings, plus milk solids.  Cacao content is typically between 30 and 40 percent.  Dark milk chocolate, a new trend, has a higher than usual cacao percentage.

• Unsweetened baking chocolate:  100-percent cacao with no sugar; it’s used in cooking but can be eaten, too, if you can tolerate the bitter flavor.

• White chocolate:  A blend of cocoa butter, sweeteners, and flavorings — with no cocoa solids and thus no flavonoids.  In 2002, the US standards of identity for chocolates were changed to allow such products to be called white chocolate if they contain at least 20-percent cocoa butter (which gives it a chocolate flavor) and meet other criteria.  The percentages listed on the labels of some white chocolates refer to the percent of cocoa butter (not cacao content).

Chocolate tidbits

 â€¢ Not all chocolates are created equal.  Processing of cocoa beans into commercial chocolate candy greatly reduces flavonoid levels.  In fact, a main manufacturing objective is to remove these compounds because they have a bitter taste. Some companies use — or claim to use — methods that better preserve the heart-healthy compounds.

 â€¢ Dark chocolates generally have more flavonoids than milk chocolates, but it’s hard to know how much a particular bar has.  The percent cocoa (or cacao) listed on the label is not a reliable indicator of flavonoid content, and a bar that is, say, 70-percent cocoa, from one manufacturer is not necessarily better than one that is 60 percent from another manufacturer.  In addition to processing, the type of cocoa beans used and the manufacturer’s “recipe” also play a significant role in determining final flavonoid content.  At the very least, the darker the chocolate, as indicated by a higher percent of cocoa solids, the less room there is for sugar.

 â€¢ Although chocolates are high in saturated fat (from cocoa butter), this is mostly stearic acid, which has a neutral effect on blood cholesterol. On the other hand, milk chocolates have added fats that are not good for your heart, as well as more added sugar than dark chocolates.  Milk chocolates have twice as much sugar as the darkest chocolate.

• Cocoa powder is highest in cocoa solids and has the most flavonoids — though “Dutch” (or alkali) processing destroys them. If you use cocoa powder, look for unsweetened natural versions.  Next highest in flavonoids is unsweetened baking chocolate.

• Chocolate contains a small amount of caffeine — about 20 milligrams in an ounce of dark chocolates, and six milligrams in milk chocolates (compared to about 100 to 150 milligrams in a cup of coffee).

             Chocoholic advice     

Chocolates may provide some heart-health benefits, especially if you eat them in place of other snacks or desserts that are high in calories and saturated fat.  Choose the darkest chocolate that you like.  Cocoa beans or some variations, such as cacao, chocolate liquor or cocoa mass, should be the first ingredient, not sugar.

But even if it’s rich in flavonoids, think of chocolate as a treat, not a health food, because of its hefty calories.  Fruits and vegetables are better sources of flavonoids on a daily basis — they have fewer calories and an abundance of vitamins and minerals, along with other healthy plant compounds and fiber.

The bottom line is, throughout all these years, chocolates may have been getting an unduly bad rap.  They are actually a tasty indulgence with true health benefits. Really.