Cocoa Flavanols and Cardiovascular Health

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It is critical to note that the amount and type of flavanols in any food, including cocoa and chocolate products, can vary widely. This point must be considered when evaluating the potential bioactivity of cocoa flavanols regarding cardiovascular health. The amount of flavanols present in finished food products, including cocoa and chocolate, largely depends on the cultivar type, geographical origin, agricultural practices, post-harvest handling, and processing of the flavanol-containing ingredient. For example, post-harvest handling techniques such as prolonged fermentation and alkalization will greatly reduce or eliminate the flavanol level remaining in a finished cocoa or chocolate product.

Table 1 provides an example of how flavanol content can vary in cocoa-based products due to the use of different processing techniques. Other flavanol-containing ingredients used widely in the food industry have similar issues related to content remaining in the finished products. Thus, caution must be used when interpreting flavanol levels likely to be present in specific finished food products based on information derived from raw ingredients or generic food composition tables.

Clinical investigators wishing to ascertain the vascular actions of flavanols in chocolate or cocoa should use only specific products that are well characterized for their flavanol content.

Notes on Chocolate Specifically

One of the primary uses of cocoa is the manufacture of chocolate. Chocolate is an energy-dense food and individuals must keep caloric intake and expenditure in mind when including it in their diet, as any food when eaten in excess will cause an increase in weight. Physical activity, diet, and other lifestyle factors must be carefully balanced to avoid detrimental weight gain over time.

In the context of nutrition, one must also consider that the cardiovascular benefits of flavanol-rich foods, including those chocolates that are flavanol-rich, could be offset if they were to simultaneously contribute significant levels of unhealthy fats, such as certain saturated fatty acids that are known to raise blood cholesterol levels. In addition to palmitic acid, chocolate is rich in oleic and stearic acids, and several studies have demonstrated a neutral effect on blood lipids in humans following short-term consumption of cocoa butter and/or chocolate.

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