Scientific studies attesting to the health benefits of dark chocolate are welcome news to chocolate lovers and chocolate manufacturers. But in some cultures, chocolate's wholesomeness is already a part of life. For example, the Kuna Indians of Central America consume ten times more cocoa than nearby Panamanians and have about 80 percent less heart disease. Interestingly, when Kuna Islanders migrate to other regions and assume the dietary habits of their adopted countries, their incidence of cardiovascular disease increases to match their new environs.
Flavanols
Cocoa is a rich source of antioxidant molecules called flavanols, particularly epicatechin. Flavanols help to remove free radicals from your tissues, which reduces inflammatory damage, but they have other properties, too. Several studies, including a 2006 trial in the "Journal of Agricultural and Food Chemistry," demonstrate that flavanols inhibit the activity of an important enzyme that increases your blood pressure. Another 2007 article in "The Journal of the American Medical Association" demonstrated that flavanols evoke beneficial changes in the concentration of nitric oxide in your tissues.
Blood Pressure
Pre-hypertension and hypertension, or high blood pressure, affect two-thirds of U.S. adults. A 2010 review in "Hypertension" shows that routine use of cocoa reduces blood pressure in test subjects. In an "Annals of Epidemiology" trial from that same year, pregnant women who regularly consumed chocolate were less likely to develop pregnancy-induced hypertension, or preeclampsia.
Insulin Resistance
One of the major physiologic problems in type 2 diabetes and metabolic syndrome is insulin resistance, which is a condition where your body doesn't respond normally to the insulin produced by your pancreas. Many type 2 diabetics actually have higher-than-normal insulin levels, but their cells simply "ignore" insulin's signals. A 2009 article in "Circulation" suggests that cocoa ameliorates insulin resistance, improves the function of insulin-secreting cells and decreases blood clotting tendencies. All of these properties are beneficial whether or not you have insulin resistance, but chocolate has not been approved in the United States for treating diabetes or any other metabolic disorder.
Not All Chocolate Is the Same
Although it might be tempting to add chocolate to every meal in the hopes that your health will improve, research shows that not all chocolate confers health benefits. Differences in genetics and cultivation techniques can cause four-fold variations in the flavanol content of cocoa beans. And processing methods, such as fermentation, roasting, alkalinization, flavoring and sweetening, all reduce flavanol content.
Recommendations
Until scientists can better define the mechanism or mechanisms responsible for cocoa's activity, and until chocolate manufacturers become less guarded with information about the sources and processing of their products, the best way to find good chocolate is to choose products with a higher cocoa content. Some brands, such as Ritter's and Dove, have been used in clinical trials, but not always with consistent results. Flavanols are quite bitter, which is a quality that many chocolate producers attempt to eliminate and many chocolate lovers try to avoid, but "good" chocolate is necessarily dark and bitter.
References
- "Hypertension"; Does dark chocolate have a role in the prevention and management of hypertension?; Egan B, et al.; 2010
- "Journal of Agricultural and Food Chemistry"; Inhibition of angiotensin converting enzyme activity by flavanol-rich foods; Actis-Goretta L, et al.; 2006
- "The Journal of the American Medical Association"; Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide; Taubert D, et al.; 2007
- "Annals of Epidemiology"; Does chocolate intake during pregnancy reduce the risks of preeclampsia and gestational hypertension?; Safflas A, et al; 2010
- "Circulation"; Cocoa and cardiovascular health; Corti R, et al.; 2009



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