Cacao: Benefits, Dosage, Precautions
Other name(s)
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Scientific name(s)
Theobroma cacao
Family or group:
Plants
Active ingredients:
Caffeine
Catechins
Theobromine
Indications
Rating methodology
EFSA approval.
Cardiovascular diseases ✪✪✪✪✪
Clinical studies and meta-analyses reveal the effectiveness of cocoa flavanols in managing cardiovascular diseases. A major clinical study involving adults without cardiovascular disease showed that daily intake of a specific cocoa extract, containing 500 mg of flavanols including 80 mg of epicatechins, for about 3.5 years reduced cardiovascular-related death risk by 27%, although it didn’t reduce the risk of major cardiovascular events or overall mortality. In 2023, the FDA approved a qualified health claim stating that very limited scientific evidence suggests that cocoa flavanols in high-flavanol cocoa powder, for products containing at least 4% naturally preserved cocoa flavanols, may reduce the risk of cardiovascular disease. Additionally, meta-analyses have shown that cocoa consumption significantly improves flow-mediated dilation and reduces both systolic and diastolic blood pressure. Recent systematic reviews also found that cocoa improves markers of vascular function, insulin resistance, and cholesterol levels, confirming cocoa’s beneficial impact on cardiovascular health thanks to its antihypertensive, anti-inflammatory, and antioxidant effects. The EFSA (European Food Safety Authority) evaluated health claims regarding cocoa flavanols. In its scientific opinion, the EFSA acknowledges that cocoa flavanols help maintain blood vessel elasticity, contributing to good blood circulation, provided that at least 168 mg of cocoa giving at least 88 mg of cocoa flavanols is consumed daily.
Posologie
Orally
168 mg
standardized extract
Cocoa intake, blood pressure, and cardiovascular mortality: the Zutphen Elderly Study
Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial
Scientific Opinion on the substantiation of health claims related to cocoa flavanols and protection of lipids from oxidative damage (ID 652, 1372, 1506, 3143), and maintenance of normal blood pressure (ID 1507) pursuant to Article 13(1) of Regulation (EC) No 1924/2006
Chocolate Consumption and Risk of Coronary Heart Disease, Stroke, and Diabetes: A Meta-Analysis of Prospective Studies
Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study
Flavonoid-rich cocoa consumption affects multiple cardiovascular risk factors in a meta-analysis of short-term studies
Hypertension ✪✪✪✪✪
Clinical research shows that daily consumption of chocolate or cocoa containing 25 to 1080 mg of flavonoids modestly reduces blood pressure in hypertensive patients. Meta-analyses indicate that daily consumption of commercially available dark chocolate or flavanol-enriched cocoa products for 2 to 8 weeks decreases systolic blood pressure by about 4 mmHg and diastolic blood pressure by about 2 mmHg in hypertensive patients compared to control products with low or no flavanols. This blood pressure reduction appears more pronounced in hypertensive or pre-hypertensive individuals compared to normotensive individuals. Cocoa consumption may also reduce the risk of developing hypertension in normotensive patients.
Posologie
Orally
168 - 1080 mg
standardized extract
Effect of cocoa on blood pressure
Effects of Cocoa-Rich Chocolate on Blood Pressure, Cardiovascular Risk Factors, and Arterial Stiffness in Postmenopausal Women: A Randomized Clinical Trial
Consumption of cocoa-containing foods and risk of hypertension in French women
Cognitive performance ✪✪✪✪✪
Research on cocoa's effects on cognitive decline shows mixed results. While some studies have found no significant effect of cocoa or chocolate on cognition with chronic administration, others suggest potential benefits, particularly regarding cerebral blood flow improvement and brain activity specific to certain regions. For instance, clinical studies indicate that consuming flavanol-rich dark chocolate can improve visual contrast sensitivity, spatial memory, and reduce the time needed to detect movement in healthy young adults. Other studies suggest a modest enhancement of certain cognitive functions in adults over 60 after sub-chronic consumption of various doses of cocoa.
Posologie
Orally
45 mg
standardized extract
Acute effects of cocoa flavanols on visual working memory: maintenance and updating
A double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adults
Acute cocoa flavanols intake improves cerebral hemodynamics while maintaining brain activity and cognitive performance in moderate hypoxia
Consumption of cocoa flavanols results in acute improvements in mood and cognitive performance during sustained mental effort
Neurovascular coupling, cerebral white matter integrity, and response to cocoa in older people
A combined DHA-rich fish oil and cocoa flavanols intervention does not improve cognition or brain structure in older adults with memory complaints: results from the CANN randomized, controlled parallel-design study
Effects of cocoa-rich chocolate on cognitive performance in postmenopausal women. A randomised clinical trial
Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study--a randomized controlled trial
Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial
Wrinkles ✪✪✪✪✪
Preliminary clinical research on adults with aging skin shows notable improvements in fine wrinkles, sun damage, and skin elasticity after daily ingestion of a product containing cocoa extract and other nutrients, combined with tazarotene cream over 90 days. Additionally, drinking a flavanol-rich cocoa beverage for 24 weeks improved wrinkle depth and skin elasticity. Cocoa flavanols also contribute to endogenous photoprotection, enhance dermal blood flow, and positively influence skin elasticity and texture.
Posologie
Orally
100 mg
standardized extract
Cocoa Flavanol Supplementation Influences Skin Conditions of Photo-Aged Women: A 24-Week Double-Blind, Randomized, Controlled Trial
Emotional balance ✪✪✪✪✪
Chocolate is renowned for its diverse psychological effects, including improved alertness, boosted well-being and euphoria, and triggering cravings. These impacts are partially attributed to chocolate’s sensory properties, such as taste, smell, and texture, as well as pharmacologically active substances like tyramine and phenylethylamine, which may modulate mood by influencing dopamine and norepinephrine neurotransmission. Studies also suggest that cocoa flavanols can improve calmness and satisfaction, contributing to better emotional balance when consumed regularly.
Posologie
Orally
500 mg
standardized extract
Properties
Antioxidant
Cacao flavanols, such as catechin and epicatechin, contribute to its potent antioxidant effect. These compounds reduce the oxidation of low-density lipoproteins (LDL), a risk factor for cardiovascular diseases, by neutralizing harmful free radicals in the body.
Cardiovascular
Cacao possesses cardiac-stimulating, vasodilatory, and diuretic properties thanks to theobromine, which has a tenth of the cardiac activity of caffeine. Cacao flavanols, such as epicatechin, enhance vasodilation by increasing circulating nitric oxide (NO), promoting artery dilation and improving microcirculation. This NO activation leads to improved vascular reactivity and increased flow-mediated dilation response, essential for cardiovascular health. Flavanols also reduce platelet activation and modify pro-inflammatory cytokine production, potentially decreasing cardiovascular disease risk.
Usages associés
Flavonoids, flavonoid-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials
Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial
Antihypertensive
Cacao flavanols have demonstrated the ability to reduce systolic and diastolic blood pressure. A Cochrane review in 2012 analyzed 20 studies involving 856 generally healthy adults, revealing that a supplement of flavanol-rich chocolate for 2 to 18 weeks reduced average systolic blood pressure by 2.77 mmHg and average diastolic pressure by 2.20 mmHg. These effects are observed in various groups, including normotensive individuals with slight hypercholesterolemia and hypertensive patients. Additionally, clinical trials have shown that regular cocoa consumption can improve other cardiovascular risk factors like serum lipids and vascular function. For instance, a double-blind controlled study found that daily consumption of 100 g of dark chocolate, containing about 500 mg of polyphenols, for 15 days reduced diastolic pressure, improved flow-mediated dilation, and increased insulin sensitivity in newly diagnosed essential hypertension patients. These benefits are attributed to the antioxidant effect of flavanols and the increased synthesis of nitric oxide, enhancing endothelial function and reducing insulin resistance.
Usages associés
Neurological
Cacao stimulates the central nervous system, and preliminary research suggests that cacao flavanols could enhance some measures of cognitive function in adults over 60 with mild memory impairment without signs of dementia. Proposed mechanisms include increased cerebral blood flow and perfusion due to vasodilation, reduced oxidative stress, improved glycemic control, and effects on intracellular signaling pathways in the brain. Epicatechin, a cacao constituent, may induce angiogenesis and neurogenesis in the brain. Moreover, epicatechin and catechin protect cell membranes from beta-amyloid protein-induced neurotoxicity, suggesting neuroprotective effects. A study in rats demonstrated that daily administration of a polyphenolic cacao extract improved age-related cognitive deficits, urinary free dopamine levels, and longevity.
Usages associés
Antiplatelet/Anticoagulant
Dietary intervention studies in humans and animals show that flavanol-rich foods and drinks like cacao can reduce platelet reactivity and improve vascular function. Cacao flavanols and procyanidins inhibit platelet activation and have an aspirin-like effect on primary hemostasis shortly after consumption. A controlled study demonstrated that regular consumption of dark chocolate significantly decreases collagen-induced platelet aggregation, potentially altering eicosanoid synthesis.
Dermatological Effect
Cacao extracts are used in dermatological products for their beneficial effects on the skin, particularly against aging. Studies show that cacao polyphenols improve signs of aging such as wrinkles, roughness, and skin elasticity. They also inhibit the activation of cyclooxygenase-2 and the production of inflammatory mediators, while increasing dermal blood flow. Regular consumption of flavanol-enriched cacao enhances the skin's resistance to UV-induced erythema and reduces trans-epidermal water loss, thereby improving skin hydration and density.
Usages associés
A single center, pilot, double-blinded, randomized, comparative, prospective clinical study to evaluate improvements in the structure and function of facial skin with tazarotene 0.1% cream alone and in combination with GliSODin( ae) Skin Nutrients Advanced Anti-Aging Formula
Cocoa Flavanol Supplementation Influences Skin Conditions of Photo-Aged Women: A 24-Week Double-Blind, Randomized, Controlled Trial
Cocoa polyphenols and their influence on parameters involved in ex vivo skin restructuring
Mood Effect
Cacao contains phenylethylamine and tyramine, stimulants that modulate mood, as well as methylxanthines like caffeine and theobromine, which act on alertness and well-being. Compounds like N-oleoylethanolamine, related to anandamide (the "internal happiness chemical"), might activate cannabinoid receptors, although their concentration in cacao is too low for notable central effects. A study showed that daily consumption of 500 mg of cacao polyphenols for 30 days significantly improves calmness and satisfaction, suggesting cacao could help reduce stress through its effects on mood and general well-being.
Usages associés
Consumption of 85% cocoa dark chocolate improves mood in association with gut microbial changes in healthy adults: a randomized controlled trial
Cocoa polyphenols enhance positive mood states but not cognitive performance: a randomized, placebo-controlled trial
Safety dosage
Adult: 168 mg (standardized extract)
Cocoa consumption is considered safe when used appropriately orally. However, cocoa naturally contains caffeine, and doses of more than 400 mg of caffeine per day may be unsafe. Studies suggest that an effective dose of dark chocolate is about 40 to 100 g or 15 to 30 g of cocoa powder, providing about 200 to 500 mg of polyphenols, with more likely beneficial effects from using cocoa powder or dark chocolate containing more than 60% cocoa. Note that, sometimes, cocoa extract is standardized to 10% theobromine. The European Food Safety Authority (EFSA) concluded that a daily intake of 200 mg of cocoa flavanols from food sources like cocoa and dark chocolate poses no safety concern for healthy adults.
Plantes ou autres actifs
Cocoa: strong interaction
The polyphenols present in cocoa can reduce iron absorption, with a cocoa drink containing 100 to 400 mg of total polyphenols per serving shown to reduce iron absorption by about 70%. It is therefore recommended not to consume cocoa at the same time as iron-rich foods or iron supplements to avoid reduced iron absorption.
Precautions
Child: use with caution
Data on cocoa dosage in children is limited. It is recommended to consult a healthcare professional before giving medicinal quantities of cocoa to children, especially those under 2 years old. Children should avoid high doses of cocoa due to caffeine and heavy metal content.
Pregnant woman: use with caution
Cocoa consumption is likely safe when used orally in moderate amounts. However, monitoring cocoa’s caffeine content closely during pregnancy is essential to ensure moderate consumption. Doses up to 300 mg per day may be consumed without increased risk to pregnancy.
Breastfeeding woman: use with caution
Cocoa consumption is likely safe when used in moderate amounts or at levels commonly found in foods. However, cocoa’s caffeine content should be closely monitored during breastfeeding. Moderate cocoa consumption would likely result in very low caffeine exposure for the breastfed infant.
