Cocoa and chocolate flavonoids: Implications for cardiovascular health

https://doi.org/10.1053/jada.2003.50028Get rights and content

Abstract

This paper offers a review of current scientific research regarding the potential cardiovascular health benefits of flavonoids found in cocoa and chocolate. Recent reports indicate that the main flavonoids found in cocoa, flavan-3-ols and their oligomeric derivatives, procyanidins, have a variety of beneficial actions, including antioxidant protection and modulation of vascular homeostasis. These findings are supported by similar research on other flavonoid-rich foods. Other constituents in cocoa and chocolate that may also influence cardiovascular health are briefly reviewed. The lipid content of chocolate is relatively high; however, one third of the lipid in cocoa butter is composed of the fat stearic acid, which exerts a neutral cholesterolemic response in humans. Cocoa and chocolate contribute to trace mineral intake, which is necessary for optimum functioning of all biologic systems and for vascular tone. Thus, multiple components in chocolate, particularly flavonoids, can contribute to the complex interplay of nutrition and health. Applications of this knowledge include recommendations by health professionals to encourage individuals to consume a wide range of phytochemical-rich foods, which can include dark chocolate in moderate amounts. J Am Diet Assoc. 2003;103:215-223.

Section snippets

Lipids

Cocoa butter accounts for 50% to 57% of the dry weight of cocoa beans and is responsible for the melting properties of chocolate. The predominant fatty acids in cocoa butter are saturated (stearic; 18:0, 35% and palmitic; 16:0, 25%) and monounsaturated (oleic; 18:1, 35%), with the remaining fat being primarily polyunsaturated linoleic (3%) ((16)). Palmitic and stearic acid are chemically defined as saturated fatty acids (SFA). In general, SFA consumption is correlated with an increased risk of

Antioxidant effects

The flavan-3-ols have been identified as the major antioxidant components of different cocoa ingredients and chocolate preparations [81], [87], [88]. Oxygen radical absorbance capacity (ORAC) data show that chocolate, as a whole food, has a potent antioxidant capacity when compared with other phytochemical-rich foods such as garlic, blueberries, and strawberries [88], [89], [90], [91]. Furthermore, chocolate products have higher ORAC values than most other flavanol-containing foods (Table 2).

Effects on platelet activation

In addition to the antioxidant effects observed, cocoa flavonoids may influence cardiovascular health through other mechanisms. Platelets function to maintain vascular integrity. However, increased platelet reactivity and aggregation in the presence of endothelial dysfunction can lead to the development of arterial thrombosis and the progression of atherosclerosis ((1)).

Rein and colleagues ((110)) evaluated whether the consumption of a cocoa beverage modulates human platelet function. Platelet

Effects on modulation of immune response

Cacao liquor polyphenols were first described to decrease the expression of interleukin 2 messenger RNA (mRNA) in human lymphocytes in 1997 ((115)). Subsequently, Mao and colleagues [116], [117], [118] have published several in vitro studies reporting the ability of individual cocoa procyanidin fractions to modulate expression of a variety of cytokines involved in immune responses. The effects of procyanidins on cytokines were observed to be at the transcriptional level and were reflected in

Applications

  • As the puzzle continues to unfold with respect to health promotion and bioactive phytochemicals in foods, health educators should continue to reassess and evaluate traditional views on foods and their contribution to health ((122)). Scientific evidence supports the hypothesis that a variety of plant-based foods in the diet can provide a wealth of potentially beneficial phytochemicals and other components that contribute to reducing cardiovascular disease risk.

  • Currently, there is not adequate

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