Holistic Approaches to Heart Health: Nutrition
Is Chocolate Good For Your Heart?
By Nicole L. Hatcher, DHS(c), MPAS, PA-C
Adjunct Professor, Kaplan University School of Health Sciences

Heart disease continues to be the number one killer of Americans. A well, balanced diet has long ago been identified as a viable way to reduce the risk of this spectrum of devastating diseases. The American Heart Association recommends a diet consisting of whole grains, fruits, vegetables, and legumes which help you obtain dietary fiber. Additionally, limiting saturated fat, sodium, and sugar sweetened beverages benefits your heart health by helping you to maintain a normal weight as well as normal cholesterol, blood pressure, and blood glucose.1 In recent years there has been a lot of discussion in the media, as well as in research literature, about the possible heart healthy benefit of chocolate. Some remain skeptical. Can something that tastes so good also be good for you?

The simple answer is yes. Flavonoids, a group of naturally occurring antioxidants that are found in plant based foods, play an important role in protecting plants against environmental toxins and repairing damage. An increasing amount of evidence suggests that those who consume foods rich in flavanoids may also reap specific health benefits. Flavanols are the primary flavanoid found in cocoa and chocolate.

Numerous dietary intervention studies show a clear connection to flavanols and heart health. The specific benefits to heart health include decreased vascular inflammation and decreased platelet aggregation. On a clinical level, this potentially translates to lowered blood pressure, improved heart function, and decreased risk for a heart attack.2, 3 The antioxidant properties of flavanols have also been shown to contribute to lowered low-density lipoprotein (LDL) cholesterol, otherwise known as bad cholesterol, and reduce cardiovascular risk by lowering insulin resistance in those with type2 diabetes.3, 4

However, it is important to realize that not all chocolate is created equally. Cocoa and chocolate products have a tendency to have varying amounts of flavanols. It has also been suggested that dark chocolate is better for you than milk chocolate. Experts suggest that this notion can be misleading for consumers because the color of the chocolate may not necessarily reflect the amount of flavanols present in the product.5 It is necessary to also differentiate between the natural product, cocoa, and the processed product, chocolate.3 Naturally occurring cocoa contains more flavanols that can contribute a strong, sometimes unpleasant bitter taste to the product. For this reason, producers of chocolate may utilize alkalization, fermentation, roasting, or other forms of processing in order to make the final product more palatable.5 The end product is chocolate that may also contain milk, sugar, and other added ingredients. There is a clear inverse relationship between processing and the amount of flavanoids contained in the final product. Essentially the more processing cocoa undergoes, the less flavanols it is likely to contain. Depending on the amount of manipulation that is done, the final product can lose up to 90 percent of its natural flavanols during processing.6

The evidence supporting the benefits of chocolate on heart health is both compelling and exciting. However, there are a few things to consider before loading your pantry with all sorts of chocolate products in the hope of improving your heart health. At present time, there are no established recommendations for the serving amount or frequency of chocolate consumption that will be beneficial for heart health. Additionally, there is no standardization of flavanol content in chocolate products so consumers cannot be sure that the chocolate being consumed has the adequate amount of flavanols present to minimize cardiovascular risk. Although it may now be easier for you to eat chocolate while feeling guilt-free, keep in mind that further research is needed before chocolate has a distinct position on the food pyramid.


References

1. American Heart Association (AHA), “Healthy Diet Goals.” Retrieved from http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Healthy-Diet-Goals_UCM_310436_SubHomePage.jsp
2. 2. C.L. Keen et al., “Cocoa Antioxidants and Cardiovascular Health,” American Journal of Clinical Nutrition 81, no. 1 (2005): 298S-303S.
3. R. Corti, A.J. Flammer, N.K. Hollenberg, and T.F. Luscher, “Cocoa and Cardiovascular Health,” Circulation 119, no. 10 (2009): 1433-1441.
4. U. Campia and J.A. Panza, “Flavanol-Rich Cocoa: A Promising New Dietary Intervention to Reduce Cardiovascular Risk in Type 2 Diabetes,” Journal of the American College of Cardiology 51 (2008): 2150-2152.
5. N.K. Hollenberg and N.D. Fisher, “Is it the Dark in Dark Chocolate?” Circulation 116 (2007): 2360-2362.

6. S.M. Hannum and J.W. Erdman, “Emerging Health Benefits From Cocoa and Chocolate,” J Med Food 3 (2000):73–75.


Nicole L. Hatcher, DHS(c), MPAS, PA-C

Dr. Nicole Hatcher is an adjunct professor at Kaplan University’s School of Health Sciences and teaches the course Models of Health and Wellness. In addition, she works full-time as a physician assistant in cardiology in Norfolk, Virginia. Dr. Hatcher received a Bachelor of Science in Physician Assistant Studies from Howard University and a Master of Advanced Physician Assistant Studies from Oregon Health & Science University. She holds a Doctor of Health Science degree from Nova Southeastern University.

Kaplan Higher Education Corporation is a division of Kaplan, Inc., a subsidiary of The Washington Post Company.

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