February 13, 2023
Just in time for Valentine's Day, the U.S. Food and Drug Administration has weighed in on whether chocolate is good for the heart. The answer, it turns out, is a bit more complicated than a simple yes or no.
The FDA recently responded to a 2018 request from Swiss chocolate maker Barry Callebaut, which sought to use health claims on some of its products. After reviewing all available studies, however, the FDA wasn't able to find conclusive evidence.
"Supportive but inconclusive scientific evidence suggests that consuming at least 200 mg of cocoa flavanols daily, such as provided by high flavanol cocoa powder, or high flavanol semisweet or high flavanol dark chocolate, may reduce the risk of cardiovascular disease," the agency wrote in a letter to the company.
Any health benefit associated with chocolate depends on how much cocoa flavanols are in each serving. In order for chocolate makers to be able to make health claims, their cocoa products must contain at least 4% of naturally conserved cocoa flavanols. This is a lot more bitter than most chocolate candy.
Though chocolate has been around for centuries, with many early civilizations believing it held medicinal qualities, modern research hasn't been able to provide hard evidence of these benefits.
Studies show that dark chocolate is better for one's health than milk or white chocolate because it is rich in minerals like iron, magnesium and zinc. It also contains high levels of antioxidants, which may lower blood pressure by producing nitric oxide, a molecule that relaxes the blood vessels, promoting blood flow.
A recent study led by Brigham and Women's Hospital in Boston found that taking a 600-mg daily supplement of cocoa flavanols can reduce deaths from heart disease by 27%. However, it did not lead to a reduction in heart attacks or strokes. And a 600-mg supplement is equivalent of eating nearly 4,000 calories of milk chocolate or 600 calories of dark chocolate.
One research review indicated that eating chocolate three times per week may lower the risk of cardiovascular disease by 9%. Another suggested that easting 45 grams of chocolate each week reduced cardiovascular disease risk by 11%.
Observational studies have suggested chocolate may balance the immune system, offer protection against diabetes, improve brain function and reduce stress. Some research even suggests the certain compounds in dark chocolate may offer skin protection from the sun.
The time of day that a person eats chocolate also may impact its health benefits. One study found that people who ate chocolate in the morning had less body fat, lower glucose levels and healthier microbiomes. Another small study also suggests that eating dark chocolate supplemented with the flavanol lycopene decreases total cholesterol, low-density lipoprotein cholesterol and triglycerides.
More research is needed before there can be any conclusive claims that eating a certain amount of chocolate reduces heart disease could be made. Most studies have been purely observational and some have even suggested no benefit from eating chocolate at all.
The type of study that would offer the most accurate results – a clinical trial of thousands of people where one group agreed to eat chocolate every day for years and another group agreed to never eat chocolate during that same time period – would be hard to execute, experts say.
"Cocoa is clearly good for you," Dr. Dariush Mozaffarian, a cardiologist and professor of nutrition at the Tufts Friedman School of Nutrition Science and Policy, told The New York Times last year. "Whether chocolate is good for you or not depends on how much cocoa is actually in it, and what else is in it."
Besides the amount of cocoa flavanols a chocolate bar contains, people also need to consider how many calories and grams of sugar they are consuming. Many chocolate bars contain the upper daily limits of added sugar recommended by the American Heart Association. Milk chocolate has twice the amount of sugar as dark chocolate.
"We found in the Women's Health Initiative that eating chocolate several times a week, just regular chocolate candy, did lead to weight gain," Dr. JoAnn Manson, of Brigham and Women's Hospital told NPR earlier this month. Plus, excess weight is a known risk factor for cardiovascular disease.
The bottom line? Though cocoa flavanols are healthy, it is unlikely that people will get enough of them in most highly-processed, sweetened chocolate candy, expert say. This doesn't mean that one shouldn't indulge a sweet tooth – just be sure to enjoy it in moderation. And always read labels carefully. The chocolate that has been linked to the most health benefits is dark chocolate that is at least 70% cocoa.