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NMR News: Volume 3, Issue 2, February 2010




    Chocolate: More than just a holiday
                 treat?
                                       By: Charles Spielholz, Ph.D.




C
        hocolate may just be one of the most            maintain cardiovascular health and help
        sought after foods in the world. Used as        prevent heart attack and stroke. Some support
        a candy or as a flavor in baked goods,          for such a conclusion is provided by a small
ice cream and other treats, chocolate is a              Dutch study of 470 elderly men tracked over 15
significant social food that is much craved in          years. The results of that study indicated that
many societies. Some people even appear to              men whose diets included cocoa were less
become addicted to it (1,2) which may have              likely to die from cardiovascular disease and
some negative effects (1,2). The interesting            had slightly lower blood pressure than men
news is that chocolate may also have some               whose diets did not contain significant levels of
health benefits due to some of its components
which include antioxidants, flavonoids,
polyphenols and some trace minerals. In
addition, chocolate contains methylxanthines
including caffeine, theobromine, and
theophylline.

Cardiovascular benefits are a primary area of
inquiry among those studying chocolate and
health. There is evidence that indicates that
chocolate may lower blood pressure (3-6), may
decrease or inhibit buildup of plaque on artery
walls (7,8), may help maintain healthy levels of
cholesterol, may have inhibitory effects on the
aggregation of platelets (3), and may decrease
serum concentrations of C-reactive protein (9).
Such effects would be expected to help


                                                    1
NMR News: Volume 3, Issue 2, February 2010


cocoa (4). The Kuna Indians of Panama also
have a very low level of cardiovascular disease
which some reports have attributed to the
cocoa in their diets (10-12).

Of course, such observations regarding
cardiovascular function and chocolate require
extensive research in order to be confirmed
(13,14). Such research must include well
planned clinical trials. Clear, bona fide,
                                                       These nutrients include small amounts of
physiological or biochemical mechanisms that
                                                       calcium, potassium, magnesium, copper,
explain the results of the clinical trials also
                                                       phosphorus, and iron. Chocolate also contains
need to be established before any solid
                                                       a small amount of plant based protein and
conclusions can be made. One possible
                                                       some unsaturated fatty acids. If the chocolate
physiological/biochemical mechanism currently
                                                       contains milk, there will be a small amount of
proposed is that the antioxidants in chocolate
                                                       the healthy components of milk present.
may prevent the oxidation of molecules which
would otherwise contribute to plaque buildup
                                                       Flavonoids in chocolate may have some anti-
(7).
                                                       inflammatory properties (18,19). Agents with
                                                       anti-inflammatory properties may have some
A few studies, all of which have been
                                                       positive effects on heart health (18,19), and
performed in the laboratory, vaguely suggest
                                                       may influence immune response, function
that chocolate may lower the risk of cancer
                                                       and/or development (20,21). However, the
(15,16). Possibly due to the flavonoids and
                                                       effects of chocolate on the immune system are
antioxidants found in chocolate (15,16), such
                                                       not ready for the testable stage in a clinical trial
preliminary observations will require a lot more
                                                       and will require significant amounts of basic
work before any scientific statement can be
                                                       laboratory bench work before any proposals
made. For example, one key question is if the
                                                       can be made.
amount of flavonoids found in different
preparations of chocolate are actually high
                                                       Since foods containing chocolate usually
enough to have any biological activity against a
                                                       include added sugar, there have been concerns
tumor in an individual.
                                                       about obesity and diabetes. However, the
                                                       sugar content in good quality chocolate tends
Chocolate does contain some nutrients in small
                                                       to be low and is not a critical factor in healthy
amounts that are beneficial in the diet (17).

                                                   2
NMR News: Volume 3, Issue 2, February 2010


people who enjoy chocolate as a special treat.
Chocolate products also contain fat. Again, for
those individuals who are healthy and enjoy
chocolate products in moderation, the fat
content is not critical. And since chocolate is a
plant based product, chocolate contributes no                  This means animals, especially household pets
cholesterol to a food product.                                 including dogs, cats, birds, and others should
                                                               never be given chocolate to eat.
Chocolate does contain methylxanthines.
Methylxanthines are based on purine and have                   Theobromine has shown some promise as an
mild stimulating effects on the body. Three                    inhibitor of coughing (24); however chocolate
methylxanthines found in chocolate are                         is not a proposed treatment for cough.
caffeine, theophylline, and theobromine. Both
caffeine and theophylline are present in very                  So what’s the conclusion? Enjoy chocolate!
low concentrations in chocolate. Concern                       There is some evidence that it is heart healthy
about caffeine levels in chocolate is generally                and it may have positive effects on the
unwarranted since the levels of this                           discomfort of inflammation. When eaten in
stimulatory molecule are much lower than                       reasonable amounts on special occasions by
coffee, a drink which is known to be safe for                  healthy individuals, it is not a significant source
healthy individuals (22,23).                                   of calories or caffeine. Just keep in mind that
                                                               chocolate is not a treatment for cardiovascular
Concern about the theobromine content is                       disease. If you believe you have cardiovascular
warranted, but not for humans. Humans are                      disease, or have a question regarding your
able to safely metabolize theobromine;                         cardiovascular health, you must seek the
however many animals, including household                      advice of your health care provider.
pets, are not able to metabolize theobromine.

References

1) Bruinsma K, Taren DL. (1999) Chocolate: food or drug?
J Am Diet Assoc. 99:1249-1256.

2) Yanovski S. (2003) Sugar and fat: cravings and
aversions. J Nutr. 133:835S-837S

3) Engler MB, Engler MM. (2006) The emerging role of
flavonoid-rich cocoa and chocolate in cardiovascular
health and disease. Nutr Rev. 64:109-118.

                                                           3
NMR News: Volume 3, Issue 2, February 2010



4) Buijsse B, Feskens EJ, Kok FJ, Kromhout D. (2006)              14) Ariefdjohan MW, Savaiano DA. (2005) Chocolate and
Cocoa intake, blood pressure, and cardiovascular                  cardiovascular health: is it too good to be true? Nutr Rev.
mortality: the Zutphen Elderly Study. Arch Intern Med.            63:427-430.
166:411-417.
                                                                  15) Weisburger JH. (2001) Chemopreventive effects of
5) Corti R, Flammer AJ, Hollenberg NK, Lüscher TF.               cocoa polyphenols on chronic diseases. Exp Biol Med
(2009) Cocoa and cardiovascular health. Circulation.              (Maywood). 226:891-897.
119:1433-1441.
                                                                  16) Maskarinec G. (2009) Cancer protective properties of
6) Desch S, Schmidt J, Kobler D, Sonnabend M, Eitel I,            cocoa: a review of the epidemiologic evidence. Nutr
Sareban M, Rahimi K, Schuler G, Thiele H. (2010) Effect of        Cancer. 61:573-579.
cocoa products on blood pressure: systematic review
and meta-analysis. Am J Hypertens. 2010 23:97-103.                17) Steinberg FM, Bearden MM, Keen CL. (2003) Cocoa
                                                                  and chocolate flavonoids: implications for cardiovascular
7) Kris-Etherton PM, Keen CL. (2002) Evidence that the            health. J Am Diet Assoc. 103:215-223.
antioxidant flavonoids in tea and cocoa are beneficial for
cardiovascular health. Curr Opin Lipidol. 13:41-49.               18) Selmi C, Mao TK, Keen CL, Schmitz HH, Eric Gershwin
                                                                  M. (2006) The anti-inflammatory properties of cocoa
8) Heiss C, Schroeter H, Balzer J, Kleinbongard P, Matern         flavanols. J Cardiovasc Pharmacol. 47:S163-S171
S, Sies H, Kelm M. (2006) Endothelial function, nitric            (discussion S172-S176).
oxide, and cocoa flavanols. J Cardiovasc Pharmacol.
47:S128-S135.                                                     19) Selmi C, Cocchi CA, Lanfredini M, Keen CL, Gershwin
                                                                  ME. (2008) Chocolate at heart: the anti-inflammatory
9) di Giuseppe R, Di Castelnuovo A, Centritto F, Zito F, De       impact of cocoa flavanols. Mol Nutr Food Res. 52:1340-
Curtis A, Costanzo S, Vohnout B, Sieri S, Krogh V, Donati         1348.
MB, de Gaetano G, Iacoviello L. (2008) Regular
consumption of dark chocolate is associated with low              20) Ramiro-Puig E, Castell M. (2009) Cocoa: antioxidant
serum concentrations of C-reactive protein in a healthy           and immunomodulator. Br J Nutr. 101:931-940.
Italian population. J Nutr. 138:1939-1945.
                                                                  21) Kenny TP, Shu SA, Moritoki Y, Keen CL, Gershwin ME.
10) Hollenberg NK. (2006) Vascular action of cocoa                (2009) Cocoa flavanols and procyanidins can modulate
flavanols in humans: the roots of the story. J Cardiovasc         the lipopolysaccharide activation of polymorphonuclear
Pharmacol. 47:S99-S102.                                           cells in vitro. J Med Food. 12:1-7.

11) McCullough ML, Chevaux K, Jackson L, Preston M,               22) Chou TM, Benowitz NL. (1994) Caffeine and coffee:
Martinez G, Schmitz HH, Coletti C, Campos H, Hollenberg           effects on health and cardiovascular disease. Comp
NK. (2006) Hypertension, the Kuna, and the                        Biochem Physiol C Pharmacol Toxicol Endocrinol.
epidemiology of flavanols. J Cardiovasc Pharmacol. 47             109:173-189.
S103-S109.
                                                                  23) Nawrot P, Jordan S, Eastwood J, Rotstein J,
12) McCarty MF, Barroso-Aranda J, Contreras F. (2010)             Hugenholtz A, Feeley M. (2003) Effects of caffeine on
Potential complementarity of high-flavanol cocoa                  human health. Food Addit Contam. 20:1-30.
powder and spirulina for health protection. Med
Hypotheses. 74:370-373.                                           24) Usmani OS, Belvisi MG, Patel HJ, Crispino N, Birrell
                                                                  MA, Korbonits M, Korbonits D, Barnes PJ. (2005)
13) Fisher ND, Hollenberg NK. (2005) Flavanols for                Theobromine inhibits sensory nerve activation and
cardiovascular health: the science behind the sweetness.          cough. FASEB J. 19:231-233.
J Hypertens. 23:1453-1459.

                                                              4

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Chocolate Article Feb 2010

  • 1. NMR News: Volume 3, Issue 2, February 2010 Chocolate: More than just a holiday treat? By: Charles Spielholz, Ph.D. C hocolate may just be one of the most maintain cardiovascular health and help sought after foods in the world. Used as prevent heart attack and stroke. Some support a candy or as a flavor in baked goods, for such a conclusion is provided by a small ice cream and other treats, chocolate is a Dutch study of 470 elderly men tracked over 15 significant social food that is much craved in years. The results of that study indicated that many societies. Some people even appear to men whose diets included cocoa were less become addicted to it (1,2) which may have likely to die from cardiovascular disease and some negative effects (1,2). The interesting had slightly lower blood pressure than men news is that chocolate may also have some whose diets did not contain significant levels of health benefits due to some of its components which include antioxidants, flavonoids, polyphenols and some trace minerals. In addition, chocolate contains methylxanthines including caffeine, theobromine, and theophylline. Cardiovascular benefits are a primary area of inquiry among those studying chocolate and health. There is evidence that indicates that chocolate may lower blood pressure (3-6), may decrease or inhibit buildup of plaque on artery walls (7,8), may help maintain healthy levels of cholesterol, may have inhibitory effects on the aggregation of platelets (3), and may decrease serum concentrations of C-reactive protein (9). Such effects would be expected to help 1
  • 2. NMR News: Volume 3, Issue 2, February 2010 cocoa (4). The Kuna Indians of Panama also have a very low level of cardiovascular disease which some reports have attributed to the cocoa in their diets (10-12). Of course, such observations regarding cardiovascular function and chocolate require extensive research in order to be confirmed (13,14). Such research must include well planned clinical trials. Clear, bona fide, These nutrients include small amounts of physiological or biochemical mechanisms that calcium, potassium, magnesium, copper, explain the results of the clinical trials also phosphorus, and iron. Chocolate also contains need to be established before any solid a small amount of plant based protein and conclusions can be made. One possible some unsaturated fatty acids. If the chocolate physiological/biochemical mechanism currently contains milk, there will be a small amount of proposed is that the antioxidants in chocolate the healthy components of milk present. may prevent the oxidation of molecules which would otherwise contribute to plaque buildup Flavonoids in chocolate may have some anti- (7). inflammatory properties (18,19). Agents with anti-inflammatory properties may have some A few studies, all of which have been positive effects on heart health (18,19), and performed in the laboratory, vaguely suggest may influence immune response, function that chocolate may lower the risk of cancer and/or development (20,21). However, the (15,16). Possibly due to the flavonoids and effects of chocolate on the immune system are antioxidants found in chocolate (15,16), such not ready for the testable stage in a clinical trial preliminary observations will require a lot more and will require significant amounts of basic work before any scientific statement can be laboratory bench work before any proposals made. For example, one key question is if the can be made. amount of flavonoids found in different preparations of chocolate are actually high Since foods containing chocolate usually enough to have any biological activity against a include added sugar, there have been concerns tumor in an individual. about obesity and diabetes. However, the sugar content in good quality chocolate tends Chocolate does contain some nutrients in small to be low and is not a critical factor in healthy amounts that are beneficial in the diet (17). 2
  • 3. NMR News: Volume 3, Issue 2, February 2010 people who enjoy chocolate as a special treat. Chocolate products also contain fat. Again, for those individuals who are healthy and enjoy chocolate products in moderation, the fat content is not critical. And since chocolate is a plant based product, chocolate contributes no This means animals, especially household pets cholesterol to a food product. including dogs, cats, birds, and others should never be given chocolate to eat. Chocolate does contain methylxanthines. Methylxanthines are based on purine and have Theobromine has shown some promise as an mild stimulating effects on the body. Three inhibitor of coughing (24); however chocolate methylxanthines found in chocolate are is not a proposed treatment for cough. caffeine, theophylline, and theobromine. Both caffeine and theophylline are present in very So what’s the conclusion? Enjoy chocolate! low concentrations in chocolate. Concern There is some evidence that it is heart healthy about caffeine levels in chocolate is generally and it may have positive effects on the unwarranted since the levels of this discomfort of inflammation. When eaten in stimulatory molecule are much lower than reasonable amounts on special occasions by coffee, a drink which is known to be safe for healthy individuals, it is not a significant source healthy individuals (22,23). of calories or caffeine. Just keep in mind that chocolate is not a treatment for cardiovascular Concern about the theobromine content is disease. If you believe you have cardiovascular warranted, but not for humans. Humans are disease, or have a question regarding your able to safely metabolize theobromine; cardiovascular health, you must seek the however many animals, including household advice of your health care provider. pets, are not able to metabolize theobromine. References 1) Bruinsma K, Taren DL. (1999) Chocolate: food or drug? J Am Diet Assoc. 99:1249-1256. 2) Yanovski S. (2003) Sugar and fat: cravings and aversions. J Nutr. 133:835S-837S 3) Engler MB, Engler MM. (2006) The emerging role of flavonoid-rich cocoa and chocolate in cardiovascular health and disease. Nutr Rev. 64:109-118. 3
  • 4. NMR News: Volume 3, Issue 2, February 2010 4) Buijsse B, Feskens EJ, Kok FJ, Kromhout D. (2006) 14) Ariefdjohan MW, Savaiano DA. (2005) Chocolate and Cocoa intake, blood pressure, and cardiovascular cardiovascular health: is it too good to be true? Nutr Rev. mortality: the Zutphen Elderly Study. Arch Intern Med. 63:427-430. 166:411-417. 15) Weisburger JH. (2001) Chemopreventive effects of 5) Corti R, Flammer AJ, Hollenberg NK, L√ºscher TF. cocoa polyphenols on chronic diseases. Exp Biol Med (2009) Cocoa and cardiovascular health. Circulation. (Maywood). 226:891-897. 119:1433-1441. 16) Maskarinec G. (2009) Cancer protective properties of 6) Desch S, Schmidt J, Kobler D, Sonnabend M, Eitel I, cocoa: a review of the epidemiologic evidence. Nutr Sareban M, Rahimi K, Schuler G, Thiele H. (2010) Effect of Cancer. 61:573-579. cocoa products on blood pressure: systematic review and meta-analysis. Am J Hypertens. 2010 23:97-103. 17) Steinberg FM, Bearden MM, Keen CL. (2003) Cocoa and chocolate flavonoids: implications for cardiovascular 7) Kris-Etherton PM, Keen CL. (2002) Evidence that the health. J Am Diet Assoc. 103:215-223. antioxidant flavonoids in tea and cocoa are beneficial for cardiovascular health. Curr Opin Lipidol. 13:41-49. 18) Selmi C, Mao TK, Keen CL, Schmitz HH, Eric Gershwin M. (2006) The anti-inflammatory properties of cocoa 8) Heiss C, Schroeter H, Balzer J, Kleinbongard P, Matern flavanols. J Cardiovasc Pharmacol. 47:S163-S171 S, Sies H, Kelm M. (2006) Endothelial function, nitric (discussion S172-S176). oxide, and cocoa flavanols. J Cardiovasc Pharmacol. 47:S128-S135. 19) Selmi C, Cocchi CA, Lanfredini M, Keen CL, Gershwin ME. (2008) Chocolate at heart: the anti-inflammatory 9) di Giuseppe R, Di Castelnuovo A, Centritto F, Zito F, De impact of cocoa flavanols. Mol Nutr Food Res. 52:1340- Curtis A, Costanzo S, Vohnout B, Sieri S, Krogh V, Donati 1348. MB, de Gaetano G, Iacoviello L. (2008) Regular consumption of dark chocolate is associated with low 20) Ramiro-Puig E, Castell M. (2009) Cocoa: antioxidant serum concentrations of C-reactive protein in a healthy and immunomodulator. Br J Nutr. 101:931-940. Italian population. J Nutr. 138:1939-1945. 21) Kenny TP, Shu SA, Moritoki Y, Keen CL, Gershwin ME. 10) Hollenberg NK. (2006) Vascular action of cocoa (2009) Cocoa flavanols and procyanidins can modulate flavanols in humans: the roots of the story. J Cardiovasc the lipopolysaccharide activation of polymorphonuclear Pharmacol. 47:S99-S102. cells in vitro. J Med Food. 12:1-7. 11) McCullough ML, Chevaux K, Jackson L, Preston M, 22) Chou TM, Benowitz NL. (1994) Caffeine and coffee: Martinez G, Schmitz HH, Coletti C, Campos H, Hollenberg effects on health and cardiovascular disease. Comp NK. (2006) Hypertension, the Kuna, and the Biochem Physiol C Pharmacol Toxicol Endocrinol. epidemiology of flavanols. J Cardiovasc Pharmacol. 47 109:173-189. S103-S109. 23) Nawrot P, Jordan S, Eastwood J, Rotstein J, 12) McCarty MF, Barroso-Aranda J, Contreras F. (2010) Hugenholtz A, Feeley M. (2003) Effects of caffeine on Potential complementarity of high-flavanol cocoa human health. Food Addit Contam. 20:1-30. powder and spirulina for health protection. Med Hypotheses. 74:370-373. 24) Usmani OS, Belvisi MG, Patel HJ, Crispino N, Birrell MA, Korbonits M, Korbonits D, Barnes PJ. (2005) 13) Fisher ND, Hollenberg NK. (2005) Flavanols for Theobromine inhibits sensory nerve activation and cardiovascular health: the science behind the sweetness. cough. FASEB J. 19:231-233. J Hypertens. 23:1453-1459. 4