Dark Chocolate and Artery Function

Image Credit: Kyknoord / Flickr. This image has been modified.

How Dark Chocolate Affects Our Arteries

Chocolate: delicious beauty or harmful beast? Or both?

Although chocolate products can contain high levels of fat and sugar, the cocoa powder itself may have beneficial effects in a number of chronic disease conditions including heart disease.

Flow-mediated dilation, measured in the main artery of the arm, is considered one of the best measures of arterial function, a predictor of cardiovascular mortality. Researchers found that a little cocoa can give one a significant boost in arterial function within hours of consumption. It doesn’t take much—just about a teaspoon of natural cocoa powder (or about a tablespoon or more of Dutched cocoa). For a graph of this, check out my video, Dark Chocolate and Artery Function.

Now, it might make us a little suspicious that the author of this study works in Hershey, Pennsylvania, at the Hershey Medical Center, and has accepted money from our largest chocolate manufacturer’s Center for Health and Nutrition, conveniently located near the intersection of Chocolate and Cocoa Avenue (seriously!).

However, putting together all of the best available evidence, dozens of randomized controlled trials, arterial function was significantly improved within hours, and after weeks and months of chronic cocoa consumption. It’s always difficult to tease fact from fiction when such powerful financial interests are involved though. Many of the other studies were funded by industry as well, and as in all areas of research, evidence suggests that industry funding is associated with pro-industry conclusions. But even after removing studies funded by industry, reviewers found the same protective effect.

The reason researchers often measure arterial function in the arm rather than where we really need it—in the coronary arteries of the heart—is that it would require an angiogram, which is a much more invasive procedure. But what if we were able to find people already scheduled for an angiogram anyway? A double-blind, randomized trial of people already scheduled for an angiogram found that dark chocolate actually opens up coronary arteries. When researchers did what’s called a “cold pressor test,” where they plunge subjects’ hands into buckets of ice water, they found that after dark chocolate consumption, arteries actually dilated when they’re normally supposed to constrict.

Because chocolate also contains fat and sugar, we have to be careful. Furthermore, most chocolate products are manufactured with milk, an ingredient known to influence the antioxidant capacity in our blood. Even if milk chocolate had the same flavonoid phytonutrient content as dark chocolate, the antioxidant effect of cocoa is potentially weakened in the blood when milk is consumed.

So, not only are there triple the antioxidants in dark compared to milk chocolate, but the milk actively works against the effects in the human body. Eat dark chocolate, and we get a nice spike in the antioxidant power of our bloodstreams within an hour. Eat milk chocolate, and we get nothing. If we eat that same dark chocolate with a cup of milk, the benefit is suppressed. The addition of milk, either in your stomach or in the chocolate, inhibits the within-body antioxidant activity of chocolate and the absorption into the bloodstream of one of the target phytonutrients.

Sugar isn’t good for us either. Sugar impairs arterial function. One bottle of soda’s worth of sugar can cripple arterial function. That’s why sugar-free cocoa improves arterial function better than the same amount of cocoa with sugar added. So, eliminating sugar appears to amplify the beneficial effects of cocoa.

The bottom line is that although the positive effects of chocolate and cocoa products seem apparent, precautions exist when we’re talking about the calories, fat, and sugar in chocolate. Cocoa powder, then, offers the best of both worlds. Although not as tasty, cocoa-based products with little or no sugar or fat are certainly preferred. And we can make them tasty as I note in my Healthy Chocolate Milkshake recipe, and my healthy chocolate ice cream video.

More on the corrupting effect of money in nutrition research in Academy of Nutrition and Dietetics Conflicts of Interest.

I’ve covered chocolate before, coming to basically the same conclusion:

What effects do other foods have on arterial function? See:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of DeathMore Than an Apple a DayFrom Table to Able, and Food as Medicine.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

70 responses to “How Dark Chocolate Affects Our Arteries

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  1. Welcome everyone to day #4 of Julieanna Week! Isn’t she great? Joseph is taking a week to do offline work for us, and so Julieanna Hever, R.D. is stepping in to be NutritionFacts.org’s resident dietician. This is everyone’s opportunity to take advantage of her vast knowledge of how to take all the science and translate it into day-to-day healthier living for your family. We’re just so honored to have her on board this week!

    1. Do you have a preference over dutched or non-dutched chocolate (regardless of cost) when it comes to health? I know of others who have raised concerns about the dutching process leaving behind chemicals and maybe some other stuff. And even though the dutched-chocolate can be bought for cheaper, one has to use more of it.

      As far as “opening up coronary arteries”, do blueberries and some other berries work just as well as chocolate at achieving this? Have you done a “ranking” of antioxidant foods (1-10) for opening up coronary arteries and improving blood flow?

      1. Yes! Foods high in antioxidants – like blueberries and other fruits, vegetables, herbs, spices, tea, nuts, seeds, and legumes – helps improve arterial health by quenching the free radicals that disrupt nitric oxide activity. In fact, it appears as though the more antioxidant-rich foods consumed, the greater the potential health benefits! It is estimated that each single serving of fruits and vegetables improved endothelial function by 6%!

        There are scales that measure antioxidant capacity, such as ORAC (Oxygen Radical Absorbance Capacity) and FRAP (Ferric Ion Reducing antioxidant Power) which are compared here and have provided scientists with quite a bunch of information. But since food works in incredible synergistic ways, isolating single nutrients seems unhelpful and even perhaps distracting from the bigger picture. A wide variety of different plant foods contain hundreds – or likely, thousands – of compounds that work together to help via different mechanisms to support health.

        So, when you are taking in a constant flow of these artery-enhancing foods, as in a whole food, plant-based diet, you are bathing your bloodstream with beneficial compounds…

        In terms of what type of cocoa, the evidence suggests that the natural (non-alkalized) version retains more of its flavanols when compared to its Dutched or alkalized derivative. Which is likely why, in the first paragraph of this blog post, Dr. Greger suggests one teaspoon of natural or one tablespoon of Dutched cocoa for the same benefit.

        1. Thank you for this. I’d truly like to know how you and Dr. Greger would rank chocolate versus the antioxidant-rich fruits and veggies that are known to improve/open up coronary arteries. Is today’s video suggesting (I don’t think it is, but I could see how some readers out there might think…”oh, looks like chocolate must be the best in this regards, maybe even the only option.” I think it benefits us all here to know how these fruits rank with chocolate. Is chocolate “that” much better, or is it actually way less capable in this regard than, say, certain berries and veggies?

          As far as the “dutching process”, what I am asking is in regards to possible chemicals ending up in the dutched-chocolate as a result of the processing the chocolate goes through to make it “dutched.” There are consumers who avoid chocolate that has been “dutched because of their feeling that this might be an issue. So what I am asking is….what does the data/science suggest, in your and/or Dr. G’s opinion?

    2. Thank you, Dr. Greger, and to the wonderful commenters and guests here! I am loving spending time on my favorite website this week! For those of you who may not know me, I am known as the Plant-Based Dietitian and I am an author, speaker, and tv host. I also work with clients around the world using whole food, plant-based nutrition to help improve their health and performance. I am happy to answer questions and digging into chocolate (yum!) and anything else related to nutrition, health, fitness, and plant-based parenting…

      1. The above questions by Leslie seems very relevant. I too would love to know if there are fruits that achieve the same (or better!) artery widening effect that Dr.G highlights in chocolate. Some of us can not tolerate chocolate at all.

        1. Yes, you do not need to consume chocolate to derive all of the vast benefits of antioxidants that are ubiquitous in plant foods. Instead, focus on eating colorful fruits and vegetables, spices, herbs, nuts, legumes, drink tea, and exercise to maximize your arterial function and health!

  2. Shouldn’t it be a good thing that our arteries constricts when we dunk our hands in a bucket of water? Isn’t the constricting process supposed to help protect the blood from the cold temperature?

    1. Under normal circumstances you would be correct, the body would try to maintain it’s internal core body temperature by vasoconstricting. If a person is hyperthermic however, or has very high core body temperature then being vasodilated and plunging the hand into cold water would be great. This is because humans (and most mammals) have special blood vessels in their hands, feet, and face (arteriovenous anastomoses or AVAs) that act as a superhighway to exchange blood from the hands to the core of the body to provide rapid cooling (or heating) of the body as long as the hands/feet/face are vasodilated. The problem as was previously discussed is that under normal circumstances, vasoconstriction occurs, so if you were really overheated and plunged your hand into ice water it would actually act to seal the heat in. This is why Stanford researchers Grahn and Heller created devices that have a cold surface and pull a vacuum on the hand (to cause vasodilation) to rapidly cool the body for hyperthermic individuals or during exercise. They also used the same method to rapidly heat the body (for hypothermic patients coming out of anesthesia) using the AVAs and showed to increase warming time from 1 hour to about 8 minutes.

      But apparently cocoa powder and a bucket of ice water would be just as good as the vacuum device!

  3. Chocolate contains high amount of copper. Am I incorrect in thinking copper to be similar to iron, in that it’s not good to over-consume it? I’m asking this because copper happens to be abundant in leafy green vegetables like kale for example, and also legumes and nuts contain moderate amounts as well.

    1. That is a great question, since we have seen links between copper and Alzheimer’s disease. Copper is an essential nutrient, necessary for many physiological functions in the body. Human exposure to copper primarily comes from the water supply. Toxic levels of copper are rarely found in the general population. In fact, this study showed a favorable effect of copper on cholesterol levels and concluded that chocolate is a “pleasant dietary supplement.” Another study showed that cocoa provided a safe and effective dietary treatment for copper deficiency associated with tube feeding. Higher exposure would come from consuming concentrated sources, such as in meats, supplements or with copper-lined cookware. The RDA for copper in adults is 900 micrograms for adults. One tablespoon of cocoa powder contains about 200 micrograms of copper. Basically, consuming cocoa can easily fit into a healthy, wholesome plant-based diet without concern of risk from its copper content.

      1. Maybe also make sure if you’re eating a lot of copper-rich foods, to also increase potassium-rich foods as well, I think if I remember correctly copper decreases potassium level somewhat.

        1. Google for copper-zinc ratio. Example (first link):


          “It has been reported (HRI-PTC) that 80% of hyperactive patients and 68% of
          behavior-disordered patients have elevated blood copper levels. Their families
          often report worsened hyperactivity/behavior after consuming vitamin supplements
          or cereals rich in copper. In many cases, symptoms may be provoked by consuming
          chocolate (rich in copper) or food dyes rich in hydrazines,
          which lower blood zinc levels.

          Elevated copper/zinc ratios can be especially serious for persons with low blood
          histamine (over-methylation). This combination of imbalances has been
          associated with anxiety, panic disorders, paranoia, and (in severe cases)

      2. im so glad i found this site i have two dilemmas, one is my hair test showed high copper, i eat about 3 ounces dark chocolate a day! its my splurge and actually an addiction more likely . but we also have copper pipes and I drink water out of the tap. In addition, I have high LDL and very high Lpa levels and the apoe 3/4 gene the 4 increasing risk of alzheimers. so this whole chocolate and copper issue couldnt be more relevant and I have yet to find anyone who knows anything about the two and true relationship , if any, between the two
        so to summarize.
        does high copper in hair reflect true copper levels
        does 2-3 oz dark chocolate a day signigantly raise copper levels
        does drinking water out of a tap of copper piping raise copper (we thought it was an improvement over the lead piping we used to have)
        does copper in high levels oxidize cholesterol
        does copper have a brain toxic effect
        reading Stearic Acid is one of only foods that has been shown to RAISE lpa levels usually Lpa levels arent affected by \
        could i be accumulating copper more than average person bc i have the MTHFR CT gene reducing detox pathways..
        the short of it is that i love chocolate and its a great source of extra calories for me as I have trouble keeping weight on, its gluten free free as im celiac and is delicious do I have to give it up? and could that be the cause of high copper in hair, high LDL and high lpa
        i take ip6 and zinc to help lower it havent retested

  4. As I understand; if you’re buying raw cacao you need to be careful on several fronts;

    1. Most of it cannot possibly be organic, as labels claim, cause there just isn’t that much of it in the world.
    2. Most if it cannot possibly be Arriba Criollo, the most highly sought form, cause there just isn’t that much of it in the world. (David Wolfe said this.)
    The farmers apparentally lie to get higher prices, being desperate.

    3. You don’t want to buy the cacao powder – cause from these charts you can see it generally is more contaminated than the nibs or other forms. I also have read the the milling equipment used to grind salt, such as Himalayan salt, puts nickel into the salt, and so perhaps other metals as well? – similarly with cacao powder?

    Mike Adams –
    “Why are cacao powders higher in cadmium than nibs? Possibly due, in part, to the extra processing and grinding machinery used to create the powder.”

  5. “. . . the cocoa powder itself may have beneficial effects”

    Why do so many nutrition articles nearly always fudge (pun intended) their health claims with “may”?
    The way I see it, it’s either beneficial or it isn’t.

    1. Dommy: The way I see it, life just isn’t that simple. For one thing, people are different–there are always outlier people. For another thing, food is different. One cocoa powder is not always the same as another. Finally, when someone is an authority figure and needs to use careful language, that person needs to acknowledge that we don’t know all the qualifiers at this moment. We could learn something new in the future that changes what we know today. Using the word “may” or “might” is often the right choice over adding a million qualifiers to a statement. Adding so many qualifiers would make the message unclear–unnecessarily.

      I think a smoking example may (note the intentional use of ‘may’ because I don’t know if it will help you or not even though I think it has a high probability of helping) help clarify the situation. Suppose someone says, “Smoking may cause lung cancer.” That statement could be considered more accurate than saying, “Smoking will cause lung cancer.” Because the truth is that some people smoke and never get lung cancer. A vast number of studies indicate that smoking increases the risk of lung cancer in individuals. We can say that in most individuals, smoking is not beneficial. At the same time, in some rare individuals, smoking (or say eating meat) doesn’t seem to hurt them. Someone recently posted on this site how his father smoked every day and lived to be a happy 91. That doesn’t make smoking beneficial in general, or even for that individual. (Who knows? Maybe that person would have lived to be 101 without the smoking…)

      In casual language, it would be perfectly fair to say that “Smoking causes lung cancer”, because everyone should have the common sense understanding that such a statement means that smoking does cause lung cancer in some people, but will not always do so. But when someone is trying to use language very carefully and as accurate as possible (which as an authority figure, I presume Dr. Greger tries to do), they would do better to use the statement, “Smoking may cause lung cancer.” in order to acknowledge that 1) not everyone who smokes gets lung cancer and that 2) there are some situations in which smoking’s harmful effects might be mitigated (such as massive eating of greens) and that 3) it is hubris to assume that we know everything right now (even if the information has been largely unchanged for decades).

      The sentence, “Smoking may cause lung cancer.” is worth saying even with the qualifications of “may” — if the evidence is strong enough. It would be potentially (intentionally grey word) detrimental to wait for absolute proof before taking action on certain types of very strong information.

      Does that make sense? What do you think?

      1. Given the positive results unhesitatingly reported in the rest of the article, why not instead say “the cocoa powder itself *often shows* beneficial effects” or “…shows *marked benefits*” — at least state it more forthrightly since it’s warranted by the results. I like fudge but not fudging without a cause.

        Nevertheless I appreciate your well-expressed perspective.

    2. That is a good question, Dommy! The reason is that there really is no scientific proof. Because – especially with health and nutrition – there are so, so many variables that come into play and studies and humans are infinitely complex, it is not truly accurate to say that “a” causes “b” or that “c” prevents “d.” Thus, researchers and scientists have a specific code of verbiage, like saying “may reduce risk of” or “likely to promote,” in order to intentionally not stay conclusive.

      1. When I was a small child I was terribly allergic to chocolate and peanuts. Even a few grains or crumbs and I’d break out in hives for days and weeks. The allopathic MD specialists all told my parents there was no cure but – good news – I’d grow out of it eventually, probably in my 20’s.

        At eight years old a chiropractor completely cured me after only a couple of months of adjustments! Same as he’d remarkably done with a maternal cousin a year earlier who’d been born with the same allergies.

        Point? I could have opened the above with “cocoa powder may have detrimental health effects,” since that was the gist of my evidence.

        So sure there are variables in everything. My only point (and it’s a small one) is I felt the evidence put forth in Dr. Greger’s article deserved more than a conservative opener.

        Thanks for responding Julieanna — and Welcome!

          1. Let me tell you a bit more because looking back it seems unbelievable even now. It was the 1950’s. My parents, and certainly I, had never heard of chiropractors, didn’t know the first thing about it. My cousin and I missed so much school because of our allergies. Mr. Hershey, Mr. Nestle and Mr. Planters were banned from our homes.

            One day 8-year old cuz comes to visit, and he’s snacking on a bag of peanuts!

            “Michael!” my mother cries, “you know you’re not allowed to eat that!”

            “Oh, I’m all better now.” WHAT? How?? So he tells her his mom takes him to a “chiropractor” who cured him of all his allergies.

            Incredulous, my mom immediately calls her sister who tells her that a friend recommended this local guy who was a doctor, but not a regular doctor, a ‘chiropractor.”

            “What’s that?”

            At this point I was intrigued, especially when cuz tells me he doesn’t need to get shots anymore(!). I clearly remember at the end of the conversation my mom hanging up the phone, relaying all this to my father and saying, “I don’t know, but if it’s good enough for Michael it’s good enough for Dommy!”

            So we made an appointment, and the rest is allergy-free history.

  6. Do we know what it is in dark chocolate that causes the benefits? Is it just antioxidants in which case why not just stick to berries? Or is there more to it?

    1. S Slavin: A thought in response to the question: “…why not just stick to berries?” I would say that a lot of people greatly enjoy chocolate. They would welcome good news about any health benefits of chocolate. With the intense interest in chocolate, the benefits and harm from chocolate is worth exploring even if berries are also very healthy. Variety is a good thing when the variety includes healthy foods. That’s just my 2 cents. What do you think?

      1. Ya you’re right, it just seems chocolate is specifically mentioned in related to heart health whereas things like berries are mentioned in more general health terms, almost as if chocolate is BETTER at heart health than things like berries.

        So I wonder if chocolate has something special or unique, or it’s just antioxidants and, like you said, it’s just nice to have another option for heart healthy food.

        1. its mainly composed of stearic acid as the fatty acid which is LDL neutral and HDL raising all great UNLESS you have the lpa gene as I do its literally one of the only foods that has the ability to raise lpa levels so for me my chocolate addiction i developed years ago before knowing about my lpa , thinking it was heart healthy isnt so heart healthy for me…

  7. “….the author of this study works in Hershey, Pennsylvania, at the Hershey
    Medical center, and has accepted money from our largest chocolate
    manufacturer’s Center for Health and Nutrition, conveniently located
    near the intersection of Chocolate and Cocoa Avenue (seriously!)”

    Uh-huh. I’m wondering why Hershey hasn’t jumped on the band wagon and offered us a dark chocolate bar that does NOT contain milk.. Or have things changed since I last read the ingredients in their chocolate bar wrapperss? Get with the program, Hershey people!

    I confess I’m a choco addict: After my evening meal, I scarf down three squares of either Lindt 85% or Ghirardelli Intense Dark 72%. Yumsville! No other dessert…pies, cookies or cake hold no interest for me. (On the other hand, I wouldn’t turn up my nose at a piece of fruit pie made with a gluten-free crust if it ever crossed my path. :-)

    1. I was eating around 50 grams of 85% for awhile…but I guess all the cocoa butter caused skin problems….15 grams of the 50 grams is saturated fat.

      Loved the taste and the mental boost. Had some bourbon flavored dark chocolate that I’d die for….so before you quit…try some of this! LOL.

  8. I’ve read that all cocoa has cadmium and sometimes lead because it is in the soil where cocoa beans grow, and that these collect in the body. Is there any way to purge heavy metals from the body?

    1. My impression about the lead is that it’s more common in West African-grown chocolate, because the practice is to sun-dry the beans by roadsides where they pick up lead from leaded gasoline.
      The cadmium may be, as someone said, from the grinding. Incidentally, both (unDutched) cocoa and chocolate are processed; for cocoa, some fat is removed, and that is added to the chocolate to make it fattier. Whether the nibs are much less processed, I’ve no idea. Details, details.

    2. ok so re the lead in chocolate there is amounts of lead in it PASCHA chocolate is the only chocolate that has been tested for lead and they keep it very low. i love MAST bros and Lindt and Theo but am now only having Pascha bc I eat a large amount daily and do have some lead concern

  9. i believe the science has well established the benefits of unprocessed cacao (see, eg, http://news.harvard.edu/gazette/story/2007/02/cocoa-shows-promise-as-next-wonder-drug/ ). still, after using for a time (this brand, which is very tasty: http://www.amazon.com/Healthworks-Certified-Organic-Cacao-Powder/dp/B00EKLPLU4/ref=sr_1_2?s=grocery&ie=UTF8&qid=1446754145&sr=1-2&keywords=cacao) , i’ve discontinued it due to my inability to find any definitive answer on the cadmium issue. it’s not clear if the toxic metal comes from the soil or grinding machinery (perhaps both), nor how much is actually to be found in particular brands. i hope someday to be able to use again, but will live without it for now.

    1. I decided to started using cocoa nibs over the powder for reasons discussed and I found I can use less and better tasting since it is 100% raw cacao.

    2. Thanks for that Cd figure. Granted that any amount of a useless element known to be toxic is likely bad (hormesis excepted?), I’d decided lead levels were not problematic till 11 grams of cocoa, while notions of a J-curve of benefit were said to peak about 6, and treating theobromine plus small nits of caffeine as caffeine-equivalent by weight gave ~4 grams as a limit…
      now your ‘superior’ 1.145ppm Cd equates to 114.5mcg Cd/100g, so with 10, 20 or 40mcg as limits (the last near a supposed ‘average’ in the SAD, the middle a limit in 2 liters of either drinking water or urine), even the lowest Cd is well over 4g cocoa, or 6g if you believe the J-curve anecdote.
      That’ll give you over 3 mmol ORAC units for either ‘raw’ or just unDutched cocoa.

  10. This article mentions that milk is an ingredient known to influence the antioxidant capacity in our blood. If milk, or perhaps dairy, clobbers antioxidant effects then perhaps I need to avoid some of my favorite food combinations such as cheddar cheese and apples, mozzarella on tomato/basil pizza, cream with strawberries, cream in coffee or cheese sauce on broccoli. What component of milk is responsible for the influence on antioxidants?

    1. Lumpy: I can sure understand why those are some of your favorite food combos! You are not alone. Sadly, dairy/milk is a known problem in a whole host of health areas, not just the one discussed here. Here are some pages on NutritionFacts which address dairy:
      http://nutritionfacts.org/topics/dairy/ (just updated a few days ago!)

      A quote from the above topic page: (see topic page for links)
      “Commercial dairy has been found to contain: industrial toxins (see also here, here, here, here, here), trans-fats, saturated fat (see also here, here), cholesterol, mercury, and hormones (see also here, here).

      Consuming commercial dairy products is may be linked to: heart disease (see also here, here), acne (see here, here, here, here, here), constipation, Parkinson’s, imbalanced hormones, canker sores, mucus, high cholesterol (see here, here), diabetes, obesity, early onset puberty, cancer, pancreatic cancer, breast cancer (see also here), sudden infant death syndrome (see here, here), autism, cataracts, Crohn’s disease, and inflammation (see also here, here).”


      My 2 cents: Rather than trying to identify a particular aspect of dairy (in the hopes that you might be able to avoid that aspect and still enjoy your cheese and cream?), I would recommend finding substitutes that appeal to you. It may take a little work, but how about trying various vegan cheeses until you find ones that you like? And/or maybe start to work to wean yourself off cheese? Just an idea for you. If you want some specific suggestions, let me know as dairy cheese is definitely the hardest dairy food to give up.

      Good luck.

  11. Chocolate isn’t palatable without some form of sweetener. Chocolate and milk were made for each other, however, I can give up the milk part, but not the sugar. Oh well, so much for that.

    1. I mix a quarter cup of erythritol with a bit of warm water and a tablespoon of honey or maple syrup then dump it on almonds that I’m toasting, let it boil down a couple minutes then toss a half cup of cocoa on and let it all sort of cling to the almonds, then dump it out to dry on a plate. if it doesn’t dry enough after a few minutes, I sprinkle on a bit more cocoa.
      It’s not half bad for those cold nights when I don’t want make the strawberry Ice with cocoa that Dr. G. recommends but still have a bit of a craving.

      1. Erythritol? Uh, no thanks. I’m not worried about table sugar. The only reason I commented was because, according to the content, chocolate should be consumed in its natural state without sugar. Then one should simply put it in capsule form and swallow it like medicine, because that’s what it ends up becoming instead of the delightful thing it can be. Its a zero sum total. I consider it a waste of chocolate to consume it without sugar or some form of cocoa butter. What’s the point? I’ll let the other foods I eat take care of my arteries if chocolate won’t do it the way I enjoy it.

    2. Nigel: I agree that no one is going to eat cocoa powder by itself by the spoonful. But there are lots of ways to sneak in some good chocolate flavor in dishes without a ton of table sugar. (If eating chocolate appeals to you. I’m not saying anyone *should* do this. I’m just saying it is possible.)

      2tsaybow gave two nice examples. Here are some more ideas: Use dates as your sweetener. Dates are incredibly sweet. I used to make a delicious chocolate (using cocoa powder) oatmeal for breakfast that was sweetened with dates and bananas. It got some rave reviews from family, friends and even people on this site. And there are a ton of recipes out there for “truffles” made out of essentially dates and cocoa and a few other things. These would be very calorie-dense, but so is chocolate. So, this would be a way to enjoy some cocoa flavor without the table sugar. While pretty sweet, dates seem to come out pretty good health-wise in the literature:

      Another idea is to use some cocoa in savory dishes. Think “mole”. Adding some cocoa powder to tomato sauces/dishes seems to work well in some situations. You could play around with this idea in some of your favorite dishes and see what happens.

      The following is copied from a post that Darryl made some time ago: “How do the Kuna Indians of Panama get all the benefits of cocoa flavonols without the saturated fats? They start with raw cocoa (that hasn’t been treated with alkali or roasted), grind and boil it with banana, then pass it through a strainer (which removes the cocoa & banana solids and most of the saturated fat). http://nutritionfacts.org/video/kuna-indian-secret/

      Just some ideas for you.

      1. Actually it can be taken in a homemade capsule form. But what’s the point? Chocolate is meant to be enjoyed, and I would consider capsule form a waste of good chocolate. I am not going to stop eating it the way I’ve always eaten it sweetened. I’m not going to obsess over the minor arterial benefits of raw cocao powder. I’m not eating animals and if that’s not good enough, oh well.

        1. Nigel: Sure, enjoy chocolate any way you want. I was giving you some yummy ideas for chocolate which involve lots of enjoyment and no capsules. And little or no table sugar. But if that doesn’t interest you, for sure, enjoy your chocolate bars. I’m not saying otherwise. I was just explaining that there are options that involve plenty of enjoyment. Hope that makes sense.

  12. This is why when I make my homemade granola I always add a few heaping tablespoons of unsweetened cocoa, so I get the benefits without the sugar/fat.

  13. If the added sugar in typical chocolate is detrimental, is it that much different to consume the healthy chocolate drink you recommend which contains sugar, albeit from dates and dark red cherries? While acknowledging that whole foods and fruits are much, much better than isolated sugar, does the pulverizing of the dates and cherries somewhat negate the benefits of these actually being whole foods that contain good amounts of fiber?

  14. Yes, but what is the actual Cause of the opening of the arteries?
    Is the cocoa doing this or the caffeine?
    Doesn’t cocoa contain natural caffeine? And doesn’t caffeine naturally open arterial capacity in a “fight or flight” kind of capacity?
    So how do we know the opening of the arteries isn’t activated by the rush of caffeine instead of another compound in cocoa?

    From a personal standpoint, I really dislike cocoa because my body has a terrible reaction to it, just like I do to coffee (black) or black and green tea (plain). And this is because my body cannot handle any amount of caffeine in my system. My system has too much unnatural adrenaline pumping through. And any additional caffeine, even from plain cocoa, is too much, and my fight or flight system goes haywire.

    So, to me, while it may seem cocoa is the the thing giving the arterial boost here, I suspect it is just an artificial dilation boost caused by the caffeine, NOT the cocoa.

    1. Midnight Luck: Caffeine does not dilate blood vessels. Caffeine actually raises blood pressure by increasing arterial stiffness and increasing peripheral vascular resistance. The exact mechanisms for the improved vascular function after consuming cocoa are not completely clear. Thus far, the research is pointing to antioxidants, flavonols and nitric oxide as being responsible for the cardiovascular benefits of cocoa.

  15. Hi Doctor Michael.

    It’s a good article. I have a question, maybe you can help me.

    When you refer the “sugar” you mean all sugar, natural sugar (the one that you can find in fruits) or refined sugar? Is all the same effect about cocoa?

    Kind regards.

    1. Hi Anyah- Thanks for reposting your question. Sadly, yes, cocoa powder is high in oxalates so could inhibit calcium absorption (and increase the risk of oxalate kidney stones in those who are prone to them). That said, I wouldn’t recommend stopping chocolate intake (that’s just too sad to contemplate!)–just eat your calcium-rich foods at another time.

  16. yes there is oxalates in chocolate unless you are eating large amounts of it an ounce here and there is fine a very low oxalate diet should be observed if you have kidney stones though

  17. Question: How dark is dark? Like, what’s the minimum cocoa percentage at which we start to see benefits? I personally eat 80%+, though it seems the most popular on the market are 60-70.

    1. Dear Seth,

      the more, the better. It also depend on what’s the remaining 20%…

      Health Support Adam P.

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