The Medical Minute: Chocolate for your heart?

By John Messmer, M.D.
Penn State Milton S. Hershey Medical Center

Chances are you have plenty of chocolate treats left over from Halloween. The good news is that you can go ahead and indulge a little, since medical studies have shown that eating chocolate might actually lower your risk of heart disease and cancer. Hard to believe, right?

Chocolate is made from cocoa beans, which are technically a fruit, from the cacao tree. Many fruits and plant products contain flavonoids; a group of diverse chemicals that help plants repair injury and inhibit bacterial growth. Flavonoids are found in strawberries, blueberries, cranberries, tea, red wine, peanuts, apples, onions, nuts, red pepper, celery, tomatoes and citrus fruits in different amounts.

In chocolate, flavonoids are found in highest quantities in cocoa powder and dark chocolate. A little more than an ounce of dark chocolate has about the flavonoid content of a cup of tea or a glass of wine. Cocoa powder has about twice as much.

In humans, flavonoids have shown diverse effects. You may know that aspirin is recommended to reduce the risk of heart attack in susceptible people. Aspirin inhibits platelets from sticking together to form a blood clot, which can block an artery in the heart and cause a heart attack. Flavonoids in chocolate do a better job of blocking this platelet effect than aspirin and do not cause ulcers as aspirin might. Also, flavonoids help arteries stay dilated to reduce blood pressure and maintain blood flow.

Some of these flavonoids also work as antioxidants -- the chemicals that neutralize free radicals, the by-products of bodily processes that can contribute to heart disease, cancer and the aging process. Some types of flavonoids have been shown to reduce the oxidation of the so-called “bad” or LDL cholesterol. This should limit the tendency of LDL cholesterol to stick to and clog artery walls.

Speaking of cholesterol, you might wonder if the fat in chocolate would counter the beneficial effects by raising cholesterol. Actually, the kind of fat in chocolate, stearic and linoleic acids, tends to have a neutral effect on LDL cholesterol and can improve HDL or “good” cholesterol.

So what’s the downside? So far this sounds too good to be true. The benefits only come from regular chocolate -- white chocolate has no cocoa in it so it does not have this benefit. Most chocolate consumed in America has less cocoa than in Europe and other parts of the world so the benefit is not as great. Solid chocolate has more benefit than filled candies, which may have little or none.

Chocolate does have calories however -- from fat and sugar. Even though the fat does not raise the LDL cholesterol directly, it can contribute to weight gain, which can influence total cholesterol and can lead to diabetes. Four ounces of chocolate typically has 220 calories. A similar amount of fruit may have less than 100 calories. Plus fruit has fiber, vitamins and other nutrients not found in chocolate.

Nonetheless, chocolate need not be considered a completely guilty pleasure. The bottom line is that if you eat a balanced diet, exercise and maintain a normal weight, you can enjoy chocolate treats in moderation.