Cocoa: A Surprising Superfood

Amazing but true: Eating chocolate could actually save your life, by dramatically reducing risk for heart attacks and stroke, new research shows. Dark chocolate and cocoa powder actually contain more disease-fighting antioxidants than do blueberries, cranberries, acai, and other “superfruits,” according to a peer-reviewed study published in Chemistry Central Journal.

People who eat the most chocolate are 37 percent less likely to develop cardiovascular disease (CVD)—the leading killer of Americans—and 29 percent less likely to suffer a stroke, compared to those who eat the least, according to an analysis of seven earlier studies involving 114,009 participants. One of the most surprising findings was that indulging in the sweet treat also trims diabetes risk by 31 percent, an international team of researchers reported in British Medical Journal.

Used as currency by ancient Aztecs and dubbed “food of the gods” by 18th century naturalist Carl Linneaus, the beans of the tropical cacao tree contain powerful disease-fighting compounds called flavonols--antioxidants also found in tea, wine, fruits and vegetables. To find out about cocoa’s cardiometabolic benefits, I talked to Amy Doneen, MSN, ARNP, medical director of the Heart Attack and Stroke Prevention Center in Spokane, Washington.

Learn which foods help to improve heart health.

Why does cocoa fight heart attacks and diabetes?

A new analysis of 42 earlier randomized clinical trials of chocolate, cocoa and flavan-3-ol (a heart-healthy flavonol in cocoa) found “previously unreported promising effects” on insulin resistance (IR), a condition that greatly magnifies the risk of type 2 diabetes. “Research also shows that insulin resistance is also root cause of 70 percent of heart attacks,” reports Doneen.

Here’s how IR happens: Insulin, a hormone produced by the pancreas, acts as a key to unlock cells, allowing glucose to enter and be converted into energy. Obesity, particularly in the belly, plus genetic factors, often causes the body to become insensitive to insulin, forcing beta cells in the pancreas to go into overdrive, pumping out more and more insulin to keep up with demand. If IRs goes untreated, eventually the beta cells break down, like a burnt-out motor. Blood sugar starts to climb, leading to type 2 diabetes.

Watch out for these heart attack warning signs. 

How does insulin resistance cause heart attacks?

The chemical changes triggered by IR attack blood vessels in a variety of stealthy ways, explains Doneen. “Injuries to vessel walls make it easier to LDL cholesterol to burrow inside and clump into plaque deposits. HDL (good) cholesterol becomes less effective at cleaning blood vessels.”

Over time, blood vessels grow stiffer, contributing to high blood pressure and wear and tear on artery linings. “Plaque deposits become increasingly inflamed, making them likely to rupture,” adds Doneen. “Blood gets stickier and more likely to clot, all of which sets the stage for a heart attack.”

How does cocoa combat stroke?

The analysis, conducted by researchers from Harvard and other centers, also found that chocolate, cocoa, and flavan-3-ol reduce major CVD risk factors, by increasing blood flow through vessels, improving cholesterol, and reducing blood pressure.

“Since high blood pressure is the number 1 cause of stroke, the blood-pressure reductions seen in this and several other major studies are the most likely reason why dark chocolate has been linked significantly lower rates of stroke in randomized clinical trials,” says Doneen. Studies typically show a small, but significant, drop in both systolic and diastolic pressure in people who ate the most chocolate and cocoa.

Isn’t pigging out on chocolate unhealthy?

Although three major randomized studies all found that people who ate the most chocolate achieved the greatest heart health benefits, here’s the disappointing news for chocoholics: On average, those study participants consumed less than two ounces of chocolate a week.

Yet even that tiny amount can have a surprisingly big impact: A 2010 study published in European Heart Journal reports that people who ate an average of 7.5 grams of chocolate a day were 27 percent less likely to have heart attacks and 48 percent less likely to suffer strokes than those who ate less than one gram per day, even after risk factors like smoking, obesity and lack of exercise were taken into account. The researchers tracked 19,357 people ages 35 to 65 for about eight years.

What’s the best “dose” of chocolate for heart health?

Based on this scientific evidence, says Doneen, “One little square of dark chocolate a day is all you need—and the darker, the better. Ten grams (one-third of an ounce) has about 50 calories, so it won’t make you fat, but it does your heart good.”

Here are some chocolate do’s and don’ts:

  • Choose dark chocolate that is at least 70 percent cocoa.
  • Don’t bother with milk chocolate or white chocolate for health benefits--they don’t give you the flavanols you need.
  • Don’t depend on cocoa for flavanols--most products are too processed to provide any. Your best bet is cocoa that hasn’t undergone “Dutch processing,” which treats cocoa with an alkali to neutralize its acidity.

Find out why having a sweet tooth makes you a sweeter person.

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