February 2016 Issue

Ask the Expert: Chocolate's Health Benefits
By Toby Amidor, MS, RD, CDN
Today's Dietitian
Vol. 18 No. 2 P. 10

Q: My clients have been asking me about the health benefits of chocolate. What are some of the differences among milk, dark, and white chocolate?

A: Chocolate is derived from the fruit pods of the cacao tree. After the beans are removed from their pods, they're fermented, dried, roasted, and cracked; this separates the beans from the shells to form what is called a nib. The nibs are ground to extract some of the cocoa butter, which results in a thick, dark brown paste called chocolate liquor (a combination of cocoa solids and cocoa butter). Cocoa butter is the natural fat found in the cacao bean and provides chocolate with its creamy mouth feel. If the cocoa butter is removed, the pure cocoa solids can be ground into cocoa powder.

Different combinations of chocolate liquor, cocoa solids, milk, sugar, and cocoa butter create different varieties of chocolate. Milk chocolate contains at least 10% chocolate liquor and 12% whole milk, while bittersweet chocolate (characterized as dark chocolate) contains at least 35% liquor. Food manufacturers add varying amounts of cocoa butter and sugar to create the flavor they want. White chocolate lacks cocoa solids and cocoa powder, so technically it isn't chocolate. It's made using a combination of sugar, cocoa butter, milk, and soy lecithin.

One ounce of dark chocolate that contains 60% to 69% of pure cocoa provides 162 kcal, 11 g total fat, 6 g saturated fat, 15 g carbohydrates, and 2 g protein. It contains 19% DV of manganese, 17% DV of copper, 12% DV of magnesium, 10% DV of iron, and lesser amounts of phosphorus, potassium, zinc, selenium, and calcium. Dark chocolate also contains fewer amounts of vitamins, including vitamins K, B12, thiamin, riboflavin, niacin, and pantothenic acid. Finally, the cocoa bean also is a rich source of the antioxidant theobromine, which helps reduce inflammation and may help lower blood pressure. Because dark chocolate contains more cocoa, it has higher amounts of the aforementioned nutrients.

Health Advantages
Studies have found numerous health benefits in chocolate consumption. A 2015 study published in the journal Heart reviewed food frequency questionnaires of 20,951 men and women. The researchers found that habitual chocolate consumers had a lower risk of coronary heart disease and stroke compared with subjects who didn't eat chocolate.1 A 2015 study published in The American Journal of Clinical Nutrition examined cognitive function in older adults in the Cocoa, Cognition, and Aging (CoCoA) Study. The double-blind, controlled study randomly assigned 90 elderly subjects to consume for eight weeks either a high-, intermediate-, or low-cocoa flavanol drink. Those who consumed the high- and intermediate-flavanol drink showed significant improvements in cognitive function compared with those who consumed the low-flavanol drink.2 The authors suggested that cocoa flavanols may reduce some measure of age-related cognitive dysfunction with habitual intake. A 2005 study published in the journal Hypertension looked at subjects who were randomly assigned to consume flavanol-rich dark chocolate (100 g/day) or flavanol-free white chocolate (100 g/day) over a 15-day period. The results found that the flavanols in dark chocolate increased nitric oxide, which improved insulin sensitivity and blood flow and lowered blood pressure.3

Client Recommendation
Although chocolate, especially dark, contains a plethora of nutrients, it's high in calories. If clients want to include chocolate in their diet, they should choose at least 60% to 70% dark chocolate and consume 1 oz maximum per day to help keep calories and saturated fat in check.

— Toby Amidor, MS, RD, CDN, is the founder of Toby Amidor Nutrition (http://tobyamidornutrition.com) and the author of the cookbook The Greek Yogurt Kitchen: More Than 130 Delicious, Healthy Recipes for Every Meal of the Day. She's also a nutrition expert for FoodNetwork.com and a contributor to US News Eat + Run, Shape.com, and MensFitness.com.

References
1. Kwok CS, Boekholdt SM, Lentjes MA, et al. Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women. Heart. 2015;101(16):1279-1287.

2. Mastroiacovo D, Kwik-Uribe C, Grassi D, et al. Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study—a randomized controlled trial. Am J Clin Nutr. 2015;101(3):538-548.

3. Grassi D, Necozione S, Lippi C, et al. Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensives. Hypertension. 2005;46(2):398-405.
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