Cocoa is a natural source of flavonoids and other bioactive compounds. Its potential benefits on our health have been hidden by the presence of chocolate, leading to confusion beween cocoa and chocolate. Within the flavonoids contained in cocoa we encounter flavanols, associated with a variety of health benefits. So can cocoa improve our health?
During this review we'll go through the main evidence of cocoa flavanols and the different benefits can provide us.
Cocoa is Not Chocolate
First of all is necessary to finish with this discussion. When we talk about cocoa we are not referring to chocolate or any derived compound.
"I'm eating a double choco cookie, but I've read chocolate is good for you"
"Let's have a brownie to get our daily intake of cocoa flavonols"
Cocoa is in chocolate, for sure, but it's not the only component. If we look at the label of a random chocolate we'll find:
As you can see, chocolate is not even in the first place on the ingredient. In food labels, the higher the ingredient is on the list the higher the content on the product. That means that sugar is in higher contents that cocoa. And for every 2oz (57g) we'll have 19g added sugars, which is the same as 33g per 100g of product.
Now we have the food label of just cocoa powder. No added sugars. Calories are similar, but while 50g of chocolate are considerably easy to intake, 50g of cocoa powder are impossible to intake at once.
When we talk about cocoa and the benefits associated to it we are not referring to chocolate or any derived products. Cocoa, and more in specific the bioactive compounds in it are responsible of all the benefits associated. Chocolate contains cocoa, but the amount are insiginificant compared with cocoa powder. And the potential benefits will be masked by the high content in sugars and other ingredients.
What are Cocoa Flavanols?
Flavonoids are polyphenolic compounds found naturally in different plants sources. They show antioxidant functions, fighting free radicals in our metabolism and improving our cel'sl activity (study)
Flavanols are a subclass of flavonoids, showing a small structural variation that changes their properties and metabolic actions. In cocoa, the main flavanols are catechin, epicatechin and procyanidins (study). Catechin and epicatechin are the most abundant cocoa flavanols, and are responsible for most of the health benefits associated to cocoa.
In the table below you can see the content of polyphenols in different sources of cocoa (study). Cocoa is one of the natural dietary sources with the highest content on polyphenolic compounds. A lot of research has been done to investigate the potential benefits of cocoa flavanols.
Before getting deeper into the health benefits of cocoa flavonols, let's go through the main flavanols: catechin, epicatechin and procyanidins.
Catequin are polyphenolic compounds found in plant sources. They protect the plant from environmental toxins and have been shown to exert a potential antioxidant effect (study). In this subclass of compounds we have different metabolites such as EGCG (tea), epicatechin (apricots), or epigallocatechin (red algae) (study).
Products with high content in catechins has been found to be antioxidative, antihypertensive, anti-inflammatory, antiproliferative, antithrombogenic, and anti-hyperlipidemic (study). However, catechins are not the only compounds in these products, and some of the benefts may be associated to different compounds.
This flavanol is an isomer derived from catechin, showing a similar structure but with a slight variation in the 3-D distribution and location of functional groups (study).
This compounds has been well studied with respect to improved cardiovacular events and blood lipid profile (study). In addition to that, it could also provide neuroprotective effects (study) and prevent metabolic disorders (study)
Procyanidins are the major compounds responsible of the bitterness of cocoa. They are captured by salvary proteins forming a complex and exerting that bitter taste (study).
Procyanidins are oligomeric compounds formed by catequin and epicatequin. They have shown to be antioxidants, dealing with free radicals in our organism (study). It has also been shown to serve as prebiotic to improve composition and metabolic activity of the gut microbiota (study)
Health Benefits of Cocoa Flavanols
Now that we have a brief idea of what we talk about when we are referring to cocoa flavanols, we'll dive into the evidence supporting different outcomes related with overall health and specific functions.
Cocoa Flavanols show a potent antioxidant function (study). Not only that, but they also seem to have antiinflamatory effects, both through direct and indirect relationship with our metabolism (study).
Low chronic inflammation is of high interest because of its relation with increased risk of cardiovascular disease, aging and other metabolic disorders (study). Mechanisms involved in chronic inflammation are production of interleukins, NFK-B, TNF-α and pathways such as NO metabolism. To avoid and improve inflammation status, substances improving this causes may be of relevance.
And here is where we have the cocoa flavonols. Studies in vitro have found an association of these molecules with an inhibition of producing-eicosainoides enzymes. More in specific, flavanols could downregulate the action of COX1, enzyme catalyzing the production of prostaglandines and thromboxanes (study)
Procyanidin plays a role in platelete aggregation and accumulation (study), modulating platelet activation and function. In this study, subjects that followed an intake of a high-cocoa beverage showed a reduction in platelet function and activation (study).
A lof of this studies have been done in vitro or using animal models. The results are promising and seem to have strong findings and correlations, but we'll have to wait for further studies to potentiate this claim.
Cocoa Flavanols reduce the risk of cardiovascular events
Near 500 million persons per year suffered from cardiovascular events in 2019 (source). Substances improving cardiovasular markers are of high interest. And again, here we have our friends cocoa flavanols. While evidence around antiinflammatory effects is still premature, we have a sh*t ton of systematic reviews and strong evidence supporting the benefits of cocoa flavanols on cardiovascular events.
Cocoa flavanols reduce the risk of cardiovascular disease is by improving blood lipid profile, endothelial dysfunction, blood pressure, and vascular stiffness (study). Therefore, cocoa flavanols have been shown to reduce risk of stroke, myocardial infraction and other cardiovascular events (study)(study)(study)
We have enough evidence to suggest that intake of cocoa (not chocolate) benefits and lowers the risk of suffering from cardiovascular events.
Effects of cocoa flavanols on cognitive performance
[If you are a student or you just simply want to improve your cognitive capabilities, this is of your interest]
The first study investigating effects of cocoa in cognitive function was in 2010 (study). They showed that acute intake of cocoa led to improved working memory and lower mental fatigue. From there, some other studies have back up this claim.
The mechanisms suggest an interaction between cocoa flavanols and metabolites present in brain cells such as brain derived neutrophic factor (BDNF), nerve growth factor (NGF) or other mechanisms involving prefrontal cerebral flow (study)
The main problem here is the heterogeneity in the methodology of the studies. We have a lot of references about supplementation of cocoa flavanols, doses, resulting markers, duration,... making it confusing to get strong conclusions.
But results are there, and numbers are numbers. To date, cocoa flavanols have potential benefits to improve our working memory, reduce mental fatigue and enhance our overall cognitive performance.
Cocoa Flavanols improve Obesity and Metabolic disorders
Obesity is of high prevalence on modern societies. Researches have investigated cocoa flavanols to see its potential mechanisms and attribution to improve metabolic markers and risk of obesity.
First of all, let me tell you that the results positively associating reduced body weight with cocoa intake are masked by a possible hypocaloric diet. Without caloric deficit, weight loss is technically impossible, and no substances (in principle) can promote weight loss without an hypocaloric diet. This being said, let's have a look at what science has to offer us.
The main benefit of cocoa flavanols in relation of risk of obesity points towards higher satiety and less appetites. Studies found a loss in appetite, decreased ghrelin and increased leptin when compared to control groups (study)(study). Also, cocoa intake improves blood pressure (as we saw before) and improves blood lipid profile, markers associated with obesity as well.
The antiinflammatory actions of cocoa flavanols could also benefit metabolic diseases such as type 2 diabetes mellitus. Markers associated with this diseases such as HOMA-IR are lowered by the acute intake of cocoa, suggesting an improved insulin resistance (study). The antioxidant properties of cocoa flavanols could also improved the overall status and lower the risk of metabolic disorders.
- The main cocoa flavanols are catechin, epicatechin and procyanidins
- Cocoa flavanols could improve cardiovascular healhth by lowering blood pressure and improving lipid blood profile, vascular stiffnedd and endothelial function
- Evidence suggesting improved cognitive performance is scarce but promising.
- The antiinflamatory and antioxidant actions of cocoa flavanols are of high interest to improve our health
Other Health Benefits of Cocoa Flavanols
Cocoa flavanols improve gut microbiota composition
Gut microbiota, as you already know (read HERE about it), plays important roles on our metabolism and health. Novel mechanisms have associated cocoa flavanols and polyphenols as modulators of the microbiota (study).
Cocoa flavanols have low bioavailabaility and intestinal absorption (study). Only 1-2% is absorbed in its natural form, while microbial interaction and secondary metabolites make up the rest. Due to the low absorption rate, they reach the colon, in where we find a high density of fermentative bacteria willing to take those nutrients and synthesize other metabolites (SCFAs, for example)
Cocoa flavanols modulate the gut microbiota composition and richness by favouring microbial growth of benefitial microorganisms such as Lactobacillus or Bifidobacterium and inhibiting microbial growth of pathogens such as Clostridium Perifrengis (study). In clinical studies, intake of dark chocolate could have a prebiotic effect (study)
Modulates the inmune system
The inmune system is such a complex system with a lot of organs, molecules and structures are involved. Evidence relating intake of cocoa flavanols on the inmune system are scarce, but the research done so far (mainly in vitro and in animals) proves the impact of these compounds on the inmune system.
Cocoa flavanols could modulate and improve the function of lymphoid tissues, in charge of differentiation and proliferation of inmune cells (study). They could also have an impact on the adaptive inmune response, modulating T cells and improving the inmune response (study).
Mechanisms behind this actions are still unknown to date, and we will need more evidence and studies in human to certainly say that cocoa flavanols benefit our inmune system.
Cocoa Flavanols and Sport
Now it's time to geet into our 'sweet spot'. This is TBS, and we care about your sports performance. Can cocoa improve your performance? Let's have a look at the evidence known to date.
Overall benefits of cocoa flavanols on performance
The best evidence found was a meta-analysis performed in 2018 investigating all the evidence relating cocoa intake and sports performance (meta-analysis). The authors found that cocoa flavanols intake downregulates blood pressure and improves cardiovascular parameters (study).
The effect of cocoa flavanols on carbohydrate and fat metabolism was also investigated. In this study, 3 months intake of cocoa lead to an increase in available glucose and decrease in glucagon. However, the effect was small (study). This could suggest a higher efficiency when using carbohydrates for physical activity. Not only that, but free fatty acid mobilization was improved in this other study (study).
Lastly, cocoa flavanols don't seem to impact and improve sports performance directly. Out of all the studies known to date, tha majority shows non-consistent neutral effects or a small benefit possibly due to the methodology used or some random effect (meta-analysis)
Researcher have investigated cocoa flavanols related to improved muscle recovery due to their antiinflamatory and antioxidant effects. In this narrative review, they found a possitive effect on attenuating exercise-induced oxidative stress and inflammation after acute exercise (study).
But not everything is 'pink' here, and muscle soreness was not improved by cocoa intake. Sequently, muscular function did not change within groups either.
Cocoa flavanols could solely improve our sports performance by enhancing muscle recovery and attenuating excess oxidative stress.
- Cocoa flavanols can serve as prebiotics
- Inmune systems seems to be potentiated by cocoa flavanols
- Cocoa flavanols don't improve directly sports performance
- Muscle recovery after exercise is enhanced by the intake of cocoa flavanols
Cocoa flavanols, more in specific catechin, epicatechin and procyanidin, have been associated with a variety of different health benefits. Among these, we can say that there's enough evidence behind improved cardiovascular parameters, antiinflammatory and antioxidant effects and possibly metabolic disorders and cognitive performance.
When we looked at sports performance, cocoa flavanols seem to effectively improve muscle recovery, but no improvements in sports performance directly were found.
Dose and uses of cocoa flavanols are still uncertain. Cocoa flavanols are a novel and potent compound to use in the future to improve our health. But to date, there are some other supplements in the market with lower prices, more effectiveness and more evidence behind
If you still have doubts about any aspect, leave it down on the comments section.