It seems like chocolate is everywhere. But if you think that chocolate is a decadent, forbidden food, then think again. Chocolate has a rich history, and from a medical perspective, there is a lot to love about chocolate. In addition to learning about the health benefits associated with moderate consumption of chocolate, you will also learn about some different types of chocolate and the importance of the country of origin of the cocoa beans you purchase.

Chocolate has a long and distinguished history. Indigenous to Central America and Mexico, chocolate is made from the seeds of the Theobroma cacao tree. The ancient Mayan people used ground beans of the cocoa tree as far back as 2600 years ago to make xocolatl, a spicy beverage. Cocoa beans were often used as currency. Pre-Columbian civilizations such as the Maya and Aztec reserved the use of cocoa beans to only the highest noblemen and clerics. Both Columbus and Cortes are credited with sending cacao beans back to Spain but, due to the bitter taste of chocolate, it took some time until the Spanish found a way to improve the flavor and texture of chocolate. As with other imported products, chocolate beverages were enjoyed mostly by the wealthy. Solid chocolate in the form of bars were developed in the early to mid 1800’s in Europe.

Approximately 2/3 of the world’s chocolate is produced in West Africa, and almost half of the crops in Africa are grown in the Ivory Coast. The remaining cacao crops are grown in Latin America and Southeast Asia. It has been estimated that 90% of cocoa farms in Côte d'Ivoire have used some form of slave labor in order to remain viable. What this means is that by purchasing chocolate products that originate in the Ivory Coast, we are potentially supporting the practice of child slavery and trafficking. While most of us may not think about this when we grab our favorite chocolate bar, we can make a difference by purchasing products that contain fairly traded cocoa. There are a lot of great manufacturers that use only ethically traded cocoa, such as Endangered Species, Dagoba, Equal Exchange, and Newman’s Own.

Chocolate is much more than a delicious confection. There is substantial research published in the medical literature supporting a number of health benefits associated with moderate consumption of dark chocolate. Chocolate has beneficial effects on blood pressure and endothelial function. Its antioxidant properties exceed those of other antioxidant rich foods. Flavanol-rich cocoa has been found to increase cerebral blood flow to gray matter and may possibly play a role in the treatment of vascular impairments such as dementia and strokes. Chocolate may significantly inhibit atherosclerosis: it lowers cholesterol, LDL (bad cholesterol), and triglycerides, while raising HDL (good cholesterol). Chocolate seems to protect lower density lipoproteins from oxidation, further benefiting heart health. Chocolate not only may help lower blood pressure, but it improves insulin sensitivity in healthy persons. The significance of this in individuals with diabetes has not been well researched. Although it looks good from a cardiovascular perspective, chocolate’s role in long-term cardiovascular health has yet to be determined. Chocolate, with its theobromine content, can function as an effective cough suppressant. In a study exploring maternal chocolate consumption during pregnancy, mothers who consumed chocolate on a daily basis rated the temperament of their infants at 6 months more positively than those who consumed much less. And just when you thought that the news on chocolate couldn’t possibly get any sweeter, here’s one more morsel: when it comes to dental health, eating dark chocolate may result in a reduction in the risk for dental caries and periodontal disease.

There are three main varieties of cacao, each with their own distinct flavors: Criollo, Forastero, and Trinitario. Also influencing flavor is the amount of cocoa used and other ingredients such as vanilla, milk, sugar, etc. As the percent of cocoa used goes up, the amount of sugar is reduced, producing a less sweet flavor since cocoa itself is bitter. When it comes to chocolate bars, my personal favorite is Endangered Species Supreme Dark Chocolate, with a cocoa content of 72%. Portland is home to Alma Chocolates; a small company that makes beautiful, hand-crafted confections using only fair-traded cocoa and other fresh, organic ingredients.

The bottom line on chocolate seems to be that good quality, dark chocolate can offer a number of benefits to your health when consumed in moderate quantities. With its high calorie content, however, if you decide to include moderate amounts in your diet, consider either cutting out some calories elsewhere or increasing your level (or frequency) of physical activity. If you haven’t already done so, explore the wide range of flavors by purchasing chocolates produced by different makers and with varying amounts of cocoa. And the next time you take a bite, remember that chocolate is much more than a tasty treat. Feel free to email me if you would like a list of references.

By Marcela Vinocur, MD of Portland Health and Wellness

About Marcela Vinocur, MD: Dr. Vinocur is a graduate of Indiana University School of Medicine. She completed her residency in psychiatry at Oregon Health Sciences University in 1993. She has worked in both the public and private sectors and has had a long-standing interest in women’s health. Her professional interests include treatment of obesity, affective disorders, nutrition, preventive medicine, cross-cultural psychiatry, and developmental disabilities. Dr. Vinocur is an experienced psychopharmacologist. She is particularly interested in diabetes prevention and the relationship between chronic illness and mood disorders. Along with a psychotherapist and 3 nutritionists, she has developed an evidence-based weight reduction program for women who suffer from weight-related health problems or are at risk of developing such problems.

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