Cocoa Extract

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    Peter Woznik

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    Giulia Guerrini, Molly Gregas
    Last Updated: April 24, 2025

    Cocoa, a powder that is rich in polyphenols, is used to make chocolate. Cocoa products can have effects like lowering blood pressure and inflammation and have resulted in small improvements to some outcomes in cardiovascular disease.

    Overview

    Dosage information

    Formulation:

    Cocoa is a powder that can be consumed in drinks, for example, or made into chocolate.[1]

    The flavanol content in cocoa varies based on the variety and ripeness of the cocoa beans and the processing steps applied. Dark chocolate contains larger amounts of cocoa (more than 50%) than milk chocolate (20%–30%).[1]

    Range of dosages studied:

    Dosages of 1 to 105 grams per day of cocoa or cocoa products (e.g., chocolate) have been studied.[1][2][3][4][5]

    Effective Dosages:

    All-cause mortality: Adults: 2 grams per day of dark chocolate reduced the risk of all-cause mortality the most, with no benefit beyond 5 grams per day.[3] A square of chocolate, a chocolate snack bar, and a bar of chocolate can weigh 10 grams, 50 grams, and 100 grams, respectively (with much variability);[6][3][7] therefore, eating one 10-gram square of dark chocolate approximately 1 to 3 times per week may benefit all-cause mortality.

    Cardiovascular disease: Adults: A variety of dosages of cocoa (70% or higher) or dark chocolate may benefit some outcomes in cardiovascular disease[2][5][8][1] and are associated with benefits in type 2 diabetes, heart attack, stroke, and congestive heart failure, but not atrial fibrillation,[9][10][11][12][13][14][15]; daily doses of approximately 2 to 10 grams of dark chocolate were associated with larger improvements in some meta-analyses.[3][16][6] A square of chocolate, a chocolate snack bar, and a bar of chocolate can weigh 10 grams, 50 grams, and 100 grams, respectively;[6][3][7] therefore, eating one 10-gram square of chocolate approximately 1 to 7 times per week, or every other day, may provide a benefit.

    Hypertension: Adults: Moderate dosages of dark chocolate (e.g., 70% or higher) or cocoa (e.g., 2 to 20 grams per day [17] have improved hypertension-related outcomes (e.g., flow-mediated dilation) more than higher or lower dosages in some meta-analyses.[4][18][4] However, another meta-analysis has shown the same effects with higher and lower dosages.[19] A square of chocolate, a chocolate snack bar, and a bar of chocolate can weigh 10 grams, 50 grams, and 100 grams, respectively;[6][3][7] therefore, eating two 10-gram squares of chocolate approximately 1 to 7 times per week, or every other day, may provide a benefit.

    Other Considerations:

    Pregnancy: Some evidence shows that polyphenol consumption that exceeds 125 mg per day might inhibit inflammatory factors and potentially contribute to a fetal heart complication (ductus arteriosis constriction).[20][21][22] Cocoa is a source of polyphenols, but the density of polyphenols varies. In one study, 10 grams (0.35 oz; 1 square in some chocolate bars) of 99% dark chocolate contained 65 mg of polyphenols,[23], but in another study, 10 grams of 83% dark chocolate contained 180 mg of polyphenols.[24] Therefore, consumption of cocoa in pregnancy is cautioned.

    Polyphenol/flavanol content: The evidence is mixed, but there is overall stronger support for a higher[2][25][26][27] or moderate[28][17][4][18] dosage of polyphenols (of which flavanols are the primary polyphenol) for improved cardiovascular outcomes, compared to a lower[19][29] dosage of polyphenols. Although polyphenol content is very rarely advertised in commercial chocolate or cocoa, higher-percentage dark chocolate and more minimally processed cocoa/dark chocolate tend to have higher concentrations of polyphenols.[1]

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    Frequently asked questions

    Update History

    Research Breakdown

    Examine Database References

    1. High-density lipoprotein (HDL) - Tokede OA, Gaziano JM, Djoussé LEffects of cocoa products/dark chocolate on serum lipids: a meta-analysisEur J Clin Nutr.(2011 Aug)
    2. High-density lipoprotein (HDL) - Fraga CG, Actis-Goretta L, Ottaviani JI, Carrasquedo F, Lotito SB, Lazarus S, Schmitz HH, Keen CLRegular consumption of a flavanol-rich chocolate can improve oxidant stress in young soccer playersClin Dev Immunol.(2005 Mar)
    3. High-density lipoprotein (HDL) - Davison K, Coates AM, Buckley JD, Howe PREffect of cocoa flavanols and exercise on cardiometabolic risk factors in overweight and obese subjectsInt J Obes (Lond).(2008 Aug)
    4. High-density lipoprotein (HDL) - Grassi D, Lippi C, Necozione S, Desideri G, Ferri CShort-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy personsAm J Clin Nutr.(2005 Mar)
    5. High-density lipoprotein (HDL) - Muniyappa R, Hall G, Kolodziej TL, Karne RJ, Crandon SK, Quon MJCocoa consumption for 2 wk enhances insulin-mediated vasodilatation without improving blood pressure or insulin resistance in essential hypertensionAm J Clin Nutr.(2008 Dec)
    6. High-density lipoprotein (HDL) - Grassi D, Desideri G, Necozione S, Lippi C, Casale R, Properzi G, Blumberg JB, Ferri CBlood pressure is reduced and insulin sensitivity increased in glucose-intolerant, hypertensive subjects after 15 days of consuming high-polyphenol dark chocolateJ Nutr.(2008 Sep)
    7. Blood glucose - Almoosawi S, Fyfe L, Ho C, Al-Dujaili EThe effect of polyphenol-rich dark chocolate on fasting capillary whole blood glucose, total cholesterol, blood pressure and glucocorticoids in healthy overweight and obese subjectsBr J Nutr.(2010 Mar)
    8. Blood glucose - Grassi D, Desideri G, Necozione S, Ruggieri F, Blumberg JB, Stornello M, Ferri CProtective effects of flavanol-rich dark chocolate on endothelial function and wave reflection during acute hyperglycemiaHypertension.(2012 Sep)
    9. Blood Lactate (Exercise) - Glen Davison, Robin Callister, Gary Williamson, Karen A Cooper, Michael GleesonThe effect of acute pre-exercise dark chocolate consumption on plasma antioxidant status, oxidative stress and immunoendocrine responses to prolonged exerciseEur J Nutr.(2012 Feb)
    10. Triglycerides - Tzounis X, Rodriguez-Mateos A, Vulevic J, Gibson GR, Kwik-Uribe C, Spencer JPPrebiotic evaluation of cocoa-derived flavanols in healthy humans by using a randomized, controlled, double-blind, crossover intervention studyAm J Clin Nutr.(2011 Jan)
    11. Blood Pressure - Ottaviani JI, Balz M, Kimball J, Ensunsa JL, Fong R, Momma TY, Kwik-Uribe C, Schroeter H, Keen CLSafety and efficacy of cocoa flavanol intake in healthy adults: a randomized, controlled, double-masked trialAm J Clin Nutr.(2015 Dec)
    12. Fat Oxidation - Allgrove J, Farrell E, Gleeson M, Williamson G, Cooper KRegular dark chocolate consumption's reduction of oxidative stress and increase of free-fatty-acid mobilization in response to prolonged cyclingInt J Sport Nutr Exerc Metab.(2011 Apr)
    13. Oxidative Stress Biomarkers - Carnevale R, Loffredo L, Pignatelli P, Nocella C, Bartimoccia S, Di Santo S, Martino F, Catasca E, Perri L, Violi FDark chocolate inhibits platelet isoprostanes via NOX2 down-regulation in smokersJ Thromb Haemost.(2012 Jan)
    14. Oxidative Stress Biomarkers - Zhu QY, Schramm DD, Gross HB, Holt RR, Kim SH, Yamaguchi T, Kwik-Uribe CL, Keen CLInfluence of cocoa flavanols and procyanidins on free radical-induced human erythrocyte hemolysisClin Dev Immunol.(2005 Mar)
    15. HbA1c - Balzer J, Rassaf T, Heiss C, Kleinbongard P, Lauer T, Merx M, Heussen N, Gross HB, Keen CL, Schroeter H, Kelm MSustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trialJ Am Coll Cardiol.(2008 Jun 3)
    16. Mitochondrial Protection - Pam R Taub, Israel Ramirez-Sanchez, Theodore P Ciaraldi, Guy Perkins, Anne N Murphy, Robert Naviaux, Michael Hogan, Alan S Maisel, Robert R Henry, Guillermo Ceballos, Francisco VillarrealAlterations in skeletal muscle indicators of mitochondrial structure and biogenesis in patients with type 2 diabetes and heart failure: effects of epicatechin rich cocoaClin Transl Sci.(2012 Feb)
    17. Blood Flow - Heinrich U, Neukam K, Tronnier H, Sies H, Stahl WLong-term ingestion of high flavanol cocoa provides photoprotection against UV-induced erythema and improves skin condition in womenJ Nutr.(2006 Jun)
    18. Skin Dryness - Mogollon JA, Boivin C, Lemieux S, Blanchet C, Claveau J, Dodin SChocolate flavanols and skin photoprotection: a parallel, double-blind, randomized clinical trialNutr J.(2014 Jun 27)
    19. Skin Dryness - Yoon HS, Kim JR, Park GY, Kim JE, Lee DH, Lee KW, Chung JHCocoa Flavanol Supplementation Influences Skin Conditions of Photo-Aged Women: A 24-Week Double-Blind, Randomized, Controlled TrialJ Nutr.(2016 Jan)
    20. Peripheral Vascular Disease Symptoms - Hammer A, Koppensteiner R, Steiner S, Niessner A, Goliasch G, Gschwandtner M, Hoke MDark chocolate and vascular function in patients with peripheral artery disease: a randomized, controlled cross-over trialClin Hemorheol Microcirc.(2015)
    21. Peripheral Vascular Disease Symptoms - Loffredo L, Perri L, Catasca E, Pignatelli P, Brancorsini M, Nocella C, De Falco E, Bartimoccia S, Frati G, Carnevale R, Violi FDark chocolate acutely improves walking autonomy in patients with peripheral artery diseaseJ Am Heart Assoc.(2014 Jul 2)
    22. Adrenaline - Wirtz PH, von Känel R, Meister RE, Arpagaus A, Treichler S, Kuebler U, Huber S, Ehlert UDark chocolate intake buffers stress reactivity in humansJ Am Coll Cardiol.(2014 Jun 3)
    23. Arterial Stiffness - Charalambos Vlachopoulos, Konstantinos Aznaouridis, Nikolaos Alexopoulos, Emmanuel Economou, Ioanna Andreadou, Christodoulos StefanadisEffect of dark chocolate on arterial function in healthy individualsAm J Hypertens.(2005 Jun)
    24. Arterial Stiffness - West SG, McIntyre MD, Piotrowski MJ, Poupin N, Miller DL, Preston AG, Wagner P, Groves LF, Skulas-Ray ACEffects of dark chocolate and cocoa consumption on endothelial function and arterial stiffness in overweight adultsBr J Nutr.(2014 Feb)
    25. Blood glucose - Monahan KD, Feehan RP, Kunselman AR, Preston AG, Miller DL, Lott MEDose-dependent increases in flow-mediated dilation following acute cocoa ingestion in healthy older adultsJ Appl Physiol.(2011 Dec)
    26. Blood glucose - Arisi TOP, da Silva DS, Stein E, Weschenfelder C, de Oliveira PC, Marcadenti A, Lehnen AM, Waclawovsky GEffects of Cocoa Consumption on Cardiometabolic Risk Markers: Meta-Analysis of Randomized Controlled Trials.Nutrients.(2024 Jun 18)
    27. Triglycerides - Engler MB, Engler MM, Chen CY, Malloy MJ, Browne A, Chiu EY, Kwak HK, Milbury P, Paul SM, Blumberg J, Mietus-Snyder MLFlavonoid-rich dark chocolate improves endothelial function and increases plasma epicatechin concentrations in healthy adultsJ Am Coll Nutr.(2004 Jun)
    28. Triglycerides - Shiina Y, Funabashi N, Lee K, Murayama T, Nakamura K, Wakatsuki Y, Daimon M, Komuro IAcute effect of oral flavonoid-rich dark chocolate intake on coronary circulation, as compared with non-flavonoid white chocolate, by transthoracic Doppler echocardiography in healthy adultsInt J Cardiol.(2009 Jan 24)
    29. Triglycerides - Crews WD Jr, Harrison DW, Wright JWA double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adultsAm J Clin Nutr.(2008 Apr)
    30. Blood Pressure - d'El-Rei J, Cunha AR, Burlá A, Burlá M, Oigman W, Neves MF, Virdis A, Medeiros FCharacterisation of hypertensive patients with improved endothelial function after dark chocolate consumptionInt J Hypertens.(2013)
    31. Blood Pressure - Mogollon JA, Bujold E, Lemieux S, Bourdages M, Blanchet C, Bazinet L, Couillard C, Noël M, Dodin SBlood pressure and endothelial function in healthy, pregnant women after acute and daily consumption of flavanol-rich chocolate: a pilot, randomized controlled trialNutr J.(2013 Apr 8)
    32. Blood Pressure - Verawati Sudarma, Sri Sukmaniah, Parlindungan SiregarEffect of dark chocolate on nitric oxide serum levels and blood pressure in prehypertension subjectsActa Med Indones.(2011 Oct)
    33. Blood Flow - Loffredo L, Carnevale R, Perri L, Catasca E, Augelletti T, Cangemi R, Albanese F, Piccheri C, Nocella C, Pignatelli P, Violi FNOX2-mediated arterial dysfunction in smokers: acute effect of dark chocolateHeart.(2011 Nov)
    34. Low-density lipoprotein (LDL) - Hamed MS, Gambert S, Bliden KP, Bailon O, Singla A, Antonino MJ, Hamed F, Tantry US, Gurbel PADark chocolate effect on platelet activity, C-reactive protein and lipid profile: a pilot studySouth Med J.(2008 Dec)
    35. Platelet Aggregation - Luisa M Ostertag, Paul A Kroon, Sharon Wood, Graham W Horgan, Elena Cienfuegos-Jovellanos, Shikha Saha, Garry G Duthie, Baukje de RoosFlavan-3-ol-enriched dark chocolate and white chocolate improve acute measures of platelet function in a gender-specific way--a randomized-controlled human intervention trialMol Nutr Food Res.(2013 Feb)
    36. Platelet Aggregation - Pearson DA, Paglieroni TG, Rein D, Wun T, Schramm DD, Wang JF, Holt RR, Gosselin R, Schmitz HH, Keen CLThe effects of flavanol-rich cocoa and aspirin on ex vivo platelet functionThromb Res.(2002 May 15)
    37. Blood glucose - Grassi D, Necozione S, Lippi C, Croce G, Valeri L, Pasqualetti P, Desideri G, Blumberg JB, Ferri CCocoa reduces blood pressure and insulin resistance and improves endothelium-dependent vasodilation in hypertensivesHypertension.(2005 Aug)
    38. Blood glucose - Lívia de Paula Nogueira, Marcela Paranhos Knibel, Márcia Regina Simas Gonçalves Torres, José Firmino Nogueira Neto, Antonio Felipe SanjulianiConsumption of high-polyphenol dark chocolate improves endothelial function in individuals with stage 1 hypertension and excess body weightInt J Hypertens.(2012)
    39. Blood Pressure - Karin Ried, Peter Fakler, Nigel P StocksEffect of cocoa on blood pressureCochrane Database Syst Rev.(2017 Apr 25)
    40. Blood Pressure - Karin Ried, Oliver R Frank, Nigel P StocksDark chocolate or tomato extract for prehypertension: a randomised controlled trialBMC Complement Altern Med.(2009 Jul 8)
    41. Blood Pressure - Eunice K Chan, Jon Quach, Fiona K Mensah, Valerie Sung, Michael Cheung, Melissa WakeDark chocolate for children's blood pressure: randomised trialArch Dis Child.(2012 Jul)
    42. Blood Pressure - Desch S, Schmidt J, Kobler D, Sonnabend M, Eitel I, Sareban M, Rahimi K, Schuler G, Thiele HEffect of cocoa products on blood pressure: systematic review and meta-analysis.Am J Hypertens.(2010 Jan)
    43. Adrenaline - von Känel R, Meister RE, Stutz M, Kummer P, Arpagaus A, Huber S, Ehlert U, Wirtz PHEffects of dark chocolate consumption on the prothrombotic response to acute psychosocial stress in healthy menThromb Haemost.(2014 Dec)
    44. C-Reactive Protein (CRP) - Di Renzo L, Rizzo M, Sarlo F, Colica C, Iacopino L, Domino E, Sergi D, De Lorenzo AEffects of dark chocolate in a population of normal weight obese women: a pilot studyEur Rev Med Pharmacol Sci.(2013 Aug)
    45. High-density lipoprotein (HDL) - Hooper L, Kay C, Abdelhamid A, Kroon PA, Cohn JS, Rimm EB, Cassidy AEffects of chocolate, cocoa, and flavan-3-ols on cardiovascular health: a systematic review and meta-analysis of randomized trialsAm J Clin Nutr.(2012 Mar)
    46. Risk Of Cardiovascular Disease - Buitrago-Lopez A, Sanderson J, Johnson L, Warnakula S, Wood A, Di Angelantonio E, Franco OHChocolate consumption and cardiometabolic disorders: systematic review and meta-analysis.BMJ.(2011 Aug 26)
    47. All-Cause Mortality - Zhao B, Gan L, Yu K, Männistö S, Huang J, Albanes DRelationship between chocolate consumption and overall and cause-specific mortality, systematic review and updated meta-analysis.Eur J Epidemiol.(2022 Apr)
    48. Attention - Francis ST, Head K, Morris PG, Macdonald IAThe effect of flavanol-rich cocoa on the fMRI response to a cognitive task in healthy young peopleJ Cardiovasc Pharmacol.(2006)
    49. Attention - Pase MP, Scholey AB, Pipingas A, Kras M, Nolidin K, Gibbs A, Wesnes K, Stough CCocoa polyphenols enhance positive mood states but not cognitive performance: a randomized, placebo-controlled trialJ Psychopharmacol.(2013 May)
    50. High-density lipoprotein (HDL) - Wan Y, Vinson JA, Etherton TD, Proch J, Lazarus SA, Kris-Etherton PMEffects of cocoa powder and dark chocolate on LDL oxidative susceptibility and prostaglandin concentrations in humansAm J Clin Nutr.(2001 Nov)
    51. Triglycerides - Esser D, Mars M, Oosterink E, Stalmach A, Müller M, Afman LADark chocolate consumption improves leukocyte adhesion factors and vascular function in overweight menFASEB J.(2014 Mar)
    52. Blood Pressure - De Gottardi A, Berzigotti A, Seijo S, D'Amico M, Thormann W, Abraldes JG, García-Pagán JC, Bosch JPostprandial effects of dark chocolate on portal hypertension in patients with cirrhosis: results of a phase 2, double-blind, randomized controlled trialAm J Clin Nutr.(2012 Sep)
    53. Blood Pressure - Terai N, Gedenk A, Spoerl E, Pillunat LE, Stodtmeister RThe short-term effect of flavonoid-rich dark chocolate on retinal vessel diameter in glaucoma patients and age-matched controlsActa Ophthalmol.(2014 Aug)
    54. Kidney Oxygenation - Menno Pruijm, Lucie Hofmann, Julie Charollais-Thoenig, Valentina Forni, Marc Maillard, Andrew Coristine, Matthias Stuber, Michel Burnier, Bruno VogtEffect of dark chocolate on renal tissue oxygenation as measured by BOLD-MRI in healthy volunteersClin Nephrol.(2013 Sep)
    55. Acne Symptoms - Caperton C, Block S, Viera M, Keri J, Berman BDouble-blind, Placebo-controlled Study Assessing the Effect of Chocolate Consumption in Subjects with a History of Acne VulgarisJ Clin Aesthet Dermatol.(2014 May)
    56. Heart Failure Risk - Fei Gong, Shuyuan Yao, Jing Wan, Xuedong GanChocolate Consumption and Risk of Heart Failure: A Meta-Analysis of Prospective StudiesNutrients.(2017 Apr 20)