Background: Accumulating evidence suggests potential preventive effects of chocolate/cocoa on the
risk of cardio vascular disease (CVD). However, cocoa products also contain high levels of sugar and fat, which
increase CVD risk factors. Even, the identity of the substance in chocolate/cocoa that has a favorable effect on
CVD and CVD risk factors remains unclear, growing evidence from experimental studies suggests that cocoa
polyphenols might be a major contributor to cardiovascular-protective effects. However, epidemiological studies,
which are necessary to evaluate an association between the risk of CVD and cocoa polyphenol, remain sparse.
Methods: We will discuss recent evidence regarding the association between cocoa polyphenol consumption and
the risks of CVD and its risk factors by reviewing recent epidemiological studies. We shall also provide some
guidance for patient counseling and will discuss the public health implications for recommending cocoa polyphenol
consumption to prevent CVD.
Results: Epidemiological studies evaluating the association between cocoa polyphenol itself and the risk of CVD
are sparse. However, evidence from limited epidemiological studies suggests that cocoa polyphenol consumption
may lower the risk of CVD.
Conclusion: Given the potential adverse effects of the consumption of cocoa products with high fat and sugar and
the fact that the most appropriate dose of cocoa polyphenol for cardio-protective effects has not yet been established,
health care providers should remain cautious about recommending cocoa/cocoa polyphenol consumption
to their patients to reduce the risk of CVD, taking the characteristics of individual patients into careful consideration.