Benefits shown in middle-aged and elderly women

Middle-aged and elderly Swedish women who regularly ate a small amount of chocolate had lower risks of heart failure risks, in a study reported in Circulation: Heart Failure, a journal of the American Heart Association.  The nine-year study, conducted among 31,823 middle-aged and elderly Swedish women, looked at the relationship of the amount of high-quality chocolate the women ate, compared to their risk for heart failure. The quality of chocolate consumed by the women had a higher density cocoa content somewhat like dark chocolate by American standards. In this study, researchers found:

  • Women who ate an average of one to two servings of the high-quality chocolate per week had a 32 percent lower risk of developing heart failure.
  • Those who had one to three servings per month had a 26 percent lower risk.
  • Those who consumed at least one serving daily or more didn’t appear to benefit from a protective effect against heart failure.

The lack of a protective effect among women eating chocolate every day is probably due to the additional calories gained from eating chocolate instead of more nutritious foods, said Murrray Mittleman, M.D., Dr.P.H., lead researcher of the study.  “You can’t ignore that chocolate is a relatively calorie-dense food and large amounts of habitual consumption is going to raise your risks for weight gain,” said Mittleman, director of the Cardiovascular Epidemiology Research Unit at Harvard Medical School’s Beth Israel Deaconess Medical Center in Boston. “But if you’re going to have a treat, dark chocolate is probably a good choice, as long as it’s in moderation.”

High concentration of compounds called “flavonoids” in chocolate may lower blood pressure, among other benefits, according to mostly short-term studies. However, this is the first study to show long-term outcomes related specifically to heart failure, which can result from ongoing untreated high blood pressure.   In the observational study, researchers analyzed self-reported food-frequency questionnaire responses from participants 48-to-83-years-old in the Swedish Mammography Cohort. Combining the results with data from national Swedish hospitalization and death registries between 1998 through 2006, the researchers used multiple forms of statistical modeling to reach their conclusions on heart failure and chocolate consumption.

Mittleman said differences in chocolate quality affect the study’s implications for Americans. Higher cocoa content is associated with greater heart benefits. In Sweden, even milk chocolate has a higher cocoa concentration than dark chocolate sold in the United States.    Although 90 percent of all chocolate eaten across Sweden during the study period was milk chocolate, it contained about 30 percent cocoa solids. U.S. standards only require 15 percent cocoa solids to qualify as dark chocolate. So, by comparison, American chocolate may have fewer heart benefits and more calories and fat per equivalent amounts of cocoa content compared to the chocolate eaten by the Swedish women in the study.   Also, the average serving size for Swedish women in the study ranged from 19 grams among those 62 and older, to 30 grams among those 61 and younger. In contrast, the standard American portion size is 20 grams.

“Those tempted to use these data as their rationale for eating large amounts of chocolate or engaging in more frequent chocolate consumption are not interpreting this study appropriately,” said Linda Van Horn, Ph.D., R.D., immediate past chair of the American Heart Association Nutrition Committee and professor in the Department of Preventive Medicine at Northwestern University’s Feinberg School of Medicine in Chicago. “This is not an ‘eat all you want’ take-home message, rather it’s that eating a little dark chocolate can be healthful, as long as other adverse behaviors do not occur, such as weight gain or excessive intake of non-nutrient dense ‘empty’ calories.”

Heart failure occurs among about 1 percent of Americans over age 65. A condition in which the heart can’t pump enough blood to the rest of the body, heart failure rates are increasing as our aging population grows.“Anything that helps to decrease heart failure is an important issue worth examining,” Mittleman said.

Co-authors are Elizabeth Mostofsky, M.P.H.; Emily Levitan, Sc.D.; and Alicja Wolk, Dr.Med.Sci. Author disclosures and funding support are on the manuscript.

Source: Press release prepared by the American Heart Association



Chocolate and blood pressure? For the Kuna Indians living on a group of islands off the Caribbean coast of Panama, hypertension doesn't even exist. Their average blood pressure is a perfect 110/70. Harvard researchers were stunned to discover it's because they drink about 5 cups of cocoa each day. The flavonols in cocoa stimulate your body's production of nitric oxide,boosting blood flow to your heart, brain, and other organs

I can see how truly raw (organic) chocolate can lower the risk of hear failure, but don't see how refined chocolate loaded with fat can be anything but harmful. John

As others have already stated ... there are studies on both sides, and it is up to the individual to take the correct type of chocolate and in moderation. I agree with John that too much fat in the chocolate will negate any positive effects. One of the things that I have seen very little written about are chocolate nibs (organic). What is the concentration of flavonoids in these nibs? Is there a way to determine better nibs than others? Do the countries of origin have anything to do with it? Being able to use a product that has no additives, no sugar, no fat certainly appeals to me.

It seems like every time you turn around there is a study about chocolate being good for you or being bad for you. I think the main thing to take away from all these studies is organic dark chocolate in moderation could be good for you but Hershey bars and M&M's eaten all the time aren't going to be a positive for your health.

Thanks for this article! I love milk chocolates for a treat, but now I'll switch and try dark chocs! Thank you!

It is high time that health chocolates with right amount of cocoa and related ingredients specifically targeted to elderly to reduce the risk of heart diseases. More research is in order to understand the true health benefits of the chocolate.

Dark chocolates really do have high levels of antioxidants - but don't get less than 86% cocoa. Make it as dark as can be. It takes getting used to but I totally prefer the dark chocolate over milk chocolate now!

It does take a while to get used to dark chocolate. When you start making healthier eating choices, it takes time to develop a taste for some things.

Dark chocolate sales have seen insane sales increases since this new information has been arriving. Pretty crazy.

Chocolate has a lot good health benefits. I was just talking to an herbalist today about chocolate. Raw chocolate is the best to eat. Even though raw chocolate does not have the same sweetness, it can be sweetened with raw sugar, and also flavored with pure vanilla. Chocolate lovers - good news for all of us!!

I found cocoa nibs the other day and went crazy. I LOVE dark chocolate. I chop those nibs and put them in yogurt. I am so used to just cocoa now, I can't go lower than 70% cacao for chocolate or it will taste like cheap candy.

they are talking about dark chocolate right? cause if i'm not mistaking, dark chocolate are healthier than the regular ones... Editor: Yes, dark chocolate

Well, it is basically because it doesn't really have the sugar that other chocolates have. But the bittersweet taste it gives will really make you crave for it! Well, you should keep your intake below 30 grams a day if you want to stay healthy. But it's really difficult to stop once you've started munching on a chocolate bar.

Raw cacao (cocoa) is one of the world’s most nutrient-rich and complex foods. It contains over thousand active compounds and amazingly 10 % of its weight are antioxidants. The antioxidants (polyphenols) contained in cacao prevent specially bad LDL cholesterol from becoming oxidized. This protects our bodies, for example, from different heart diseases. Polyphenols have also blood thinning properties that lower blood pressure and prevent heart attacks. Also, cacao is a good source of magnesium. When heart problems occur, magnesium is the primary mineral that is missing. Magnesium gives more vitality to the heart muscle. However, recent studies show that the most important compound found in raw cacao is epicatechin, which is a powerful heart-protective compound. EDITOR'S COMMENT: I checked with the director of our Center for Integrated Medicine and Wellness about the benefits of cacao since I personally don't know the facts about cacoa. Here is what she said: Cocoa contains a variety of chemicals, including antioxidants called flavonoids. It is not clear how these might work in the body, but they appear to cause relaxation of veins. This could lead to lower blood pressure. Preliminary research suggests that flavanol constituents in cocoa might be beneficial in cardiovascular disease. Dark chocolate contains higher amounts of these potentially beneficial constituents than milk chocolate or white chocolate. However the color of the chocolate and the percentage of cocoa present do not provide a measure of the flavanol content. Several studies show that eating 46-105 grams per day of dark or milk chocolate lowers the systolic blood pressure by 4.7 mmHg and the diastolic blood pressure by 2.8 mmHg in people with normal blood pressure or high blood pressure.Some research suggests that healthy elderly men who eat a large amount of cocoa from dietary sources have a lower average blood pressure compared to those who eat less. The chocolate eaters also have a lower risk of death from heart disease and all causes.

Thank you for a wonderful article regarding the health benefits to older, and elderly women. I would be interested in how many participants were of the elderly classification, such as above 65. Or at least a better break down of the age groups that were studied. It would also be very interesting to know how the chocolate affected each age range and if there were significant differences from middle aged women to elderly women who might be at higher risk. IE: should younger women eat more chocolate until they become elderly women if there were a cumulative effect without adverse conditions to worry about. Thank you again for a very well written article.

Dark chocolate actually fires off more endorphins than milk or white chocolate so not only is it better for you it actually makes you feel better as well. Red wine does the same (or very similar) so why not have a decadent evening for the sake of your health :) Great article

If that's the case then I would constantly eat dark chocolate every week but I think that there are a lot of factors that trigger heart failure and can only be avoided with balanced diet and exercise. Eating any food in a moderate amount will be okay for your health.

Good article. The chocolate is good for you as long is natural and not filled up with all sorts of chemicals.

There are many benefits when eating dark chocolates. It gives anti-oxidants. Thanks for this post. I learned something new.

Everything in moderation. Dark chocolate can be healthy, but of course, the fat content and all isn't quite what you need in your diet. Raw cacao actually has many more benefits than the dark chocolate variety discussed here. Check it out.

wow is this true? i love chocolates and it amaze me how it can help me to lower the risk of heart dse. you have helped a lot on your article.thanks

Thanks for this wonderfull write up, chocolate or at leat quality chocolate that has is less refined and processed in moderation is truly a super food.

All is good as long as in moderation. Love the taste of dark chocolate. Its not too sweet and a little bitter is better. However, people should be made aware of the potential dangers of eating chocolates if over indulge.