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There has been growing interest in the potential cardiovascular benefits associated with cocoa consumption. As a result of accurate analytical methodologies, there is evidence to support that the flavanols in cocoa can be absorbed, are bioactive, and may be responsible for the cardiovascular benefits associated with regular cocoa consumption. The flavanols in cocoa exist in a multitude of different stereochemical configurations, thus giving rise to a unique and complex mixture of compounds. Given this complexity, the quantitative analysis of cocoa flavanols in foods can be challenging. While there are published methods suitable for the analysis of these compounds, these methods require sophisticated instrumentation and can be challenging to set up. As such, simpler techniques that measure such things as total phenolic content or antioxidant potential have been used as indicators of flavanol content. However, as these simpler assays are prone to interferences and are not specific for flavanols, these methods are not appropriate for use in studies that aim to examine the physiological effects of cocoa flavanols. It is only through the use of methods that can accurately quantify these flavanols that it will be possible to make meaningful dietary recommendations regarding the consumption of cocoa flavanol containing foods.

Epidemiologic investigations support the hypothesis that regular consumption of flavonoid-containing foods can reduce the risk of cardiovascular diseases (CVD). While flavonoids are ubiquitous in plants, cocoa can be particularly rich in a sub-class of flavonoids known as flavanols. A number of human dietary intervention trials with flavanol-containing cocoa products have demonstrated improvements in endothelial and platelet function, as well as blood pressure. These studies provide direct evidence for the potential cardiovascular benefits of flavanol-containing foods and help to substantiate the epidemiological data. In this review, results from selective published trials with cocoa and chocolate focused on risk for CVD will be discussed along with a study we recently completed evaluating the effects of the daily consumption of flavanol-containing dark chocolate (CocoaVia?) with and without plant sterol esters on CVD markers in a normotensive population with mild hypercholesterolemia. In this study, the daily consumption of flavanol-containing dark chocolate was associated with a significant mean reduction of 5.8 mmHg in systolic blood pressure. Together the results of these human dietary intervention trials provide scientific evidence of the vascular effects of cocoa flavanols and suggest that the regular consumption of cocoa products containing flavanols may reduce risk of CVD.