Alternate Title

  • Cacao (Theobroma cacao)

Related Terms

  • Anandamide, black chocolate (BC), Butyrum cacao, cacahuatl (Nahuatl), cacao (Brazilian Portuguese, English, Spanish), cacao bean husk extract, cacao tree, cacaoboom (Dutch), cacaoeiro (Brazilian Portuguese), cacaoyer (French), cacaueiro (Brazilian Portuguese), caffeine, carboxylic acids, catechin, CBC, CBH, chicolatl (Nahuatl), chocol (Mayan), chocolate flavonoids, chocolate milk, chocolate tree, cocoa bean, cocoa bran, cocoa butter, cocoa husk, cocoa oil, cocoa powder, cocoa tree, CocoaVia®, dark chocolate, Dutch chocolate, epicatechin, FCMC, fiber, flavan-3-ols, flavanols, flavonoids, granos de cacao (Spanish), harilik kakaopuu (Estonian), hot chocolate, inulin, isomalt, kakao (Danish), Kakao (German), kakaó(fa) (Hungarian), Kakaobaum (German), Kakaopflanze (German), kakaotræ (Danish), kakaowiec (Polish), kakav (Slovenian), kawkaw (Mayan), ke ke (Chinese), lipids, methylxanthine alkaloids, methylxanthines, milk chocolate, N-linoleoylethanolamine, N-oleolethanolamine, oleic acid, oligofructose, palmitic acid, phenylethylamine, phytochemicals, phytosterols, polyphenols, procyanidin oligomers, procyanidins, purine alkaloids, saturated fatty acids, sorbitol, stearic acid, Sterculiaceae (family), stimulant drug, sucrose, Theobroma cacao L., theobromine, white chocolate, xocoatl (Mayan, Nahuatl), xocolatl (Mayan, Nahuatl).
  • NOTE: This monograph covers Theobroma cacao, cacao, cocoa products, and chocolate.

Background

  • Cocoa and chocolate are derived from the cacao bean (Theobroma cacao). Cacao is native to South America and has been grown in the tropics for at least 3,000 years. Today, the African country Ivory Coast is the largest supplier of raw cocoa.
  • Cocoa products have been considered delicacies by many cultures. Cocoa products have recently been recognized as a significant source of a number of compounds, such as flavonoids, that may have valuable health benefits. For this reason, and because it is so popular, chocolate is the focus of intense research.
  • Chocolate has been studied to investigate its effectiveness in the treatment of a variety of conditions, including heart disease, skin conditions, and constipation. However, there is a lack of studies to support the use of chocolate to treat any conditions in humans.

Evidence Table

    Disclaimer

    These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

    Antioxidant

    Cocoa can be a rich source of flavonoids. These compounds may protect the body from the damaging effects of chemicals known as free radicals. More high-quality studies are needed before a conclusion can be drawn.

    Anti-platelet effects (blood thinning)

    While some studies have suggested that flavonoids in cocoa may have blood-thinning effects, more research is needed in this area before a conclusion can be made.

    Cardiovascular health

    Some research suggests that a diet high in flavonoids may help protect against heart disease. However, more high-quality studies are needed before a conclusion can be drawn.

    Constipation

    The fiber found in cocoa husk may be a valuable source of dietary fiber. Preliminary evidence suggests that cocoa husk fiber may be helpful in treating constipation in children. More studies are needed in this area.

    Hypercholesterolemia (high cholesterol)

    Several studies suggest that eating cocoa butter or chocolate may lower cholesterol. More research is needed before a conclusion can be drawn.

    Hypertension (high blood pressure)

    Some, but not all, studies have suggested that chocolate may lower blood pressure. More research is needed before a conclusion can be made.

    Insect repellant

    Preliminary studies have suggested that cocoa oil may be an effective insect repellant. However, additional studies are needed in this area.

    Skin conditions

    Studies in human have suggested that flavonols, which are found in chocolate, may protect against sun damage. Additional study is required before any conclusions can
    be made.

    Wound healing

    Cocoa butter may help moisturize skin, prevent stretch marks during pregnancy, and help heal burn scars. However, more research is needed before further conclusions may be made regarding uses of cocoa butter for these conditions.

*Key to grades:

Tradition

    Disclaimer

    The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

    Disclaimer

    The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

  • Adults (18 years and older)

    • For use as an antioxidant, one serving of the flavanol-rich drink CocoaVia® taken by mouth has been used.
    • For cardiovascular disease, one flavanol-rich chocolate bar and cocoa drink taken by mouth once daily for six weeks has been used. One CocoaVia® drink for two days has also been used.
    • For high cholesterol, one CocoaVia® Crunch snack bar daily for six weeks has been used. One high-flavanol cocoa drink daily for six weeks has also been used.
    • For high blood pressure, 100g of dark chocolate taken by mouth daily for 15 days has been used.
    • For skin conditions, a high-flavanol cocoa powder dissolved in hot water taken by mouth daily for 12 weeks has been used.
    • For wound healing, cocoa butter rubbed on a burn scar for 30 minutes twice a week for five weeks has been used.
    • As an insect repellent, cocoa oil applied to the skin has been used.
  • Children (under 18 years old)

    • For constipation, a supplement containing 4g of cocoa husk dissolved in 200mL of milk taken by mouth twice daily for four weeks in children 3-6 years old has been used. A larger dose of the same supplement, containing 8g of cocoa husk dissolved in 200mL of milk, taken by mouth twice daily for four weeks in children 7-10 years old has been used.

Safety

    Disclaimer

    The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

  • Allergies

    • Avoid with known allergy or hypersensitivity to chocolate, cocoa, any of its components (including caffeine), or members of the Sterculiaceae family. Migraine headaches and eczema have been reported.
  • Side Effects and Warnings

    • General: Some side effects and warnings are based on the relatively high levels of caffeine in chocolate.
    • Use with caution in patients with addictive tendencies, anemia, cardiovascular disease, endocrine disorders, gastrointestinal disorders, nervous disorders, respiratory disorders, and skin disorders. Use with caution in patients prone to migraine headaches or kidney stones. Use with caution in patients who are overweight or obese and in those trying to become pregnant.
    • Use with caution in patients using agents that affect the cardiovascular system, antimicrobials, ergot derivatives, painkillers, birth control pills, and stimulants.
    • Use cautiously in children, due to the risk of developing habits that could lead to obesity and poor health.
    • Chocolate may raise blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
    • Chocolate may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
    • Chocolate may increase blood pressure. Caution is advised in patients with high blood pressure and in those taking drugs, herbs, or supplements that affect blood pressure.
  • Pregnancy and Breastfeeding

    • Use with caution and avoid excessive doses of chocolate during pregnancy and breastfeeding, due to the relatively high level of caffeine in chocolate. Chocolate also contains two compounds that may cause birth defects.

Interactions

    Disclaimer

    Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

  • Interactions with Drugs

    • Chocolate may increase blood sugar levels. Caution is advised when using medications that may also affect blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
    • Chocolate may increase the risk of bleeding when taken with drugs that increase the risk of bleeding.
    • Chocolate may increase blood pressure. Caution is advised in patients taking drugs that affect blood pressure.
    • Chocolate may also interact with antibiotics, antifungals, anti-inflammatory agents, beta-agonists, birth control pills, caffeine, calcium salts, cannabinoids (present in marijuana), cholesterol-lowering agents, decongestants, drugs that affect the cardiovascular system, drugs that affect the gastrointestinal system, drugs that affect the immune system, drugs that affect the nervous system, drugs that affect the respiratory system, ergot derivatives, fertility agents, iron salts, and painkillers.
  • Interactions with Herbs and Dietary Supplements

    • Chocolate may raise blood sugar levels. Caution is advised when using herbs or supplements that may also affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
    • Chocolate may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding.
    • Chocolate may cause high blood pressure. Caution is advised in patients taking herbs or supplements that affect blood pressure.
    • Chocolate may increase the amount of drowsiness caused by some herbs or supplements.
    • Chocolate may also interact with antifungals, anti-inflammatory herbs and supplements, birth control agents, caffeine, calcium, cholesterol-lowering herbs and supplements, fertility agents, gastrointestinal herbs and supplements, grapefruit, herbs and supplements that affect the cardiovascular system, herbs and supplements that affect the immune system, herbs and supplements that affect the nervous system, herbs and supplements that affect the respiratory system, iron, painkillers, stimulants, and vitamins.

Attribution

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration ().

Bibliography

    Disclaimer

    Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to . Selected references are listed below.

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