title: The cardiovascular benefits of dark chocolate.
abstract: Dark chocolate contains many biologically active components, such as catechins, procyanidins and theobromine from cocoa, together with added sucrose and lipids. All of these can directly or indirectly affect the cardiovascular system by multiple mechanisms. Intervention studies on healthy and metabolically-dysfunctional volunteers have suggested that cocoa improves blood pressure, platelet aggregation and endothelial function. The effect of chocolate is more convoluted since the sucrose and lipid may transiently and negatively impact on endothelial function, partly through insulin signalling and nitric oxide bioavailability. However, few studies have attempted to dissect out the role of the individual components and have not explored their possible interactions. For intervention studies, the situation is complex since suitable placebos are often not available, and some benefits may only be observed in individuals showing mild metabolic dysfunction. For chocolate, the effects of some of the components, such as sugar and epicatechin on FMD, may oppose each other, or alternatively in some cases may act together, such as theobromine and epicatechin. Although clearly cocoa provides some cardiovascular benefits according to many human intervention studies, the exact components, their interactions and molecular mechanisms are still under debate.
authors.affiliation: School of Food Science and Nutrition, Faculty of Maths and Physical Sciences, University of Leeds, Leeds LS2 9JT, UK.
authors.forename: Asimina
authors.initials: A
authors.lastname: Kerimi
authors.affiliation: School of Food Science and Nutrition, Faculty of Maths and Physical Sciences, University of Leeds, Leeds LS2 9JT, UK. Electronic address: g.williamson@leeds.ac.uk.
authors.forename: Gary
authors.initials: G
authors.lastname: Williamson
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002099:Cacao / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000378:metabolism* / Q000517:prevention & control*; D002392:Catechin / Q000302:isolation & purification / Q000494:pharmacology / Q000627:therapeutic use; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism; D005419:Flavonoids / Q000302:isolation & purification / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D013805:Theobromine / Q000302:isolation & purification / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D005419:Flavonoids; D002392:Catechin; D013805:Theobromine
keywords: Cocoa; Endothelial dysfunction; Flavonoid; Nitric oxide; Theobromine