I “Heart” Chocolate

With Valentine’s Day today, many women will soon be opening heart-shaped boxes of chocolate. This sweet indulgence is a once-a-year splurge for many women. But this customary gift may tell that special woman in your life that you love her, and her heart.

Chocolate has been consumed for centuries, often used as a food staple, medicine, and an offering in religious ceremonies. Chocolate has been the topic of numerous literary works, as well as involved in countless crimes (culinary and otherwise). Chocolate has impacted religion, economics, and culture throughout the world. And now, evidence shows it is a heart-healthy treat.

One of the latest studies analyzing the beneficial effects of chocolate consumption, published in Circulation: Heart Failure in 2010, reports that regular consumption of chocolate is associated with a lower rate of hospitalization and death due to heart failure (HF). The study evaluated nearly 32,000 women aged 48 to 83 years who were part of the Swedish Mammography Cohort. The women completed questionnaires detailing their health, lifestyles and diets.

In the 9 years of follow-up, 419 women were hospitalized for HF or died from HF. Overall, women who reported moderate intake of chocolate on a regular basis had a lower risk of HF morbidity and mortality than women who did not consume chocolate on a regular basis. Compared to women without regular chocolate intake, the risk of HF was 26% lower among women who consumed 1 to 3 servings of chocolate per month, and 32% lower among women who consumed 1 to 2 servings per week. The risk of HF was not different for women who consumed 3 to 6 servings per week, 1 or more servings per day, or no chocolate.

In the current study, the type of chocolate (milk or dark) was not assessed, nor was the actual amount consumed. However, a large majority of the chocolate consumed in Sweden is milk chocolate. The standard serving size of chocolate was 30 grams for women aged 62 or older, and 19 grams for women younger than 62.

In addition to HF, chocolate has been shown to improve cardiovascular risk factors by decreasing blood pressure, increasing HDL (“good” cholesterol), inhibiting LDL (“bad” cholesterol) oxidation, and reducing systemic inflammation. In addition, dark chocolate improves metabolic functions. Chocolate consumption improves the prevalence of cardiovascular disease, as well as its mortality.

While the exact mechanisms of chocolate’s benefits are unknown, they may be due to the concentrations of flavanoids found in chocolate. These substances, also abundant in fruits and vegetables, may act as angiotensin converting enzyme inhibitors — naturally-occurring versions of a popular and often-used antihypertensive drug class. Caffeine, also found in chocolate, may also contribute some of the beneficial cardiovascular events.

Lifestyle and dietary factors are significant risk factors for cardiovascular disease, and influence the morbidity and mortality associated with these conditions. Fortunately, diet is also one of the most easily modifiable risk factors. The taste of success can be oh-so sweet when diet modification consists of adding a few servings of chocolate to your weekly food intake. However, as the study underscores, moderation is key. These findings are not an excuse to transition to an all-chocolate all-the-time regimen, but a few chocolate delicacies may do more good than harm. So, open that heart-shaped box of confections and enjoy a heart-healthy treat this Valentine’s Day.


Djoussé L, Hopkins PN, North KE, Pankow JS, Arnett DK, & Ellison RC (2010). Chocolate consumption is inversely associated with prevalent coronary heart disease: The National Heart, Lung, and Blood Institute Family Heart Study. Clinical nutrition (Edinburgh, Scotland) PMID: 20858571

Echeverri D, Montes FR, Cabrera M, Galán A, & Prieto A (2010). Caffeine’s Vascular Mechanisms of Action. International journal of vascular medicine, 2010 PMID: 21188209

Janszky I, Mukamal KJ, Ljung R, Ahnve S, Ahlbom A, & Hallqvist J (2009). Chocolate consumption and mortality following a first acute myocardial infarction: the Stockholm Heart Epidemiology Program. Journal of internal medicine, 266 (3), 248-57 PMID: 19711504

Mostofsky E, Levitan EB, Wolk A, & Mittleman MA (2010). Chocolate intake and incidence of heart failure: a population-based prospective study of middle-aged and elderly women. Circulation. Heart failure, 3 (5), 612-6 PMID: 20713904

Persson IA, Persson K, Hägg S, & Andersson RG (2011). Effects of cocoa extract and dark chocolate on angiotensin-converting enzyme and nitric oxide in human endothelial cells and healthy volunteers–a nutrigenomics perspective. Journal of cardiovascular pharmacology, 57 (1), 44-50 PMID: 20966764

Pryde MM, & Kannel WB (2010). Efficacy of dietary behavior modification for preserving cardiovascular health and longevity. Cardiology research and practice, 2011 PMID: 21253499

Rusconi M, & Conti A (2010). Theobroma cacao L., the Food of the Gods: a scientific approach beyond myths and claims. Pharmacological research : the official journal of the Italian Pharmacological Society, 61 (1), 5-13 PMID: 19735732

Vlachopoulos C, Alexopoulos N, & Stefanadis C (2006). Effect of dark chocolate on arterial function in healthy individuals: cocoa instead of ambrosia? Current hypertension reports, 8 (3), 205-11 PMID: 17147918

Jennifer Gibson, PharmD

Jennifer Gibson, PharmD, is a practicing clinical pharmacist and medical writer/editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. She is the owner of Excalibur Scientific, LLC.
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