Dark Chocolate AND Cholesterol: The Ultimate Guide and What You Need to Know!

by Ramon E Martinez February 28, 2021

INTRO

The most comprehensive guide about dark chocolate, cacao, and your cholesterol is here! You will read about the effects of cacao's powerful components and their impact on blood fats.  

Dietary and healthy food recommendations are always changing. It's hard to know what is right for your health and what isn't. Chocolate and cholesterol are among the most controversial areas in nutrition.

Then the question is: is dark chocolate healthy for our cholesterol levels? This ultimate guide is the answer.

WHY?

One of the most common questions we get as craft chocolate connoisseurs and me personally as a doctor is: Isn't chocolate full of fat and sugar? Would it increase my cholesterol?

I'm an endocrinologist, a doctor who specializes in metabolic (energy conversion) conditions, as well as a chocolate enthusiast for more than 10 years. I felt compelled to research and publish on this exciting topic.

This article is for those of you interested in preserving your health, primarily through real food. If you want to know how to keep your cholesterol levels on the healthy side and enjoy a bar of flavorful dark chocolate, then keep reading.

EPISODE 1 - WHAT IS CHOLESTEROL?

At first glance, cholesterol looks like a waxy substance, like cacao butter. It's fat, and it's essential for life. Cholesterol is the basic structure of many things in our bodies, from hormones to cell membranes (every cell's outer layer). Our body produces the cholesterol it needs to generate hormones, vitamin D, substances that help digest food and make the cell protection structure.

Too much cholesterol traveling in the blood can be a problem. It can attach to things it's not supposed to. As a result, plaque formation occurs, a buildup called atherosclerosis. This process is like debris going through a water pipe and then getting stuck in its edges. These plaques can then reduce blood flow through the arteries (like the debris would minimize water flow within a line). In the end, it might cause cardiovascular conditions like angina (chest pain), heart attack, or a stroke, the #1 cause of death in the USA. These heart and vascular situations end up happening because "the clogged pipes" (our obstructed arteries) are affected in part by elevated cholesterol. Afterward, they cannot take the needed oxygen for the organs to function.

 

Humans that have not eaten western-modified food regimens tend to have low cholesterol levels in the blood. Therefore we have some reasons to think that what we eat can affect our cholesterol levels. Also, in western countries, cardiovascular conditions are more frequent. Some scientists believe and have proved that abnormally high cholesterol levels in the blood are an essential contributor to these vascular ailments.

So, what if dark chocolate can help you have a healthier cholesterol profile? As a result, it might help you avoid cardiovascular complications. In Episode 2 (below), we will explain a few scientific studies that show that delicious craft chocolate improves blood cholesterol levels. 

Before we move forward, it's essential to know that we can measure different cholesterol particles traveling in our body; we call them lipoproteins.

HDL stands for high-density lipoproteins and is commonly referred to as "good" cholesterol. HDL transports cholesterol from other parts of the body to the liver, then metabolized. It tends to not get stuck in our blood vessels.

On the other hand, LDL means low-density lipoproteins, often called "bad" cholesterol. It carries cholesterol particles throughout the body that are more likely to build up in the arteries' walls, causing damage. 

But what does dark chocolate have to do with all of this? 

EPISODE 2 - HOW AND WHY DARK CHOCOLATE HELPS

Several researchers have found that dark chocolate and cacao can reduce LDL levels in the blood. It is believed that some types of flavonols (already known to be a substance abundant in cacao beans) inhibit cholesterol absorption and the expression of LDL cholesterol receptors.

Also, in 2010 the Hull York School of Medicine in the UK investigated whether rich polyphenols chocolate with a high concentration of cacao improves HDL cholesterol in patients with type 2 diabetes. 

Twelve people with type 2 diabetes enrolled. They received 45 grams of chocolate, with or without a high polyphenol content, for eight weeks. Before and after the intervention, the researchers examined changes in weight, glucose control, lipid profile, and high-sensitivity C-reactive protein.

The result? HDL cholesterol (good) increased significantly with chocolate high in polyphenols. 

Researchers also concluded that high-polyphenol chocolate is a powerful ally in improving the atherosclerotic cholesterol profile in patients with diabetes. It increases HDL cholesterol and improves the cholesterol LDL to HDL ratio without affecting weight, inflammatory markers, insulin resistance, or glycaemic control. 

Also, there are two metanalyses, i.e., review of several studies looking at the same outcomes, which can be summarized as:

1. Statistically significant lowering of LDL and total cholesterol levels by consuming dark chocolate
2. No meaningful impact on HDL (slight increase) or triglyceride levels (which is good) since chocolate did not adversely affect these parameters; no harm was done.
3. The effects seem more pronounced in those patients with a higher chance of heart conditions. 

EPISODE 3 - DARK CHOCOLATE +

While dark chocolate is an excellent ally for lowering cholesterol, it can be extraordinary when paired with almonds. In a study published in the Journal of the American Heart Association, researchers tested cholesterol levels in a group of 31 people between the age of 30 and 70 testings this combination. 

Thirty-one (31) people completed the study in which they had:

• No chocolate or almonds for 1 month
• 42.5 grams of almonds daily throughout the second month, then
• 43 grams of dark chocolate + 18 grams of cacao powder daily during the third month, and finally
• All three products through the final month.

As a result, almonds alone reduced total cholesterol, non-HDL, and LDL by as much as 7%. Similarly, almonds with dark chocolate and cacao had the most significant reduction of small dense LDL particles. The latter are believed to cause the most "clogging" in our blood vessels.

In this study's findings, researchers recommended incorporating almonds, dark chocolate, and cacao into a typical American diet to reduce coronary heart disease risk. 

CONCLUSION

To lower cholesterol, I often recommend the following actions in my daily practice as a physician. 

• Heart-healthy diet - Michael Pollan's recommendations (eat food, not too much, mostly plants)
• Weight control
• Physical activity 
• Managing stress 
• No smoking
• Good sleep habits
• And why not? A daily piece of real dark chocolate! 

Are you a dark chocolate lover? Well, then now you know that it's delightful, but it's also a fantastic partner for your health.  Be selective with the quality of the chocolate you eat.  Look at the packaging and bite it without guilt. Enjoy it and spread the word, so everyone knows what it means to live #TheGoodnessOfLife with bean-to-bar chocolates.

SOURCES:

1. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1464-5491.2010.03108.x
2. https://www.ahajournals.org/doi/10.1161/JAHA.116.005162
3. Tokede OA, et al. Effects of cocoa products/dark chocolate on serum lipids: a meta-analysis. Eur J Clin Nutr. 2011 Aug;65(8):879-86.
4. Jia L, Liu X, et al. Short-term effect of cocoa product consumption on lipid profile: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2010 Jul;92(1):218-25.
5. Dicks L, et al Regular Intake of a Usual Serving Size of Flavanol-Rich Cocoa Powder Does Not Affect Cardiometabolic Parameters in Stably Treated Patients with Type 2 Diabetes and Hypertension-A Double-Blinded, Randomized, Placebo-Controlled Trial. Nutrients. 2018 Oct 5;10(10):1435.
6. Sansone R, et al.  Flaviola Consortium, European Union 7th Framework Program. Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study. Br J Nutr. 2015 Oct 28;114(8):1246-55.
7. Neufingerl N, et al Effect of cocoa and theobromine consumption on serum HDL-cholesterol concentrations: a randomized controlled trial. Am J Clin Nutr. 2013 Jun;97(6):1201-9.
8. Basu A, et al. Acute Cocoa Supplementation Increases Postprandial HDL Cholesterol and Insulin in Obese Adults with Type 2 Diabetes after Consumption of a High-Fat Breakfast. J Nutr. 2015 Oct;145(10):2325-32.
9. Davinelli S, et al Short-term supplementation with flavanol-rich cocoa improves lipid profile, antioxidant status and positively influences the AA/EPA ratio in healthy subjects. J Nutr Biochem. 2018 Nov;61:33-39.
10. Sarriá B, et al Regular consumption of a cocoa product improves the cardiometabolic profile in healthy and moderately hypercholesterolaemic adults. Br J Nutr. 2014 Jan 14;111(1):122-34.
11. Khan N, et al  Regular consumption of cocoa powder with milk increases HDL cholesterol and reduces oxidized LDL levels in subjects at high-risk of cardiovascular disease. Nutr Metab Cardiovasc Dis. 2012 Dec;22(12):1046-53.

Photo by National Cancer Institute on Unsplash

Photo by Robina Weermeijer on Unsplash

Photo by Jocelyn Morales on Unsplash

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