New research findings on the health benefits of chocolate

By Naveed Saleh, MD, MS
Published June 25, 2021

Key Takeaways

We Americans love our chocolate—in fact, we consume a whopping 2.8 billion pounds of the stuff per year. This breaks down to 11 pounds per person! Although this may sound like a lot, the Swiss—perhaps not surprisingly—consume the most chocolate in the world, followed by residents of the United Kingdom.

With all this indulgence, it’s no wonder that chocolate has become a focus of health research. But is chocolate good for you? Some studies say yes. Let’s take a look at recent research on the health effects of chocolate. 

Lipid levels

Even more so than green tea or red wine, cocoa is rich in a variety of dietary polyphenols and flavonoids. The main flavonoid in cocoa is epicatechin, and along with flavan-3-ols, anthocyanins, and flavones, is linked to improvements in lipid levels. These effects could slow the progression of atherosclerotic heart disease in patients with diabetes, according to the authors of a study published in Nutrients.

In the 2020 study, researchers demonstrated that a polyphenol-rich cocoa beverage consumed with a fast-food style high-fat breakfast lowered postprandial very-low density lipoprotein levels (VLDL) and chylomicron particles, as well as increasing HDL concentrations in those with obesity and type 2 diabetes. This intervention also reduced IL-18 levels, thus decreasing postprandial inflammation.

The authors suggested that the clinical trial “shows that polyphenol-rich cocoa with a HF meal is a promising acute dietary intervention for postprandial VLDL and chylomicron particle excursions in people with obesity and T2D.” They also stressed the benefit in terms of HDL levels.

Of course, this is not the first study to link chocolate with improvements in cardiovascular health. Read 5 foods you didn’t know could help cut cholesterol on MDLinx. And speaking of red wine, could a diet of chocolate and red wine help you lose weight? Click here to learn more. 

Energy expenditure

In a randomized trial published in a 2021 issue of International Journal of Exercise Science, researchers had 18 female athletes supplement their diets with either 20 g of dark chocolate or 20 g of white chocolate per day for 30 days. They then determined the effects of this intervention on resting energy metabolism and during two different steady-state exercises.   

Although dark chocolate intake did not impact energy expenditure during exercise, it did increase resting energy expenditure by 9.6%, or increasing calories burned by 140 kcal per day.

Although the mechanism underlying chocolate’s effects on resting energy expenditure remains to be elucidated, the authors did suggest that “a positive health benefit attributed to DC [dark chocolate] consumption is the strong polyphenol qualities of the flavonoid (−)-epicatechin. However, accumulating evidence suggests that flavonoids with high total antioxidant capacity (TAC) may actually inhibit, rather than enhance, skeletal muscle adaptations to exercise.”

They added, “It is quite plausible that a larger dose of DC may actually exhibit a negative effect on physiological function, whereas a smaller dosage would not.”

In other words, just a little bit of dark chocolate each day may be the trick to improving metabolic expenditures, with too much having the opposite effect.


Although lab and animal studies have indicated an inverse association between chocolate consumption and cancer risk, to date, results from population-based studies have been mixed.

In a 2021 epidemiologic study published in the Journal of the Academy of Nutrition and Dietetics, researchers mined the Women’s Health Initiative Study, a prospective cohort study with a 14.8-year follow-up that enrolled 161,808 postmenopausal women at 40 clinical centers nationwide. Of this cohort, researchers identified 114,281 participants with food-frequency data reflecting chocolate consumption.

The researchers found no significant correlation between the intake of chocolate and breast cancer rates. They did, however, note an 18% higher risk of invasive colorectal cancer. “This result may be attributable to the excess adiposity associated with frequent chocolate candy consumption,” according to the authors.


Diet may increase the risk of early-onset dementia. To test this hypothesis, Italian researchers publishing in a 2020 issue of Nutrients conducted a case-control study on environmental and lifestyle risk factors for early-onset dementia in 54 adults. Dietary patterns were assessed using food-frequency questionnaires.

Although the general consumption of sweets (eg, pastries, cakes, ice cream) increased the risk of early-onset dementia, chocolate alone decreased the risk.

“[W]e observed an indication of beneficial effects from moderate consumption of chocolate products, consistent with previous studies,” the authors wrote. “Such beneficial effects, if real, may be due to the cocoa polyphenol intake that might slow MCI [mild cognitive impairment] progression to dementia.”

Ready to learn more about the health benefits of chocolate? Check out What do sex, chocolate, and exercise have in common? on MDLinx 

Share with emailShare to FacebookShare to LinkedInShare to Twitter