Cocoa Overconsumption and Cardiac Rhythm: Potential Arrhythmogenic Trigger or Beneficial Pleasure?

Abstract

The interrelation between arrhythmias and lifestyle factors is acknowledged. On the one side, there is a recognized interaction between atrial fibrillation and obesity, hypertension, dyslipidemia and type 2 diabetes mellitus. Saturated fats, excessive added salt, tea, coffee and energy drinks are often deleterious in rhythm disorders. The role of others, such as cocoa-rich foods, is less evident: several authors displayed the beneficial effect of the polyphenols content on numerous cardiovascular risk factors, while little is known about the potential link between diet and incident arrhythmias. Arrhythmias’ most frequent risk factors include aging, hypertension, congenital cardiopathy, heart failure, valvulopathy, thyroid diseases and diabetes. Nevertheless numerous arrhythmias are not related to any of these risk factors: in these cases, immunological, functional and even nutritional mechanisms might be involved in dysrhythmias’ genesis. Aim of this narrative review is to analyze the potential adverse effect of cocoa excessive consumption on cardiac rhythm and its mechanisms and to provide state-of-the-art knowledge on this topic.

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“…In addition to flavor and quality perception, higher cocoa percentage has been linked to greater content of free phenolic compounds and higher antioxidant capacity [ 27 ]. The main bioactive compounds found in chocolate are shown in Table 1 [ 28 , 29 , 30 , 31 , 32 ].…”

“…Dark chocolate contains flavonoids, including catechins, epicatechin, and procyanidins and methylxanthines (caffeine, theobromine, phenylethylamine, paraxanthine and theophylline) from cocoa beans, responsible for the higher intensity of bitterness, cocoa flavor, acid taste and astringency in the product [ 32 ]. Moreover, methylxanthines are psychoactive dopaminergic substances responsible for its pleasurable effects and influence on plasmatic levels of stress hormones such as cortisol and catecholamines (both adrenaline and noradrenaline) [ 30 , 31 ]. All these compounds can directly or indirectly affect the cardiovascular system by multiple mechanisms.…”