The Health Effects of Chocolate and Cocoa: A Systematic Review

Abstract

Chocolate has a history of human consumption tracing back to 400 AD and is rich in polyphenols such as catechins, anthocyanidins, and pro anthocyanidins. As chocolate and cocoa product consumption, along with interest in them as functional foods, increases worldwide, there is a need to systematically and critically appraise the available clinical evidence on their health effects. A systematic search was conducted on electronic databases such as MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) using a search strategy and keywords. Among the many health effects assessed on several outcomes (including skin, cardiovascular, anthropometric, cognitive, and quality of life), we found that compared to controls, chocolate or cocoa product consumption significantly improved lipid profiles (triglycerides), while the effects of chocolate on all other outcome parameters were not significantly different. In conclusion, low-to-moderate-quality evidence with short duration of research (majority 4–6 weeks) showed no significant difference between the effects of chocolate and control groups on parameters related to skin, blood pressure, lipid profile, cognitive function, anthropometry, blood glucose, and quality of life regardless of form, dose, and duration among healthy individuals. It was generally well accepted by study subjects, with gastrointestinal disturbances and unpalatability being the most reported concerns.

Can Nutrients and Dietary Supplements Potentially Improve Cognitive Performance Also in Esports?

“…Beetroot juice is a scientifically proven supplement. It is a popular additive that has been widely studied for its effects on improving the ability to perform long-term submaximal training [ 172 ] and intense, intermittent, short-term exercise [ 132 , 173 ] ( Table 3 ). Its beneficial effect in the context of sports is due to the high content of nitrates (NO 3 − ), compounds found naturally in vegetables.…”

“…One study found that dietary nitrates increase performance during repeated sprints and may ameliorate the cognitive decline (particularly in reaction time) that may occur with prolonged repetitive exercise [ 132 ]. In another randomized, double-blind, placebo-controlled, parallel group study, 40 healthy adults received a placebo or 450 mL of beetroot juice.…”

“…Beet juice may also have positive effects on cognition and reaction time during prolonged repetitive exercise [ 132 ]. The player’s reaction time is particularly important in multiplayer online battlefield arena games (including LOL, DOTA2) [ 11 ] and first-person shooters (Overwatch, Counter Strike, Global Offensive CS: GO) [ 11 , 14 , 207 ].…”

“…Dietary NO 3 − enhances repeated sprint performance and may attenuate the decline in cognitive function (and specifically reaction time) that may occur during prolonged intermittent exercise. [132] Table 3. Cont.…”

Preventive Effect of Cocoa Flavonoids via Suppression of Oxidative Stress-Induced Apoptosis in Auditory Senescent Cells

“…Natural antioxidants inhibiting ROS production are fundamental in protecting the ear from age-induced damage. In this sense, cocoa and its derivates have been shown to contain important antioxidants such as polyphenolic compounds [ 27 ]. This biological property points to cocoa polyphenols as interesting candidates for cellular protection.…”