Flavanols and related polyphenolic antioxidants from the cacao bean (Theobroma cacao) appear to protect vascular endothelium, increase bioavailability of nitric oxide, and decrease the risk factors for cardiovascular disease (1), the disease ranked first in the United States. Not only does this literature review discuss the history of cocoa and the discovery of cardiovascular risk markers, but it examines and summarizes a number of significant research findings and conclusions regarding the effects of antioxidant-rich chocolate on cardiovascular health and the population groups who most benefit. This review also highlights implications for future clinical trials as the scientific community stands to gain a more thorough understanding of potential life-saving treatment modalities through ongoing, long-term research using not only the standard protocol for measuring cardiovascular risk but more advanced testing as well. Because derivatives of the cocoa bean are typically combined with other ingredients and processed in various ways by the food and pharmaceutical industries, it is crucial for researchers to differentiate between chocolate products that have limited antioxidant effect with those that are highly health protective. Due to the fact that there are many different spellings referring to cacao (i.e., coco, cocao, cocoa, etc.), for the purpose of consistency and clarity and because most studies discussed in this paper use the spelling "cocoa," this paper will from this point forward use the spelling "cocoa."
This abstract is reproduced with the permission of the publisher. Full text is available by subscription.