3,7-dihydro-3,7-dimethyl-1h-purine-2 6-dione, Beurre de Cacao, Cacao, Chocolat, Chocolat Noir, Chocolate, Cocoa Bean, Cocoa Butter, Cocoa Oleum, Cocoa Seed, Cocoa Semen, Cocoa Testae, Dark Chocolate, Dutch Chocolate, Fève de Cacao, Graine de Cacao, Theobroma, Theobroma cacao, Theobroma sativum, Theobromine, Théobromine.
Overview InformationCocoa is the plant from which chocolate is made. Bitter chocolate is produced by pressing roasted cocoa kernels (seeds) between hot rollers. Cocoa powder is produced by squeezing the fat (cocoa butter) from bitter chocolate and powdering the remaining material. Sweet chocolate is produced by adding sugar and vanilla to bitter chocolate. White chocolate contains sugar, cocoa butter, and milk solids.
Cocoa is most commonly used for heart disease and high blood pressure.
How does it work?Cocoa contains a variety of chemicals, including antioxidants called flavonoids. It is not clear how these might work in the body, but they appear to cause relaxation of veins. This could lead to lower blood pressure. These compounds might also reduce the activity of chemicals in the body that promote inflammation or blockage of blood vessels.
Uses & Effectiveness
Possibly Effective for
- Heart disease. Some research shows that eating cocoa lowers the chance of heart disease and death. Cocoa might have this effect by lowering blood pressure and improving blood vessels function.
- High blood pressure. Most research shows that eating dark chocolate or cocoa products for 2-8 weeks can lower the top number in a blood pressure reading (systolic blood pressure) by 4 mmHg. The bottom number (diastolic blood pressure) is also lowered by 2 mmHg in people with high blood pressure. Eating cocoa might also help prevent high blood pressure in people with normal blood pressure, but only if the cocoa comes from plain chocolate. Eating cocoa from desserts might increase the risk for high blood pressure.
Possibly Ineffective for
- High cholesterol. Cocoa products do not seem to improve cholesterol levels in people with high cholesterol.
Insufficient Evidence for
- Aging skin. Some research shows that taking cocoa extract alone or in combination with other ingredients might improve skin wrinkles, elasticity, and roughness.
- Irregular heartbeat (atrial fibrillation). People who eat more chocolate don't seem to have a lower risk of irregular heartbeat.
- Chronic fatigue syndrome (CFS). Early research shows that consuming a large amount of cocoa daily can reduce fatigue, anxiety, and depression and increase the overall ability to function in people with CFS.
- Liver scarring (cirrhosis). Research shows that consuming a liquid meal plus dark chocolate can improve liver health in people with cirrhosis.
- Memory and thinking skills (cognitive function). Cocoa might improve memory and thinking skills in some people. But not all research agrees. The benefit, if any, may depend on the person's age, the duration of cocoa intake, the dose of cocoa, and the difficulty of the cognitive testing.
- Decline in memory and thinking skills in older people that is more than what is normal for their age. Early research shows that cocoa might improve memory and thinking skills in adults with mild decline in thinking skills.
- Constipation. Early research shows that taking cocoa daily might soften stools in children with constipation.
- Diabetes. Early research shows that cocoa might reduce insulin resistance and improve sensitivity. But cocoa doesn't seem to blood sugar levels, especially when used in small amounts or in single doses.
- Heart failure. People who eat up to 250 grams of chocolate per week seem to have a reduced risk of heart failure. However, eating 300 grams of chocolate or more per week doesn't seem to be linked with a reduced risk.
- Abnormal levels of blood fats in people with HIV/AIDS. Early research shows that eating dark chocolate for 15 days doesn't lower total cholesterol or low-density lipoprotein (LDL or "bad") cholesterol in people with HIV/AIDS.
- Insect repellant. Early research shows that applying cocoa oil to the skin reduces black fly insect bites.
- High blood pressure in which only the first number (systolic pressure) is too high (isolated systolic hypertension). Early research shows that eating 100 grams of dark chocolate that is rich in cocoa flavonoids daily might slightly reduce systolic and diastolic blood pressure in elderly people with isolated systolic hypertension.
- Obesity. Early research shows that following a reduced-calorie diet, eating two squares of dark chocolate, and drinking a sugar-free cocoa beverage daily for 18 weeks does not increase weight loss in overweight or obese individuals.
- Parkinson disease. Early research shows that eating 200 mg of dark chocolate does not improve movement in people with Parkinson disease.
- Narrowing of blood vessels that causes poor blood flow to the limbs (peripheral arterial disease). Early research shows that drinking a cocoa beverage rich in certain chemicals called flavanols for 6 months can increase walking distance in people with this condition.
- Stroke. People who eat more chocolate seems to have a reduced risk of stroke compared to those who eat less chocolate.
- Intestinal disease.
- Lung congestion.
- Liver disease.
- Bladder and kidney ailments.
- Preventing wrinkles.
- Preventing stretch marks during pregnancy.
- Other conditions.
Side Effects & SafetyWhen taken by mouth: Eating cocoa is LIKELY SAFE for most people. But keep in mind that cocoa contains caffeine and related chemicals. Eating large amounts might cause caffeine-related side effects such as nervousness, increased urination, sleeplessness, and a fast heartbeat.
Cocoa can cause allergic skin reactions, constipation, and might trigger migraine headaches. It can also cause digestive complaints including nausea, intestinal discomfort, stomach rumbling, and gas.
When applied to the skin: Applying cocoa butter to the skin is also LIKELY SAFE for most people. It can, however, cause a rash.
Special Precautions & Warnings:Pregnancy and breast-feeding: Cocoa is POSSIBLY SAFE in pregnancy and during breast-feeding when used in moderate amounts or in amounts commonly found in foods. But be sure to monitor your intake.
Consuming cocoa in larger amounts during pregnancy is POSSIBLY UNSAFE because of the caffeine it contains. Caffeine found in cocoa crosses the placenta. Although controversial, some evidence suggests that high doses of caffeine during pregnancy might be associated with premature delivery, low birth weight, and miscarriage. Some experts advise keeping caffeine consumption below 300 mg per day during pregnancy. Keep in mind that chocolate products provide 2-35 mg caffeine per serving, and a cup of hot chocolate provides approximately 10 mg. So these products probably aren't a big concern. But unsweetened, dry cocoa powder can contain up to about 200 mg of caffeine per cup
Caffeine is also a concern during breast-feeding. Breast milk concentrations of caffeine are thought to be approximately half the level of caffeine in the mother's blood. If the mother eats too much chocolate (16 oz per day), the nursing infant may become irritable and have frequent bowel movements because of the caffeine.
Anxiety: There is a concern that the caffeine in large amounts of cocoa might make anxiety disorders worse.
Bleeding disorders: Cocoa can slow blood clotting. Consuming a lot of cocoa might increase the risk of bleeding and bruising in people with bleeding disorders.
Heart conditions: Cocoa contains caffeine. The caffeine in cocoa might cause irregular heartbeat in some people and should be used cautiously in people with heart conditions.
Diabetes: Cocoa seems to be able to raise blood sugar levels and might interfere with blood sugar control in people with diabetes.
Diarrhea. Cocoa contains caffeine. The caffeine in cocoa, especially when taken in large amounts, can worsen diarrhea.
Gastroesophageal Reflux Disease (GERD): Cocoa seems to hinder the effectiveness of the valve in the food tube (esophagus) that keeps the contents of the stomach from coming back into the food tube or the airway. This could make the symptoms of GERD worse.
Glaucoma: Cocoa contains caffeine. The caffeine in cocoa increases pressure in the eye and should be used cautiously in people with glaucoma.
High blood pressure: Cocoa contains caffeine. The caffeine in cocoa might increase blood pressure in people with high blood pressure. However, for people who already consume a lot of caffeine, it might not cause a big increase.
Irritable bowel syndrome (IBS): Cocoa contains caffeine. The caffeine in cocoa, especially when taken in large amounts, can worsen diarrhea and might worsen symptoms of IBS.
Migraine headaches: Cocoa might trigger migraines in sensitive people.
Weak bones (osteoporosis): Cocoa contains caffeine. The caffeine in cocoa might increase how much calcium is released in the urine. People with osteoporosis should limit their intake of cocoa.
Surgery: Cocoa might interfere with blood sugar control during and after surgical procedures. Stop eating cocoa at least 2 weeks before a scheduled surgery.
Rapid, irregular heartbeat (tachyarrhythmia): Cocoa from dark chocolate can increase heart rate. Cocoa products might also make irregular heartbeat worse.
Be cautious with this combination
Adenosine (Adenocard) interacts with COCOA
Cocoa contains caffeine. The caffeine in cocoa might block the affects of adenosine (Adenocard). Adenosine (Adenocard) is often used by doctors to do a test on the heart. This test is called a cardiac stress test. Stop taking cocoa or other caffeine-containing products at least 24 hours before a cardiac stress test.
Clozapine (Clozaril) interacts with COCOA
The body breaks down clozapine (Clozaril) to get rid of it. The caffeine in cocoa seems to decrease how quickly the body breaks down clozapine (Clozaril). Taking cocoa along with clozapine (Clozaril) can increase the effects and side effects of clozapine (Clozaril).
Dipyridamole (Persantine) interacts with COCOA
Cocoa contains caffeine. The caffeine in cocoa might block the affects of dipyridamole (Persantine). Dipyridamole (Persantine) is often used by doctors to do a test on the heart. This test is called a cardiac stress test. Stop drinking cocoa or other caffeine-containing products at least 24 hours before a cardiac stress test.
Ergotamine (Ergomar) interacts with COCOA
Cocoa contains caffeine. Caffeine can increase how much ergotamine (Ergomar) the body absorbs. Taking cocoa along with ergotamine (Ergomar) might increase the effects and side effects of ergotamine.
Estrogens interacts with COCOA
The body breaks down the caffeine in cocoa to get rid of it. Estrogens can decrease how quickly the body breaks down caffeine. Taking caffeine along with estrogens might cause jitteriness, headache, fast heartbeat, and other side effects. If you take estrogens limit your caffeine intake.
Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.
Lithium interacts with COCOA
You body naturally gets rid of lithium. The caffeine in cocoa can increase how quickly your body gets rid of lithium. If you take products that contain caffeine and you take lithium, stop taking caffeine products slowly. Stopping caffeine too quickly can increase the side effects of lithium.
Medications for asthma (Beta-adrenergic agonists) interacts with COCOA
Cocoa contains caffeine. Caffeine can stimulate the heart. Some medications for asthma can also stimulate the heart. Taking caffeine with some medications for asthma might cause too much stimulation and cause heart problems.
Some medications for asthma include albuterol (Proventil, Ventolin, Volmax), metaproterenol (Alupent), terbutaline (Bricanyl, Brethine), and isoproterenol (Isuprel).
Medications for depression (MAOIs) interacts with COCOA
Cocoa contains caffeine. Caffeine can stimulate the body. Some medications used for depression can also stimulate the body. Consuming cocoa with these medications used for depression might cause too much stimulation. This could cause serious side effects including fast heartbeat, high blood pressure, nervousness, and others.
Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.
Medications for diabetes (Antidiabetes drugs) interacts with COCOA
Cocoa might increase blood sugar. Diabetes medications are used to lower blood sugar. By increasing blood sugar, cocoa might decrease the effectiveness of diabetes medications. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Phenylpropanolamine interacts with COCOA
The caffeine in cocoa can stimulate the body. Phenylpropanolamine can also stimulate the body. Taking cocoa along with phenylpropanolamine might cause too much stimulation and increase heartbeat, blood pressure, and cause nervousness.
Theophylline interacts with COCOA
Cocoa contains caffeine. Caffeine works in similar ways in the body as theophylline. Caffeine can also decrease how quickly the body gets rid of theophylline. Taking cocoa along with theophylline might increase the effects and side effects of theophylline.
Be watchful with this combination
Antibiotics (Quinolone antibiotics) interacts with COCOA
The body breaks down caffeine to get rid of it. Some antibiotics might decrease how quickly the body breaks down caffeine. Taking these antibiotics along with cocoa can increase the risk of side effects including jitteriness, headache, increased heart rate, and other side effects.
Some antibiotics that decrease how quickly the body breaks down caffeine include ciprofloxacin (Cipro), enoxacin (Penetrex), norfloxacin (Chibroxin, Noroxin), sparfloxacin (Zagam), trovafloxacin (Trovan), and grepafloxacin (Raxar).
Birth control pills (Contraceptive drugs) interacts with COCOA
The body breaks down the caffeine in cocoa to get rid of it. Birth control pills can decrease how quickly the body breaks down caffeine. Taking cocoa along with birth control pills can cause jitteriness, headache, fast heartbeat, and other side effects.
Some birth control pills include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.
Cimetidine (Tagamet) interacts with COCOA
Cocoa contains caffeine. The body breaks down caffeine to get rid of it. Cimetidine (Tagamet) can decrease how quickly your body breaks down caffeine. Taking cimetidine (Tagamet) along with cocoa might increase the chance of caffeine side effects including jitteriness, headache, fast heartbeat, and others.
Disulfiram (Antabuse) interacts with COCOA
The body breaks down caffeine to get rid of it. Disulfiram (Antabuse) can decrease how quickly the body gets rid of caffeine. Taking cocoa (which contains caffeine) along with disulfiram (Antabuse) might increase the effects and side effects of caffeine including jitteriness, hyperactivity, irritability, and others.
Fluconazole (Diflucan) interacts with COCOA
Cocoa contains caffeine. The body breaks down caffeine to get rid of it. Fluconazole (Diflucan) might decrease how quickly the body gets rid of caffeine. Fluconazole (Diflucan) might cause caffeine to stay in the body too long. Taking cocoa along with fluconazole (Diflucan) might increase the risk of caffeine side effects such as nervousness, anxiety, and insomnia.
Mexiletine (Mexitil) interacts with COCOA
Cocoa contains caffeine. The body breaks down caffeine to get rid of it. Mexiletine (Mexitil) can decrease how quickly the body breaks down caffeine. Taking Mexiletine (Mexitil) along with cocoa might increase the caffeine effects and side effects of cocoa.
Verapamil (Calan, Covera, Isoptin, Verelan) interacts with COCOA
The body breaks down the caffeine in cocoa to get rid of it. Verapamil (Calan, Covera, Isoptin, Verelan) can decrease how quickly the body gets rid of caffeine. Taking caffeine along with verapamil (Calan, Covera, Isoptin, Verelan) can increase the risk of caffeine side effects including jitteriness, headache, and an increased heartbeat.
The following doses have been studied in scientific research:
- For heart disease: Cocoa 19-54 grams daily, dark chocolate 46-100 grams daily, or cocoa products containing 16.6-1080 mg of cocoa polyphenols daily.
- For high blood pressure: Chocolate or cocoa providing 25-1,080 mg of cocoa polyphenols daily.
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