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Cocoa Extract

Cocoa extract is a bitter mixture with a chocolate taste, made up of xanthine molecules (theobromine and caffeine) and procyanidins. Supplementing cocoa extract may provide cardiovascular and cognitive benefits through improved blood flow and antioxidant effects.

Our evidence-based analysis on cocoa extract features 199 unique references to scientific papers.

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Summary of Cocoa Extract

Primary information, health benefits, side effects, usage, and other important details

Cocoa extract refers to the bioactive compounds found in cocoa products. These compounds include flavanols, procyanidins and (-)-epicatechin. Though these molecules are not unique to cocoa, cocoa extract contains a particularly high level of (-)-epicatechin, compared to other plant products.

Supplementing cocoa extract or eating dark chocolate is linked to better blood flow and improved insulin sensitivity.

Preliminary research suggests (-)-epicatechin may also provide benefits for longevity by increasing blood flow and oxygenation in the brain. Though this effect has not been linked to improved memory or cognitive performance, it may play a protective role during aging. Some evidence also suggests (-)-epicatechin can help mitigate the effects of impaired mitochondria.

When (-)-epicatechin is absorbed by the body, it activates an insulin signaling pathway, which causes a mild increase in glucose uptake. Increased glucose uptake means the body is able to take in sugar from the blood more effectively. Supplementing (-)-epicatechin also increase the production of nitric oxide, a molecule that widens blood vessels and improves blood flow.

Eating about 26-40g of dark chocolate products containing at least 75% cocoa makes supplementing cocoa extract and (-)-epicatechin unnecessary. This is about 200 calories of dark chocolate, a bit less than a standard candy bar. Products low in cocoa, like milk chocolate and white chocolate, do not replace supplementation. Cocoa extract is a safe supplement that promotes circulation and effective energy production. It has great potential long-term benefits, whether the (-)-epicatechin comes from supplements or food products.

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How to Take

Medical Disclaimer

Recommended dosage, active amounts, other details

Studies show that 5-26g of dark chocolate contains 65-1,095mg of flavanols. The standard dose for cocoa flavanols is 500 – 1,000mg a day, taken with meals.

Supplementing cocoa extract can be replaced by dark chocolate consumption. The recommended amount is 25 – 40 g of dark chocolate, containing at least 85% cocoa. This is about 200 calories of dark chocolate. Milk and white chocolate do not contain enough cocoa to replace supplementation.

More research is needed to determine the optimal dose of cocoa extract.

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Human Effect Matrix

Unlocked for Examine members

The Human Effect Matrix summarizes human studies to tell you what effects Cocoa Extract has on your body, how much evidence there is, and how strong these effects are.

Full details are available to Examine members.
Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-a Notable Very High See all 20 studies
Blood flow appears to be increased in the body very reliably as assessed by flow-mediated vasodilation (FMD) by around 2%, affecting both healthy and unhealthy people. There may also be an increase in arterial blood flow which is less reliable.
grade-a
Minor
- See all 23 studies
While not affecting everybody, there appears to be a decrease in blood pressure when assessing mildly hypertensive people; the increase in blood flow seen in healthy people is not accompanied by a decrease in blood pressure, while the xanthine (caffeine) content of chocolate products may cause a mild and transient increase in blood pressure in some subjects.
grade-a Minor Very High See all 15 studies
Cocoa products appear to be able to reduce LDL cholesterol due to their flavonoid component, with the reduction in LDL-C being mild.
grade-a - Very High See all 15 studies
While an increase of HDL-C may occur, it is both mild and infrequent so large studies and meta-analyses fail to find reliable evidence for cocoa.
grade-a - Very High See all 14 studies
Although LDL-C may be decreased mildly, alterations in total cholesterol did not appear to occur; this may be due to unreliable but mild increases in HDL-C balancing out the numbers.
grade-a - Very High See all 16 studies
The vast majority of studies assessing either dark chocolate products or isolated polyphenolics from cocoa fail to find any influence on triglycerides relative to placebos or control chocolates.
grade-b Minor Moderate See all 4 studies
This biomarker of inflammation has been noted to be reduced in two studies where the subjects were prooxidative at rest (PAD and smokers), with no influence in other studies of otherwise healthy subjects.
grade-b Minor Moderate See all 6 studies
A potential yet unreliable decrease in biomarkers of oxidation in serum following ingestion.
grade-b Minor Moderate See all 9 studies
Many studies have noted a minor benefit to insulin sensitivity in both healthy subjects and diabetics, likely due to a transient increase of glucose uptake into tissue (a more 'bandaid' effect rather than a curative one).
grade-b - Very High See all 3 studies
In assessing the effects of cocoa on mood states, attention does not appear to be significantly altered when compared to placebo.
grade-b - High See all 10 studies
It is possible that the improvement in insulin sensitivity could beneficially influence blood glucose, but most studies assessing diabetic or healthy subjects find no difference in fasting glucose concentrations. The increase in serum glucose in response to an oral glucose tolerance test may be attenuated somewhat.
grade-b - Very High See all 8 studies
Most studies assessing cocoa flavanols do not find reliable reductions in C-reactive protein when compared to placebo or control treatments.
grade-b - Very High See all 10 studies
Cocoa and the main constituent (-)-epicatechin do not appear to have an appreciable effect on heart rate at rest or during exercise when compared to placebo.
grade-b - High See all 9 studies
Despite improvements in insulin sensitivity, only one study has noted a reduction in fasting insulin in diabetics while other studies (in diabetics and healthy subjects) do not notice any significant alterations in insulin concentrations.
grade-b - Very High See all 3 studies
Peripheral concentrations of noradrenaline do not appear to be influenced by supplementation of cocoa.
grade-b - High See all 5 studies
The majority of evidence does not find a significant alteration in the rate of LDL oxidation with cocoa or its isolated flavanols relative to placebo.
grade-b - Very High See all 10 studies
Beyond one study suggesting benefits, the majority of studies including cocoa flavanols in the diet have failed to note significant weight loss compared to isocaloric controls.
grade-c Notable - See all 3 studies
Mixed results reported. Two randomized, controlled trials report significant protection from UV-induced skin damage with 320-326mg/day cocoa flavanols over 6-24 week time periods. In contrast, another study using high flavanol chocolate (600mg flavanols) over a period of weeks failed to note any increase in the resistance of the skin towards reddening in response to light.
grade-c Notable Very High See all 5 studies
Both acute and prolonged ingestion of reasonable levels of cocoa flavonoids (500mg or more) appear to reduce the aggregation of platelets, although the potency is lesser than that of a baby aspirin (81mg).
grade-c Minor Moderate See 2 studies
Mixed evidence as to whether serum adrenaline can be reduced in serum following cocoa ingestion prior to an acute stressor.
grade-c Minor Very High See 2 studies
Mixed evidence as to whether cocoa flavanols can decrease arterial stiffness in otherwise healthy adults, with the one study coming back positive being conducted in overweight adults
grade-c Minor - See study
One study measuring blood viscosity has noted a decrease associated with cocoa flavanols, likely associated with the reduction in platelet aggregation.
grade-c Minor - See study
One study using relatively high doses of cocoa flavanols (500mg) found an increased rate of calmness and well being when compared to placebo in otherwise healthy subjects.
grade-c Minor - See study
Cerebral blood flow during cognitive testing in youth can be increased from 170mg cocoa flavanols, although may not coexist with increases in cognition.
grade-c Minor - See study
The rate of cerebral oxygenation in youth subject to a cognitive task appeared to be increased alongside increased cerebral blood flow, despite no acute benefits to cognition.
grade-c Minor - See study
An improvement in the HPVG has been noted in subjects with liver cirrhosis given cocoa flavanols.
grade-c Minor Moderate See 2 studies
Mixed evidence as to whether cocoa flavanols can increase insulin secretion, with the positive result coming from a very high dose (1,000mg flavanols) in hyperglycemic subjects.
grade-c Minor Moderate See all 4 studies
Decreases in lipid peroxidation (assessed by serum MDA) have been noted in oxidative states such as exercise, but have not been noted in resting states after cocoa flavanol ingestion.
grade-c Minor Moderate See all 5 studies
There is mixed evidence in both smokers and subjects with peripheral vascular disease (two states of high endothelial oxidation) as to whether the inclusion of dark chocolate can increase nitric oxide levels, which would underlie improvements in blood flow.
grade-c Minor Very High See 2 studies
A slight increase in skin elasticity has been noted with oral flavanol supplementation in women, noted in the temple but not arm.
grade-c Minor Moderate See 2 studies
There is mixed evidence as to suggest benefits to peripheral vascular disease when cocoa (40-50g dark chocolate) is ingested acutely before walking tests.
grade-c - - See study
One study assessing the blinded intake of chocolate in subjects who reported to be acne prone found an increase in acne when chocolate was given relative to placebo.
grade-c - - See study
No significant influence on circulating adiponectin concentrations when compared to control.
grade-c - Very High See all 3 studies
Serum ACTH concentrations do not appear to be influenced by supplementation of cocoa.
grade-c - - See study
The performance of soccer players is unaltered in response to cocoa flavanol ingestion.
grade-c - Very High See all 4 studies
As a general statement, supplementation of cocoa flavanols does not appear to appreciably reduce cellular adhesion factors (ex. ICAM-1 or VCAM-1) when compared to placebos with low cocoa flavanol content.
grade-c - - See study
General cognition does not appear to be acutely affected by supplementation of cocoa flavanols.
grade-c - - See all 3 studies
The increase in cortisol has been buffered in one study where stress was introduced, but otherwise cocoa does not appear to influence resting cortisol concentrations.
grade-c - Very High See 2 studies
Serum creatinine does not appear altered from supplementation of flavanols from cocoa.
grade-c - Very High See all 3 studies
The rate of fat oxidation relative to carbohydrates does not appear to be altered in response to supplementation of cocoa flavanols.
grade-c - - See study
Fatigue during cognitive testing in otherwise healthy youth is not affected by supplementation of cocoa flavanols.
grade-c - - See study
HbA1c does not appear to be altered in response to cocoa flavanol ingestion.
grade-c - - See study
Homocysteine has been found to be unaltered in response to cocoa ingestion compared to control.
grade-c - Very High See all 4 studies
Serum interleukin six (IL-6), a biomarker of inflammation, does not appear to be altered in response to supplementation of cocoa.
grade-c - - See study
Cocoa does not appear to reduce intraocular pressure when given to subjects with glaucoma.
grade-c - - See study
No significant influence on circulating leptin concentrations when compared to control.
grade-c - Very High See 2 studies
In subjects with otherwise healthy cognition, the addition of cocoa flavanols to the diet does not appear to significantly increase memory retention when compared to placebo.
grade-c - - See study
An increase in plasma vitamin E concentrations have been noted in soccer players alongside an increase in other antioxidative biomarkers, suggesting an antioxidant effect in this study.
grade-c - - See study
While cocoa flavanol showed benefit to subjects with liver cirrhosis, it was unrelated to reductions in portal (liver) hypertension.
grade-c - Very High See all 3 studies
Oral supplementation of cocoa flavanols does not appear to significantly influence skin hydration when compared to placebo.
grade-c - Moderate See all 3 studies
While one study using high dose flavanols (250-500mg) found increased well being in subjects during cognitive testing, other studies using dark chocolate have failed to notice any benefit to self-reported well being compared to placebo.
grade-c - Very High See all 3 studies
The circulating biomarker of inflammation TNF-alpha does not appear to be altered in response to supplementation from cocoa flavanols.
grade-c - - See study
Urea is not altered in the blood when compared to control.
grade-c - - See study
Serum uric acid/urate seems unaltered in response to cocoa flavanol supplementation.
grade-c - Very High See 2 studies
In otherwise cognitively well subjects, working memory does not appear to be increased in response to cocoa flavanol ingestion.
grade-c - Very High See 2 studies
vLDL-C concentrations in serum do not appear to be altered in response to supplementation of cocoa flavanols.
grade-d Notable - See study
One study has found longer-term high-flavanol cocoa improves cutaneous blood flow in women.
grade-d Minor Very High See 2 studies
The increase in oxygenation during exercise can be attenuated by supplementation of cocoa flavanols taken prior to exercise.
grade-d Minor Moderate See 2 studies
Mixed evidence as to whether the receptor for IL-1a is reduced in amount following cocoa ingestion.
grade-d Minor - See study
An increase in oxygenation of renal (kidney) tissue has been noted with supplementation of cocoa flavanols in otherwise healthy subjects
grade-d Minor - See study
In subjects with diabetes-associated heart failure, low dose epicatechin (100mg) appeared to improve mitochondrial function and structure
grade-d - - See study
Anaerobic exercise does not appear to be beneficially influenced by pre-exercise supplementation of cocoa flavanols in otherwise healthy subjects.
grade-d - Very High See 2 studies
Fat mass does not appear to be influenced with supplementation of cocoa flavanols
grade-d - - See study
Fibrinogen concentrations do not appear altered when 100g chocolate is ingested in otherwise healthy subjects
grade-d - - See study
The inclusion of cocoa flavanols via dark chocolate does not appear to alter whole-day food intake when compared to low flavanol chocolate.
grade-d - - See study
Serum glucagon does not appear to be influenced by ingestion of cocoa flavanols.
grade-d - - See study
IL-1a has been found to be unaffected by supplementation of chocolate in otherwise healthy subjects
grade-d - Very High See 2 studies
Interleukin-1B does not appear to be influenced by supplementation of cocoa flavanols
grade-d - - See study
Serum interleukin-10 does not appear to be influenced with supplementation of cocoa flavanols
grade-d - - See study
The rate of lactate accumulation and production during exercise does not appear to be significantly influenced by pre-exercise supplementation of cocoa flavanols
grade-d - - See study
Lean mass does not appear to be increased in response to supplementation of cocoa flavanols
grade-d - - See study
Liver enzymes do not appear to be altered with supplementation of cocoa flavanols
grade-d - - See study
Neutrophil activity does not appear to be altered in response to cocoa flavanol supplementation
grade-d - Very High See 2 studies
The overall amount of neutrophils in serum do not appear to be altered in response to cocoa flavanols
grade-d - Very High See 2 studies
The rate of perceived exertion during exercise does not appear to be altered when cocoa flavanols are ingested prior to exercise.

Studies Excluded from Consideration

Note: The above rubric includes studies both on isolated (-)-epicatechin as well as cocoa products with a high flavonoid content (ie. dark chocolate), but not studies on milk or white chocolates

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Things to Note

Is a Form Of

Primary Function:

Also Known As

Chocolate polyphenols, Cocoa polyphenols, Cacao polyphenols, Cacao extract, Chocamine

Do Not Confuse With

Chocolate (The extract paired with macronutrients)

  • There may be some stimulatory properties exclusively in those highly sensitive to the small caffeine content of cocoa

  • While technically the bioavailability of cocoa can be influenced by diet, there tends to be no major differences in absorption between supplements and chocolate products

  • Dark chocolate tends to refer to 70% cocoa content or higher, and is seen as the best source of cocoa polyphenolics due to being both palatable and a dense source of polyphenolics. Unsweetened baking chocolate and unsweetened cocoa powder are better souces but less palatable

  • Milk chocolate is seen as a poor source of polyphenolics whereas white chocolate contains so little as to not even be considered a source of cocoa polyphenolics

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Click here to see all 199 references.