Cocoa is a sweet treat that many of us enjoy, but if I asked you ‘is cocoa healthy?’, I think that most people would say no.
Realistically that comes from the way we consume cocoa (in hot chocolate and the like), rather than cocoa powder itself.
Those outcomes are connected to compounds in the chocolate, including flavanols.
The similarity of cocoa to chocolate means that many of the outcomes for chocolate may also be true of cocoa.
One research paper (Sorond et al., 2013) focused on this topic in an older population.
The authors of the study were interested in two main things.
The first was whether there was a relationship between neurovascular coupling and cognitive function.
Neurovascular coupling is a term that refers to the way that neural activity affects blood flow in the brain.
The second thing was that the authors were interested in seeing whether cocoa consumption could alter that coupling.
If both of those areas were true, then it would suggest that cocoa might be able to alter cognitive function – potentially improving it.
The Study Itself
The study made use of 60 participants, who were an average of around 73 years of age.
The authors made use of an approach known as a parallel-arm design.
This means that there are two groups in the study, each of which undergoes one treatment.
Additionally, the authors used a double-blind design. This is where neither the researchers nor the participants know which group each participant is in.
That approach is used as a way to reduce potential bias.
In one arm of the study, participants were given a flavanol-rich cocoa drink (609 mg flavanols/serving), while the other group received a flavanol-poor cocoa drink (13 mg flavanols/serving).
Individuals in each group had the cocoa twice each day for a 30-day period.
Outcomes for individuals were studied on day 1, day 2 and day 30 of that period.
On those days, the authors looked at blood pressure and a range of cognitive outcomes.
Additionally, participants followed these conditions:
- Did not eat any other form of chocolate
- Eliminated an element of their normal diet to keep their calorie intake the same as it had been prior to the study
- Did not have any caffeine on the three study days
The authors found that there was an association between neurovascular coupling and cognitive performance, and also to the integrity of white matter.
The outcomes of the study also indicated that cocoa consumption may be able to alter neurovascular coupling.
In particular, the authors found that cocoa consumption improved neurovascular coupling.
Surprisingly, the authors found that the observed results were true for flavanol-rich and flavanol-poor cocoa.
That outcome is very unexpected, as flavanols are thought to be the key factor in the health benefits of chocolate and cocoa.
The authors argued that this might mean that another aspect of cocoa drove the observed outcomes.
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Strengths and Limitations
Typically, a parallel arm study has one treatment group and one control group.
That was not fully the case with this study.
The authors did control for flavanols, which was why one group received high-flavanol cocoa and the other received low-flavanol.
However, that is not a true control, as both groups received cocoa.
That makes it impossible to know whether the experimental conditions caused any of the observed effects.
As such, the design of the study was a major limitation.
Realistically, the authors may have been better to have three groups, one high-flavanol cocoa, one low-flavanol cocoa and one group that received a placebo.
Nevertheless, the design was effective at seeing whether flavanols affected the outcomes of interest, so that is one strength of the study.
A second area to consider is the sample.
This study specifically focused on elderly participants.
That isn’t really a limitation – but it does change the implications of the study.
Because of the sample, we don’t know whether the observed relationships are also present in younger populations.
To know that, more research will need to be done in a wider population.
Implications of the Study
The outcomes of the study did suggest that cocoa consumption has the potential to improve cognitive performance via the impact on neurovascular couplings.
So, is cocoa healthy?
The simple answer is that it might be.
Certainly, cocoa may help to improve cognitive function in seniors.
But, more research is needed before we know why and whether this is true for other groups of people.
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How many of you drink cocoa regularly? Do some of you still do this, or has everyone moved onto coffee?